Introduction: Merely mimicking youth in an aging face can be elusive and controversial. Restoring the vitality, pleasantness, and fitness of the face (improving the expression), has been greatly rewarding for my patients. Holistic parameters are instilled in my approach to countering the negative societal responses to older faces. The objectives of this study were to (1) measure the social impact of focused facial rejuvenations and (2) validate the combination of original techniques used in this series.Materials and Methods: Eighty medical students were asked to rate, in term of "social acceptance/desirability," a random mix of before-and-after photographs of 15 women, aged 45 to 75 years old, who had undergone facial rejuvenation.Results: A clear gain in social acceptance is demonstrated in after results.Conclusions: The marked increase in social acceptance after improving expression or "Emoticon effect" amply supports this simple paradigm in the planning of a facial rejuvenation. The combination of a vertical refresher lift, a modulated dual-plane brow lift (subcutaneous/subgaleal), and simultaneous sectional fat grafting has been instrumental in obtaining the desired results.
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