Archive for August, 2013


August 5, 2013

The facelift has evolved significantly since it was first performed over 100 years ago. The first facelift procedures were simple operations removing of a small piece of skin in front of the ear and then pulling the skin back. This was a novel and exciting idea at the time. The first facelift technique gave people options they never had before to combat the effect of gravity on the soft tissue of the face.

Innovators in the field, however, saw shortcomings with that procedure. The procedure did not drape the skin of the face in a natural way and it did not reposition the sagging tissue of the cheek or jowl. Therefore, additional lifting and re-draping of the skin around the face and neck were introduced in order to make the facelift and necklift procedure more effective. This became the “standard” facelift and necklift operation for the next 50 years. Many surgeons currently still use this technique.

This procedure evolved again in the 1980s to improve upon the necklift and facelift procedures we had at the time. Because skin is an elastic structure, it serves better as a cover for the deeper layers rather than as a structural element. French Surgeons who used deeper layers of the face to reposition sagging tissue led the philosophical shift to approaching this procedure in this manner. Facial structure and shape is now a much more importation issue than skin.

Skin now plays a secondary role to the deep layers of the face. Skin is re-draped gently to cover what we do underneath. In addition, we no longer need to pull tightly on skin because the important part of the operation is the repositioning of sagging cheeks, jowls and neck skin. Necklifts have similarly evolved over time. The necklift no longer uses the skin to reposition the sagging neck. A modern necklift in our practice now focuses on deeper structures to allow the contouring and tightening of the neck.

Fat grafting, which we have written about before, has been the largest advance in treating the aging face since the advances of the deep layer facelift and necklift. Fat grafting has allowed us to contour and finesse our results in cases where we could not otherwise get such a nice result.

For more information, or to make an appointment with Dr. Deschamps-Braly, please contact our San Francisco office +1.415.624.3922.

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Cleft Lip and Palate

August 16, 2013

Cleft lip and palate is a spectrum or disorders based around the term orofacial clefting. The majority of cleft lip and palate patients do not have any genetic basis for the disease, and instead represent an anomaly during the developmental part of pregnancy not related to a gene or mutation in the genetic code.

Therefore, it should be well understood that the vast majority of children with cleft lip and palate might grow up with normal intelligence and ultimately lead productive and happy lives. Cleft lip and palate patients are cared for with a dedicated team of specialists, including a craniofacial surgeon in order to make sure that we attend to every detail of your child’s care.

Most children with cleft lip and palate undergo most of their reconstructive procedures before school age, which has benefits for their psychosocial health. However, some reconstructive procedures such as corrective jaw surgery may be delayed until your child has attained their teenage years.

A detailed consultation is required to give a more adequate assessment of your child’s treatment plan.

For further information or to request an appointment, please contact our San Francisco office +1.415.624.3922.

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