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Have you wondered whether placement of hyaluronic acid filler such as Restylane© in the lips can impart a more voluminous and youthful appearance to your lips? Have you wondered how this compares with a surgical lip lift? The lip lift is a procedure that can be performed under local anesthesia or IV sedation to address specific aesthetic concerns of the lip that lip filler cannot. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. The Lip Lift Can Address What Lip Filler Cannot The red portion of the upper lip loses height and volume as we age. Some individuals are born with thin, deflated lips. Lip filler can re-volumize deflated lips. However, lip filler cannot increase the height of the red lip without projecting it, potentially resulting in a "duck-lipped" appearance. In addition to the red lip, the area of the lip between the red lip and the base of the nose lengthens as we age. This can be worsened by overfilling the lip with hyaluronic acid. The lip lift can be an excellent option to improve the height of the red lip and restore a "pouty" appearance to the lip by reducing the overall length of the lip to a more youthful length. The incision is hidden in a natural crease at the base of the nose. Lip Filler Can Complement the Lip Lift It is important to note that while the lip lift can address aesthetic concerns lip filler cannot, this does not prevent you from receiving hyaluronic acid filler in the future to re-volumize a deflated lip as demonstrated in the before-and-after images below. In fact, hyaluronic acid filler can be a wonderful complement to the lip lift. The above patient underwent a lip lift followed by lip filler in order to balance her bottom lip volume with her top lip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified, fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us

The effects of some non-surgical procedures on the face and neck are often promoted as approaching/approximating the effects of a facelift and/or neck lift. These procedures fall into three categories: fillers, energy-based devices, and sutures, otherwise known as threading. In fact, many describe one or a combination of more than one of these non-surgical procedures as a "non-surgical" facelift and/or neck lift. The reality is that none of these interventions or combination of interventions approximate the effects of a facelift and/or neck lift. Instead, we feel the potential benefits of these interventions should be described for what they are and not compared with surgical procedures. The most effective way to treat age related changes to the face and neck remains surgery. More specifically, in the event of loose tissue and drooping volume in the face and neck, we feel the extended deep plane facelift and neck lift are the best surgical techniques to provide a natural appearing and long-lasting result. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Fillers Add but Do Not Lift Volume Fillers, including hyaluronic acid fillers and others, add volume to the face. They do not, however, lift volume in the face. Some argue that, by lifting the soft tissue and injecting filler inferior to it, treatment with hyaluronic acid filler can effectively lift this tissue. We believe this to be false. Hyaluronic acid filler is a gel with variable properties depending on its formulation. However, even the firmest, most "structural" fillers can still be injected through a small syringe. The idea that a gel could hold up drooping facial volume like a cantilevered balcony in a house makes little sense. Instead, fillers can increase the volume of an area in which they are injected such as the cheeks, lips, and chin. Sutures Temporarily Pull Skin but Do Not Lift Volume Naturally Threading involves the use of barbed, dissolvable sutures placed under the skin in multiple directions to pull skin in the cheeks, jawline, neck, brows, and other locations. See the following blog post describing the "fox eye" procedure using threads in the brows. Threading is sometimes referred to as a "non-surgical" facelift because of the pull it is purported to have on the skin. However, this comparison is inaccurate. Facial aging involves much more than simply loose skin. Facial aging involves drooping fat, muscle, and fascia in the face and neck. Appropriately addressing this volume requires surgical release of the deeper structures of the face and neck to prevent distortion of the mouth, eyes, and other surrounding structures that can occur by simply pulling on the skin. Furthermore, this suture dissolves within a few months. As a result, the potential effects of threading are relatively short lived, especially when compared with facelift and neck lift surgery. Energy-Based Devices Heat Fat and Skin but Do Not Lift Energy-based devices utilize ultrasound, radio waves, and/or plasma to heat up tissue, most commonly the fat immediately deep to the skin. These devices are often advertised as a "non-surgical" facelift, again an inaccurate statement. Simply heating up subcutaneous fat and skin does not lift volume. Furthermore, the "new collagen" formed, from our experience operating on patients who have undergone these procedures, should more accurately be described as scar formation, which can make performing a facelift and neck lift more complex. No Combination of the Above Approaches the Effects of a Facelift and Neck Lift Some even argue that a combination of hyaluronic acid fillers, threading, and energy-based devices can result in a "non-surgical" facelift. We feel this is inaccurate for the reasons discussed above. