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The Evolution of the Facelift

By Dr. Henry Wells

Standing in the January snow in front of Manhattan Eye and Ear Hospital, I had no idea what was ahead of me. As the senior plastic surgery resident from the University of Missouri, my chief simply told me to go to New York and spend the month working with Dr. Tom Reese and the NYU Plastic Surgery Residents. Fortunately, I was in a position to be introduced to surgeons who were or would become icons in the world of Plastic Surgery.

At this international center for cosmetic surgery, Facelifts were one of the most popular procedures. At that time many facelifts were done by undermining and tightening just the facial skin. But because skin can easily stretch over a short period of time, many patients returned for revisions or additional procedures. Today, many surgeons continue do a skin-only Facelift, but the effects are not as lasting or profound.


Deeper Structures Before with the Incisions









At Manhattan Eye and Ear, in an effort to improve the results of the Facelift some surgeons revisited and developed a technique that tightens deeper structures of the face to provide a more lasting result. The power of this technique was realized when we learned how to adequately mobilize these deeper structures to their optimum position, and over the years these techniques have been perfected for a lasting natural looking result for very happy patients.

Along with addressing deeper structures, many surgeons now use shorter incisions and have also learned how to address the neck through a small incision under the chin, lessening scarring as well. The importance of volume replacement as part of a facelift has been clearly demonstrated. Because of my preference for these advanced Facelift techniques, I was led to my mentor Dr. Fritz Barton, and adopted many of his advanced techniques. He even did my facelift and I experienced his perioperative care and facial surgery involving correcting lower structures firsthand.

What we do with Deeper Structures during the Facelift to Tighten











Not all plastic surgeons do – or can – perform a facelift that involves the sculpting and repair of deeper structures of the face and neck.  However, it is the best procedure to leave you with a natural and a longer lasting, refreshed look without the ‘stretched’ look every patient wants to avoid.  With a skin-only facelift, the price may be lower, surgery times shorter, and you may not be fully put to sleep, but you cannot get the best result.

When you are consulting with a plastic surgeon, make sure they clearly explain which type of facelift you are getting and what you can expect. Get several opinions, educate yourself, and choose the best procedure that will give you the best results.

I have seen facelifts evolve over my 30 years in practice, and my techniques have evolved as well. They have gone from simple skin tightening procedures, to procedures that involve multiple layers, structures and restoration of facial volume. I have learned what works best in my hands, from the creative surgeons who, over the years, have shown me the way.

Rhinoplasty Corrects Shape & Size of the Nose

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Rhinoplasty or commonly referred to as a nose job is one of the most popular procedures in cosmetic surgery. There are many types of rhinoplasty which can be modified to meet the needs of the specific individual.

The most common procedure is a reduction rhinoplasty which addresses the large ethnic nose with a prominent hump or bump. This surgery can be done through incisions inside the nose. Many surgeons use an open approach to better visualize the anatomic structures and their steps to correct them. The two approaches look very similar except the open approach has a small incision across the skin bridge (columella) that separates the two nostrils.

Both approaches allow trimming of the nasal tip cartilage but the open approach also allows better visualization for the placement of sutures to shape the cartilage and narrow the nasal tip.

Reduction of a prominent nasal bump requires careful removal of the projecting cartilage and bone to obtain a straight profile. This can also create a wide flat surface, which is corrected by cutting the nasal bones and moving them closer together.

A long nose can be shortened and the tip lifted by removing a small amount of the tip of the cartilage that separates each side of the nose. The nose can be made more prominent if necessary with cartilage grafts from the ear or in nasal reconstruction rib cartilage. This is done to change a flat profile as found in the Asian or African American population.

Recovery from rhinoplasty nasal surgery is fairly quick.

  • The nose is frequently packed with special gauze or foam packing which is usually removed within 48 hours
  • A small plastic or aluminum splint is also applied to protect the healing nasal bones
  • This splint is usually removed after 10 days.
  • Most patients return to work after a week
  • You can resume more vigorous activity after 3 weeks

Did you know?

Lip Enhancement can correct down-turned lips? Read this information provided by Susan Wells, RN, MS, CANS. As we age lips can develop a down-turned shape but there is no need to look like you’re frowning all the time!  This can be corrected easily with Botox or Dysport.


Contact us today to learn more!

Facial Rejuvenation – Face Summer with a More Handsome You!

June Buzz Newsletter 2015 – Face Summer With a More Handsome You! Check out our June Special Offers, learn more about Facial Rejuvenation with Rejuvapen, and read more on our newest Patient Story.

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Facial Rejuvenation for Men – A Means of Staying Competitive in the Workplace

Blog1Today over 90% of plastic surgery patients are women. But that number is steadily decreasing as men are realizing the important benefits both personally and financially of facial rejuvenation.  They are seeing that this can help them looking young and vital.  In business the old adage of ‘image is everything’ applies when you are working with younger and more tech savvy competition.

The larger number of female patients is understandable since they have to deal with the after effects of child bearing.  However, we all get older while younger, recently educated people are constantly entering the workplace.  It is not at all unreasonable to consider cosmetic surgery as a means of staying competitive.

Most men fear that surgery will make them look too different.  Because of this men sometimes opt for minimal procedures thinking the results will be less drastic.  Liposuction can make the neck look better in younger patients, but it can’t correct the loose skin of older patients.  A smaller procedure can even have a negative impact in your appearance when a more dramatic procedure is actually the appropriate course of action.

What are the most popular cosmetic surgery options for men?  Rhinoplasty is one of the most common procedures and chin implants are becoming very popular for men.  Upper eyelid surgery is also very popular with men but if overdone can make the eye round and thus more feminine.  The same applies to a brow-lift, which makes women look youthful, but a lower brow is a very masculine characteristics, so lifting it should be approached with caution. Robert Redford and Clint Eastwood in their prime were excellent examples of very masculine eyes.  On the other hand, lower eyelid surgery can make men look rested and more youthful without altering the shape of their eyes.

Face-lifts and neck-lifts sound like a lot of surgery, but the effect can make you look younger without drastically changing your appearance, with many patients returning to work in a week.  It’s almost like coming back from a week long vacation looking relaxed and refreshed.

Cosmetic surgery can be considered an investment in yourself, and when chosen appropriately and performed with an eye for subtlety, can make you look younger, fresher and more competitive compared to your younger, less experienced colleagues.

Wells Plastic Surgery and Skin Care can schedule a consultation to discuss your rejuvenation options personally with Dr. Wells.  The $100 consult fee is applied directly to your procedure costs.  Non-surgical procedures could be your ‘jumping off’ place, like Botox, IPL or Rejuvapen treatments. 

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