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Aging Face Part 2: Sagging

One of the “6 uglies of the aging face”  is sagging or fat protrusion.  At mid forties patients will notice the eyebrows are lower than they used to be when they were in their early 30’s. Their eyes may appear smaller and people will often ask if they are tired. There can be excessive upper eyelid skin also making the eyes smaller as well. The lower eyelid can begin to show bulges especially when looking in a mirror with your head bowed down.

In the midface, the cheek mounts can fall making the lip-cheek groove appear deeper than it should. At the same time the cheek mount will lose volume and shrink.

In the lower face, jowls appear as the fat becomes more obvious. Usually in most females that can occur at their mid 40’s. If left, the jowls become larger and the natural jaw line of youth disappears.

However, the neck can age slower than the jowl formation. If a patient has fat under their chin; that does not really sag until menopause and, of course much much later in men. The mound of fat will act as a weight causing it sag and become more obvious. Often there is no fat under the chin, and cords start to appear around menopause. Early on, they can be helped by Botox, but eventually surgery will be needed.

When significant sagging occurs, surgery is often the best choice, but other choices can be available. Dr Ellis will make a proper diagnosis so that patients can make a proper educational choice that meets their needs in a very natural way.

Aging Face Part 1: What happens when our face ages?

Dr. Ellis states there are “6 uglies of the aging face”. They are classified under facial structure and the aging skin.

In facial structure, there is sagging, hollowing, and skin wrinkling while under aging skin; there can be worsening of skin texture with dullness, increased broken capillaries, and blotchy brown spots or hyperpigmentation.

All these occur at different times with different ethnics, and different patients. They all occur with everyone.

Evaluating which component show be treated first will depend on the surgeon and the patient.  In each classification, there can be multiple treatment options so it is very important to accurately plan a proper treatment plan.

Anti-Aging Procedures

Aging produces 3 conditions that alter facial structure and the skin.  With the aging facial structure, there is wrinkling, sagging, and hollowing.  With aging skin, the skin turns red, hyperpigmented, and appears rough with the lack of tone.

Anti-aging procedures usually start when the patient’s age is 30.  The 5R’s is an easy way to remember what can be done to minimize the aging process: relax, refill, retighten, reposition, and resurface.

  1. Relax.  The use of Botox injected into the muscle to give relaxation to the muscle is a popular occurrence in patients who started young and will not develop any lines around their eyes, between their eyebrows, or the forehead.  After rejecting Botox, within 3 days.  The muscle begins to relax and stretches out giving us smoother contour the lines above.  Botox will last initially about 4 months, but after 2 years of regular use, the interval between injections can stretch to 6 months.
  2. Refill.  The use of short-term and long-term hyaluronic acid fillers are very popular to create fuller cheeks, improve the lip cheek groove, and even enlarge the lips to their natural size.  With aging and with weight loss done the various clinics, patients often see the volume of their cheeks, decrease sometimes dramatically.  Elderly patients will often see a vertical groove down through their cheek often called grandmother’s groove.  The use of fillers such as Juvederm Voluma, Volbella used to restore more full youthful cheeks.
  3. Retighten.  For years now, the skin physiologists know that heating the skin up to about 45 degrees Celsius causes the skin to shrink and increase its elasticity.  40-year-olds are the ideal candidate to have this done as the residual collagen is still sufficient enough to create a good result.  Dr. Ellis uses a two-dimensional technique combined of laser Genesis and Titan.  Both these techniques are non-invasive causing virtually no downtime except for a red face for a couple of hours after treatment.  Multiple treatments are necessary to achieve a satisfactory result.
  4. Reposition.  This is a surgical technique whereby the sagging skin is repositioned posteriorly and upwardly removing the jowls and tightening the skin of the neck.  Depending on the age and the problems under the skin, this can be described as S-lift, neck lift, or full facelift.
  5. Resurface.  Resurfacing the skin helps to treat the skin roughness and tone, as well as the redness as and Rosacea, and pigmentation problems.  These are non-invasive techniques in which take multiple treatments as well as at home medical topicals to improve the appearance of the skin.  There are also more aggressive resurfacing techniques called ablative resurfacing using a CO2 or YSGG laser that removes microscopic columns of skin to induce the patient to lay down their own collagen making the skin less wrinkled and smoother.

Depending on one’s age and one’s concern, a treat regime can be designed to minimize the effects of aging.  Some of these schedules are simple and required  minimum downtime while others are more extensive requiring some downtime but the results can be very dramatic.

What is 3D Revitalization?

