Dr. Moelleken offers his signature 360 Facelift® for patients in Beverly Hills, Los Angeles, and Santa Barbara.
The 360 Facelift® combines a number of advanced techniques to tighten and rejuvenate the skin of the face, including:
While every facelift is different, the skill and training of the surgeon performing the facelift is crucial to a successful outcome. One important feature of the modern facelift is the ability to effectively hide scars. Dr. Moelleken almost always places incisions in front of the ear, where the scars are invisible even the day after surgery. Dr. Moelleken’s signature facelift in Los Angeles, and Santa Barbara uses advancements in anchoring techniques, to ensure that the ears remain unaltered. This is opposed to older techniques, which pull down the ears and change the shape of the face.
Because he believes that a facelift should go beyond just tightening, Dr. Moelleken restructures and elevates the deep layers of the face for a fresher, more youthful look. Dr. Moelleken also offers a number of extra procedures to complement the results of the facelift. These procedures include brow elevation, eyelid surgery, cheeklifts, laser resurfacing, grafting to hollow areas and lips, chin implants, lip lifts, neck tightening, and earlobe reduction. The additional procedures Dr. Moelleken depend on the unique physiology and aesthetic needs of each patient. However, they are as important as the facelift itself, because they enable Dr. Moelleken to rejuvenate your entire face as a harmonious whole.
All of us can take steps to maintain our facial appearance but the fact is, your face and neck change with age. The greatest changes occur from infancy to puberty as your face and head mature into an adult form. The eyes, nose, and mouth features of your face expand to fill a greater area of the surface of the cranium; the relative area occupied by your forehead shrinks as your eyes move up; your eyes become proportionately smaller and your forehead slopes back; your face becomes smaller in respect to the rest of your body; and your chin tends to become larger and more protrusive. Although some of these changes continue into adulthood, other variations begin to occur to mark aging and correspond to the decline of your face. As your face matures, it changes some of its most enduring properties and acquires new attributes that are not necessarily appreciated. Your skin becomes darker, less flexible, and more leathery; lines, wrinkles, folds, pouches, and blemishes or discolorations gradually appear; muscles and connective tissues change their elasticity; and fatty deposits and bone may be lost to produce pouches in your cheeks, bags under your eyes, sagging under your chin, and other changes in the way soft tissues conform to your underlying bony structure.
Most people within a given society agree among themselves about what makes faces attractive and what makes them that way. They may disagree about certain attributes of beauty but much of what is considered attractive is shared universally across cultures.
The common characteristics that contribute to facial beauty include:
Symmetry: There is a significant correlation between a symmetric face and beauty. This means that facial features are mirrored across the vertical midline of your face. With aging, any facial asymmetry becomes more pronounced. Slight imperfections in symmetry are not significant but deviations such as a crooked mouth, twisted nose, or one eye smaller than the other disrupts the perception of beauty. Several studies have shown that the perceived age can be lowered when facial asymmetry is improved.
Good Proportion: Proportion among facial features contributes to beauty. Features such as your mouth or nose should not be too large or small in comparison with your other facial features.
Proper Placement: Proper placement of the features on your face is another factor contributing to beauty. The eyes should not be too close together or too far apart and the eyes and mouth lie approximately upon lines dividing the face into thirds.
Shape: The shape of the face in profile also shows a clear relation to attractiveness.
Some important facial shapes include:
The Ideal Beautiful Cheeks
One of the features of a beautiful face in a woman is a pronounced cheekbone with narrow cheeks. The ideal beautiful cheek has been found to be oval, not round. It is also angled which extends from the angle of the mouth to the base of the helix of the ear.
The Ideal Beautiful Lip
Having fuller lips is considered a desirable trait.
The Ideal Beautiful Brow
Your eyebrows bring attention to your eyes and help frame your face. The beautiful brow is typically arched at the junction of the medial 2/3 and outer 1/3 of the eyebrow. The lateral tip of a beautiful brow should be higher than the medial tip of the brow.
