Facelift in Chicago, IL

A facelift can give a patient a more youthful appearance. However, many can also turn out looking plastic. Dr. Shah is trained in facial plastics, so he has the skill to give patients a more natural, youthful looking appearance.

Facelift Cosmetic Surgery In Illinois

Dr. Shah’s facelift procedure in Chicago helps create a natural-appearing result with remarkable effectiveness because he uses a customized approach based on each individual’s anatomy. His technique differs from other surgical options in that he is able to slide the deeper tissues into a more youthful position, creating a natural improvement. This technique also allows for rapid recovery with patients being able to return to work and normal routines often a week after surgery. Dr. Shah’s technique has been cultivated over the last decade and provides patients with a safe approach to creating a more youthful appearance. Reading this article you will learn if you would be a good candidate.

Facelift Scars and Incisions

Chicago’s Plastic Surgeon Philosophy Before & Afters Facelift Technique – Video Dr. Shah’s Approach What Makes Dr. Shah Different? Before Facelift Treatment Facelift Treatment Why Doesn’t Every Surgeon Perform a Deep Neck Lift? Facelift With Facial Scars Facial Analysis Before Facelift Chicago Ethnic Facelift Surgery Facial Anatomy Role Important Terms to Know

Chicago’s Plastic Surgeon Philosophy

Chicago board certified plastic surgeon Dr. Shah’s philosophy on face and necklift is mated to making a series of natural changes to the face. His goal is to restore a person’s appearance rather than to change it. Many of his patients will bring a picture of how they used to look and a frank and honest discussion takes place on how various approaches will help approach this goal. Dr. Shah uses the latest in techniques (he’s helped develop a facelift approach coveted around the world), technology (like to see yourself in 3D and the use of endoscopic techniques), and therapies (nutraceuticals, lasers, radiofrequency) to create a unique plan for each patient seeking to look like their former self.

Facelift Technique

His technique is based on the scientific data he helped discover, which includes the discovery of the platysma muscle’s extension into the face, the knowledge of what the best locations are in the face to secure it to, and the discovery of an anatomic landmark making the remarkably complex procedure safer for the patient.

Dr. Shah’s Approach

Surgeons perform facelift surgery in Chicago under general anesthesia the same way. A survey by the Aesthetic Plastic Surgery Society found that over 95% of its members performed SMAS only lifts. The SMAS is a covering of the face that surgeons use to pull on it in an attempt to produce changes to the face.

While SMAS lifts have been around since the 1970’s, many surgeons express frustrations with the limits in which it can change the face naturally. Surgeons who use this technique will try and pull the SMAS tissue and secure it. However, often at three months after the outpatient procedure, the patients will complain that they look exactly the same. Sometimes surgeons will attempt to pull more skin in an attempt to lift the face, however, patients will now have a pulled skin look, but not like more youthful. I have learned a better method of rejuvenating the face, which is called CPMS. CPMS stands for Complete Platysma Muscular Suspension from a colleague of mine Dr. David Rosenberg in NYC.

If you look at an anatomy textbook, it demonstrates that the platysma muscle is a neck-only muscle. However, Dr. Rosenberg’s and my experience have demonstrated that this is not accurate. The platysma muscle actually has a significant facial component.

We just can’t overstate the significance of this anatomic finding. This finding demonstrates that many surgeons have been lifting the wrong tissue for the last 35 years. Dr. Shah proposes that the method of effectively rejuvenating the face is repositioning of the platysma muscle. There are many benefits of this approach to the procedure including a natural embryologic glide plane. Beneath the platysma muscle there are very few if any blood vessels. This allows the muscle to slide back to a more youthful position. The benefit of this lift is that it is a “true” facelift and that results are natural but will demonstrate improvement in both the face and neck of the aging process.

Why don’t other surgeons utilize this technique?

The face has one of the most complex areas of anatomy in the body with many important structures. Most surgeons are hesitant to utilize more complex methods because of inadequate anatomic knowledge or experience in sophisticated techniques. This technique is a new concept that only 2 surgeons in the world are performing.

