Signs of Aging

        Starting in the mid 30's several signs of age are manifested in the face, eye  and neck areas.  These include sagging of upper eyelid skin, bags under the eyes caused by fat, fine to deep wrinkling around the eyes, horizontal and vertical frown lines in the brow, drooping of the eyebrow, and fine wrinkling around the mouth.  As aging progresses, additional signs are noted including double chin, vertical cordlike bands of skin in front of the neck, drooping of the cheek with deepening of the nasolabial folds, and development of jowls.

           The changes of aging occur at a different rate in each person.  The degree of concern caused by these changes also differs from person to person.  Each of the broad types of changes, wrinkling, skin laxity and fat excess or contour thinning, requires a different form of treatment.  For this reason, Dr. Bass will formulate a treatment plan with you to correct the changes present and based on your concerns.

Surgical Technique

            The facialplasty or face lift operation restores a
more youthful contour to the face and neck by removing excess skin and fat and tightening deeper layers of the face.  This is usually done through incisions hidden behind the hairline and in natural skin creases in front of and behind the ear.  Minimal incision necklift, mid-facialplasty, mini-facialplasty, submentalplasty and other more minimal procedures reduce incisions, and recovery time.  These procedures are selected when specific limited areas of the face require improvement or in younger individuals with less in  the way of aging changes.   Careful evaluation is necessary to select  the correct procedure .  Facialplasty is often combined with other facial procedures, particularly eyelidplasty.  Endoscopic browlift, laser skin resurfacing, liposuction, cheek or chin implants or fat injection may help improve some of the aging changes you wish to have corrected.  These can be used in addition to or instead of facialplasty depending on the physical finding in each individual case.  Threadlift is a newer procedure that is designed to use non-absorbable  sutures configured with barbs to suspend portions of the face without surgical dissection and with less recovery. Improvement is much more short-lived than surgical lifting procedures but recovery is much more limited.  If you have any questions about these procedures, please ask during the consultation.                                                                                                                                         

Extent of Improvement

            The goal of aesthetic surgery is to provide the best appearance possible.  The extent of improvement is influenced by a number of factors, such as the condition of the skin, previous sun exposure, underlying bone structure, heredity and others.  Facialplasty will make you look fresher and more rested.  It will not transform you back to the appearance you had in your 20's.  All surgery necessarily leaves scars.  All surgical scars are permanent and cannot be erased.  Plastic surgical scars are designed to lie in natural lines of the face, where they are least noticeable. 

Duration of Improvement

            Facialplasty does not stop the clock but seems to slow the process of aging.  Most patients will maintain the result for 10 or more years, slowly aging during that time.  Some patients require additional correction as early as 5 years while others may not require additional surgery for much longer.  In an operation as highly individualized as facialplasty, when you will need or want additional correction can not be determined with certainty.

Day of Surgery

            The procedure will be performed in the office operating room, or hospital if you prefer.  The procedure is performed utilizing local anesthesia with sedation.  The operation takes about 3 hours, although this will be longer if additional procedures are to be added.  After a short period of recovery in the office, you will be discharged home but must avoid all unnecessary activity during the first few days. 

After Surgery

            You will need someone to accompany you home and provide care for you at home during the first few days after surgery.  In many cases bulky bandages and drains can be avoided using new tissue sealants (Tiseel, platelet gel) which help seal the skin back down to the underlying tissues.  This helps reduced bruising and swelling, speeding recovery.   Stitches are removed at 5-7 days after surgery and remaining stitches are removed approximately 10-14 days after surgery. 

            After surgery you should expect swelling and bruising about the face.  This takes several weeks to subside.  Makeup can usually be worn after all stitches are removed, masking the small amount of residual swelling and bruising after 1.5-2 weeks.  At that point, most patients are able to appear in public.  

 Selected Research by Dr. Bass Related to Facial Rejuvenation

Presentations:

“Fractional resurfacing”.  NYC Aging Face Conference.  New York, New York.  August 2006.

“Nonsurgical facial rejuvenation with hydroxylapatite fillers”.  Emerging Technologies & Techniques in Plastic Surgery.  NYU Medical Center.  New York, New York.  May 2006

 “IPL treatments: Completing the job of facial rejuvenation”.  Emerging Technologies and Techniques in Plastic Surgery.  NYU Medical Center.  New York, New York.  May 2005.

“Ongoing results with the Erbium laser and a CO2 retrospective”.  Rejuvenation Medicine: Take Charge of Aging Symposium.  Plastic Surgery Educational Foundation/American Society for Aesthetic Plastic Surgery.  New York, New York.  May 2004.

“Evaluating new technologies.”  Emerging Technologies and Techniques in Plastic Surgery: Innovations in Facial Surgery, Breast Surgery, Body Contouring and Laser and Skin Care.  NYU Medical Center.  New York, New York.  May 2003.

