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Question:
I have sunken areas beneath my eyes. It looks like these circles need to be filled in. Would blepharoplasty or a facial fat transfer be the best option here?

Answer:
You are asking a very good question with regards to your eyes. The question of whether fat transfer or blepharoplasty is the best procedure can only really be answered with a proper consultation. In my experience, a combination of the two may be indicated. I generally perform lower lid blepharoplasty for excess skin, lax muscle and laxity of the lower eyelid, and for fat bulges. If there is a hollowness to the eyes along with some of the other findings I mention above, then I perform fat repositioning in combination with the lower lid blepharoplasty. I rarely remove fat from the lower lid without repositioning the fat as I feel that removing too much fat leaves the lower eyelid looking hollow and skelatanized rather than youthful and refreshed.

Posted by Dr. Philip Schoenfeld

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Question:
Does your office have digital imaging capabilities? I would like a chin implant but do not know what shape I want.

Answer:
I use computer imaging and morphing software for most of my facial consultations. Chin augmentation is one of the better procedures used with the morphing software as the changes to your face on front and profile views are well demonstrated. I tend to use an extended chin implant as I feel that chin augmentation requires not only improvement of the projection of the chin, but, also refinement of the jaw line. The size that I use for chin implantation is determined at the preoperative consultation and also in the operating room with the use of sizers.

Posted by Dr. Philip Schoenfeld

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Question:
Are there different types of implants that can be used for chin augmentation? What are they and are some better than others?

Answer:
There are several different implants available for chin augmentation. Implants are made of silicone, Gortex, Medpor, and likely other materials. I prefer a silicone chin implant for several reasons. The silicone chin implant feels natural, it is inert – which means the body will not reject the chin implant as a foreign body, it rarely becomes infected, and if for some reason the chin implant needs to be removed, it can be done easily.

Posted by Dr. Philip Schoenfeld

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Question:
I’ve heard that rhinoplasty is often combined with chin augmentation. Why is this? What is the benefit and is it safe to perform the two procedures at the same time?

Answer:
I perform a great deal of rhinoplasty surgery. Quite frequently a patient will present for rhinoplasty surgery, who also has a weak chin. During the preoperative consultation while viewing photos, we will see that the chin is weak. Using computer imaging I am able to show the patient what the effects of a chin implant will have on the overall appearance of the face. In the proper candidate, a chin implant in combination with a rhinoplasty will bring the face into proper balance. These two procedures may be performed at the same time and frequently are.

Posted by Dr. Philip Schoenfeld

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Question:
I received a facelift a little over a month ago. My face still feels very stretched and tight and it’s very uncomfortable. Is this normal and when should it clear up?

Answer:
If you received a facelift about a month ago you should still be in the healing phase. Tightness of the skin is not particularly concerning, but, significant amounts of discomfort a month after you facelift may be something that you will want to discuss with your surgeon and be specific about the locations of the discomfort so that they can best address your concerns.

Posted by Dr. Philip Schoenfeld

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Question:
How young is generally too young for a facelift?

Answer:
I am asked about the appropriate age for a facelift quite often. I try not to have a too young criteria but, clearly, if I feel that the concerns that the patient has are of proportion to the physical findings I would not recommend having a facelift or any other procedure performed. I really try to treat each patient individually. I perform a great deal of mini facelift procedures on people in their late forties so any younger than that would be perhaps, too young.

Posted by Dr. Philip Schoenfeld

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Question:
I’m a 57 year-old man and I’ve been considering getting a facelift. Since the facial skin is repositioned, how does this affect the appearance of the sideburns? How do you keep them from looking unnatural?

Answer:
There are definitely differences that need to be considered in performing a male facelift compared to a female facelift. Women generally wear their hair down and so the incisions around the ears and especially the sideburn regions are more easily camouflaged than in male facelift patients. In male facelift surgery, it is important to make sure that the sideburn is not elevated too high, and also to make sure that the sideburn is not pulled back too far into the ear so that the sideburn grows with the repositioned skin into the ear. To insure the best male facelift outcome and a naturally appearing sideburn, I make my incisions at the lower part of the sideburn and leave a small cuff of skin in front of the ear to prevent an unnatural look. Hair will grow through the incisions which will help camouflage the facelift incision even further.

Posted by Dr. Philip Schoenfeld

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Question:
I have very bad facial acne scars. I hate looking like this and it seems to look even worse every year. I am Mexican and have darker skin. Is there a skin resurfacing procedure that I can have that won’t change my skin color but will get rid of some of the pitting on my face?

Answer:
You have a very difficult problem for two reasons. Treatment of deep acne scars can be challenging and treatment of facial scarring in darker skinned individuals can be even more challenging. I would suggest a trial of Fraxel laser to treat your acne scarring. The Fraxel laser treatments will give you a decent amount of improvement in the texture of your skin form the acne scarring but, it is also the safest approach to prevent post procedure complications such as hyper or hypopigmentation of the skin. More invasive procedures such as, full face laser resurfacing or dermabrasion for acne scarring is more effective but your risk of complications is significantly increased.

Posted by Dr. Philip Schoenfeld

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