Dr. Little’s Philosophies
Solid Implants in Facial Rejuvenation
The use of foreign (non-autologous) substances in the aging face to improve volume and appearance is a strategy that has been around for many years, and some facelift surgeons are quick to turn to such solid implants as another easy way to boost or even exaggerate facial contours during facelift surgery. Dr. Little has almost eliminated such “solid foreign-body” augmentation from his practice, preferring instead the subtler contours of tissue shifts and structural fat grafting. Thus he no longer finds cheek or “tear trough” (lower lid) implants necessary and only occasionally utilizes chin implants (typically in patients with a life-long concern about a significant “weak” chin). While many patients benefit from an alteration to their aging chin contour, Dr. Little most often accomplishes this through a combination of fat grafting and his “mentalis hitch” (simple internal elevation of the chin pad, performed through the mouth).
Illustration: Leonardo da Vinci, “Geometrical figure in perspective,” ca. 1510, Codex Atlanticus, fol. 709r (ex 263r-d), Biblioteca Ambrosiana, Milan