Facelift Before and After

Facial enhancement is a complex art and, if performed correctly, won’t result in a tight, pulled, or unnatural look. This is where Dr. BYUN’s extra training in facial enhancement is crucial. As the leading expert in his field, Dr. BYUN recommends customized variations of this procedure for a refreshed, restored, and natural look. Plan out a time for rest and recovery, then return to your daily routines with a new outlook and confidence.

Dr. BYUN says, “Stop Everything!”

Dr. BYUN has been teaching this very simple, yet important concept for over 25 years; “STOP Everything and JUST Age!” Don’t let bad cosmetic procedures be performed on you because you will be chasing problem after problem until you’re no longer recognizable. Dr. BYUN teaches this to everyone he can including his students and residents at Northwestern University. Yes, everyone ages. But every ‘minor’ cut, pull, injection and fat transfer add up and negatively affect one’s ‘normal aging.’  No, you don’t have to age like a grandma, you can age gracefully with a Face Restoration, which is 180° different from a Facelift. The popular buzzwords such as vertical lift, deep plane lift, etc are all pulling the tissues apart from where they came from. Fat grafts leave lumps and migrate south, especially with multiple treatments. Man made pharmaceutical products should NOT be stuffed into the face due to making the face heavier thus expediting the aging process. PDO threading and skin tightening lasers all create scar tissues and damage your tissues.

ALL of these nonsensical procedures should be stopped immediately. Surgeons, dermatologists, and other related titles should honor human facial tissues, not pump them up, burn or destroy them. Do NOT let any surgeon pull your facial tissues away (up and sideways), and definitely do NOT let them add anything to, or subtract anything from your face. The only way Plastic surgeons should be repairing the face is by placing the tissues back to where they came from. DIRECTION is what has Dr. BYUN standing out amongst his peers. While 99% of surgeons will pull the skin, muscles, and other tissues up and away (towards the ears), Dr. BYUN places the muscles back up and IN towards the MIDLINE of the face; back to where the muscles fell from in the first place, honoring the orientation of the tissues, their insertion, and origin of muscle fibers. He does not pull them away, but telescopes them back into layers. Dr. BYUN visualizes the aging muscles from underneath via endoscope during this procedure. He sees facial tissues from the inside out, not the outside in. This is the most physiologically correct way to repair the ‘aging’ face. 

Dr. BYUN is considered a global expert and leader in facial enhancement procedures. Aging normally over the next 20+ years after the repair is the true BYUN difference.

You may be wondering, how is he the only surgeon using this technique? The answer is found in the before and after photos of many surgeons. Other surgeons choose to showcase very young patients and neglect to show how they age over time. Their faces aren’t restored, if you look closely, you can see the patient’s displaced muscles. They can look “good” for a short period of time due to swelling, and the temporary benefits of fat grafts and/or fillers BUT, eventually, they age into an abnormal face.

If you have these above issues, you will be a good candidate for Dr. BYUN’s restorative repair surgery. If you have been delaying face surgery because you have seen so many bad facelifts out there, you have come to the right source. Dr. BYUN will honor your tissues and put your aging tissues back to their native position, so you will look normal and age normally forever.

Dr. BYUN’s Midface Technique was presented at the national meeting of Plastic Surgery.

The technique was featured as a video at the American College of Surgeons at the Orlando meeting May 1998.

The delicate aging process of the midface involves the relationships between the lower eye, the cheek area, and the corner of the mouth. Thus, the process of one area affects the other.

The concept of Dr BYUN’s facelift is to restore the natural youthful disposition of the cheek by elevating the descended malar cheek pad through very small incisions therefore helping to reshape the central face and achieving a revitalized look.

Unfortunately, ear lobe cannot be cut and replaced, skin and muscle inferior to the ear lobe have to be lifted to reduce tension along the ear lobe. This is the reason why quick skin based facelift will always cause a bad appearance of the ear lobe. Good news is it can be corrected with midface facelift or muscle based facelift along with the ear lobe.

He has been the pioneer and one of the very first to work on mid facelift or muscle lift of the face since 1997. As a matter of fact Dr. BYUN was the first to perform the surgery at Northwestern University in 1998 and his video of ‘VECS’ was first presented to the American College of Surgery in 1998. His presentation of Vertical lift, Endoscopic assisted, Composite muscle flap Suspension technique (VECS) was its first at Chicago plastic surgery meeting in 1998. He has been perfecting his method of face muscle lift since then, now almost 20 years.

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What Exactly is a Facelift?

The way that the industry defines a ‘facelift’ is all too vague.  Between extreme commercialism and gimmicky marketing, the term facelift has actually become quite confusing.  We can, however, gain some clarity, but only when proper terminology is applied.  This article will help the reader categorize the vast number of confusing facelift terms and be able to identify which procedure may actually be right for them.