3D Revitalization is unique to each customer that takes it up. 3D Revitalization serves to analyze each person’s specific needs and to address them all in one single treatment. Utilizing Limelight / IPL, a light-based procedure, one can address surface problems on the skin such as redness, mottled complexions, freckles, and sun damage. Laser Genesis is used to stimulate new collagen for improvement of fine lines, wrinkles, pore size, and textured skin. Then Titan’s infrared light is used to heat the tissue in the deep dermis to improve skin elasticity. A series of 3D Revitalization is required to achieve optimal results from the procedure.

We understand that every person ages at a different rate and in different ways. Through the procedures illustrated for you above, we are able to treat each or all of these conditions to bring your skin back to its former state.

For some, these imperfections define them. Aging, sun damage, and scars are common in all three layers of skin. 3D Revitalization works to target each layer of skin and improve upon these imperfections. Rejuvenate your skin and treat these common conditions for what they are. Eliminate them for good.

Watch them fade and disappear. Feel your skin become tighter. See a smoother, healthier looking complexion develop right before your very eyes.

3D Revitalization can assist you in looking younger than you’ve looked in years and put that energy that you have inside on display for the whole world to see. Aging is inevitable but that doesn’t mean that you can’t be treated to assist you in looking your absolute best as we continue to progress through the years. Contact us for more information on how 3D Revitalization can benefit you and discuss with an expert the benefits of these procedures to determine whether it is necessary for you.

Juvederm Volbella is not just for big lips

Ah! No doubt the common reaction when seeing a botched surgery job which often is seen from the viewpoint of big pronounced lips and the tight look that surrounds those lips. One need not be afraid of lip injections however. Juvederm and Volbella are two forms of lip injections designed to recreate what you have lost in your lips as opposed to making them larger.

Aging can cause “smoker lines” – that is, vertical lines above your lips that become more pronounced when you speak and say certain words or when you pucker up your lips. This is just one instance where Volbella can be used to fill in those lines to make the skin above your lips smoother. This isn’t a complicated procedure and poses little to no risk to you or your visual features. What lip injections such as these look to do is not necessarily enhance but to bring your lips back to the fuller look they once embodied. They aren’t meant to be used in a way that creates larger lips but rather to enhance the presentation of the lips you already have.

Juvederm Volbella is a new facial filler designed specifically for gently restoring natural-looking lip volume and defining lip contours. It is made from a hyaluronic acide (HA), a naturally occurring sugar found in your body which helps to maintain volume and elasticity in the skin.

Injections are made easy for patients who can return to work the next day following treatment. No time is needed to recovery. Lips may appear somewhat swollen the day of the injections and for the next couple of days. It is recommended to moisturize that first week where your lips may feel dry and flaky. Beyond this small change in your morning routine, with Juvederm Volbella, you can have the lips you used to have ready for action in no time.

Is Plastic Surgery Right for Men?

Plastic surgery isn’t a topic typically discussed among men and is one often associated with women yet many men surprisingly ask the question – is plastic surgery right for me? The number of men choosing to have cosmetic surgery has recently increased 5% from 2011 which accounts for upwards of 9% of the country’s population. Nose reshaping is the number 1 cosmetic surgery in 2012 among men, as performed in the United States according to the American Society of Plastic Surgery and it’s easy to see why.

Nose reshaping or rhinoplasty can help correct the hump, change nostril and/or nose width, improve breathing, change the nasal tip shape of the nose, and improve the overall size of the nose.

Man or woman, you can have the nose you want with rhinoplasty and there aren’t any restrictions to the kind of minor adjustments and improvements that can be made.

Recovery is quick as well with only two weeks of approximate recovery time needed. The first few days – at home. Then onwards, it’s more or less a case of waiting for your support structure to settle and heal.

Men see the nose like the rest of the population does. Sitting in the center of the face, it draws a lot of attention to itself. Men often prefer a less pronounced nose, or inversely a larger and less feminine version of their nasal anatomy. Caucasians favour the removal of humps from their nose and building the bridge closer to the face. Asian and African American men often make inquiries into a higher and more refined bridges – the opposite.

As plastic surgery becomes more commonplace in modern day society, it will no doubt follow suit that more men become involved in minor surgeries such as rhinoplasty to develop a better image for professional and/or personal reasons.


Art of Facial Surgery is Proud to Welcome Dr. Tee Sin Lee

Dr. David Ellis is pleased to welcome Dr. Tee Sin Lee to his practice.  Dr. Lee is from Singapore where he completed his Medical Degree at the National University of Singapore.  He then completed his five years of surgical training in Otolaryngology – Head and Neck Surgery and has been working as an Associate Consultant at Changi General Hospital in Singapore.

