Facial Rejuvenation
Generally, the face and neck can be divided into 4 zones and each zone will be addressed with respect to skin texture, pore size, discolorations, lesions, wrinkles, volume loss, pore size and skin laxity.
The upper face includes the forehead and eye areas. Common problems in this area include forehead and glabellar wrinkles, eyebrow position, crow’s feet, upper and lower eyelid skin laxity, bulging fat in the eyelids, and temporal wasting.
The midface includes the cheeks and nose and is evaluated for cheek descent, volume loss, and nasolabial folds.
The lower face includes the lips, corners of the mouth, chin and jawline. Common problems associated with aging in this zone include Marionette lines, drooping of the corners of the mouth, volume loss in the lips, loss of the white roll at the margins of the lip, radial lip lines,
The fourth zone is the neck and will be evaluated for skin laxity, platysmal bands, and prominent horitzontal wrinkles.
Facelift
A facelift can erase years of aging and is indicated in patients who present with significant skin laxity over the cheeks and jowls areas. Dr. Hertl performs a vertical facelift to reposition sagging tissues using discrete incisions. An S-shaped incision is made in the sideburn then behind the tragus, under the earlobe, and up onto the back of the ear to optimally conceal scarring. Lifting can be combined with careful localized liposuction of the jaw and neck to enhance the results. Mild laxity or volume loss in this area is best treated with a liquid facelift utilizing fillers such as Radiesse or your own fat.
Lifting of the lateral brows to rejuvenate the upper face can easily be combined with the face and neck lift procedures.
A facelift can erase years of aging and is indicated in patients who present with significant skin laxity over the cheeks and jowls areas. Dr. Hertl performs a vertical facelift to reposition sagging tissues using discrete incisions. An S-shaped incision is made in the sideburn then behind the tragus, under the earlobe, and up onto the back of the ear to optimally conceal scarring. Lifting can be combined with careful localized liposuction of the jaw and neck to enhance the results. Mild laxity or volume loss in this area is best treated with a liquid facelift utilizing fillers such as Radiesse or your own fat.
Lifting of the lateral brows to rejuvenate the upper face can easily be combined with the face and neck lift procedures.
Necklift
A necklift is most often performed in conjunction with a facelift, but can be performed alone. The incision is located under the earlobe, up onto the back of the ear, and extended posteriorly in the hair-bearing scalp. If there is significant platysmal banding, a small incision will be made under the chin to tighten the platysma muscles.
A necklift is most often performed in conjunction with a facelift, but can be performed alone. The incision is located under the earlobe, up onto the back of the ear, and extended posteriorly in the hair-bearing scalp. If there is significant platysmal banding, a small incision will be made under the chin to tighten the platysma muscles.
Liquid facelift
For patients wishing to avoid surgical procedures for facial rejuvenation, the combination of injectables such as Botox and fillers can be used to temporarily achieve remarkable and satisfying results. Each face is different, so the goal is to globally treat the many aspects of facial aging in an individual way. Each patient is carefully assessed and a personal care plan devised.
In the upper face, we can use Botox to eliminate dynamic wrinkles of the brow, between the eye’s (glabella), and crow’s feet at the corners of the eyes. Botox can also be applied to the lateral brow to achieve a browlift effect. Fillers such as Restylane and Juvederm can be used to camouflage under eye circles and thinning of the temporal areas.
The midface can be treated with fillers, Radiesse and Juvederm , to correct the cheek volume loss and midface descent. Which in turn allows us to use less filler in the nasolabial fold area (groove extending from the corner of your nose the to the corner of the mouth).
As we age, the lips undergo a significant masculinizing change with loss of volume, loss of the defining border (white roll), and the development of both static and dynamic fine lines and wrinkles. These changes are best addressed with injectables. Small amounts of botox can be injected at the borders of the lips to relax radial lines in this area. Additionally, Juvederm can be added to treat residual fine lines and to augment the lips themselves. Patients are often surprised and delighted by the positive change this treatment achieves.
In the lower face, the aging process results in the formation of jowls at the jawline, marionette lines extending form the corners of the mouth, and descent of the corners of the mouth causing a frowning appearance. Banding of the platysma muscles and vertical lines may appear in the neck area. Botox and fillers in combination can be used to fill the marionette lines and elevate the corners of the mouth. Fillers can be applied to the area in front of and behind the jowls to smooth the jawline. Botox can be injected into the platysmal bands to relax them, and filler can be applied to vertical neck lines.
For patients wishing to avoid surgical procedures for facial rejuvenation, the combination of injectables such as Botox and fillers can be used to temporarily achieve remarkable and satisfying results. Each face is different, so the goal is to globally treat the many aspects of facial aging in an individual way. Each patient is carefully assessed and a personal care plan devised.
In the upper face, we can use Botox to eliminate dynamic wrinkles of the brow, between the eye’s (glabella), and crow’s feet at the corners of the eyes. Botox can also be applied to the lateral brow to achieve a browlift effect. Fillers such as Restylane and Juvederm can be used to camouflage under eye circles and thinning of the temporal areas.
The midface can be treated with fillers, Radiesse and Juvederm , to correct the cheek volume loss and midface descent. Which in turn allows us to use less filler in the nasolabial fold area (groove extending from the corner of your nose the to the corner of the mouth).
As we age, the lips undergo a significant masculinizing change with loss of volume, loss of the defining border (white roll), and the development of both static and dynamic fine lines and wrinkles. These changes are best addressed with injectables. Small amounts of botox can be injected at the borders of the lips to relax radial lines in this area. Additionally, Juvederm can be added to treat residual fine lines and to augment the lips themselves. Patients are often surprised and delighted by the positive change this treatment achieves.
In the lower face, the aging process results in the formation of jowls at the jawline, marionette lines extending form the corners of the mouth, and descent of the corners of the mouth causing a frowning appearance. Banding of the platysma muscles and vertical lines may appear in the neck area. Botox and fillers in combination can be used to fill the marionette lines and elevate the corners of the mouth. Fillers can be applied to the area in front of and behind the jowls to smooth the jawline. Botox can be injected into the platysmal bands to relax them, and filler can be applied to vertical neck lines.
Blepharoplasty (eyelid tightening)
Upper eyelid blepharoplasty is a commonly performed operation to remove excess fat and skin and improve a tired angry expression. The inconspicuous scar is placed in the eyelid crease. Lower eyelid blepharoplasty is performed using an internal hidden incision (trans-conjunctival incision) when the primary problem is bulging fat. If skin needs to be removed, an external incision is made just below the eyelashes. Doing either upper or lower eyelids is called a 2-lid procedure. This is typically well-tolerated when performed in the office using oral sedation and local anesthesia.
Doing upper and lower eyelid tightening together is called a 4-lid procedure. Although this can be performed in the office in selected patients using oral sedation, most patients choose to do this in an operating room under sedation or general anesthesia.
Otoplasty (ear re-shaping)
Large or protruding ears are common childhood deformities that often create significant self-consciousness in the bearer. This problem is easily corrected through an inconspicuous scar placed on the back of the ear.
Large or protruding ears are common childhood deformities that often create significant self-consciousness in the bearer. This problem is easily corrected through an inconspicuous scar placed on the back of the ear.
Excision of benign and malignant Lesions
Dr. Hertl will gladly remove benign or malignant skin lesions and is skilled at Moh’s defect reconstruction using a wide variety of complex techniques.
Dr. Hertl will gladly remove benign or malignant skin lesions and is skilled at Moh’s defect reconstruction using a wide variety of complex techniques.