The real way to categorize facelifts is by these FACTORS:

  1. Anatomical Site/Region
  2. Anatomical Layers/Depth
  3. Fixation Method
  4. Direction of the Repair
  5. Injection Method (what goes inside)
  6. Method of Exposure

Let’s dive in…

1. Facelift, is a face lift.

You are lifting something.  What are we lifting?  That depends on what Anatomical Site or Region is the focus:

Midface Lift, is lifting the mid part of the face (cheek & under eye).
Jowl Lift, is lifting the muscles near the mandible.
Neck Lift, is lifting regions of the neck. 
Brow Lift, is lifting the upper part of the face (eyebrow & forehead).

These terms are used to define anatomical regions of the face. 

2. This category is very important for the consumer or patient to visualize and understand; the Anatomical Layer, or Depth of the Facelift.  People often talk about Deep Plane Rhytidectomy vs Superficial Facelift vs the Mini Facelift. Confusing right? Let’s zoom out; Starting from the outside of the face (skin layer), we can then move deeper through the layers of tissue and stop at the skull (bone layer).

As a rule of thumb, Superficial Facelifts are defined by the dissection being below the skin, but above the muscle. A Skin Facelift only goes as deep as the subcutaneous level. Other examples include, the Mini Facelift, Subcutaneous Level Facelift and the Ponytail Lift or the Ponytail Facelift. No matter who does it and no matter what commercialized terminology the procedure has, facelifts involving skin and fat layers will always be a very superficial lift, as these are not lifting the muscles.

The problem with just pulling and fixating these layers without carefully separating them causes abnormal scarring due to uneven tension. This also interferes with normal aging. The layers above should all be independently moved up as a flap and independently secured. For these reasons, Dr. BYUN does not endorse any of the above procedures.

A Composite Lift, includes multiple layers -skin, fat and muscle. As we move deeper to the muscle layer, common facelifts you will hear about are SMAS (superficial musculoaponeurotic system), which is the top of the muscle that’s lifted.  A Deep Plane Facelift is a dissection under the muscle. Subperiosteal Lift, is a dissection below the muscle and the periosteum, which makes it the deepest level, right above the bone. These terms are used to define the depth of the procedure.

Dr. BYUN’s facelift utilizes all of these layers. So simply asking your doctor “what level are you dissecting to?” can help the patient see through the commercialized terminologies.

3. The third part of the differentiation is the Method of Fixation. Therefore, how do you get the layers to stay exactly where you want them?  Most surgeons are using absorbable sutures, permanent sutures, or staples.  You also need to ask your doctor “what fixation method will be used?”  This is where the following terms come from:

Suture Lift, which is using a suture under the skin to temporarily lift and tighten the skin. Often referred to as a Lunchtime Facelift. A Feather Lift is when threads are inserted in the subcutaneous level to temporarily lift sagging skin. PDO Threads or the PDO Thread Lift, use dissolvable sutures to temporarily and lift the skin.

These terminologies are basically describing the fixation, material, and method. So does it really matter? Yes, but very impartially. Because every surgeon has a way to fixate the layers that they separate at the regions described above. Since the beauty industry has started reaching outside of their area of expertise, they have come up with sensationalized and highly commercialized phrases. These are all discouraged by Dr. BYUN. Some of the most common lifts using these methods are: the Lifestyle Lift, the Weekend Facelift, or Weekend Lift, MiniLift, or Mini Facelift, Quick Recovery Lift, No Scar Lift, and the list goes on. These are examples of more gimmicky phrases that consumers should not pay attention to as they are not true facelift techniques.

4. The Direction of the Repair is very important and it’s what truly separates Dr. BYUN from the masses.  As we age our muscles move Down and Out, to reverse this, Dr. BYUN repairs Up and In. Tissues that have aged are reversed, meaning that tissues are NOT pulled laterally (out/away), but rather they are pulled medially (up/in). Ask your surgeon, “What direction are you pulling the muscles?” If the answer is up and away or up and out, you should run up and out of that surgeon’s office. Many surgeons use the term Vertical Facelift. This means that they move the tissue layers up. Because most surgeons want to get rid of all the wrinkles, they pull up and lateral (out/away) towards the ears causing distortion. Dr. BYUN utilizes the Vertical method, BUT he is about the only one who pulls the muscles back to the midline.