Dr. Lee has a special interest in Facial Plastic and Reconstructive Surgery, and he has been awarded the prestigious Higher Medical Diplomas Scholarship, which is a national level award in Singapore, to pursue his interest.

With this award, he is currently continuing his training with a one year fellowship under the guidance of Dr. David Ellis. This highly competitive one year fellowship position with Dr. Ellis is one of 43 in North America and only two in Canada offered by the American Academy of Facial Plastic & Reconstructive Surgery.

Dr. Lee speaks fluently in English, Mandarin and Hokkien, and will be available for Botox and injectable filler treatments.  He also works alongside Dr. Ellis assisting in rhinoplasties, facelifts, blepharoplasties and all other cosmetic facial surgical procedures at Art of Facial Sugery.

To book an appointment with Dr. Lee or Dr. Ellis, please call our office at 416.229.1050 or email at or click on the link below.

Art of Facial Surgery received a Pass by the College of Physicians and Surgeons of Ontario

College of Physicians and Surgeons of Ontario mandatory inspections

Out-of-Hospital Premises inspection now made public by the College of Phsycians and Surgeons of Ontario.

As of January 31, 2013, the By-law passed by the College of Physician and Surgeons of Ontario will now make the inspections results public.  This is great news for the public as we will know through the College inspections that the facilities are properly equipped and staffed in the interest of patient safety.  With the new by-law, the public will now be able to search the most current status of the premises inspections.   To search a facility, visit the College website at

The College of Physicians and Surgeons of Ontario will review the facility to assess premise requirements including the procedure and operating room, staff qualifications, infection control standars and quality assurance activity.

To date, 251 private medical clinics was inspected, 9 failed assessments because they were found to be putting patients at risk, 64 passed with conditions and 178 passed.

Art of Facial Surgery has received a PASS and that can be verified at

Dr. David Ellis is a Peer Assessor with the College of Physicians and Surgeons of Ontario where he will with nurses  and physicians assess premises in Ontario.


Dr. David Elllis featured in Fashion Magazine March 2013

Dr. David Elllis featured in Fashion Magazine March 2013

Check out the March issue of Fashion Magazine 2013.

Dr. Ellis is featured in “Shops FOCUS”

Dr. David Ellis

Dr. David Ellis featured in Fashion Magazine March 2013

Top Questions in Cosmetic Procedures

Top Questions in Cosmetic Procedures

With so many new medical aesthetic treatments options coming to the Canadian Market, and more on the horizon, all the options can be welcoming yet very confusing to the general public.  The fact is that products vary significantly in what they are made of, how they work, where they are used, and how much experience a doctor may have with a certain product.  Dr. David Ellis a facial plastic surgeon in Toronto works very closely with the makers of Botox and Juvederm and can answer these questions in person and others should they arise.  Here Canada’s leading medical aesthetic physicians answer common questions to help provide education and promote patient safety in a crowded market.

1.  Are medical aesthetic treatments really safe?

Many of these treatments are prescription products and need to be treated as such. Making a decision on what treatment to get is not the same a picking an anti-aging cream or a new lipstick, for example.   Medical aesthetic treatments have different chemical formulations, manufacturing processes, dosing guidelines and safety profiles and so it is important to learn about treatment facts.  Patients need to ask themselves some important questions: What is the safety record of this product?  What is the approved use for the product?  How well-researched is the product?  What is my desired effect?  Efficacy, safety, science and patient satisfaction are important considerations when choosing a medical aesthetic injectable, for example.  The products that Dr. David Ellis make available to his patients at Art of Facial Surgery has been studied and has peer reviews to show its safety and effaces.

2.  What are the questions women  should ask their physicians?

As important as researching into different treatments is choosing the physician.  Patients should ask their physician about his or her qualifications, including how long he or she has been injecting that particular product, and how many patients they have treated with it.  They should ask their physician to show them the injectable treatment he or she will be using to ensure they are getting the treatment they’ve requested.  Also, it is important that patients share their medical history with the treating physician.

3.  How can woman help ensure they are going to have a positive treatment experience?

Before getting any medical aesthetic injectable treatment, patients need to follow the ABCs of patient safety:  Ask about the treatment facts;  Be aware of the treatment you are getting, where you are getting it and by whom; and always get a medical Consultation with a physician.  As per the College of Physicians and Surgeons of Ontario, it is a standard of practice for the patients to see their physician in a medical consultation if the treatment is to be performed by the medical aesthetician or nurse.  Dr. David Ellis or his associate is readily available for a consultation prior the patients treatments.

For more information or for a consultation with Dr. Ellis please call 416.229.1050