Procedure for TV show offers 'cutting edge' solutions for facial refresher

Leaning over the patient on the operating table, Dr. Achih Chen carefully traces a line around the right ear to hide the incision for the facelift as a freelance producer films him nearby.


The surgery at The Georgia Center for Facial Plastic Surgery in Evans will be part of an upcoming episode of The Doctors daytime television show, which asked Chen to perform a “cutting edge” surgery for the segment, he said. Chen calls it “The Total Face Rejuvenation” and he presented it in January at the Scientific Meeting of the American Academy of Cosmetic Surgery, and will soon be submitting it for publication.

The procedure is designed to attack three facial problemsat once. One is sagging skin and muscle along the jawline and neck that results in jowls and hanging loose folds of skin. There the traditional facelift is a good option.

“Pulling tight does work well in certain areas,” Chen said. ”So in the jawline and the neckline that works really well because if you look at someone who is young they have a good jawline and neckline.”

In this case, Chen makes an incision just below the chin, where it will be hidden, removes a fold of skin, and then sews together the sagging bands of muscle. He makes incisions around each ear to create a flap that he tunnels under to the muscle, pulling it tight and repositioning it before trimming the excess skin.

But that won’t work as well in the next problem area– the mid-face, or the area between the corners of the eyes and the corners of the mouth.

“You’ll see a lot of fullness in the mid-face in someone who is young,” Chen said. “What happens as we get older is this cheek fatpad deflates and then everything slides down. It’s very much like taking air out of a balloon.”

But trying to tighten that sagging skin doesn’t look quite right, he said.

“The problem is if you pull that tight, if you take that back and upwards, you’ll take a three-dimensional structure and you’ll flatten it into two dimensions,” Chen said. “The result will be a flat and wide midface.” That would look less natural, he said. Instead, Chen places a small, flexible implant into that pouch area to restore volume. It is attached directly to the bone and once it heals the patient never feels it, Chen said.

“A lot of people actually, over time, will forget they had one,” he said.

The last step is a laser resurfacing of the skin to make it appear more smooth.

“At the end of the day, if you don’t solve the covering, then you still haven’t given a good rejuvenation,” Chen said. Recovery time is about the same for a facelift, with patients back to work in a couple of weeks and ready for social events in a month, he said. The point is to look younger without looking like major work was done, Chen said.

“We are not trying to make someone look like they had surgery,” he said. “We’re trying to make someone look younger.”