What Makes Dr. Shah Different?

One of the advantages of this technique is that it helps eliminate the “windblown” or “plastic look after a facelift. Some surgeons rely on pulling the skin tight in order to achieve a lift. Unfortunately, pulling skin tight is based on a false premise that a youthful face is back and tight. If you look at a young face, there is a roundness and soft quality. Repositioning the deeper tissue allows for rejuvenation of the face. Another advantage of this technique is a rapid recovery period. Most patients feel comfortable in public within 5 to 12 days after the procedure with recommendations fo the doctor such as keeping your head elevated.

Before Facelift Treatment: Facial Aging Curve

The facial aging curve is a guide for patients to understand how various techniques can reverse aging. Aging is a constant process and this model helps us understand its process.

What causes facial aging?

Aging isn’t just as simple as something falling down or gravity. Aging is a multifactorial process that can affect every cell in our body. So it seems to make sense that addressing aging needs to look at all factors contributing. Let’s take a look at aging layer by layer:

Skin: The skin of the face can become lax with age. The skin loses collagen and its quality is overall thinner with age. A face and neck-lift can address the excess skin issue by removing excess skin. The skin itself often needs to be resurfaced with a laser to help it have more collagen.
Fat: We lose fat over time and some of the fat descends into areas where it no longer was present such as the jowls and neck. Dr. Shah addresses this issue by sculpting the excess fat with liposuction techniques with microcannulas, facetite and other modalities. For descended fat, he can reposition the fat to help the face appear in a more ideal location. For patients missing fat and volume, fat grafting and nanofat grafting can help restore a youthful countenance. We can use Dermal Fillers and fat to replenish the face.
Muscle: is the one layer often failed to be addressed by most facelifts. Dr. Shah’s approach involves lifting the muscle of the face and neck rather than the SMAS. The advantages of lifting the muscle is that a more natural contour can be created and avoids the overly pulled look seen with excessive skin removal.
Bone: We lose bone over time. Don’t think so. Ever wonder how an archealogist can tell the difference between an 80 year old and 24 year old skull. So how does one replace bone? In some cases the use of anatomically accurate implants can help. This is done on a case by case basis.

Facelift Treatment: Deep Neck-Lift In Chicago, Il

What is a deep neck-lift?

A deep neck-lift is a type of facelift performed when mere liposuction will not be sufficient to contour the neck and deeper structures are addressed. Let’s learn about the structures in the neck:

Skin: excessive sagging skin is usually either excised or tightened using RF technology such as Facetite
Subcutaneous fat: This is the area addressed by traditional neck liposuction as well as kybella and coolsculpting. This area can be a contributing factor but is not the only one.
Platysma muscle: Most patients don’t have an issue with the thickness of the muscle but its separation. This muscle can constitute with surgery.
Deep fat: The fat deep to the platysmal muscle also known as subplatysmal fat is a factor in fullness in necks. Too much fat here can lead to a persistently full neck. Deep neck contouring requires advanced anatomy of the face and neck.
Anterior belly of digastric muscle: This muscle can lead to fullness along the border of the medial and lateral. neck. This is often missed as a source of fullness and can be seen with deeper inspection of the neck.
Submandibular gland excess: The gland that is responsible for saliva can also in some cases lead to an overly full neck. Typically a portion of the gland is removed. This is used in select cases.

Why doesn’t every surgeon perform a deep neck lift?

It requires advanced anatomy of the neck. Most ignore this area completely. Dr. Shah has written 3 landmark articles on facial anatomy and teaches an anatomy course at the University of Chicago. He is an expert.

Does every patient need a deep neck-lift?

This area is important to be recognized. Dr. Shah will account for this area in your consultation and discuss whether or not this area should be addressed.

Is recovery longer with a deep neck-lift?

Not necessarily. Most patients can realize their goals earlier but this approach requires more work.

Can I have a deep neck lift instead of losing weight?

