Objectives: To demonstrate the rationale of anatomic approaches to the treatment of lost facial volume as well as repositioning tissues.
Introduction: The reconstruction of youth can be approached not only through a thorough aesthetic evaluation, but also through understanding the dynamic changes that occur in the functional matrix of the face, including the soft tissues and bone.
Materials / method: By careful anatomic evaluation of the patient’s appearance juxtaposed on analysis of the patient’s photographs from earlier in life, the extent and location of facial decay can be evaluated. Once, the extent of facial fat loss in superficial and deep compartments are evaluated, a treatment plan is selected to replace and regenerate the lost and decayed tissues. At the same time, the anatomic changes related to laxity as well are addressed with extended deep plane and deep neck surgery.
Results: Our experience in patients undergoing combined fat grafting and deep plane facelift surgery show progressive improvement in mid-facial volume up to 24 months after surgery.
Conclusion: The reconstruction of youth can be achieved by careful analysis of the dynamic facial changes that have occurred in the bone, deep and superficial fat compartments and the skin over time. By looking at the “motion picture” of these aging tissues, a more precise treatment plan can be developed that addresses the major changes in skin, soft tissue and bony volume and laxity.
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