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching "plastic surgery near me." Get in touch with us to learn more. 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The following information is adopted from a lecture I give to head and neck surgery residents at the University of Cincinnati on the aging face and how it can be treated. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Introduction to Facial Anatomy and Facial Aging It is important to start any discussion about the changes that occur in our faces when we age with the fact that the face is composed of multiple stacked layers. Facial aging results in changes in all these layers, some more obvious than others. The focus of a facelift procedure – or any cosmetic facial plastic surgery procedure for that matter – is to address the most obvious of these changes, namely, loosening of skin and drooping fat. There are individual fat pads all over the face. Ligaments, which is soft tissue that act as support structures to the face, surround these fat pads. The ligaments surrounding these fat pads become more visible as they loosen and the fat pads drop, leading to more visible lines around the mouth (e.g., nasolabial folds, marionette lines) and the lower eyelids (e.g., tear trough). The fat pads along the jawline also begin to blend in with the neck, making the jawline look much shorter than it is. Skin loosens as the ligaments weaken and fat pads drop. The purpose of a facelift procedure is to address these changes. The first facelift was performed over 100 years ago. Multiple facelift techniques have been developed and evolved as our understanding of facial anatomy has improved. Facelift techniques can be broadly grouped into three (3) types, though there is wide variability in the details of each procedure in each group. Skin Lift, SMAS Pull Facelift The first type of facelift releases only skin and only pulls on the SMAS layer of tissue under the skin. The SMAS layer is a thick layer that lies under the skin but over the facial muscles and most of the fat pads in the face. They include a SMAS imbrication and SMAS plication, the details of which are not important except to say that this approach involves the most limited surgery. As a result, there is more limited improvement in the jowl than other approaches, no lifting of the cheeks, and little improvement in the nasolabial folds. The skin is placed under more tension than with other approaches because the retaining ligaments in the face are not released with the lift. SMAS Facelift The second type of facelift involves the lifting of skin as with the SMAS techniques described above. However, these facelift approaches go under the SMAS layer itself, albeit on the side of the face closer to the ear. There are many ways to go under the SMAS layer itself in this location, with multiple incision types and differences in the extent of the surgery. The improvement in jowls can be better than if the SMAS layer is just pulled up with sutures (stitches) like the first type of facelift procedures. The lift can also be made a little more vertical than a SMAS imbrication or plication, which is more natural. However, again, there is no cheek lift with these approaches, little improvement in the nasolabial folds, and persistent, though less, tension on the skin when the procedure is complete. This is because the area where this SMAS layer is addressed is very firmly adherent to the deep layers of the face, unlike the front of the face. As a result, there is less lift of the front of the face. Deep Plane Facelift If you observe the aging process closely, you will realize that most of aging occurs at the front of the face. The deep plane facelift and subsequently the extended deep plane facelift were developed to address the problems associated with the previous broad approaches to the facelift. Like the SMAS facelifts, the deep plane facelifts go below the SMAS layer. However, they do it at the front of the face, bypassing the areas on the side of the face that do not drop with age and targeting the areas at the center of the face that do drop with age. The front of the face is the primary location where aging occurs, as evidenced by the jowls and drooping of the cheeks. There are ligaments, or tension points, in this area of the face, that need to be released to lift those fat pads in a more natural, long-lasting manner. The deep plane facelift, the details of which were published in the 1990s, addressed the above. The extended deep plane facelift, the details of which were published in the 2000s, extended that concept to the side of the neck to better address aging of the neck but also to better improve the youthfulness of the jawline by restoring some definition and volume to the back of the jaw. Overall, while a more complex procedure, the benefits of a deep plane or extended deep plane approach are that, unlike the above approaches, the cheeks can be lifted, there is improvement in the nasolabial folds, and the skin is placed under no tension, thereby significantly reducing the risk of poor healing and widening of the incisions around the ears. Conclusion Facelift techniques will continue to improve over time. It is important that these improvements reflect an understanding of the anatomy, focus on addressing the actual changes that occur with aging, and maintain patient safety. The extended deep plane facelift is a natural evolution of these concepts and the current gold standard in facelift techniques. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified, fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us References Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J. 2013 Aug 1;33(6):769-82. Jacono AA, Bryant LM, Ahmedli NN. A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization. Aesthet Surg J. 2019 Nov 13;39(12):1265-1281. doi: 10.1093/asj/sjy292. Jacono AA, Bryant LM, Alemi AS. Optimal Facelift Vector and its Relation to Zygomaticus Major Orientation. Aesthet Surg J. 2020 Mar 23;40(4):351-356. Jacono AA, Alemi AS, Russell JL. A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques. Aesthet Surg J. 2019 Aug 22;39(9):927-942. Shamouelian, D (2016). Rhytidectomy Essentials. In Wong BJF, Arnold MG, and Boeckmann JO (Eds.), Facial Plastic and Reconstructive Surgery: A Study Guide (pp. 347 – 365). Springer. Stuzin JM, Baker TJ, Gordon HL. The Relationship of Superficial and Deep Facial Fascias: Relevance to Rhytidectomy and Aging. Plastic and Reconstructive Surgery. 1992 Mar;89(3):441-9. Sykes JM, Riedler KL, Cotofana S, Palhazi P. Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy. Facial Plast Surg Clin North Am. 2020 Aug;28(3):243-251.

The lips consist of complex anatomy that includes more than simply the red portion of the lips. Each anatomic area of the lip ages and may benefit from interventions targeted to those changes. The following information is adapted from a presentation I have given to other medical professionals. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Youthful Peri-Oral Anatomy The upper red lip has a well-defined "M" shaped border – called the vermillion border – with the peaks of the "M" called the cupid's bows. The bottom lip is larger and more rounded than the upper lip with an ideal ration of size between the upper and lower lip at approximately 1:1.6, which is also known as the "Golden Ratio." When most individuals refer to the lips, they are referring to the red lips as described above. However, this does not encompass the entire lip anatomy. The skin between the red upper lip, the base of the nose, and the nasolabial folds and the skin between the red lower lip, chin, and marionette lines (pre-jowl sulci) are also components of the peri-oral region. The nasolabial folds of the upper lip and the pre-jowl sulci of the lower lip are created by ligaments extending from the bone to the skin that hold up fat pads sitting above them. These fat pads droop down and to the center of our face as we age, leading to more prominent nasolabial folds and pre-jowl sulci. Age-Related Changes to the Peri-Oral Region The aging process occurs in three dimensions. First, the skin develops wrinkles (rhytids) and age spots. The depth and number of rhytids depends on several factors, including genetics and environmental factors such as smoking history, alcohol use history, and sun exposure. Overall, soft tissue and bone shrink, and soft tissue thins and droops. Probably the most noticeable change that occurs is a lengthening of the upper lip, which can eliminate the naturally youthful upper tooth (central incisor) show when the lips are relaxed and imparting a simian appearance to the lip. This effect becomes exaggerated when too much filler is placed in the lips for many years. The upper and lower red lips also shrink and lose definition, which can result in a loss of naturally youthful lip pout. The corners of the mouth, called the oral commissure, droop due to thinning of tissue. Finally, as described previously, superficial fat pads in the cheeks and along the jawline fall to the center of the face, leading to an accentuation of the nasolabial folds and pre-jowl sulci, which leads to marionette lines. Deep Plane Facelift Surgery is the Best Method to Address Deepened Nasolabial Folds and Marionette Lines Deep plane facelift surgery and, specifically, the extended deep plane facelift, is the gold-standard in facelift techniques. Deep plane facelift surgery is the only facelift technique that can naturally address the anatomic changes that lead to a deepening of the nasolabial folds and marionette lines. As discussed in a previous post, deep plane facelift surgery is distinguished from other facelift approaches by the fact that a composite skin and deep tissue – composed of muscle and the fascial layer called the SMAS – flap is lifted in the middle of the face and the ligamentous attachments in the cheeks and the jawline are released for a comprehensive, tension-free lift of not only the jowls but also the cheeks. This is what allows the nasolabial folds, marionette lines, and drooping oral commissures to be