Dr. Brent Moelleken, M.D., F.A.C.S., is a Plastic and Reconstructive surgeon with offices in Beverly Hills and Santa Barbara, California. He is double board certified by the American Board of Surgery and American Board of Plastic Surgery and specializes in cosmetic surgery. He received his premedical, medical and surgical training at Harvard University, Yale University, UCSF and UCLA. Although skin is very important, ultimately a beautiful face is determined by your skeletal structure. Because of this, Dr. Moelleken will spend a considerable amount of time analyzing your bone structure and facial features before discussing any possible improvements you are considering. In the end, you will decide the procedure you want to have but it is important to trust Dr. Moelleken and understand that his advice is based on sound principles.
Dr. Moelleken has invented several trademarked procedures including the USIC® and LUSIC® Ultrashort incision Cheeklift procedures, the 360 Facelift® a natural 3-D facelift procedure, the Hybrid tummy tuck®, a short incision, full tightening tummy tuck procedure, the LiveFill® lip and facial augmentation, all natural facial fillers using natural fat, and the Neck-Lace®, an interlacing technique to rejuvenate the neck. He is one of three surgeons in the world to complete the yearlong Aesthetic Surgery Fellowship at UCLA. He is a Fellow of the American College of Surgeons (FACS) and a member of the American Society of Plastic Surgeons (ASPS), The American Society for Aesthetic Plastic Surgery (ASAPS), Who’s Who in America, Who’s Who in the World and numerous medical and scientific organizations. He has been selected by Who’s Who in America’s Top Plastic Surgeons, Top Doctors in Los Angeles, America’s Top Surgeons, and by Vogue Magazine as one of the Top 10 Plastic Surgeons in America.
Age affects every part of the body but nowhere are the consequences on such open display as they are on your face and neck. Normally people are able to determine age from the face with surprising accuracy and nearly every woman recalls the first time she looked in a mirror and noticed a line at the corner of her mouth or near her eyes. No matter how self-assured or determined you are not to allow the external signs of aging to control your life, at the same time you always remember how disappointed you were at the sight of that first wrinkle. Men often have the same reaction when they realize that their hairline is receding or that they are developing bags under their eyes. Fine wrinkles around the corners of the mouth are one of the first signs that you are getting older and while the aging process itself cannot be changed, facial cosmetic surgery is a way to reverse some of its effects.
One of Dr. Moelleken’s signature procedures, the 360 Facelift® is for the patient who wants a complete rejuvenation of their face. Dr. Moelleken performs the 360 Facelift® with the concept in mind that the face does not just age in one or two areas: It ages overall. The 360 Facelift is designed to fix many areas the best he can. He starts with the Neck-Lace procedure, which is an incision underneath your neck. He tightens the neck muscles more aggressively than techniques used in the past when the muscles were merely tied. From the side of the face, he performs a bidirectional lift, which allows him to reach the deep, Superficial Musculoaponeurotic System (SMAS) tissues. Many people think the SMAS tissues are muscles but they are not and Dr. Moelleken lifts them up. He raises the SMAS tissue gracefully, not super-high on the edges so the pull of the face will not be obvious. By allowing the skin to go back in a more gentle direction, the “swoop” look of the past will be avoided. This gives more volume in the upper face and less volume in the jowl area. Unlike the procedures of the past, where the SMAS tissues were removed, Dr. Moelleken does not take away any volume because he understands that people need volume as they age.
LiveFill® is a new method of augmenting wrinkled or “deflated” areas in the face. LiveFill® is a better concept than fat injection because LiveFill® is tissue taken from the patient while they are fully alive. It involves grafts from the patient’s own tissues and the material is obtained as a customized fine graft with blood vessels intact. LiveFill® is basically little strips of tissue taken from areas in a patient where there is a lot of fibrous tissue, usually from the lower abdomen. This differs from traditional fat injection because this method means the tissue is not processed. Processed tissue involves sucking (aspirating) fat into a syringe, purifying it (usually through centrifugation), and then injecting it through a needle. Of course this procedure highly damages the living network of cells but with LiveFill®, Dr. Moelleken fashions completely untraumatized tissue from the patient into small, delicate grafts, resembling strings of pearls, that have structural integrity and blood supply. This technique is different from any rendition of grafted material developed thus far and because the survival of LiveFill® is better for fat injection, it is the method Dr. Moelleken uses for all areas that need extra volume. Since the face does not age in lines but in areas, it is better to fill in complete areas rather than placing filler underneath a single line. LiveFill® is placed beneath the areas that need filling such as your lips, smile lines, the area below your eyes, and in hollow portions of the face that develop with age. LiveFill® can be used for a number of different techniques and almost anywhere in the face. Since LiveFill® is a graft material similar to a skin graft, once the skin graft survives the patient will have it permanently. Dr. Moelleken says, “Once the blood supply of the body has grown into that graft, it is yours to keep forever.”
