For patients desiring to achieve a younger, natural-looking facial rejuvenation, Miami plastic surgeon George M. Varkarakis, MD says one must approach aging in a three-dimensional way. “Aging does not only occur due to loss of the support of the soft tissues of the bone, but also due to fat and bone loss. I address these concerns by not only repositioning the tissue and muscle, but also by restoring volume using my special fat grafting method.”

Dr. Varkarakis completed a fellowship in craniofacial surgery at the Craniofacial Center in Dallas, TX, where he honed his skills in facial surgery. Among his specialized techniques, he counts performing surgery using local sedation and his unique way of preparing fat as two major factors in achieving beautiful, elegant results that enhance each patient without making them look unnatural or too pulled.  

What are the key ways you address facial aging when performing your facelifts?

Dr. Varkarakis: There are two things happening with facial aging: one is the loss of volume and the second is the loss of the support of the soft tissue from the bone. The way we manage this is by repositioning the soft tissues with sutures adding fat to fill the void and to address the foundation. It’s important to address the bone structure as well. For example, the mandible, when you have a small jawline, then augmenting that with a fat graft is going to improve the result because I will do the plication or the suturing of the SMAS layer over that augmented jawline.  

How does performing your facelifts with local anesthesia help you achieve a more natural-looking result?

Dr. Varkarakis: While I’m operating, the patient is smiling, so I can see the natural movement of the face and reposition with a good predictability of the outcome. I can see how the facelift and necklift are looking and make adjustments during the surgery. When I’m repositioning the SMAS and the platysma, it’s done with a patient in the sitting position so I can see exactly how the final outcome is going to look; they can animate their features and I can get a similar view from one side to the other and tighten and adjust the midface or the neck based on what the patient needs.

How does your fat grafting technique helps create long-lasting, youthful results?

Dr. Varkarakis: My expertise in fat grafting for the face stands out, not only because of my technique for injections, but also because of the way I’m harvesting and I’m processing the fat. This special way of liposuction is important for its long-term survival. First, I harvest excess fat from another area of the patient’s body, purify it, and then inject it into areas such as the jawline, cheeks or chin for the most refreshed and naturally youthful outcome.