Course Director, Emerging Technologies and Techniques in Plastic Surgery: Innovations in Facial Surgery, Breast Surgery, Body Contouring and Laser and Skin Care.  NYU Medical Center.  New York, New York.  May 2003.

 “Minimum incision neck lift”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  May 2002.

“External ultrasound and lipolysis in facial and body contouring”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.

"Neck rejuvenation with minimized incisions”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.

Course Director, Emerging Technologies in Plastic Surgery: Innovations in Facial Surgery, Breast Surgery, Body Contouring, Tissue Replacements, Laser and Skin Care, and Practice Management.  NYU Medical Center.  New York, New York.  June 2001.

“External ultrasound and lipolysis in facial and body contouring”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001

“Neck rejuvenation with minimized incisions”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.

“Sealants for soft tissue surgery”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.

Course Director, Emerging Technologies in Plastic Surgery: Innovations in Facial Surgery, Breast Surgery, Body Contouring, Tissue Replacements, Laser and Skin Care, and Practice Management.  NYU Medical Center.  New York, New York.  June 2001.

“Rejuvenation of facial rhytids: Modern options”.  8^th Annual Philadelphia Plastic Surgery Symposium.  Temple University.  Philadelphia, Pennsylvania.  June 2000.

“Acellular dermal grafts for lips and nasolabial folds”. Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.

“Fibrin sealant in soft tissue surgery”. Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.

Course Director, Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.

"New injectables and implantables for the nasolabial fold”.  Giants in Aesthetic Plastic Surgery.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November, 1999.

“Facial soft tissue augmentation: The latest innovations”. Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1999.

“Balloon techniques in facialplasty and browlift”. Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1999.

“New injectables and implantables: A direct attack on the nasolabial fold”. Advances in Aesthetic Plastic Surgery: The Cutting Edge II.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November 1998.

“Laser Tissue Interaction Related to Skin Resurfacing.” Aesthetic Laser Surgery: The Revolution Continues. Plastic Surgery Educational Foundation.  Boston, Massachusetts.  October 1998. 

Course Director, Aesthetic Laser Surgery: The Revolution Continues.  Plastic Surgery Educational Foundation.  Boston, Massachusetts. October 1998.

“Soft tissue augmentation: Dermis and allograft”.  Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.

“Balloon techniques in facialplasty and browlift”.  Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.

Course Director, Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.

“Lasers in plastic surgery: Where we’re going, where we’ve been”.  Keynote Speaker, Laser Symposium, California Society of Plastic Surgeons.  Santa Barbara, CA.  March 1998.

Erbium:YAG: Practice and theory of advanced laser skin resurfacing.  Aesthetic Facial Symposium -A Multidisciplinary approach.  Mount Sinai Medical Center.  New York, New York.  March 1998.

“Balloon-assisted facialplasty.”  Northeastern Society of Plastic Surgeons.  Bermuda.  October 1997.

“Preliminary evaluation of Erbium:YAG laser skin resurfacing.”  Northeastern Society of Plastic Surgeons.  Bermuda.  October 1997.

“CO₂ and Er:YAG laser resurfacing: Birefringence and shrinkage measurement of thermal injury in vitro.” American Society for Aesthetic Plastic Surgery. New York, New York. May 1997.

“Shrinkage and thermal injury in human skin in vitro after resurfacing with carbon dioxide and erbium: YAG lasers.” American Society for Laser Medicine and Surgery. Tuscon, Arizona. April 1997

“Thermal injury and tissue shrinkage in human skin in vitro after Tru-Pulse, Silktouch and Ultrapulse exposure: Preliminary results.” Biomedical Optics Society. San Jose, California. January 1997.

“Balloon-assisted facialplasty.”  Northeastern Society of Plastic Surgeons.  Bermuda.  October 1997.

“Facialplasty and endobrow: The balloon technique”.  Emerging Technologies in Plastic Surgery: Laser and Endoscopy Innovations.  NYU Medical Center.  New York, New York.  May 1997.

 Moderator, Full Face Laser Resurfacing. Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.

Faculty, Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.

“Balloon assisted endoscopic browlift: Preliminary experience.” American Society for Aesthetic Plastic Surgery. Orlando, Florida. May 1996.

Publications: 

Jacobson D, Bass LS, VanderKam V, Achauer BM: Carbon dioxide and Er:YAG laser resurfacing results.  Clin Plast Surg 27(2): 241-250, 2000. 

Bass LS and the Plastic Surgery Educational Foundation DATA Committee: Skin resurfacing with Erbium:YAG lasers.  Plast Reconstr Surg, 105(1): 462-463, 2000.

Bass LS: A balloon-assisted facialplasty technique.  Ann Plast Surg 40: 335-342, 1998.

Rapaport DP, Bass LS, Aston SJ: Influence of steroids on postoperative swelling after facialplasty: A prospective, randomized study.  Plast Reconstr Surg 96: 1457-1552, 1995.

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