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This Southeast Virginia woman in her mid-fifties was very happy to have lost a large amount of weight. However, she noticed that her face seemed to have aged significantly in the process. She explained to Dr. Hubbard that there were a number of areas that she wanted to address simultaneously in a very natural looking way. Her brows were sagging more on the right with creases of the forehead that she hoped to improve. She had bulging and sagging of the lower lids, creases around her mouth and sagging of her cheeks. During a very detailed discussion of options, Dr. Hubbard explained the type of brow lift that would not raise her hair line at all. Also, Dr. Hubbard planned to weaken some of the muscles of the forehead that cause numerous creases and gently raise her brows. Usually the goal is to raise the outside of the brow and not the inside. With her forehead, though, the inside brow had to be raised more to give a friendlier, rested look. A triple modality lower lid tuck removed the bulging fat, tightened skin and also lifted the sagging muscle beneath the eye (muscle hitch). As aging always involves some hollowing or sinking in, it was extremely important to include her own fat for injectable filler material at the same time. Fat grafting was used to fill hollows beneath the eyes, hollows of the cheeks and depressions along the sides of the upper lid and nose. Her own fat would be placed to refine the jaw line especially the sunken areas in front of the jowls called the pre-jowl sulcus. Finally, a neck lift included with the facelift, would address all three layers of the neck including the skin. Our patient was quite pleased with the amount of rejuvenation that could be accomplished in such a natural way giving her a much more rested appearance.

Surgeon: Dr. Thomas Hubbard
Patient Gender: Female

Case Number: 64

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