Joseph T. Cruise, M.D.
EXCELLENCE IN PLASTIC SURGERY

NEWPORT BEACH | ORANGE COUNTY

CONTACT US
(949) 446-1421 

Upper Face Rejuvenation

Custom Approach to the Upper Face

Below, we have listed the six most common concerns regarding the upper face. Remember, the entire concept of CustomLift® is to identify which of these issues are of concern to you AND the relative importance of each concern. With this information, you can then intelligently outline which procedures are best suited for you. Unfortunately, with time everyone will experience aging to ALL six areas but this does not mean that each must be addressed at the same time.

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Upper Eyelid

The most common problem with the upper eyelid is excess skin. Fat excess is rarely a problem except in the Asian community. In fact, the upper eyelid area LOSSES fat with age and becomes hollow and gaunt. Sometimes, there is a little bulging fat pad right next to the nose but aside from this all fat in the eyelid is precious and should be preserved. If you have this fat pad it is located just above the corner of the eye near the bridge of the nose. This should be removed at the time of upper blepharoplasty.

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Before

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After

Patient with significant excess skin and hollowing of the upper eyelid. Notice how rejuvenated the post-operative picture looks, without an "operated" appearance.

Temple Region, Crow's Feet, and Outside Corner of the Eye

This is the area of the upper face that ages the quickest. Yet, it is often not addressed by most plastic surgeons. The temple region is the outer corner of the eye and the outer part of the eye brow. Typically, lifting the temple with a Temple Lift creates dramatic improvement in appearance. The nice thing about the temple lift is it can easily be done under local anesthesia with or without a blepharoplasty.

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Before

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After

Notice tired and hooded appearance of outer part of the eye and eyebrow. Notice the bright and elegant appearance after temple lift and upper blepharoplasty.

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Before

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After

Correction of crow's feet with upper eyelid surgery and temple lift.

Brow Position

With aging and loss of facial volume, the brow routinely drops down. Sagging of the brow is almost never uniform. The outer part of the brow almost always sags more than the inner part. See if this applies to you. If only the outer part of the eye brow has fallen (which is often the case) then a temple lift is the best choice for correction.

If the entire brow has fallen, then a brow lift may be necessary. I say "may" because the CustomLift® approach prefers to correct the problem at its cause. Often the brow falls because the upper eyelid/brow area has lost significant fat.

The loss of fat volume causes the brow to descend and the upper eye to look hollow. The best way to correct this is to perform a temple lift to raise the outer brow and to replenish the lost volume with either fat or a soft tissue filler.

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Before

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After

Example of one sided brow sag. Right brow corrected with brow lift.

Upper Eyelids - Sunken, Hollow Appearance

This area is a perfect continuation of the brow area. As mentioned above, the brow often falls because the brow area and upper eyelid losses fat with age. Not only does this drop the brow but it causes the upper eyelid to appear sunken and hollow.

Traditional plastic surgery principles would treat this problem with a tight upper blepharoplasty and a brow lift. This often leads to a hollow, surprised appearance that actually looks unnatural. CustomLift® principles treat this problem by replacing the lost volume with a soft tissue filler or fat which, after all, is the root cause.

Crow's Feet and Forehead Wrinkles

Wrinkles that are caused by facial expression are best corrected with Botox®. As mentioned earlier, crow's feet that are caused by excess skin are removed by performing a temple lift. Crow's feet that only occur during smiling need Botox®.

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Before

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After

Static Crow's Feet lines are corrected with a temple lift

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Before

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After

Example of face at rest with dynamic wrinkles. These are best addressed with BOTOX® The only downside is that it needs to be repeatead approximately every 3 to 4 months to maintain an optimal result.

Sun Damage and Poor Skin Quality

With age and sun damage many unfavorable things happen to facial skin. The surgical procedures above address how to manage excess skin, skin sag, volume loss, etc. The most difficult problem to correct is poor skin quality.

Aging causes the dermis to thin. This, along with sun damage, causes the skin to loose its elasticity. Therefore, neck skin that would snap back in a 30 year old becomes saggy skin in a 50 year old.

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Before

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After

A TCA peel was performed to help this patient's overall skin health and quality. Notice the significant improvement with brown spots in the after picture.

 949-446-1421