logo

Help SUPPORT Miss J's Forum by shopping through: Miss J's AMAZON PORTAL

Welcome Guest! To enable all features please Login.
Registrations are CLOSED. Please see this topic for more information.

Notification

Icon
Error

4 Pages<1234>
Options
Go to last post Go to first unread
Offline Mike D  
#16 Posted : Monday, April 18, 2016 10:27:25 PM(UTC)
Rank: Advanced Member

Joined: 7/24/2008(UTC)
Posts: 3,062
Location: Between the moon and NYC
P.S. I don't necessarily agree w/ the Baker quote, but his article does bring up some good pts.
Offline lamb  
#17 Posted : Monday, April 18, 2016 10:53:09 PM(UTC)
Rank: Advanced Member

Joined: 2/16/2009(UTC)
Posts: 1,201
Many thanks for that explanation Mike. I have the thin/long face, and I remember Marten mentioned folding or rolling (i can't remember the term he used) the SMAS on the cheeks when I saw him. he said he wasn't sure it would give me what I want but I did note it.

Is 'stacking' the same as 'folding/plication'?

I'm not sure I quite know what Baker means by that, like he augments the whole face with the SMAS? interesting.

great link too, i will read it.
Offline Sarah W  
#18 Posted : Monday, April 18, 2016 11:57:29 PM(UTC)
Rank: Advanced Member

Joined: 6/4/2008(UTC)
Posts: 9,121
Woman
All the b and a's look very natural
Offline Mike D  
#19 Posted : Tuesday, April 19, 2016 7:31:22 AM(UTC)
Rank: Advanced Member

Joined: 7/24/2008(UTC)
Posts: 3,062
Location: Between the moon and NYC
Originally Posted by: lamb Go to Quoted Post


Is 'stacking' the same as 'folding/plication'?

I'm not sure I quite know what Baker means by that, like he augments the whole face with the SMAS? interesting.

great link too, i will read it.



The stacking in Marten's case isn't the same as plication. Plication doesn't involve cutting into and undermining the SMAS. What Marten probably proposed for you was to cut into and undermine the SMAS, elevate it to its new position, and instead of cutting off the excess, he would fold it onto itself to create cheek definition. That's like Stuzin does, too. You could also add fat grafting if you had a thin face.
Offline Chris K  
#20 Posted : Tuesday, April 19, 2016 10:36:46 AM(UTC)
Rank: Advanced Member

Joined: 5/17/2008(UTC)
Posts: 8,602
Woman
Location: miss j's board
i see so much of Baker's work and his lifts look 'incomplete' to me. like one 'plane' OR 'vector' is pulled and others look relaxed. his lifts don't look whole or cohesive.


i think the reason he got so famous was because he was the nyc antidote to being over pulled. his lifts don't look totally unnatural but they don't look good either. i think his work is sloppy at this point in his career. time to retire.
Offline lamb  
#21 Posted : Tuesday, April 19, 2016 11:41:38 PM(UTC)
Rank: Advanced Member

Joined: 2/16/2009(UTC)
Posts: 1,201
Thanks that sounds about right. That's what you were referring to as 'imbiracation'?
Offline MissJ  
#22 Posted : Wednesday, April 20, 2016 12:51:56 AM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 26,549
Mike has done a good job explaining this. I will add that some familiarity with SEWING and how to affect different contours with the fabric you're working with might help with the concepts.


Plication refers to the act of folding the (SMAS) tissue onto itself without cutting into it to make the folds. It's a way of tailoring excess tissue for better (facial) contours. I don't know if you've sewn a dress from a pattern, but one example of it is making (a) DART/S; wedge shaped folds that converge at a point to tailor the material to the bust line where you want to take in the material in some places without cutting it out. It's the act of tapering unwanted droop or drape somewhere so a wanted curve can be accentuated. In face lifting, there are Ways of folding it to engage lifting in the wanted direction where you want to shrink an excess somewhere and to give added thickness somewhere else with the excess. For example, you might want to shrink the excess BELOW the cheek bone area and recruit it to the cheek bone area which they can do by making a series up upward diagonal dart maneuvers. So, you get an inward tapering effect below the cheek bone and more thickness to the cheek bone area with aim of upward diagonal flow in frontal view and better ogee curve in oblique view.


