OUR FACE SERVICES
Aging of the upper one-third of the face often manifests by lengthening of the hairline-brow distance, and descent of the eyebrow below the bony orbital rim. This contributes to the appearance of a droopy upper eyelid and may eventually cause visual obstruction.
A browlift procedure may be performed to alleviate both the appearance and the associated functional symptoms. Incisions are usually placed within the hairline for optimal cosmesis.
DOUBLE EYELID CREASE CREATION
Creation of the double eyelid crease is a common request amongst younger patients. A single eyelid is common amongst people of Oriental ancestry and is due to the lack of fibrous connections between the levator palpebrae superioris muscle and the upper eyelid skin. People with a single eyelid may appear tired and to have small eyes.
Double eyelid creation surgery may be performed through minimal incision techniques, or an open incision, depending on the individual anatomical characteristics.
The eyes are the windows to the soul. Ageing changes of the face often first manifest around the eyes. The upper eyelid and surrounding skin may become droopy, and may be associated with visual obstruction. In the lower eyelid, wrinkles and eyebags may manifest, together with hollowing of the region beneath the eyebag (the tear trough). There may be changes in the position of the lower eyelid with age, and bulging of the muscle.
Rejuvenation of the upper and lower eyelids is usually a simple procedure that may involve removal of excess skin, tightening of the muscle, and sometimes removal or addition of fat (depending on individual anatomical characteristics). Lower eyelid rejuvenation may sometimes be combined with elevation of the droopy cheek tissue to improve the appearance of the midface.
Dr Yeo has an interest in eyelid rejuvenation surgeries and is regularly invited as a lecturer regionally and locally on this topic.
The pathophysiology of the ageing face involves a multitude of factors, namely, the gradual loosening of the skin and muscle fascial system, wrinkle formation, loss of fat in various compartments of the face, and changes in the skeletal structure. Tastefully executed rejuvenation of the midface, the lower face, and the neck delivers the most significant improvement in the perception of a person’s age and makes one appear more energetic and confident.
Early facial aging may be camouflaged with minimally invasive techniques, including filler or fat injection, and various energy devices that tighten the skin or muscle. In more advanced cases of facial aging, a mini-facelift or a full facelift may be more appropriate and achieve an optimal, natural result. The excess skin is removed, the underlying muscle fascial system is tightened, and fat may be grafted to revolumize the appropriate areas in the face.
A mini-facelift involves a short incision placed just in front of the ear. A full facelift involves an incision extending from the hairline, in front and behind the ear, and along the neck hairline, and also permits tightening of the lower face and neck in the same surgery. Such incisions are concealed because of their position in the hairline, as well as the natural skin crease between the ear and the face. Dr Yeo has a keen interest in facelifts and is an invited lecturer regionally and locally on this topic.
Changes in the ageing neck include loose skin, an obtuse chin-neck angle, vertical muscle bands, an increase in fat deposition in the chin, and sometimes, enlarged salivary glands.
Minimally invasive techniques including botulinum toxin, and other energy devices that tighten the skin or muscle are efficacious in cases of early neck aging. Moderate to advanced changes of neck aging may require surgery for significant improvement.
A necklift may be performed through an incision placed beneath the chin, or through an incision around the ear and neck hairline, as part of a facelift procedure. A successful necklift significantly improves the perceived age of a person.
The nose is the central feature of the face and plays an important role in breathing as well as the overall facial aesthetic. There is a wide ethnic variation in nasal form, and also different interpersonal aesthetic ideals among patients and physicians.
Minor nasal augmentation and projection may be achieved using filler injections. Common requests for changes in the nasal form include augmentation of the nasal root, reduction of the hump, narrowing of the nasal width, and changes in the nasal tip rotation and/or projection. Significant changes in the nasal form cannot be achieved by filler injections, and will require a closed or open rhinoplasty. In a closed rhinoplasty, the incisions are performed within the nasal vestibule and are hidden. In an open rhinoplasty, the incisions are performed within the nasal vestibule, and are connected by an incision at the nasal columella. In general, the incisions heal well with time, and are inconspicuous to most individuals.
One of the early changes to the face with ageing is the loss of fat from the facial fat compartments. Deflation of the face results in sagging of the overlying facial skin and muscle.
Revolumization of the face with filler injection or fat grafting may be used to successfully reverse some of the early signs of aging. Filler injections usually consist of material that gradually resorbs from the injection site over the course of 6 to 9 months and require regular repeat treatments. Structural fat grafting is a technique of harvesting the fat from the abdomen or thighs using specific equipment and processing techniques, and grafting the resultant fat into the appropriate fat compartment. Over the course of 2 to 3 months, there is an ingrowth of new blood vessels into the grafted fat, and this fat becomes permanently incorporated into the facial tissue. This is an increasingly popular technique of achieving natural-looking and long-lasting facial rejuvenation.
Fat grafting is often used in combination with other facial aesthetic surgeries, including eyelid rejuvenation, facelifts, and lip rejuvenation.