Trifecta & Quadfecta lift
The Evolution of Eyelid Rejuvenation
We are as unique as our fingerprints. Each one of us has our own genetics, history, diet, habits, and anatomical variations which affect how we look. Therefore it’s easy to understand that there is no one size fits all solution when it comes to facial rejuvenation. I’ve been performing eyelid rejuvenation for close to two decades, and one thing I’ve noticed is that most people just want to look refreshed without looking like someone else, or worse look like they had “bad work done”. One of the philosophies that drives me is to do something natural where no one can tell any work was done. Of course everyone is affected by the aging process differently but these are some of the factors that contribute.
Skin: The skin around the eyes is the thinnest in the body. As we age it gets looser and thinner, resulting in a crepey appearance to the lower eyelids and stretching of the upper eyelids.
Eyebags: Some people anatomically have puffy lower eyelids which results in a shadow effect, especially under certain lighting, which gives the appearance of dark circles and looking tired all the time. Also the structures that hold the orbital fat loosen with time and result in what we call fat herniation and eyebags.
Volume loss: It is a known fact that we all lose volume around the face as we age, and that leads to some of the changes we see around the eyes. For example, the sub-brow fat volume loss can result in descent of the brows and droopy eyelids. We also lose volume around the orbit which is the junction of the eyelids and midface. The part closer to the nose is called the tear troughs; and as we get older we lose more volume laterally giving rise to the lateral hollow. The mid face, which is the cheek area, not only loses volume with time but it also descents and the maxillary bone that supports it also retrudes as we age.
- What is the Trifecta Lift?
- What is the Quadfecta Lift?
- What type of anesthesia?
- What is recovery like?
- When can I exercise?
- When can I expect final results?
The Trifecta lift is a surgical procedure that I have created to target the three aspects of lower eyelid aging. This technique addresses the three aspects of lower eyelid rejuvenation.
- Lower eyelid bags: a customized lower eyelid blepharoplasty is performed through the inside of the eyelids with no visible scars outside. The herniated fat pads are then repositioned to a different degree as needed to create a smooth transition of the tear troughs.
- Skin: a resurfacing or a tightening procedure is performed as needed to reduce fine lines. It must be noted that dynamic wrinkles which appear when we smile giving rise to crows feet will still be there and treatments with neurotoxins is one of the best and simplest ways to address those issues.
- Volume loss: I find this is one of the most important aspects of lower eyelid rejuvenation that usually gets neglected because we’re so focused on the “eyebags”. For me the best surgical way to revolumize the midface is to use the patient’s own fat. This is a highly technical procedure, and the goal is to create a natural feel to the midface without making someone look over inflated. Over the past 17 years I’ve performed thousands of these procedures, and I find that revolumizing the midface is one of the most essential components of the Trifecta lift technique which gives natural, long lasting results.
It is the Trifecta lift + addressing the upper eyelid changes, which may include upper eyelid blepharoplasty alone or in combination with brow lift and fat grafting. As mentioned this is not a one size fits all, but addresses the key components of the individuals periocular aging changes.
Go To TopBoth the Trifecta lift and the Quadfecta lift are performed under anesthesia. Although upper eyelid blepharoplasty when performed alone is done under local anesthesia, when it comes to total periocular rejuvenation I’ve found that it is much easier and the outcome is much better when these procedures are under anesthesia. This reduces the need to inject a lot of local anesthesia which can distort tissue and affect the outcome of the procedure and result in prolonged healing.
Go To TopEveryone heals a little differently. Depending on the person’s previous medical history there will be some swelling and bruising around the eyelids for one to two weeks. Most patients can return to work after 5 to 7 days. There is minimal eye discomfort after the procedure. Ice packs are recommended for the first 2 days to decrease swelling. Arnica & Bromelain will help reduce swelling and bruising.
Go To TopAlthough walking with proper sun protection is recommended after a few days of rest, no heavy exercise or cardio for two to three weeks after surgery.
Go To TopWe tell patients that 20% of healing takes place by the first post op week and 60% to 70% during the first month. The sweet spot for any surgical treatment is 3 to 6 months post op. Remember healing is a continuous process and the more you take care of yourself post op and listen to your body the faster you heal.
Go To TopExample Patient Story Videos
Trifecta Lift:
Quadfecta Lift:
For more examples and real patient stories, please follow us on Instagram @kamiparsamd