5. Whether or not a surgeon utilizes an Injection Method is helpful to ask. Liquid Facelifts utilize synthetic, man made fillers, which cause complications such as migration and lumpiness.  Fat Graft Facelifts cause lumpiness and calcifications. A Microfat Facelift, or Emulsified Fat Graft although sound good, will eventually meet the same fate as the Fat Graft Facelift. This set of terminologies describe the materials used and not the region, layer, or fixation method. So, what does that mean? Simply, they are not true Facelift methods. It goes without saying, but Doctor BYUN does not recommend any of these methods, he believes that for the most natural results, volume should not be added or subtracted from your face, but only repositioned.

6. The final part of the differentiation is the Method of Exposure. Most of the time, the method is open. This means the surgeon creates large incisions in the front of the ear, the back of the ear, and down the hairline on the forehead.  This is the traditional technique and is NOT recommended by Dr. BYUN. Here are a few terms that describe an Open Facelift: Short Scar Facelift,  S Shape Facelift and Limited Incision Facelift.  Alternative to the Open technique is the Endoscopic technique. The Endoscopic Facelift, is when an endoscope (small thin camera) is utilized to work on hard to reach areas. This technique utilizes very small incisions.  These terminologies all describe how much of a cut is required to do the procedure and is heavily dependent on the surgeon’s skill level. Dr. BYUN’s opinion is that less skilled surgeons will make larger incisions, or open the skin more.

The BYUN Difference

Since almost all of the techniques mentioned above aren’t able to correct the main reason for a facelift, (the aging/sagging muscles) Dr. Michael BYUN created his own technique over 25 years ago at Northwestern.  He was able to recognize that the way facelift procedures were being performed was quite wrong and didn’t fix the root of the problem. Traditionally, surgeons are taught to pull the skin, fatty tissues and muscles Up and Away. Doing this brings the muscles to a non-native and therefore non-natural location on the face. Because muscles aren’t placed back to where they started to fall from, surgeons resorted to shoving fat grafts and fillers into places where the muscles should be.

With Dr. BYUN’s repair, he simply dives underneath the muscles and repositions the muscles back to their origin. His technique not only leads to results lasting 10+ years, but patients look natural, they age more gracefully and most importantly, they look like themselves!

With all of this information drawn out, you can start to see the magic of the BYUN difference; let’s break down his methods using the guidelines above:

  1. Dr. BYUN loves to do “The Works” for patients which includes the whole face and neck. He has broken the face into four (4) different zones so that patients can still benefit from having his repair work done even if it’s not for the whole face and neck.
  2. As for the layer, Dr. BYUN has all the layers covered. He separates the SMAS that’s above the periosteum and works in the supraperiosteal layer which is essentially a deep plane or a Supraperiosteal Facelift. The skin is secured tightly enough to show off the new muscle form, but loose enough to not cause any scar spreading or tissue damage.  Dr. BYUN was one of the first to describe the VECS Lift (vertical endoscopic composite system). This utilizes deep plane rhytidectomy, SMAS, skin and fat lifting techniques.
  3. Dr. BYUN uses a very special multi-suture securement method as he places the muscles back onto the bone they fell from.
  4. By far the most important differentiation of a BYUN facelift is the direction of repositioning. We age Down and Out, he repairs Up and In. Tissues that have aged are reversed, meaning that tissues are NOT pulled sideways, but rather they are pulled back to the midline. Since he is leading the way and is the ONLY one restoring the face in this way, this is Dr. BYUN’s contribution to the field of plastic surgery and he hopes to one day win the Nobel Prize in Medicine.
  5. It goes without saying, but Doctor BYUN does not recommend any injection methods, he believes that for the most natural results, volume should not be added or subtracted from your face, but only repositioned. Like a squeeze ball that has been squeezed from the top and pouches out the bottom, to restore the structure, one must squeeze the bottom to restore the contents back up to the top. This mirrors the aging process, as we age our muscles succumb to gravity and move down and out. Therefore, the most physiologically correct way to restore the face is to bring the contents back UP and IN; but no other surgeon is doing this! Other surgeons pull muscles to a third location (UP and OUT). This distorts the face because muscles are no longer in their native location, to counter this, they will fill the face with fat graphs and fillers to try to create a more normal bulk appearance of where the muscle SHOULD be. Over time, fat grafts cause lumpiness and fillers migrate, both causing heaviness to the face and thus age it more rapidly.
  6. A big aspect of the BYUN difference is that he uses small incisions with the endoscopic technique.  Even with this challenging technique, Dr. BYUN can perform an entire face and neck lift. He was one of the first surgeons to use a small endoscope back in 1998 at Northwestern University.

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In The Media

What You Need To Know Before Getting a Facelift

Six things to be aware of before going under the knife.

When the Young, Bright Prodigy Evolves into the Great Seasoned Master

Dr. Michael BYUN is a serious doctor with seriously comprehensive experience unlike many of his peers, setting him heads and shoulders above the rest.

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Chicago magazine profile of Dr. BYUN.