Surgery should not be a substitute for weight loss. Patients should be at their ideal weight prior.

Facelift With Facial Scars

Since Dr. Shah lifts up the deeper layers of the face, tension is placed here rather than on the skin. This leads to improved cosmesis of facial scars. In addition, he hides much of the scar along with the hair and natural creases of the face so that little scarring is visibly present. Finally, he uses a meticulous technique in closing scars. Although it takes longer, Dr. Shah prefers a two-layered closure on the facelift skin to promote optimal healing. To read more about facelift scarring, click here.

Facial Analysis Before Facelift Chicago

Face analysis, particularly aging face analysis, can help demonstrate some of the areas which can improve in aging face surgery. Dr. Shah analyzes each face to determine areas that he can treat.

Face Analysis and in particular aging face, analysis can help demonstrate some of the areas which can be improved in aging face surgery.

With youth, our faces will have the appearance of an inverted pyramid. As we age, our faces tend to become more bottom-heavy and appear shaped more like a pyramid or rectangle. If you take a recognizable attractive face (not a patient of Dr. Shah’s) and change its appearance via computer manipulation to demonstrate this, you can see that the face becomes less attractive as well as appearing aged.

Part of the reason this occurs is a combination of factors including the descent of facial tissues as a result of loss of elasticity and gravity and volumetric loss. Maintenance of youth will involve restoring the balance in the face by analyzying the root cause of the aging process for each individual patient.

As we age, portions of our face and neck have distinct anatomic names, helping patients communicate about what they would like changed. There are many classification systems out there that help determine how severe the aging process is.

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Ethnic Facelift Surgery

African American Facelift

Much of the literature has focused on how aging affects patients of European descent. However, aging affects everyone, albeit in different ways. The term African American represents a broad range of skin types, pigmentation, and facial features. In fact, a recent study in Nature found that persons of African descent had the most diverse genome (genetic characteristics).

Typically, the higher melanin content in African American skin provides increased protection from the harmful effects of UVA and UVB sun damage. As a result of this protection, African American skin may continue to have a higher elasticity or spring, even in advanced age. The elasticity is an important factor in the prevention of lines and skin from sagging.

Despite the beneficial approaches seen in the skin, the aging process continues with volumetric changes to the face, midface, and cheek area. In addition, the deeper structures of the face and neck will continue to slide down, creating less defined jawlines and necks.

Dr. Shah utilizes an individualized approach in treating African American patients seeking youthful rejuvenation. First of all, some patients may benefit from a neck-only lift in order to tailor the jaw and neckline. Volumetric replenishment of the face may serve to provide a lift of the midface and lower face. Finally, in some cases, repositioning of the deeper tissues will allow for a more youthful deeper structure to the face. African American patients have a higher incidence of keloid formation. Due to this possibility, Dr. Shah advocates close follow-up after any procedure to lessen the likelihood of this occurring. Dr. Shah utilizes a series of preventative measures in order to help reduce the incidence of keloid formation.

Asian Facelift

Asian patients age differently than Caucasian patients. This is often most reflective in the skin, where the formation of fine wrinkles is less prominent. However, Asian patients may lose volume in their face, develop sagging of deeper tissues, and have prominent neckbands. In some cases, resuspension of the deeper tissues can help restore the facial appearance and make the neck and jawline tighter in appearance. It is critical to discuss the facial shape that patient desires after a facelift, as Asian bone structure, in particular, cheekbones can be markedly different than Caucasians. In addition, some Asian patients are concerned about hypertrophic scarring or keloids. Dr. Shah accounts for these changes by creating a younger face, while not making it look too full while concealing scars behind natural structures, such as the ear.

Caucasian Facelift

Caucasian male patients are seeking plastic surgery with more frequency. In part, this is due to a greater awareness of looking good, coupled with several studies showing higher earnings for patients who are more attractive.

