Hollywood bigwig Renee Zellweger, 45, looks way different now from her Bridget Jones’s look that some fans and showbiz bloggers were quick to speculate that she had a series of facial plastic surgery right before attending Elle’s 21st Annual Women in Hollywood Awards that was held a few weeks ago.
The plump cheeks that were once her signature look are nowhere to be found, her eyes seem to appear wider, and her forehead looks a bit higher, prompting some celebrity plastic surgery experts to conclude that she had a brow lift surgery alongside some minor facelift and probably Botox injections.
Some doctors believe the actress had a poorly done brow lift because it resulted in a forehead that appears higher, while her eyebrows, which were once arching, now looks too straight and unnatural. However, some experts have speculated that too much Botox injection could also be the culprit.
Dr. Tarick Smaili, a leading LA plastic surgeon who has no personal connection with the star, says that brow lift must only be done in a conservative manner—i.e., minimal skin resection and pulling—to achieve results that look natural and to preserve the natural height of the forehead and the normal appearance of hairline and ears.
But other people believe that the actress’ new look could be a combination of the natural aging process and makeup trick, rather than extensive facial plastic surgery.
Meanwhile, the Chicago actress was quick to dismiss rumors of her plastic surgery as nothing but rumors, attributing her new appearance to her healthier lifestyle and more positive outlook in life.
In her past interviews, the actress had also denied reports suggesting that she had an eating disorder and called these rumors as “very unfair and disappointing.”
In the truest sense of the word “facelift,” it is a surgical procedure that uses hidden incisions to reshape the facial skin, fat, and muscle to minimize the wrinkles and saggy appearance.
As with any surgical procedure, facelift entails that a patient is physically fit and is not suffering from any medical condition that could jeopardize her recovery or lead to undue risk, explains leading plastic surgeon Dr. Tarick Smaili.
Simply put, a facelift surgery is reasonably safe if performed on the right patient.
To assess the overall health of a patient, the renowned surgeon says that facelift always involve lengthy consultation between the patients and their doctors, blood work, and lab tests.
In some instances, facelift surgeons work closely with their patients’ general physicians to further make the surgery safer. This is particularly true for older individuals who want to undergo an elective plastic surgery.
Because a normal healing is one of the most important requirements, current smokers and users of blood-thinning medications (e.g., aspirin and ibuprofen) are generally not allowed to have any elective surgery because they are at higher risk of increased bleeding, skin necrosis, and longer recovery.
However, smokers who agree to quit the habit at least three weeks—or preferably longer—before an elective surgery may be allowed because at this stage the body has flushed out most of the detrimental effects of tobacco products, including those of a nicotine.
The nicotine is particularly detrimental to one’s healing because it shrinks the blood vessels, thereby affecting the normal flow of blood going to the wound. As a result, smokers take longer to heal than non-smokers and they are also at higher risk of developing skin necrosis or death of tissue that may lead to unnecessary scars.
To further make the surgery safer, Dr. Smaili highlights the importance of limiting facelift or any other type of surgical enhancement just under six hours, particularly if done under general anesthesia.
While combining facelift with other facial rejuvenation surgeries such as eyelid lift and brow lift is a cost-effective approach, the “six hour limit” still applies to avoid high surgical trauma, increased bleeding, and higher risk of toxicity.
The surgical setting also plays an important role in making facelift reasonably safe. It is important to note that board-certified plastic surgeons, Dr. Smaili says, only perform their operations at a hospital or accredited outpatient surgical center.
Standard facelift surgery uses a temporal incision behind the hairline that extends around the ear and ends in the lower scalp, allowing the surgeons to lift the saggy skin and soften the appearance of deep wrinkles.
The incision placement not only allows the surgeons to reduce the signs of facial aging, but it also ensures the scar is hidden from plain view. To further hide its appearance, skilled doctors also remove or at least minimize the tension on the skin and go deeper into the facial layers.
But one challenge facelift surgeons face is the receding hairline or baldness, which entails using a shorter or different pattern to make the scar inconspicuous, explains facial rejuvenation expert Dr. Karan Dhir.
Men are more commonly affected by hair loss problem than women, although the advantage is that most patients only need a small amount of lift in the upper thirds of the face to achieve natural results and avoid the “surprised” appearance.
Instead of using a standard facelift technique (which only targets the mid and lower face, possibly including the upper neck area), patients with receding hairline may benefit more with an incision technique that only goes around their ear, specifically within its natural skin fold.