Imbrication can also refer to overlapping tissue but involves cutting into the SMAS (or dissecting it), first. They can pull at the flap to smooth out and lift the tissue in the desired direction and then fold the excess onto itself in a place where the excess of it would look good. There is also the option of cutting off the excess if doing so would look better.

Regarding Martin, that's basically what is being referred to when he speaks of the 'High SMAS' lift. Not sure BUT I think pulling at the SMAS (after dissecting it) is better done with younger patients. With aging, it can get kind of 'ratty' such that pulling at it to lift it up can tear it. Maybe that's why Baker (who gets older patients) likes to plicate it and Marten (who gets younger ones) has good success dissecting it ,pulling at it and then folding the excess over itself (imbrication).

SMASectomy can be done to reduce folding to an area. Baker is known to cut out an 'L' shaped section of the SMAS near the NLF to to help smooth out the nasio labial fold. When he says not to do a SMASectomy for the THIN FACE patient, I believe he's referring to the sides of the face. They can still do one to a thin face patient who has a prominent NLF. It depends where it's done.

The acts, themselves called 'plication', 'imbrication', 'SMASectomy' don't really tell you where something is going to be folded, cut into, pulled at , cut out or displaced. Think of them as surgical maneuvers that resolve to SEWING TECHNIQUES used to CUSTOMIZE the TAILORING of the face. That's why the general advice is to pick the doctor, (outcomes he/she kicks up) not the technique.

With regard to some lifts that are marketed with catchy names and kick up a nice initial result, those are often done via purse string suture technique; run the suture through an area, pull at it and as the tissue bunches up, it can affect a lift to wanted places. Then they hoist what they lifted to a secure area to hold the thing up under tension.

Plication (folding) techniques are more time consuming to do because the fold overs need to be smooth transition, flat layering and you got to keep folding and folding (darting and darting). Also, plication does not kick up a lot of tension as does a purse string suture. Although, a purse string suture, hoisted up under a lot of tension and with a permanent suture can give a great tightening effect in the beginning, later down the line, you might see some 'ruffling' underneath (if you don't have a good skin thickness to hide it) OR if the result depends TOO MUCH on the tension and pulling on the SMAS via the hoisted up purse string suture, the suture is going to be stronger than the tissue it's holding up and can 'cheeze wire' through the SMAS if they try to lift up too much tissue with that technique alone.
Miss J. Seeing eye companion to the aesthetically blind since 1998.


If reading these posts has been helpful to you, consider helping out the board by purchasing via my AMAZON PORTAL seen at the top of each page.

Sales DIRECTLY from here help defray costs of this board. (Works for US residents only.)
Offline lamb  
#23 Posted : Wednesday, April 20, 2016 1:30:45 AM(UTC)
Rank: Advanced Member

Joined: 2/16/2009(UTC)
Posts: 1,201
Fantastic MissJ and Mike.

Is there a reason why some docs prefer plication over imbrication? Seems like there would need to be cutting of the SMAS at some point in a FL.

Offline MissJ  
#24 Posted : Wednesday, April 20, 2016 10:39:57 AM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 26,549
Well, the article Mike cited has Baker saying that pulling of the SMAS (after dissecting it) can sometimes tear it. I also said something about that in my post and mentioned that perhaps it relates to older people having more fragile tissue there.

I also mentioned that the act of folding the SMAS onto itself in a consecutive pattern of 'darting' like folds helps affect the shaping of the face.

So, preference of the doctor would resolve to what would work best for the contour they want to achieve for the patient and also if the patient's SMAS was 'strong enough' to pull at without breaking.


Originally Posted by: lamb Go to Quoted Post
Fantastic MissJ and Mike.

Is there a reason why some docs prefer plication over imbrication? Seems like there would need to be cutting of the SMAS at some point in a FL.



Miss J. Seeing eye companion to the aesthetically blind since 1998.