Indian Facelift

Indian skin and aging vary from person to person. Indians with fragile and thinner skin will often develop finer lines along with volume loss, neck fullness, and jowls. Indians with thicker skin may not develop finer lines, but will still manifest volume loss, neck fullness, and jowls with aging. Every face is different and requires a different solution. Dr. Shah customizes a solution based on the individual. In some cases, patients may experience rejuvenation with a growth factor or fat cell lift without a visible incision at all.

Middle Eastern Facelift

Middle Eastern skin and aging varies from person to person. Middle Eastern patients with fragile and thinner skin will often develop finer lines along with volume loss, neck fullness, and jowls. Indians with thicker skin may not develop finer lines, but will still manifest volume loss, neck fullness, and jowls with aging. Every face is different and requires a different solution. Dr. Shah customizes a solution based on the individual. In some cases, patients may experience rejuvenation with a growth factor or fat cell lift without a visible incision at all.

Facial Anatomy Role During Facelift Treatment

Facial anatomy plays an important role in both analysis and the underlying cause of facial aging. A simplified version of external points on the face are illustrated to facilitate communication. Understanding the anatomy of aging can be a useful tool to see what areas of your face may or may not need improvement.

Eyebrow position is usually considered the key landmark in determining the aesthetic configuration of the upper third of the face. The medial end of the eyebrow should have a club-head configuration and should be in line with a vertical line drawn through the ala of the nose. It arches superolaterally above the supraorbital rim to its apex between vertical lines drawn from the lateral limbus and lateral canthus.

Important terms to know in facelift anatomy

Nasolabial crease (sulcus): facial line b/t upper lip and cheek
Nasolabial fold: bulging fat pad and skin lateral to NLC, caused by attenuation of the zygomatic retaining ligaments causing malar soft tissues to migrate downward along zygomaticus creating a bulge along NLC
Malar fat pad: triangular fat pad with base along NLC and in younger people with apex at zygoma
Modiolus: corner of the mouth
Marionette lines: inferior extensions of the nasolabial crease below the mouth, otherwise known as NLC below commissure
Witch’s chin deformity: a droopy chin from aging, otherwise known as ptosis of the integumentary and muscular tissues of the mentum
Jowls: ovoid masses of fibrofatty tissues subcutaneous tissue immediately adjacent and lateral to inferior extremity of the nasolabial crease

Knowing several structures on the surface of the face will help improve understanding of the aging terminology.

Eye-Cheek Junction: This is a critical area in evaluating the signs of aging. Ideally this area is a smooth transition from the eye to the cheek.
Tragus: Part of the ear which is located on the face. In facelift surgery, an incision can be made behind this part of the ear (retrotragal) or in front of this part (pretragal)
Zygomatic Insertion Point: Location of the origin of zygomaticus major muscle determined by P Miller, S Smith, AR Shah (yes that is Dr. Shah). Serves also as a useful point to help identify platysma muscle location within the face.
Malar fat pad: Location of fat pad in face
Nasolabial fold: A fold that may become more prominent with aging. Note, that every person has a nasolabial fold and that its elimination will look unnatural
White part of the lip - As we age this part of the lip looks longer and the red lips become thinner.
Mandibular angle: Good bone structure may help lead to improved jawline and neckline
Marionette line: Lines along inferior lip which may become more prominent with aging.
Jowl: The jowl below the jawline can improve with liposuction, we don’t generally recommend the part above the jaw in the face for liposuction.
Chin projection: A more prominent chin can help with providing more definition to the neck
Submandibular glands: In some patients, these glands may be prominent on the side view of the neck. We generally recommended not removing them for aesthetic purposes as they provide almost 80% of saliva.
Hyoid bone: A critical bone in the neck which helps determine how much of an L can be created in the neck.
Sternocleidomastoid muscle: A neck muscle who is typically much more prominent in men and should not be removed for aesthetic purposes.

There are differences between our faces and necks which will limit how much improvement we can see in a facelift. Much of this difference has to do with innate structures in our neck such as the chin and a bone in our neck called the hyoid bone. You can feel this part of your neck because if you stick your tongue out the bottom of the tongue will move this portion of the neck forward.