treated. The extended deep plane facelift advances deep plane surgery by extending the deep plane approach into the lateral neck, which allows the jawline to be better contoured all the way to the back corner of the jawline and the central neck to be more effectively tightened. Hyaluronic acid filler such as Restylane© and Juvederm© products are commonly used in the nasolabial folds and marionette lines to "blunt" their appearance. These products are also used around the corners of the mouth to provide a "lift." While this non-surgical treatment can be appropriate in certain circumstances, the problem is they do not address the actual changes that occur with age, i.e. weakened ligaments, drooping fat, and loose muscle and skin. Attempts to eliminate the nasolabial folds and marionette lines with hyaluronic acid filler or other fillers including fat can overinflate the face and make patients look distorted by eliminating subtle transition points between the cheeks and lips. Skin Resurfacing and Nano-Fat Can Treat Peri-Oral Wrinkles Wrinkles around the mouth are treated primarily by resurfacing procedures, which fall under three categories: laser resurfacing, chemical peels, and mechanical resurfacing. All three approaches remove the top layers of the skin in a controlled fashion. The healing process after treatment results in the deposition of collagen in a more organized fashion that better reflects a youthful skin composition. Laser resurfacing devices include CO2 and Erb:YAG lasers. Resurfacing lasers target water molecules (H2O) in the skin, heating the tissue to a controlled depth. Most resurfacing lasers used today are fractional, which means the laser energy reaches the skin in organized columns with untreated skin in between. Fractional lasers heal faster and are less likely to result in complications than non-fractional lasers. Chemical peels are a diverse group of chemical mixtures (e.g., TCA peels, Hetter peels) which are applied to the skin for resurfacing. The depth of the peel is dependent on the mixture's active ingredients and their relative concentration as well as the number of passes used. Mechanical resurfacing, otherwise known as dermabrasion, involves the use of a hand piece with a spinning tip that is often diamond coated and which effectively serves as a sander for the skin. The tips come in many shapes and sizes for use on different areas of the face. The rate of spin and number of passes also contribute to the depth of the resurfacing procedure. A complementary approach to resurfacing procedures on the mouth wrinkles involves the use of nano-fat. Nano-fat is harvested from the patient's own body fat in the stomach, flank, or thighs just like fat augmentation procedures. The difference between nano-fat and the fat used to augment the face is that it is processed to be a thin liquid. Nano-fat is injected superficially into the wrinkles prior to the resurfacing procedure. The purpose of placing nano-fat in these wrinkles is primarily to improve healing after the resurfacing procedure and secondarily to soften the deeper wrinkles that may not be treated completely with the resurfacing procedure. The Lip Lift Can Treat Lip Lengthening and Thinning The lip lift procedure is the best approach to treat the lengthening of the upper lip skin as well as the loss of definition and projection of the red upper lip. Providers often try to address these changes with hyaluronic acid filler to poor effect. In fact, adding large volumes of filler to the upper lip can stretch the upper lip. Adding large volumes of filler to the upper lip can also over project the upper lip, leading to a "duck-lipped" appearance. The lip lift, which is also known as the sub nasal or bullhorn lip lift, involves the excision of skin and fat in a gullwing or bullhorn pattern at the base of the nose. This incision then hides in the creased of the base of the nose. This procedure can accomplish three things. First, it increases the height and improves the definition of the red lip. Second, it balances the length of the upper lip skin with the red lip height. Third, it improves the pout of the red lip. The lip lift is a complementary procedure to cosmetic dentistry procedures, because the lip lift can restore some of the youthful central tooth show that occurs when the lips are relaxed apart. Some providers perform lip flip procedures using botulinum toxin to the muscle surrounding the mouth, called the orbicularis oris. This procedure is not recommended, because it is generally not effective and can cause problems with speaking and drinking through straws for weeks-to-months after the procedure. Multiple Techniques Can Re-Volumize the Lips Some patients with deflated lips can benefit from procedures that restore their volume. In fact, many patients who undergo a lip lift also undergo lip volumizing procedures. Temporary options for lip volumizing include hyaluronic acid filler. Permanent options for lip volumizing include fat and SMAS, which is the strong fascia that lies over the fat and deep muscles of the face. The fat is removed from the stomach, flank, or thighs, processed, and injected using blunt-tipped cannulas into the upper and lower lips. SMAS is removed from immediately in front of the ear during the extended deep plane facelift procedure and inserted into the upper and lower lips through incisions hidden at the corners of the mouth. The patient above is an excellent example of how multiple procedures work simultaneously to rejuvenate the peri-oral region. This patient underwent a lip lift, fractional CO2 laser resurfacing with nano-fat grafting of the wrinkles around the mouth, and lip enhancement with hyaluronic acid filler to balance the bottom lip with the top lip. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us

