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by Schae Kane

Plastic Surgery Practice magazine

An artist’s eye is critical to the entire aesthetic process.

Christian G. Drehsen, MD
Tampa, Fla

Christian G. Drehsen, MD, has been practicing in the Tampa Bay area for more than 20 years, and is one of Florida’s most renowned and respected surgeons. Certified by the American Board of Plastic Surgery, he has dedicated himself to the specialized field of cosmetic surgery, and is one of Florida’s leading cosmetic surgeons.

Born in Belgium, Drehsen received his Bachelor of Science and attended medical school at the University of Brussels. Upon completion of his Doctorate of Medicine, he came to the United States, where he followed a comprehensive medical training program in all fields of plastic surgery at the University of Louisville (Louisville, Ky).

Drehsen explains that his holistic approach to facial and cosmetic surgery focuses on common sense and logic, combined with a true love of art and beauty. He talks openly about shortcomings in traditional techniques in plastic surgery, what works, what doesn’t, and how he strives to provide his patients with a truly rejuvenated and dynamic appearance, as well as restored self-esteem.

First Impressions

“The facial expression is the first thing people see. This is what I call the ‘emoticon effect’ This first impression dramatically impacts how others perceive us,” he says. “People may think we are tired or unhappy based on what our face communicates, and it indirectly affects our well-being.”

An avid art lover, Drehsen approaches each patient like a canvas, understanding that the modification of one area impacts the overall look of the entire face. He believes that a plethora of noninvasive or limited procedures—such as mini-lifts and quick-lifts—by not addressing the comprehensive whole, paradoxically often produce less natural-looking results. His goal is to understand his patients and work in concert with them to restore the natural line of a more youthful face, thereby creating a more positive first impression.

As an accomplished surgeon, Drehsen understands that the best way to achieve positive results is to focus on the goal, rather than the technique. “I got fed up with the teaching of technique over results,” he says. “So, I focus on the goal: What do I need to do to achieve the kind of results my patient wants? Then I define the procedures best in alignment with the goal.”

Drehsen uses a variety of new technologies in his practice, depending upon the patient’s overall objectives. “I consistently use fat injections to help replenish what nature and time have diminished,” he says, “and have for over a year refined the use of autologous ‘stem cell’-enhanced fat grafts in my facelift procedures. My preliminary results are pointing to better graft retention and amazingly improved skin quality in most patients.”

Preplanning is essential to the entire process. Drehsen has used computer imaging for more than 20 years, helping his patients visualize potential results. He believes this technology offers physicians the best tools to evaluate the impact of specific procedures on the rest of the face.

“Associated procedures, like chin augmentation or a browlift, can have a significant impact on an adjacent feature,” Drehsen explains. “So, based on the computer image, the patient can visualize the potential result and evaluate whether adding these associated procedures makes sense, since they have a clear picture of the overall outcome.”

Drehsen believes that an artist’s eye is critical to the entire process. Being able to clearly visualize where there is a loss in volume, understanding and paying attention to what will move, and the impact of facial relocation on the entire face is essential.

He premarks the face while his patient is standing up to get a more accurate feel for how the tissue will move upward, and sketches the anticipated volume requirements and transpositions. During surgery, he first partially lifts the tissue and the skin, and then mobilizes them vertically, reversing harmoniously the effects of gravity. He inflates the premarked areas with fat injections. And only when satisfied with those adjustments does he finalize the suspension of the tissues and the skin trimming.

“Doctors rarely use fat injections during lifts” he says. “But I have had amazing results by preplacing the fat micrografts prior to the final suspensions, therefore avoiding the problems of grafting dead space or undermined and firm tissue.”

Drehsen has established the Refresher Lift as the cornerstone of his facial-rejuvenation practice, using this unique approach to return freshness and youthfulness to an aging or tired-looking face. The procedure can be performed using standard fat micro-grafts or stem cell-boosted grafts, depending on patient preference. It incorporates a strong vertical lift of tissues and skin instead of traditional front-to-back tightening or stretching.

