For the last installment on massive weight loss, we will look at the face. Massive weight gain can cause unrecognizable changes in the face. The neck, cheeks, and chin become stretched with fatty deposits and cause skin changes that may be permanent even after weight loss.
For the lucky few, facial skin will shrink back to its near normal state. In these cases, nothing is needed. For the most part, however, what we see is skin that sags in the neck area and jowl formation in the lower face. Wrinkles may also appear in the cheek area and in the mid face we see volume loss that creates that "tired" look. In people that lose massive amounts of weight, these changes can occur regardless of age. When weight loss patients present, they usually have numerous areas of concern and I try to help them prioritize because we cannot do all procedures at once. Some want their face fixed first, some don't, again, it is a matter of priority.
The only way to gain long term results in recovering a youthful face are lifting procedures. We devide the face into three main areas. 1. The lower face and neck. 2. The mid face. 3. The brow. A fourth area would be the eyelid that I will talk about in a later blog.
The lower face and neck lift. This procedure addresses the excess neck skin, jowling, and wrinkling in the cheek area. Sagging skin in these areas can be very pronounced after massive weight loss. Incisions for this procedure are placed around the ear
and a small incision under the chin. The arrows show the direction of pull on the skin and the underlying muscle. If the neck is not lax, a mini face lift (s-lift, lifestyle lift, day lift, etc.) can be done which shortens the incision to the front of the ear and only partially up the back of the ear.
The brow, when sagging, can cause visual problems and most notably can cause wrinkling in the forehead because of continuous muscle contraction as your brain lifts the brow. For the most part, I use the endoscopic approach to lifting the brow. This is done through small incisions in the hair that are essentially invisible. The brow is lifted and anchored. After doing this procedure, the forehead becomes smooth and the hooding over the eye is gone.
The face lift and brow lift can be done simultaneously if desired.
For the mid face, the problem is usually loss of volume and a hollow appearance develops. I feel the best way to remedy this problem is by replacing this volume. This can be done in several ways. The shortest lasting way to do this is with a filler product. The volume is placed over the cheek area. The second best product is fat. The fat is harvested from the hip or abdominal area and transplanted back into the face rejuvenating the mid face. The longest lasting way is with implants. These are solid silicone, pre-formed devices that replace the lost volume in the area.
These three procedures are the ones most commonly used to treat and rejuvenate the face after weight loss. Not everyone fits the usual mode however, and consultation to figure out the best treatment for you is essential. Come see us at INTEGRIS Total Body Surgical for a complimentary cosmetic consultation.
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