The BH Beauty Club

Part 1:
Preventative Measures

So many people want absolute answers and black-and-white results, but neither life nor medicine works that way. Any procedure we undertake depends on our skill and your participation; be an active participant. You also need to be realistic; beauty is a process, not a procedure.
Accordingly, the first part of the consultation should focus on preventative measures to slow down the aging process. The following considerations will be discussed:

• Anti-aging regimen
• Skin care consultation with professional aesthetician
• Sun protection regimen
• Tobacco cessation
• Image consultation
• Dietary change

Part 2:
Non-invasive Procedures

The second phase of the consultation should address non-invasive procedures to improve the facial appearance. Many people will not need any further surgical intervention.
The options include:

• Laser resurfacing
• Chemical peels
• Soft tissue augmentation and fillers: Restylane®, Juvederm™, Perlane®, Hylaform, Radiesse®
• BOTOX®
• Collagen
• Fat grafting
• Thermage®, Titan™

Part 3:
Surgery Specific

The third aspect of the consultation should be designed to discuss areas of the face that will benefit from facial plastic surgical intervention. All regions of the face must be evaluated in order to achieve a balanced and aesthetically pleasing outcome (more on this in Chapter 2). When applicable, surgical and non-surgical methods are often combined in order to get the optimum outcome; we call these “complementary procedures” and will discuss them at length in future chapters. The following regions and surgical options are typically discussed in order to experience a thorough and realistic consultation:

The brow-eye complex

• Blepharoplasty – plastic surgery of the eyes
• Brow lift – endoscopic forehead lift
• Fat grafting

The mid-face and nasolabial fold region

• Facelift (rhytidectomy)
• Endoscopic midface lift
• Cheek implants (malar and submalar)
• Fat grafting
• Rhinoplasty (nasal reshaping, nose job)

The lower face and neck

• Facelift and Neck lift (rhytidectomy)
• Chin augmentation
• Fat grafting

Part 4:
Aftercare

The final phase of the consultation process should involve professional make-up artists and hair stylists to enhance and optimize the results achieved through non-invasive and surgical methods. After all, you want to keep the results, don’t you? So take pains to learn as much as you can about the beautification process in this all-important step.
Camouflage techniques for the initial healing process should be discussed in order to allow the patient to return to normal daily activities as soon as possible. (Skin care regimen with professional consultation needs to be continued.)

• Image consultants
• Hair stylists
• Make-up artists
• Continue anti-aging regimen
• Continue skin care regimen and consultation
• Continue dietary changes

After all, a facelift alone – be it surgical or not – cannot be considered a complete facial rejuvenation. A comprehensive approach must be utilized to obtain consistent results that are natural and long-lasting results.

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The aging process revolves around four critical factors:

1.) WRINKLES (Skin ages/loses elasticity): If you’ve ever played an afternoon of pickup basketball with your younger relatives during an extended holiday weekend – particularly if you’re not used to doing so on a daily or even weekly basis – you will know that your muscles don’t quite “bounce back” the way they used to when you were a teenager. Well, your skin is much the same. Skin consistency changes as we age, creating fine lines, aging spots and overall producing an entirely different texture of the skin. We lose what we call the “snap” factor; the skin’s ability to snap back into place if you pinch, press, pound or pull it. Try it now; with your mirror. Pinch a spot on your cheek or neck and time how slowly it snaps back into place; the older you are, the longer this takes. Now try the experiment on a teenager or older relative (if they’ll let you!). The differences can be amazing.

2.) Volume loss: As the skin naturally loses its fullness, or volume, over the course of the years it becomes less supple and more brittle. There is less wiggle room, so to speak, when it comes to handling facial expressions and other environmental factors such as exposure to the sun or smoking. So it’s not so much that the skin is sagging or drooping, as many people tend to claim, it’s merely losing the fullness and suppleness of its younger years. In a very blunt way, we can compare the skin of a younger person to a grape and the skin of an older person to a raisin; this is the end result of volume loss. Several contributing factors to volume loss include:
• Less fat in our face as we age
• Bone, cartilage and facial structure changes – chin, nose, jaws, brows, etc. Think about individuals who have dentures or poor dental hygiene. Their faces look significantly older. That is because poor dental health leads to significant bone loss in the upper and lower jaw bones.
• Loss of muscle over time

3.) Laxity: You may not know what laxity means yet, but you know it when you see it: looseness and sagginess. In other words, the effect of gravity as it pulls already weakening skin down the contours of the face. This has to do with the effects of aging on skin. After all, things do drop; gravity does affect the aging process – and not in a good way. Individuals who have weak bone structure (small chins and cheek bones) don’t have good support for soft tissue (cheeks, etc.). They tend to have more laxity – and at an earlier age.

4.) Dynamic muscle contraction: Unlike other parts of the body, many of the muscles in your face don’t attach directly to bone; instead, many such muscles attach under the skin. This unique feature lets you contort your facial muscles into a variety of features and, in the process, make dozens of expressions: sad, glad, happy, mad – they all take a toll eventually. Despite their advantage to you in conveying emotions, these same muscle movements also cause aging lines (“expression lines”). Specifically, around the eyes and mouth. As you age these lines become more evident; when you’re younger they’re only there during the dynamic movements. In other words, smiling or wrinkle lines appear only while you’re doing the action; when you’re older they stay there even when you’re not doing that anymore. Loss of skin elasticity tends to increase the depth and persistence of these “expression lines.” Ever heard the expression, “Be careful; your face will freeze like that.” Well, your great grandmother might not have been so wrong after all.

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