“The traditional facelift may pull the face back, which may not work for many patients,” he says. “As we age, gravity pulls our facial muscles and tissues downward. This very reliable vertical lift counteracts the natural way we age and restores a more youthful, natural-looking result.”

Refresher Lifts focus on the cheek area and the jowls and neck, he adds, using discreet and limited incisions combined with vertical tissue adjustments and volume restoration to produce results.

Drehsen believes a youthful cheek contour, filling of suborbital hollows, elimination of jowls, and redefining the submandibular trough is what makes his procedure different from traditional facelifts. Combined with a strong vertical lift to restore malar fullness, it is different from a mini-lift, and the lengths of the incisions vary by patient.

Keeping in Touch, Giving Back

Drehsen is an avid boater who enjoys all kinds of water sports in his spare time. With many of his immediate family still living in Europe, he travels frequently to keep in touch.

Over the years, he has worked with victims of abuse, the American Heart Association, the Breast Cancer Foundation, and other local charities to provide cosmetic and reconstructive surgical expertise for those in need.

He is fascinated by art, and finds balance and beauty all around. “Living in Florida and enjoying the wonderful weather and people here has opened my eyes to the true beauty of this world.”

Schae Kane is a regular contributor to PSP. She can be reached at PSPeditor@allied360.com.

The Refresher Lift and Stem Cell Enriched Refresher Lift

 

 

 

 

 

 

Premarking of the patient is performed in a standing position, delineating the volumes to restore in their uplifted position. Fat is extracted from the appropriate donor site and processed for stem cell extraction and micrografts.

The incisions are often carried at the intratrichial level to avoid unnatural hairline displacements.

A limited skin undermining is performed around the preplanned areas of injection but sufficient to allow adequate skin transposition. Stem cell-enriched fat micrografts are then dispersed in sufficient amounts to produce a moderate overcorrection of the premarked area, encompassing often the brows, temples, suborbital, malar, parabuccal, paragenial, and lips when needed.

A strong vertical uplift is produced by closing an obliquely directed (lateral canthus to base of earlobe) TAU- or THA-shaped masectomy. He starts with a small, pie-shaped excision of the lateral periorbital orbicularis anteriorly and finishes with a double-gathering auto-locking purse string suture that elevates the superolateral platysma and then the lower SMAS in a fanlike fashion, and secures them to the rigid pretragal smas. (This suture may extend in the neck when needed, toward the supraglottic area tightening the mid platysma.)

In most cases, a strong quasi-vertical uplift is achieved with a permanent loop anchoring the lateral malar pad to the lateral orbital periosteum. Tightening of the orbicularis resection consistently improves lower lid posture and often eliminates the need for a lower blepharoplasty.

Squinting lines are reduced by a conservative punch avulsion of the lateral periorbital orbicularis.

A receding hairline belies all rejuvenating efforts. The Refresher Lift maintains a youthful temporal hairline because the hairs are never displaced behind or above the superior auricular sulcus. This can be achieved using a sharply beveled, wavy, intra, or retro-trichial incision, designed to minimize the displacement of the temporal hairline or sideburns. The transtragal incision is refined by a one-sided Z-plasty.

When no significant redraping or no anteroposterior neck tightening is needed, the postauricular sulcus will absorb the postauricular dog ear resulting from the vertical cheek skin transfer. When a more substantial lateral neck skin redraping is needed, a beveled, wavy intra and/or retro-trichial incision is designed, following obliquely the nape of the neck.

The most common ancillary procedures performed in conjunction with the Refresher Lift or the Stem Cell Refresher Lift are intraconjunctival lower blepharoplasties with a 35% TCA peel, w-platysmaraphy to correct saggy and prominent band. The dual-plane browlift is commonly performed to restore an elegant and dynamic framing of the eyes.

Liposculpture, also known as Liposuction, is here to stay. But as always, there are many ways for a skilled surgeon to use this cosmetic surgery procedure to effectively remove unwanted fat, and contour your body. Many terms have been marketed lately. Laser, Vaser, Smart Laser Lipo, and many other catchy names, all adding to the mystique and appeal of these highly-marketed procedures.