Perioral rejuvenation – or plastic surgery of and around the mouth – is a popular topic in Cincinnati, Ohio. The perioral area includes not only the lips but also the skin and other soft tissue immediately surrounding the lips. The perioral mounds are a subunit of this anatomy that are relevant to facelift surgery. The characteristics and location of the perioral mounds make them very difficult to treat. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Perioral Mounds are Adjacent to, but Distinct From, the Jowls The perioral mounds (see image above) have been described as an area that sits between the lower edge of the cheek fat compartments and the fat compartments that form the jowls. The perioral mounds can become fuller and droopier with age (1, 2). Perioral mounds are confused by many with the jowls, which themselves are confused with buccal fat. Jowls are the fat and other soft tissue of the superficial lower cheek that hangs over the bony jawline with aging. Stuzin et al describe jowl fat as "fluffy, thick fat" which is "situated between the masseter ligaments and the mandibular ligaments overlying the facial portion of the platysma" muscle (3). In contrast, the fat located in the perioral mound is very thin with poorly defined borders. Perioral mounds are a distinct anatomic feature of the face. The fat in perioral mounds overlies soft tissue called the SMAS layer, which is superior to and continuous with the platysma muscle (1, 2). The SMAS and platysma muscle are treated during deep plane facelift surgery, which is why this approach to facelift surgery can be so effective in treating the jowls in a long-lasting and natural appearing way. However, facelift procedures of any kind do not effectively treat age-related changes at the perioral mounds (1, 2). This may be because multiple muscles that move the mouth meet at the perioral mounds. As a result, dissection does not proceed that close to the mouth. In addition, the area around the perioral mounds contracts actively with speech and emotive facial expressions, creating a crease that is often confused with the perioral rhytids/wrinkles that are typically best treated with a resurfacing procedure such as a laser, chemical peel, or dermabrasion. Such resurfacing procedures are also poorly effective at treating the skin at the perioral mounds. There are Two Treatment Options That Have Been Discussed for Perioral Mounds There is little research published on the treatment of the perioral mounds. Two studies describe the use of a small cannula to perform a limited liposuction of the site manually (1, 2). The problem with this approach is the fact that the fat in this location is very thin and close to the surface of the skin. As a result, Gu et al report "overaggressive liposuction of the perioral mound region may result in skin hyperpigmentation, unnatural facial expressions, depression, and even skin necrosis" (2). Depression or unevenness of the area from liposuction is one of the most concerning and logical risks of this technique. Also, while liposuction can reduce fat, it does not improve loose or hanging soft tissue, including the SMAS layer, which may develop with age. A second treatment described is the use of energy-based devices to melt fat and tighten skin at this site. The energy-based devices include, but are not limited to, devices that utilize radiofrequency energy to heat the tissue deep to the skin. A search of the medical literature found no article describing this technique and demonstrating its effectiveness. One should be extremely cautious at this time when pursuing treatment of the perioral mounds due to the potential risks of liposuction and the lack of published effectiveness research for energy-based devices. More safe and effective treatment options may become available in the future, however, as newer techniques and technologies become available. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati, Ohio. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching "plastic surgery near me." Get in touch with us to learn more. Contact Us References Sullivan PK, Hoy EA, Mehan V, Singer DP. An anatomical evaluation and surgical approach to the perioral mound in facial rejuvenation. Plast Reconstr Surg. 2010 Oct;126(4):1333-1340. Gu Y, Yang M, Li J, Sun J, Lv Q, Qi Y, Han X, Qi Z, Ma GE. Efficacy and Safety of Perioral Mound Region Liposuction-A Novel Concept to Improve Perioral Mound Fullness. Aesthet Surg J. 2023 Apr 10;43(5):527-534. Stuzin JM, Rohrich RJ, Dayan E. The Facial Fat Compartments Revisited: Clinical Relevance to Subcutaneous Dissection and Facial Deflation in Face Lifting. Plast Reconstr Surg. 2019 Nov;144(5):1070-1078.

