This male in his late 50s presented with a very challenging problem of deep set wrinkles that one can describe as permanent etchings. Not only was he complaining about this appearance but he was also complaining of facial skin laxity and tired eyes. Dr. HAWORTH, a facial plastic surgical expert in Beverly Hills devised a comprehensive facial rejuvenation plan which included a browlift including removal of the corrugator muscles to foster a smooth appearance, a lower eyelid blepharoplasty with fat transfer, a modified facelift (to define his jawline, tighten his neck and smooth out his midface) as well as facial fat transfer. Surgiwire release of his transverse forehead folds was performed. He was advised that multiple smaller procedures would need to be performed after his main surgery to further tackle the deepset folds and wrinkles around his chin and mouth. I considered these deep set wrinkles and folds as scars so I treated them as such-directly excising and closing them in a manner similar to a scar revision.
This patient was determined to get an excellent result and had a great attitude before the surgery which greatly contributed to a speedy recovery. He was delighted with the results and since he is a serious professional, he particularly appreciated the very natural result-a significant transformation that occurred "under the radar."
Eight-month follow-ups are presented. Note the beautiful transition from his lower eyelid into his cheek which was achieved not only via a lower blepharoplasty but also with fat transfer into the lower eyelid hollows. This is a specialty of Dr. HAWORTH who has was performed literally thousands of these permanent eyelid surgeries. Also note the near- invisible scar around his ear.