The brow lift is a surgical procedure whose purpose is to improve your appearance and tightening the brow skin and elevating the brow achieves this improvement. The degree of correction varies and is influenced by the physical traits of your skin, the structure of your brow, and the procedure performed. Previously, there was only one brow lift procedure used known as the Coronal Brow Lift. This technique involved a long incision at the top of the head, through which the muscles of the forehead were modified and the brows, usually central and lateral, were elevated. Dr. Moelleken does not offer this procedure in his practice because of the length of the scar and the possibility that it will damage the sensation to the top of the head. There are many other options available today and the newer options reflect the knowledge of the importance of the hairline and preserving its natural contours. Minimally invasive brow lifts are performed through very small incisions next to the brow itself. This brow lift aims at reducing the angry or overly concerned appearance of the central brow, particularly the “frown lines”. The Brow Lift can be totally overdone and again this is where Dr. Moelleken’s artistry comes in. While some patients are very happy with Botox injections (Botulinum toxin A) every three to four months, others desire a more permanent solution and a brow lift is a good option. Also, Botox injections cannot elevate tissues the way brow lifts do because they just relieve the wrinkles in the skin caused by the muscles below.
Endoscopic brow lifts are also available and during this procedure, surgery is performed through endoscopes that enter above the hairline modifying the frown muscles and elevating the lateral brow. The brow is fixed in an up position with screws. This approach avoids the long incision at the top of the head but its results are generally less effective than other methods and prone to relapse. For selected patients, especially a patient whose hairline is already high due to previous plastic surgery or genetics, hairline brow lifts can restore a lost hairline while elevating brow tissues to a more youthful look. No brow lift is right for every patient and they all come with a series of pros and cons, which will be discussed in detail during your consultation.
Dr. Moelleken offers his patients lip augmentation through LiveFill®, or fascial-fat grafts from their own bodies (autologous nontraumatized fascial fat grafts). This method has proven very reliable at achieving soft, full results and he finds it to be much more reliable than fat injections. This is because the grafts do not need to be aspirated and injected the way fat injections do and the grafts cannot be rejected because they come from your own tissues. Dr. Moelleken cautions against the use of silicone in any form for the lips, or any semi-permanent filler for that matter. Silicone, Artecoll, and ArteFill can cause a chronic swelling reaction over the years that can become disfiguring and often uncorrectable in some patients. Even patients injected with microdroplets of silicone can develop a blunting of the vermillion border and white roll of the lip that looks as though swollen lips had been sanded down. Silicone can run downhill and cause a very characteristic “trout lip” deformity over the years and several celebrities who have had this happen to them are very public about their dissatisfaction with silicone. Dr. Moelleken says it is important to remember that anything but your own tissue has no defense against the colonization of bacteria setting up shop in or on top of the filler.
The 360 Facelift® is usually performed as an outpatient procedure under a light general anesthetic, which means you will be asleep. In some cases, a “twilight” anesthesia may be used but these techniques will be discussed during your consultation. A board certified anesthesiologist, who will remain in attendance throughout your operation to monitor your progress, will administer the anesthetic. You must be in good health to have a 360 Facelift® and if you smoke, it is imperative that stop all nicotine products four weeks prior and four weeks after your surgery. Stop taking Aspirin, Advil, Motrin and hormone supplements for 10 days prior to surgery and two weeks after you surgery as this may cause bleeding. The length of your surgery varies depending on how much work you have done. There should be a minimal amount of pain associated with this surgery but medication is available to control any discomfort. The scars left by this procedure are unpredictable and although they eventually fade, they are permanent. Swelling is mostly resolved in two to three weeks and bruising is usually localized to the area immediately beneath your eyes and the area on either side of your neck. This usually subsides within one week and it is important to remember that it will be impossible to judge the final results of your surgery until all of the swelling has subsided and the operative area has smoothed out. Recovery is the same as for a traditional face and neck lift procedure so you should be able to return to your regular routine approximately two to three weeks after your surgery