The post-operative recovery period is an important time where meticulous care can maximize healing and minimize down time. It is for that reason that Dr. Harmon has developed a comprehensive plan for the post-operative recovery period. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. First, Dr. Harmon discusses the importance of eating a well-balanced, nutritional diet, and getting adequate sleep before and after surgery with each of his patients. Care of each incision is of paramount importance during the first 5 – 10 days after surgery. Dr. Harmon has instituted a suture removal protocol for each procedure. He removes each stitch progressively over multiple days, balancing the need for the sutures to remain in place until adequate healing occurs with the desire to remove them as quickly as possible to minimize the visibility of the incision. As a result, Dr. Harmon has an opportunity to evaluate and monitor the progression of healing closely in the first days after surgery. That way any problems or concerns can be addressed promptly. It is also important to keep the incisions moist while they are healing. The incisions are covered with an antibiotic ointment for the first three (3) days after surgery to reduce the risk of infection and keep the incisions moist. The topical antibiotic is then discontinued, and the incisions are covered with Aquaphor ointment. This is done because applying antibiotics to incisions too long can result in an allergic reaction - called dermatitis - at the incision sites. The incisions remain cared for even after stitches are removed. Dr. Harmon applies a liquid incision dressing in areas where stitches are removed. This liquid incision dressing also allows protective tape to remain adherent to the incisions, which strengthens incisions and protects them from the sun. The tape and liquid incision dressing are removed after all sutures are removed. Finally, Dr. Harmon ensures all his patients apply silicone-based gels and a mineral-based sunscreen to the incisions after all stitches are removed for weeks-to-months to encourage the gradual fading of the incision lines. It is the above interventions that allow Dr. Harmon to deliver well-hidden incisions. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified, fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us

People generally know their body better than anyone else, including their physician. However, people do not always have the medical language to explain what they see when they look in a mirror. For example, you may have heard and understand the term "jowling" but do not quite feel like that fully explains what you see. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. As explained in a previous blog post (4 Benefits of the Extended Deep Plane Facelift), the extended deep plane facelift can address multiple signs of aging of the lower two-thirds of the face as well as the neck in a manner that other facelift approaches cannot. However, the upper one-third of the face and the upper lip also undergo age-related changes, which no facelift approach can address. The lateral temporal lift and lip lift are complementary procedures to the extended deep plane facelift and neck lift. The red portion of the upper lip thins and loses definition. The skin between the red portion of the upper lip and the base of the nose lengthens. The lip lift can address these changes. The sides of the brow droop, hanging over the edge of the eyes. The lateral temporal lift can address these changes. In summary, the extended deep plane facelift, neck lift, lateral temporal lift, and lip lift can address the signs of facial aging comprehensively. Trust Your Face to a Facial Plastic Surgeon It is important to seek a double board-certified, fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us

A weak, or recessed, chin can be concerning to men and women, not only because this feature can make the face appear smaller than it is, but it can also make the nose appear larger and more projected than it is. There are surgical and non-surgical options to treat a weak chin. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Non-Surgical Treatment Options Include Hyaluronic Acid Filler While a weak, recessed chin is usually best address with an implant, hyaluronic acid filler can address concerns requiring a more subtle result. Filler can also serve as a temporary treatment to help determine whether placement of an implant could achieve the desired aesthetic result. Filler is also less expensive than an implant and results in little-to-no downtime after treatment. Hyaluronic acid filler can be placed deep along the bone and/or more superficially to firm up the skin. A firmer, more structural product such as Restylane© Lyft is a good option to project a weak chin. Surgical Treatment Options Include a Contoured Chin Implant A more permanent option involves the placement of an implant, usually silicone. There are many shapes and sizes of chin implants available. These implants can also be carved to achieve the ideal projection and width to the chin. Implants are usually placed over the periosteum of the chin – which is the fascial covering of the bone – with tapered wings placed in pockets under the peri-ostium on either side. Silicone implants can be removed and replaced if desired. The combination of chin implant and liposuction under the jawline can be a powerful combination for those individuals with excess fat under the chin. The following is just such an example of a patient: Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us

