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Restorationism facelift technique renews familiar sense of self

Article-Restorationism facelift technique renews familiar sense of self

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  • One surgeon discusses his approach to facelifting, which aims to restore identity and reunite patients with their reflection in the mirror

Pictured far left at 32 years of age, this 52-year-old patient is shown before and one year after a face/necklift and lower lid blepharoplasty to restore her "identity." (PHOTO CREDIT: G. HUNT NEUROHR, M.D.)
DALLAS, TEX. — Identity is central to everything that plastic surgeons do, yet its importance is rarely acknowledged, according to G. Hunt Neurohr, M.D., whose plastic surgery practice in Dallas, Tex., is fueled completely by word-of-mouth referrals. "Facial surgery is simply a way to restore an aesthetic image that enables my patients to once again feel like themselves," says Dr. Neurohr. "As people go through life they develop their character and their identity, and think of themselves in a certain way. As they age, changes occur that bring them to a point where they look in a mirror and say, 'who is that?' or 'that's my mother.' I look upon my job as a way to restore their identity," he explains.

COMMUNICATION & EXCAVATION Unearthing that identity requires some digging. "We have to go through a lot of layers of communication and understanding to bring that outer self and inner self as close together as possible," Dr. Neurohr tells Cosmetic Surgery Times , "but when we hit upon the look that the patient perceives as their real self, it's like striking a chord; it resonates." Excavating those layers starts with taking a thorough history. "I encourage the patient to be very frank about their life...because often there's a precipitating event that leads to an accelerated aging change that lasts for about 18 months," he notes. He found that computer imaging detracted from patient connection, so instead he encourages patients to bring in old pictures of themselves. "Communication is crucial," he observes. "The better I get to know them, the better I see them."

'FEEL' THE POSSIBILITIES Next, "I like to get my hands on them, move tissues around, and feel how the soft tissues of their face work. The absolute key to getting the best possible result is to be able to visualize it pre-operatively," he says. "If I start moving the tissue around and I can't see how surgery will accomplish the result that the patient is aiming for, I won't do the surgery." There are limits to what facelifts can do, he says, and pushing past those limits rarely ends in a pretty place. "When you get there, it's obvious that you've done too much and you can't undo it."

THE TECHNIQUE Dr. Neurohr calls his facelifting technique, "deconstructive restoration" and likens it to the work of expressionist photographer David Hockney whose photo collages comprise numerous small images in one unified graphic. This facelift technique, he explains, identifies and breaks down an individual's features and scales variations with details, preserving proportionate spatial relationships to achieve natural results that don't look "done."

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