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Preserving Expression

Sophisticated pan-facial rejuvenation techniques can create a more youthful appearance without compromising individual expression, says Sydney plastic surgeon Dr Darryl Hodgkinson.

The purpose of a facelift is not to tighten the face but to re-establish the youthful contours of the jaw line, neck and cheekbones. The more sophisticated techniques of facelifting, called pan-facial rejuvenation, are designed to address all the aesthetic areas of the face at the same time, achieving an overall more youthful appearance without compromising expression.

Natural lines of expression, such as ‘smile lines’ must be maintained so that the face is natural both in repose as well as when animated such as while speaking and laughing.

Skilled surgeons can tighten the underlying musculature and tissues that have sagged with ageing and then redrape the skin to achieve a natural-looking appearance. When the underlying tissues have been pulled into unnatural positions, a loss of natural contours and facial expression occurs.

It has been found that 80 percent of expressivity of the face is in the brow and the eyelids. For the past 15 years facial surgery techniques have evolved to create more natural-looking results and retain individual expression.

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BEFORE & AFTER facelift, endoscopic brow lift and upper eyelid surgery by Dr Hodgkinson BEFORE & AFTER facelift, endoscopic brow lift, and upper and lower eyelid surgery by Dr Hodgkinson

These techniques include the endoscopic brow lift, which can produce a more natural-looking result compared with the traditional open brow lift. The endoscopic technique can achieve a nice gentle elevation of the brows without the startled appearance the older procedure typically produced. The endoscopic method also allows for small incisions to be made rather than one long incision, thereby minimising any resulting scars.

In addition, modern eyelid surgery focuses on reducing, rather than completely eliminating, wrinkles and excess fat around the eyes. I believe leaving a few lines actually enhances the result as the patient maintains personality and appears to be happy, whereas a patient who has no lines around the eyes can appear blank and expressionless; not natural but neutral.

Eyelid surgery and brow lift surgery are often combined or performed as part of pan-facial rejuvenation. In skilled hands, these types of procedures can achieve a naturallooking, youthful enhancement, taking away scowling and tired-looking eyes but maintaining the individuality of the patient.