Aesthetic Considerations in Male Facial Rejuvenation

Abstract

Ronald E. Iversion, MD Mark A. Codner, MD Val S. Lambros, MD Gregory S. LaTrenta, MD Dr. Iverson: The first patient is a 59-year-old man who feels that his fatty cheeks and heavy nasolabial folds make him look aged (Figure 1). He would like to look completely rejuvenated. Dr. Lambros, what would your preoperative plan include? Figure 1 Preoperative views of a 59-year-old man who feels that his fatty cheeks and heavy nasolabial folds make him look aged. He desires complete facial rejuvenation. Dr. Lambros: First, we must be sure that he has realistic expectations. In my experience, and in presentations by other surgeons, I have not seen a lot of success in elevating lateral brows in patients with thick foreheads. In this patient, I would elevate the medial brows to get rid of that “cranky” expression, which I believe could be accomplished without brow distortion. One could perform a corrugator resection through the upper lid, come down from above with an endoscope, and get some support. Alternatively, an open-brow lift would be reasonable, as would an upper-lid blepharoplasty. He would need a face and neck lift with the best possible internal support. I would perform a modest amount of jowl liposuction at the same time. My main indication for opening a neck is platysma bands. Otherwise, I would simply liposuction the neck. Dr. Iverson: How would you manage the lower eyelids? Dr. Lambros: This is a patient in whom I think “doing no harm” is a good idea. He has a small amount of lateral sway in his lower lids, and my temptation might be just to perform a canthopexy and not do anything more aggressive with the lower lids. Dr. Iverson: Dr. Codner, what would you do differently? Dr. Codner: This patient has a narrow brow-lash distance, as demonstrated on …