Some individuals lose volume (i.e., fat) in their face as they age. Other individuals are born with poor volume and/or poor projection of their facial bones. Both individuals may benefit from fat augmentation. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck. Fat Augmentation is a More Permanent Alternative to Dermal Filler for the Face Fat augmentation involves the transfer of fat cells from other areas of the body (e.g., thigh, abdomen) to the face in areas with poor volume. The fat cells are carefully distributed evenly and at an appropriate depth to increase the volume of the target area. There are two areas of the face that are commonly augmented with fat. Temples The temples can hollow with age. Fat transfer to this location can restore some of that volume, in effect balancing out the volume in the lateral eyebrows. That is why fat augmentation of the temples can serve as a nice complement to the lateral temporal brow lift procedure. It is important to place the fat at the proper depth to maximize how smooth the contour of this volume is. It is a bit like adding a thick, viscous liquid to a balloon. The lining of the balloon stretches but tends to remain smooth because the liquid is distributed under the surface area of what is thick balloon material more evenly. In contrast, placement of the fat more superficially is more likely to lead to contour irregularities. Cheeks Some lose significant volume in their cheeks with age. A midface (i.e., cheek) lift through the extended deep plane facelift may be inadequate to re-approximate the youthful heart-shaped appearance to the face in those select circumstances. It is important to understand that the cheek is composed of multiple subzones, each of which volume can be lost in variably. Therefore, it is important to consider all subzones when adding volume, whether with fat or hyaluronic acid filler. Fat Augmentation is Generally a Poor Replacement for a Cheek Lift Fat augmentation can sometimes be a useful adjunct to but is generally a poor replacement for a cheek lift with the extended deep plane facelift. Augmenting the cheeks with large volumes of fat to mask drooping cheek fat can make the face appear overly rounded and unnatural, because the drooping cheek fat remains in an area that typically has a lower volume in youth. High volume fat augmentation also increases the risk of contour irregularities and asymmetries. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about volume loss in the face. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style, and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us to learn more! Contact Us

Ear pinning (otoplasty) surgery can address specific concerns about excessive projection of the ears in children and adults. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon to help determine whether ear pinning (otoplasty) surgery is appropriate for your concerns. Some Individuals are Bothered by Protruding Ears Both men and women have protruding ears, which make the face look wider than it is. Protruding ears are usually treated in childhood. Adults with untreated protruding ears often seek the care of a fellowship-trained facial plastic surgeon for correction. Ear Pinning (Otoplasty) Can Improve Protruding Ears with Hidden Incisions There are multiple approaches to treating protruding ears. The most appropriate approach depends on the patient's unique anatomy. Protruding ears are often caused by excess ear (auricular) cartilage near the opening of the ear canal. The surgical procedure correcting this anatomy involves the setback and possible reduction of the cartilage depending on the severity of the ear protrusion. The incisions are hidden in the natural deep crease behind the ears. Sutures (stitches) are removed 7 – 10 days after surgery. Ear Pinning (Otoplasty) Can be Performed Under Local Anesthesia Regardless of the approach to treating protruding ears, the surgical procedure can be performed under local anesthesia in the nationally accredited surgery suite here at Harmon Facial Plastic Surgery. Trust Your Face to a Facial Plastic Surgeon It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about age-related changes to your face and/or neck. Why Choose Dr. Harmon The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good. Dr. Harmon is a double board-certified facial plastic surgeon. Dr. Harmon values making patients feel welcomed, listened to, and respected. Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology. Dr. Harmon earned his medical degree from the University of Cincinnati. Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati. Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City. Request a Consultation Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon's credentials, style and approach. Build a relationship with our dedicated team. Do not stop at searching "plastic surgery near me." Get in touch with us today to learn more! Contact Us