Question
My consultation went well yesterday with my ps. PS suggested a SMAS, neck lift and a full brow lift. He claims that 20% of his patients that have endo brow lifts do not have successful outcomes, so he'd rather do a full brow lift.
One thing that did bug me is that the SMAS will not address the nasal labial folds fully. It may show an improvement, but not totally fix it. grrrr Is there a procedure that takes those folds away from the face? The marionettes? I suppose fillers are the only fix.
I've read the the deep plane will address the nasal area, but seems like it has more risks to damage nerves. Any furthur input would be appreciated from anyone with experience.
Thanks,
Maria


Answer
Hi Maria00,
Glad to know the consult went well! Ask your doc about an "extended" SMAS. Read more here, which I lifted from Beautysurg.com:
Extended smas - An "extended SMAS lift" goes even further towards the nose to help correct lines around the nose and mouth. This is the same surgery as the SMAS /mmh/product/facelift/index.vm?procid=7" target=_blank>facelift (see above), but with an extended SMAS lift, the SMAS is separated from the underlying structures more extensively towards the nose and upper lip. This can increase the amount of improvement that is possible in the center of the face, especially the nasolabial area. Increasing the amount of SMAS lifted also increases the risk for complications of tissue death, however, especially in smokers.
-------------------------
I would ask your doc if the extended SMAS would also increase the risk for paralysis around the mouth area!
And yes, I think fillers may be appropriate! I had just 1cc of Restylane split between both N/L folds back in Oct. It did the trick for the part they filled up. But I need to go back and get the WHOLE line addressed on each side. Well, $500 bills don't grow on trees, so I do what I can afford to do! Endo Brow Lift
Midface Lift
Upper Eye Bleph
Neck Lift
Lipo to Neck, Abs, Flanks and Knees
IPL, Sclerotherapy, Restylane as needed


Answer
maybe using the Radiesse would be best for the nose/mouth area. this is the area i'd like the most improvement though.
facial paralysis is very scary to me. i wonder how joan rivers does it?? she looks remarkable, even better than me, at how old is she? 70+?