Dr. Achih H. Chen, Director of Facial and Plastic Reconstructive Surgery at the Medical College of Georgia at Georgia Regents University, will discuss maximizing the age-minimizing results of facial cosmetic surgery on the May 8 episode of the syndicated health and wellness show, The Doctors.
The show (www.thedoctorstv.com) airs daily in the Augusta area on the NBC affiliate, WAGT-TV.
Chen, also Director of The Georgia Center for Facial Plastic Surgery in Evans, will share his experience with a single operation addressing the three major issues of the aging face and neck: a sagging chin and neck line, loss of volume in the middle of the face, and wrinkled, discolored skin.
“There is a problem in the market of facial rejuvenation where everybody thinks that it’s smaller and smaller and quicker and quicker procedures but that is not making people look younger,” Chen said.
“This is addressing what really happens when we get older. It’s doing it at a multiplanar level surgeons haven’t previously thought possible. That enables patients to address their concerns with one operation and one downtime,” said Chen, who presented his findings on a series of patients at the 2014 Scientific Meeting of the American Academy of Cosmetic Surgery.
Used alone, the traditional facelift – tightening the skin upward toward the scalp – typically won’t restore a more youthful appearance, Chen said. “The concept behind the facelift works OK for certain areas of the face, such as a saggy neck and chin line, but not for every part of the face,” Chen said. The mid-face, which is further flattened by a facelift, is a great example, he said.
“In the aging face, eye sockets deepen, the bone structure of the mid-face flattens, the teeth actually slide back a little and the chin shifts position,” Chen said. “So the mid-face problem is not a sagging problem, it’s a deflation problem. We want to create volume back in that area.”
Options include not just tightening the skin but also strategically injecting the patient’s own fat. Because fat is unpredictable with typically only about a third of it surviving after the procedure, Chen often prefers inert, soft but solid, silicone implants secured to bone with a single, titanium screw to fill out the mid-face. Implants also provide flexibility since they can be removed or replaced with a different size if desired, Chen said.
The final piece of the trifecta is resurfacing the skin’s surface to diminish discoloration and wrinkles. “We change the texture of her skin,” said Chen, who uses an ablative laser to remove the top layer that has been ravaged by time and environmental factors such as sun exposure and smoking. While the initial result looks and feels like a burn or scrape, the healing process enables collagen synthesis and additional skin tightening and smoothing. Non-ablative lasers, which work more superficially, simply can’t produce similar results, Chen said.
This emerging concept allays long-standing concerns that such extensive work at one time could actually result in skin damage and/or loss, Chen said.
“We have added another layer of complexity because we have lasered the top of the skin, we have done a lift, then we have gone under everything to place implants,” Chen said. Patients still go home the same day and recovery takes about two weeks.
Chen joined the MCG faculty 11 years ago after completing an American Academy of Facial Plastic and Reconstructive Surgery fellowship at the famed University of California, Los Angeles-affiliated Lasky Clinic in Beverly Hills. He also completed an otolaryngology residency and National Institutes of Health Research Fellowship at the University of Iowa. He is board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery. He is consistently among Consumer’s Research Council of America’s listing of American’s Topic Plastic Surgeons and America’s Top Physicians; Best Doctors in America, and Castle Connolly’s Top Doctors. He is on the Editorial Board of the journal Annals of Otology, Rhinology and Laryngology.