IN THIS ISSUE To Tell or Not to Tell... That is the Question Achieving a Younger, More Striking Appearance with Implants Ask the Surgeon / Health Tip / What's New A receding hair line getting you down? There are viable options

replace bony deficiency, to improve balance of facial features, or to reposition the sagging skin upward and outward to fill hollows and depressions.

One of the strongest characteristics of youth is fullness of the cheeks, indicating an abundance of healthy soft tissues and fat that is present under the skin. Also a sign of vitality, the cheekbones are responsible for defining the face, highlighting the eyes, and adding overall balance to your features. Not everyone can retain contour and fullness with age. Not everyone has prominent cheekbones.

When there is depletion of tissue and fat and minimal cheekbones, the skin sags, appears flattened or sunken, and may cause folds and wrinkles around the mouth. The mid-face implant can hold up the collapsed tissue and restore the youthful appearance of adequately padded skin at healthy levels of distention and elasticity. This improves the contour, creates balance, and bolsters self-esteem.

Mid-face implants are performed under local anesthesia with sedation. It may be combined with other cosmetic procedures such as rhinoplasty or facelift or chin augmentation. After the face is thoroughly cleansed with an antiseptic cleansing agent, a small incision is made inside of the mouth in the crease above the upper lip. A pocket is created over the bone.

The implants come in a variety of sizes and shapes ranging from three to six millimeters. Each patient is evaluated for proper sizing and shape of the implant that will provide the desired effect.

The sterile implant is placed into the pocket. The implant is secured and the incision is sutured closed. Supportive tissue forms around the implant after a few weeks; and once healed, it will feel like your normal underlying bone structure.

Many people have a chin that is too small for their face. Flat, under-projected chins are usually genetic, although traumatic injury or previous jaw surgery can also result in deformity. Chin augmentation can help restore balance to the lower face and jawline.

Take a look at your profile. A weak or receding chin can sometimes make your nose seem larger or more projected. During consultation, you can discuss if a chin implant will bring your profile back into balance or if a combination of rhinoplasty (nose surgery) and chin augmentation is the solution.

Some patients seek to reduce the appearance of deep grooves from each corner of the lip down to the chin. These marionette lines can be improved by placing small implants along each side of the jaw, just in front of the jowl.

Implants for the chin area come in a wide variety of sizes and shapes. Your implant will be custom fit to the configurations of your face for optimal results.

Chin augmentation is performed under local anesthesia with sedation. The face is cleansed and a small incision is made underneath the chin or inside the mouth, where gum and lower lip meet. A pocket is created by gently stretching the tissue. The sterile implant is then inserted in front of the bone. The implant is secured and the incision is sutured. When the incision is inside the mouth, no scarring is visible. If the incision is under the chin, the scar is usually imperceptible.

Immediately after surgery, you will probably have a dressing that will remain in place for two to three days. There will be some tenderness; however, any post-operative discomfort can be controlled with prescribed medications. Most patients feel a stretched, tight sensation after the surgery, but this usually subsides in a week.

Normal activity can be resumed after approximately 10 days. After two weeks there are very little activity restrictions. And, after six weeks, most swelling will be gone and you can enjoy the results of your procedure.

Facial plastic surgery makes it possible to enhance your appearance, reduce signs of aging and deformities that undermine self-confidence. Facial plastic surgery can improve your looks and your self-image, as well.

If you are considering implants to sculpt and restore the youthful contour of your face, answer these questions:

- Are you in good health?
- Do you have realistic expectations?
- Why do you want to change your appearance?
- Do you understand how the procedure(s) is performed?
- How do you feel this will change your life?

Implants for the mid-face and chin area provide a safe, effective, and long-lasting way to a more youthful appearance. After careful deliberation, make an appointment and discuss any questions, concerns, or ideas about your treatment plan.

Your nose can appear more prominent than it actually is because of other facial features. The noses in these three profiles are identical but look totally different. The first face that shows a normal jaw structure, presents a pleasing appearance. The nose in the center profile appears more prominent because of a receding chin. And the nose on the third face seems to project even more because of a long sloping forehead and a weak chin.