Extra fat has been removed from her neck, some fat has been removed
from along the jawline, and the “muscle bands” in the middle of the neck have been sutured together.

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Extra fat has been removed from her neck, some fat has been removed
from along the jawline, and the “muscle bands” in the middle of the neck have been sutured together.

A youthful contoured neck is the result.

The high cheek mass gives a youthful face its beauty and must repositioned in order to resemble the high cheek mass of youth

— a result which cannot be achieved by traditional facelift techniques.

The repositioned high cheek mass helps restore the beauty of the youthful face.

With the Composite Lift, the fat remains attached to the overlying tissues, which have been repositioned and secured to the bone of the orbit.

This assures the long-term position of these elements with very little change observed in this anatomy even ten years after surgery.

In a youthful face, the dividing line between the lower eyelid and cheek is seamless.
The Composite Facelift recreates this smooth transition by incorporating an upward
repositioning of the cheek fat and orbicularis muscle as well as with a “septal reset.”

This post-operative photo show the now seamless transition between the lower eyelid and cheek, as well as a slight upward tilt to the corner of the eye.

In the Composite Lift, the outer corner of the eye is usually tilted slightly upwards,
further reversing the downward movement of the aging lower eyelid.

Most patients like the younger look this gives, although this position can be
adjusted to suit your personal preference.

To see truly youthful changes around the eyes, the “vertical height” of the lower eyelid must be shortened. This distance, from the pupil to the cheek, is shown by the vertical line.

This element is a critical component missing from many facelift procedures.

The “vertical height” of the lower eyelid has been shortened.

* Excess upper eyelid skin has been removed. Removal of this skin may be a once-in-a-lifetime procedure, and is by far the most predictable and longest-lasting part of any facial rejuvenation surgery. This is the key to being able to wear eye shadow — to recreate a crease that serves as a platform for women to apply their makeup.

On occasion, a patient with an inherited deep area under the upper lid may not need to have skin removed.

The forehead lift enhances the upper eyelid lift, eliminates frown lines, and can reduce a high forehead.

This is the second factor in creating youthful upper eyelids, since a drooping forehead can reduce the impact of an upper blepharoplasty.

The forehead has been lifted to be harmonious with the newly positioned mid face and cheeks.

The frown muscles above the nose have been removed to prevent deep wrinkle lines. The ability to frown is minimized forever. (While Botox® injections will accomplish this as well, it requires an injection every three to four months at additional expense.)

To avoid another one of the telltale signs of facelift surgery, the earlobe must hang at the correct angle and not be pulled forward.

The incision in front of her ears is tucked inside the cartilage called the “tragus” and therefore should be hard to see.

The “lateral sweep” is the stretching of the lower face that often surfaces after a standard facelift. By lifting the skin and underlying muscle and fat of the cheek vertically, toward the eye, the Composite helps prevent this common distortion.

Not all conventional or SMAS facelifts end up with a lateral sweep, but all of them have the potential to develop this “pulled” look.

This is because the tight jawline created by repositioning the SMAS horizontally is stronger and lasts longer than the horizontal repositioning of the tissues of the cheek. The cheek skin and fat can relax in time, while the jawline remains taut. When this happens, the difference in tensions reveals itself as the lateral sweep.

Click on the image or arrows to see the rest of the benefits.

The Composite Facelift restores the original luster of your eye region with a new twist on the standard blepharoplasty. In 1995, Dr. Hamra published the original article on preserving the fat of the lower eyelid instead of the old practice of removing it. Three years later he added the “septal reset” to the procedure, to not only preserve the under-eye fat, but to reset it along with its firm cover (the septum) to a position over the orbital bone.

This creates a natural transition between the soft under-eye tissue and your cheekbone.

The septal reset was the “even better” operation Dr. Hamra advanced in 1996 and republished in 2004. He reports that he is now seeing patients with excellent results that are still stable after up to 20 years later.

A complete facelift is not always needed for rejuvenation.

This photograph records the patient ten-years after a browlift, upper blepharoplasty, and septal reset.

The septal reset produces excellent results that are still stable after many years.

This is the patient before the procedure.

The septal reset produces excellent results that are still stable after many years.

This is the patient one year after the procedure.

The septal reset produces excellent results that are still stable after many years.

This is the patient fifteen years after the procedure.

As the tissues of the cheek are lifted, they impact the tissues of the temple, which must then be moved in the same direction (vertically) as the cheek. A forehead lift is, therefore, an essential part of the Composite to prevent a bunching of skin to the side of the eyes.

By repositioning and tightening the forehead, other signs of aging in the upper face; droopy eyebrows, “hooded” eyelids, and forehead furrows — as seen in this pre-operative photograph are eliminated.

Incorporating a brow lift with the Composite does more than just do away with the worried, concerned look. When performed with other Composite maneuvers, the brow lift helps eliminate facial distortions while ensuring a pleasing, overall even look.

Disharmony may result if the forehead lift is not done and a youthful facelift is observed under an aging forehead.

The neck lift is part of every Composite Facelift and is never omitted. Individual neck anatomy varies greatly, but it can always be improved. If the neck fat is too thick, as in this pre-operative photograph, it can be reduced to a normal level.

Excess fat is reduced to a normal level.

Some patients have no extra fat, but have prominent bands of platysma muscle visible at the front of the neck. The loose skin and muscle seen in the upper pre-operative image are tightened by the neck lift as shown in the lower image.

Dr. Hamra always tells patients that the neck changes are never as impressive as the face. This is because the skin of the neck is positioned over a “hinge joint” and, like the knee and elbow, this elastic skin may look tight or loose depending on the way you tilt your head in flexion (head toward the chest) or extension (looking upward).