Dr. Little’s Philosophies
Loose Skin in Facial Rejuvenation
While the shape of the face and neck is of primary importance in rejuvenation, the correction of skin redundancy is also important. The most effective treatment of the jowl, Dr. Little feels, requires freeing of facial skin beyond the jowl, such that the skin and the jowl may then be repositioned in different directions; this in turn allows ready redraping of the freed skin, bringing multiple benefits to the facial complexion and surface. Dr. Little’s basic facelift, therefore, emphasizes not only alleviation of the jowl complex, but also wide redraping of the relaxed skin (in contrast to many current facelifts, which typically limit such redraping). Utilizing a tissue adhesive made largely from the patient’s own blood (platelet gel), such redraping of the skin can also be accomplished without tension, favoring correction of lax lower facial skin without over-tightening upper facial skin (a process Dr. Little calls “reversed gradient” skin suspension).
Redraping Trumps Resurfacing
Dr. Little has found that the improvements brought to the facial skin and complexion, as a whole, by such wide release (undermining) and redraping typically exceed the potential benefits of skin resurfacing (lasers, peels, abrasions, etc.) and skin care programs alone. While he finds resurfacing of the overall facial skin, therefore, unnecessary following most facelifts, he contnues to resurface the specialized skin of the eyelids in most…and of the lips in some.
Illustration:detail from Leonardo da Vinci, “Man’s Head Crowned with Laurels,” Biblioteca Reale, Milan