Another type of “mini” or “isolated” lift that may be appropriate for patients with hair loss problem is an endoscopic brow lift, which only targets the signs of aging in the upper thirds of the face—i.e., horizontal forehead creases, vertical frown lines between the brows, and saggy eyebrows.
An endoscopic lift uses a fiber-optic camera attached to a monitor, allowing the surgeons to shorten the incision and as well as the scar, which is perfectly hidden as long as there is some hair left in the temple region.
But Dr. Dhir warns that a type of mini lift called coronal brow lift surgery does not favor patients with a receding hairline because it may further “raise” their forehead, which could have a “feminizing” effect on the male face.
As its name suggests, the coronal brow lift uses an incision that lies across the crown of the head, behind the hairline. Aside from the long scar, the technique could inadvertently result in higher-than-usual forehead, which may look unflattering.
Because aging happens differently from patient to patient, the renowned surgeon says that a cookie-cutter approach in facelift is not the way to achieve natural results.
Forehead lift, also referred to as brow lift, is more commonly known as a cosmetic plastic surgery that minimizes the signs of aging in the upper thirds of the face. However, an article published in Plastic and Reconstructive Surgery medical journal has suggested that it could also provide migraine sufferers “excellent relief” from their symptoms.
The article, which was based on anecdotal reports provided by some plastic surgeons, has suggested that a forehead lift could reduce “temporal migraine headache’s (TMH) frequency, duration, and severity.”
The study involved 246 patients who had a procedure called “surgical deactivation” between 2000 and 2011, which was developed after some migraine patients had reported reduction in their symptoms following a cosmetic forehead lift.
The researchers have concluded that patients with TMH experience regular chronic headaches due to muscle contraction around a specific nerve located at the temple area. By releasing or disconnecting this nerve, they said that it could prevent migraine or at least reduce its frequency and severity.
Because any surgery is considered invasive, proponents have suggested to first use Botox (botulinum toxin A) to determine if the surgical deactivation approach could be a viable option for a migraine sufferer.
Meanwhile, most patients who had temporal migraine surgery also received the same procedure on the anterior part of their forehead. According to study, 85 percent of respondents rated their operation successful, with at least 50 percent improvement in TMH, while 55 percent of them said their temporal headaches were completely eliminated.
Aside from chronic headaches, patients have reported relief from blurry vision, drooping eyelid or ptosis, and lack of concentration.
Previous studies have suggested that some forehead lift patients experienced less frequent migraine and its related symptoms. Several doctors said the sagging facial tissue may be causing irritation to and/or pinching some “trigger” nerves that leads to the problem.
The standard facelift surgery only lifts the sagging skin starting from the lower eyelids down to the upper neck area. It does not involve the upper thirds of the face (i.e., forehead), the loose skin in the upper eyelids, and loss of facial volume or fat.
While as a stand-alone procedure facelift can still create a dramatic result, some patients want a more balanced, youthful appearance which can be achieved through ancillary procedures, explains Dr. Karan Dhir, a leading facial plastic surgeon based in California.
Volumizers are used to correct the gaunt appearance caused by loss of facial volume. And with the advancement in plastic surgery, patients can choose from a wide range of options including injectable dermal fillers, natural fat graft, and facial implants.
Facial implants are suitable if one needs large augmentation to correct the recessed chin or hollowed cheeks. Injectable dermal fillers and fat graft, meanwhile, are more ideal if the patient needs to correct their age-related gaunt appearance.
* Eyelid surgery or blepharoplasty
As its name suggests, the procedure rejuvenates the eyes by removing the excess skin and fat in the eyelids. But to achieve a long-lasting result, it is often necessary to go deeper into the “structure” to tighten the tissue and muscle.
For some patients, a better result is achieved if the excess fat in their lower eyelids is redistributed rather than completely removed. With this approach, the hollowed appearance in the area could be avoided.
* Brow lift surgery
The procedure, which is also referred to as forehead lift, corrects the low-lying brows and the creases across the upper thirds of the face. But to achieve natural results rather than a tight appearance, any prudent surgeon raises the area by just a few millimeters.
* Skin resurfacing
Loss of volume and soft tissue laxity are not the only manifestation of facial aging. According to Dr. Dhir, the appearance of skin also plays an important role to create a more youthful countenance, thus many facelift patients also benefit from minimally invasive procedures such as chemical-grade medical peels, laser treatments, and dermabrasions.
The primary goal of skin resurfacing treatments includes the reduction or removal of sun spots and other discoloration, superficial wrinkles, and leathery appearance.
To preserve the results of skin resurfacing treatments, the patient needs to practice good skincare that includes regular use of sunscreen and moisturizers and maintenance of a healthy lifestyle.