Wednesday, July 17, 2013

The Art and Science of Facial Rejuvenation - Part II The Mid Face

At the Obi Plastic Surgery Clinic
Part II - The Mid Face

“FACES” by Gigi Gallant’ courtesy of Obiarts Inc

As a three part series on the “Art and Science of Facial Rejuvenation”, yesterday I discussed the neck. Today I will move up anatomically to the mid face. When I look at patients, I view the entire head and neck as a single entity. It is then natural to focus on the eyes, mid face and neck. This compartmentalization is the way we, as plastic surgeons, assess our patients. As a student of art, while studying portraiture, I learned techniques of the famous Renaissance artists...most notably, the anatomic studies of Leonardo DaVinci who cleverly divided the face into three equal segments:

The lower third extends from the jawline to the base of the nose. The  middle third of the face extends from the nasal base to the brows and  the upper third of the face includes the forehead (brows to hairline). There are similar compartments for the facial width. As plastic surgeons we systematically assess the neck and forehead simultaneously. Aging of the mid face occurs secondarily to soft tissue loss (fat and muscle) as well as bony changes. This results in redundancy of the skin envelope of the face which sags because of gravity. Sunken eyes and mouth along with deepened cheek and marionette creases is a function of aging which normally begins to occur in the forties. Sag and bulges of the marionette pouch may also occur. A unique combination of technologies have allowed me to treat many patients non surgically with an innovation combining stem cell fat grafting (Adivive™) and laser tightening of the neck (SlimLipo™) in what I have termed the OPERA Lift:

Patients seeking or requiring surgical facial rejuvenation almost always benefit from large volume fillers processed from their own fat (Adivive™). Although I had the first FDA approved Adivive™ system, this concept is recognized by advanced plastic surgeons worldwide.  This is the focus of a major textbook on “The Aesthetic Uses of Stem Cells” by Dr. Melvin Shiffman. I happened to have written the chapter on the use of autologous stem cells and PRP (platelet rich plasma) for this important book. 


From the very first face lift I performed as a plastic surgeon, my personal approach has not complied with traditional techniques. However, the facelift I performed on the first day of my practice reflected my early artistic and technical skills which  I have continued to enhance and hone since. 

Dr. Obi's first facelift as performed on the first day of his private practice 

During the past five years I have integrated the use of lasers (SlimLIpo), Adivive fat grafting, PRP and advanced suture techniques in order to enhance results with my surgical face lifts.

In conclusion, I would like to point out that faces are like finger prints in that there are no two faces exactly alike, even with identical twins. That is where the “Art” of plastic surgery comes into play. Nevertheless, I also have to adhere to the “Science” component as facial anatomy is fairly consistent. As plastic surgeons we therefore learn and teach similar approaches for most of our procedures. Where we differ is in the artistry and embellishments of our techniques and I believe this is apparent in my background and working environment. 

Tomorrow I will discuss the final topic in my series of The Art and Science of Facial Rejuvenation: The Brow and Forehead.

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