We've been led to believe that these are revolutionary, in-and-out cosmetic procedures that give us a maximum benefit for a minimum price and physical impact. The reality, however, is that these so-called non-invasive and selective cosmetic weight loss procedures most often produce poor results and are neither non-invasive nor selective.

So, what does work? Well, there's the proven traditional method of liposuction, as well as power-assisted liposuction (P.A.L.). Returning from a trip to Buenos Aires where I decided to visit a few local plastic surgeons, I was impressed by some of their liposuction equipment, and made the decision to incorporate pieces into my practice.

Since incorporating the Power Assisted (high speed vibrating) Liposuction technology into my practice I have been very happy with the results - and so have my patients. After having performed literally thousands of liposuction procedures, I was pleased that this equipment proves to be more efficient and effective than the traditional manual fat removal method.

Furthermore, when our patients want to plump an area, this equipment has given me the freedom to remove excess fat from unwanted areas, and add it to more desired areas by way of micro-grafting. There is no better filler than your own fat. Micro-grafting of fat can be done under local anesthesia and presents numerous, scientifically-proven benefits by providing substantial permanency, improved skin texture (especially in depleted and irradiated tissue), correction of breast asymmetry and bony cleavage, etc. The most amazing characteristic about fat injection, or micro-grafting, is its beneficial effect on the overlying skin. You truly notice a more youthful look and feel! In my next article I will illustrate some of these applications.

Accent Your Body

The comfortable way to tone and tighten skin.

Accent^XL rejuvenates the skin's firmness and texture in a fast, safe and virtually pain-free procedure for patients. IN-Motion gradually heats the layers of skin - so it's very comfortable. Through treatment of wrinkles and rhytids, current applications for Accent XL include:

• Skin tightening
• Body Contouring

Only the Accent XL system from Alma Lasers combines two radio frequency modes into a single device. Each proprietary mode - Bipolar and Unipolar - is delivered by a discrete handpiece to distribute therapeutic heat at different tissue depths within the body.

DA clearance

Accent was FDA-cleared for the non-invasive treatment of wrinkles and rhytids on April 23, 2007 .

Accent^XL works on all parts of the body, regardless of a patient's age or skin type. In fact, more than 100,000 patients around the world have already chosen the Accent Your Body experience for superior body shaping and skin tightening. View some of the best before and after photos, below.

For patients

• Non-invasive, non-ablative, no anesthesia
• Noticeable results on all skin types and on patients of nearly any age
• Can be used on any part of the body
• No downtime procedure
• Minimal risk of side effects
• Tighter, re-contoured skin

by Christian G. Drehsen
Board Certified Plastic Surgeon

Over the past 20 years, I have been committed to the relentless pursuit of aesthetic refinement. After performing literally thousands of cosmetic surgeries, I have created a highly personal and refined breast augmentation procedure called, Subfascial Breast Augmentation. This procedure is specifically designed to achieve better cleavage and it greatly reduces breast implant displacement.

Now that the debate over Silicone vs. Saline implants is over, and silicone implants have been officially released for general use (must be over 21 years of age) in breast augmentation. The question is no longer what type of breast implant to use, but where to place it. I have found that by placing the breast implant under the muscle, one often sees a progressive loss of cleavage because of the lateral shifting of the breast implant being pushed aside by a strong pectoral muscle. Nowadays, women exercise more than ever! In addition, I have also found that placement of the breast implant under the mammary gland can result in a rippling effect, whereby one might see the implant more easily with less support. My subfascial breast augmentation avoids both the loss of cleavage as well as the rippling effect.

Because many of my patients want a long-lasting look with great cleavage, for the past year I have pioneered an approach already well known in Europe: the subfascial breast augmentation. I call it the inner bra procedure. With this placement, the breast implant rests under the dense, fibrous envelope that surrounds the muscle, without pressure from the muscle on the breast implant. My experience has shown much less breast implant shift and also less cleavage loss. In addition, some correction of breast position or asymmetry can also be accomplished by way of this revolutionary technique. Like all procedures, a full consultation and evaluation of alternative is in order.

To see more actual breast augmentation before and after photographs click here. To learn about the latest advancements in cosmetic surgery procedures visit my website Clinique of Plastic Surgery.