If reading these posts has been helpful to you, consider helping out the board by purchasing via my AMAZON PORTAL seen at the top of each page.

Sales DIRECTLY from here help defray costs of this board. (Works for US residents only.)
Offline lamb  
#25 Posted : Wednesday, April 20, 2016 12:31:58 PM(UTC)
Rank: Advanced Member

Joined: 2/16/2009(UTC)
Posts: 1,201
I see now. Thank you for clarifying that MissJ.
Offline eden  
#26 Posted : Saturday, April 23, 2016 7:08:01 AM(UTC)
Rank: Member

Joined: 5/15/2008(UTC)
Posts: 618
Woman
Originally Posted by: Beholder Go to Quoted Post
Anyone heard of Dr. David Harley from Ashville NC? He does this mini type lift and has such outstanding reviews that I can't quite belive it that he doesn't have one negative review. That puts me on guard. The procedure is relatively quick and inexpensive so that leaves me wondering. I've been told that these mini lift/short scar procedures don't hold up.

Has anyone had the Biltmore lift with Dr. H? Has it held up?


www.harleymd.com/mini-lift.shtm





Gee my friend is planning to go to him December, she has spoken to sooooo many people that simply love their face. I don't know, I hope she is not going to make a mistake. They claim his lifts last 10 yrs...
Offline Zoey  
#27 Posted : Saturday, April 23, 2016 8:45:00 AM(UTC)
Rank: Advanced Member

Joined: 12/5/2008(UTC)
Posts: 1,560
Well keep us posted. It seems as though people from all over the US are going to him. Is your friend local to him or is she traveling?
Offline Sarah W  
#28 Posted : Sunday, April 24, 2016 2:19:31 AM(UTC)
Rank: Advanced Member

Joined: 6/4/2008(UTC)
Posts: 9,121
Woman
It sounds amazing. I just cannot see how he can perform it in 2 hours~
Offline eden  
#29 Posted : Sunday, April 24, 2016 5:56:15 AM(UTC)
Rank: Member

Joined: 5/15/2008(UTC)
Posts: 618
Woman
Originally Posted by: Zoey Go to Quoted Post
Well keep us posted. It seems as though people from all over the US are going to him. Is your friend local to him or is she traveling?





she lives in NJ we will see, she spoke to so many people that did it with him, so it looks like she they even book condo's together and split the bill...she is meeting another woman there and doing that.
Offline MissJ  
#30 Posted : Sunday, April 24, 2016 1:05:28 PM(UTC)
Rank: Administration

Joined: 5/14/2008(UTC)
Posts: 26,549
My 'hunch' is that the purse string suture technique is used to tighten and hoist things up in the face as is the case with a lot of these 'quick lift', no general anesthesia, office based techniques. But instead of depending on them to ALSO bring the neck into the lift, the neck is addressed separately so it's lift is not dependent on that suture technique. Basically, when purse string suture technique is depended on to hoist up BOTH the face AND the neck, the tension to do it exceeds the strength of the tissues being held up and the sutures can 'cheese wire' through the tissue. The 'Life STyle' type lifts that hoisted up both the face and neck with purse string suture technique took about an hour to perform. BUT often cheese wired through the tissue later down the line. So purse string suture technique can work when it's NOT also depended on to lift the neck. Hence, for 2 hours, my guess is that he's using purse string suture technique for FACE with separate treatment of the neck. Separate treatment to the neck can be done via an incision under the chin and through the incision made at the back of the ear.

Disclosure: I DON'T know what technique he is using. This is just a (logical) guess as to why he can do his lift in 2 hours.


Originally Posted by: Sarah W Go to Quoted Post
It sounds amazing. I just cannot see how he can perform it in 2 hours~
Miss J. Seeing eye companion to the aesthetically blind since 1998.


If reading these posts has been helpful to you, consider helping out the board by purchasing via my AMAZON PORTAL seen at the top of each page.

Sales DIRECTLY from here help defray costs of this board. (Works for US residents only.)
Users browsing this topic
Guest (2)
Previous Topic Next Topic
4 Pages<1234>
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.