Nonsurgical procedures are the fastest growing area in aesthetics and can delay the need for invasive procedures, but they cannot treat all concerns, such as excess skin in the neck and upper eyelids and excess fat deposits, according to Palo Alto facial plastic surgeon Jill L. Hessler, M.D.
Dr. Hessler, an adjunct clinical assistant professor, otolaryngology, head and neck surgery at Stanford University School of Medicine, presented on the subject of combined treatments yesterday at the 11th annual Vegas Cosmetic Surgery and Aesthetic Dermatology multispecialty aesthetic symposium in Las Vegas.
Among the topics she tackled: surgical and non-surgical combination treatment for facelifting.
When assessing the aging face, first surgeons need to assess volume loss from skeletal changes, bone resorption and bony remodeling, as well as facial fat loss, which leads to a gaunt and hollow appearance, Dr. Hessler says.
“Secondly, there is laxity of the skin, as some of the elasticity and collagen weakens [thereby] creating the jowls, neck redundancy and dropping eyelid skin,” Dr. Hessler says. “Thirdly, there are intrinsic changes of the skin, which cause discolorations, fine and deep lines and lack of a uniform color and smooth texture. We need to address each of these areas separately.”
Nonsurgical treatments, such as laser resurfacing can address the third area, according to Dr. Hessler.
“In that past, it was suspected that combining laser resurfacing with facelift surgery would be too traumatic to the tissues and lead to a higher risk of complications,” she says. “Multiple experiences and studies have demonstrated that this is not the case, and laser resurfacing can safely be performed at the same time as facelift surgery — particularly, with new fractionated lasers….”
Patients often are concerned with fine lines and deep lines around the face. The laser, alone, can treat superficial fine lines, but, can’t adequately address the deeper lines and folds without some form of additional skin tightening, according to Dr. Hessler.
Volume loss in the face is yet another missing piece in this picture for many patients. While facelifts reposition tissue and remove the deeper lines and folds and lasers remove fine lines and discoloration, adding volume for more youthful contours creates a synergistic enhancement with these other procedures.
“Combining these procedures allows the surgeon to obtain enhanced results, while being slightly less aggressive with each treatment, which allows faster recovery and a lower chance of side effects,” she says. “Combining surgical procedures with the less invasive procedures allows surgeons and patients to obtain the best from both worlds: optimizing treatment results with more limited recovery and downtime.”
Dr. Hessler reports no relevant disclusures.