Surgical procedures of the face and neck can be divided into two different categories: 1): those that restore appearance ravished by aging, gravity, sun and stress; and 2): those that enhance undesirable features, whether it is the size and/or shape of the nose, lips, chin, cheeks or ears.

Expertise in facial rejuvenation depends on making an accurate diagnosis of what has aged and to what degree in relation to all other facial features, and which procedure(s) best restore the appearance to what is desired by the patient. The opposite of an appearance that is tired, sad or aged is vibrant, happy and youthful. Every person's face and how it ages is different due to a variety of factors, and the correct procedure(s) to repair the damage need to be specifically tailored to each individual situation. Sometimes, a combination of procedures, done in harmony, produce the most natural and aesthetically pleasing results (See Figures 1 & 2 below).

A 48-year-old woman before (left), and 3 months after (right), a complete face, neck and brow lift with an upper and lower blepharoplasty and temporalis fascia lip augmentation.

An exciting new era in facial rejuvenation is the vertical cheek lift. Since gravity pulls things straight downward, it makes perfect sense to elevate the tissues of the face that have started to sag in a more vertical direction rather than the traditional pulled-back look of the standard facelift. The added advantage of this more natural volume-redistribution-and-contouring procedure is that in many cases, no skin is removed, thereby eliminating any visible scars on the face. This also means that the blood supply to the tissues is less disturbed making this procedure safer for smokers and faster healing with less of a noticeable post-op appearance (bruising and visible scars).

A 62 year old woman before (left), and one year after (right), a complete face, neck and brow lift with an upper and lower lid blepharoplasty and a tip rhinoplasty. All patient photos are patients of Dr. Schreiber and are un-retouched in any way.

For more information on facial plastic surgery and plastic surgery patients' experiences, and to see more of Dr. Schreiber's work, please check out his web site on http://faceforum.com/surgeons_pqrs/schreiber/.

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