Face surgery & wrinkle treatment
Eyelid surgery (Blepharoplasty)
Ear surgery (Otoplasty)
Facelift
Nose surgery (Rhinoplasty)
Wrinkle treatment with Botox
Autogenous fat treatment
Fat injection procedures (Microlipoinjection)
Eyelid surgery (Blepharoplasty)
Eyelid rejuvenation is a surgical procedure for removal of excess skin or fatty deposits from the eyelids. The treatment usually gives eyes a more youthful, rested appearance. Both eyes are treated to keep a symmetrical appearance. Either upper or lower eyelids may be treated, or both, as desired. Other facial surgery such as face-lift or skin resurfacing may be performed at the same time. However, to keep procedures from affecting each other, they may be scheduled separately.
The procedure takes between one-half and two hours, usually under local anesthesia. Intravenous sedation may be given if the patient wants it. A general anesthesia is used if a face-lift is also performed.
The lid is cut along the eyelid fold, across to the smile lines. A parallel cut removes an excess skin fold. Fatty tissue in the lower lid is removed through an incision just below the eyelash or an incision on the back surface of the lid. Stitches close the incisions. A weak eyelid muscle may cause an eyelid to droop, called blepharoptosis. This condition can also be treated, with or without eyelid rejuvenation.
After the surgery, swelling may keep the eyelids from completely closing and causing eye dryness. This temporary condition can be relieved by applying artificial tears or ointments. Patients who have dry eyes before the surgery should consult an ophthalmologist before considering eyelid rejuvenation.
Stitches are removed after four, seven days. Discoloration usually goes away after several weeks; swelling may require slightly longer to completely go down.
Eyelid rejuvenation is relatively safe and straightforward. Temporary blurred vision usually clears up within a few days. Rarely, a drooping or retracted eyelid, or darkening of the lids may be caused by blood residue, but can usually be treated satisfactorily. On extremely rare occasions, blindness in an eye may occur. Back
Ear surgery (Otoplasty)
Cosmetic ear surgery is a procedure for reshaping of the ear to give it a more normal appearance. The procedure often treats ears that are too large or protrude from the head. It is usually performed on both ears so they appear symmetrical.
The surgery may be done on adults under local anesthesia and an intravenous sedative. It may also be performed using general anesthesia for others and for children. The patient is usually able to leave the hospital and recover at home or in a nearby hotel.
The procedure involves cutting the back side of the outer ear shell, just behind the ear, in the natural fold where the ear is joined to the head. The ear shell cartilage is then weakened so that it can be folded and stays in its proper position. Sometimes excess skin or cartilage is removed.
After the surgery, head bandages are applied. When these dressings are removed, the patient must wear a headband during sleep for a few weeks to keep from pulling out stitches. After several weeks, swelling and bruising gradually go away. Infections are rare and typically handled with antibiotics. Back
Facelift
Face-lift procedure is performed to restore a more youthful and rested appearance of the face, by removing excess fat, tightening underlying muscles and reshaping the skin of the face and neck. The procedure can be done separately or in conjunction with eyelid surgery, a forehead lift or nose reshaping surgery.
The incisions are hidden in the natural contours of the ear, around the earlobe and in the hairline. The facial skin is lifted and the facial muscles are tightened. If necessary, fat and excess skin are removed from facial area and neck. The remaining skin is redraped, and then looks tighter and smoother while removing the appearance of wrinkles. This may require an incision under the chin. Any loose skin is tightened and removed.
Appropriate candidates include men and women whose face and neck show sagging skin, jowl formation and prominent facial lines. At your initial consultation, it's important to discuss your expectations with the surgeon.
Preoperative photographs, routine lab work and a physical exam will be completed. Typically a second visit is arranged shortly before your surgery date. Most patients will spend one night in our ambulatory care facility. Because of the custom nature of this surgery, exact times cannot be given. On average, surgery may take 3-5 hours. The surgeon will give you a better estimate during your consultation.
In most cases, you will be seen at the office the day after surgery, again on day four or five and again at about a week. Usually, patients also are seen two weeks, six weeks, three months, six months and one year after surgery.
Facelift surgery produces a more youthful appearance, but the beneficial effect of the facelift decreases with time as aging continues. Healing times vary from individual to individual. Generally, patients should refrain from strenuous activity for two weeks after the surgery. Sutures are removed 5 to 10 days after the surgery. Swelling and discoloration usually subside in 2 to 3 weeks, but it may be several months before all the swelling is gone. The scars usually fade over several weeks to months and in most cases are well hidden. In rare cases, the scars will heal thicker than normal and may require some secondary attention. Back
Nose surgery (Rhinoplasty)
Cosmetic nose surgery is a procedure to straighten, reshape, or open passages of the nose. Surgical experts recommend measures, which include the following:
- Removing the hump on the bridge of the nose
- Narrowing the nose
- Refining or reshaping the tip of the nose
- Correcting a deviated septum, the cartilage separating the two nasal passages (Rhinoseptoplasty)
Within limits, many features of the nose may be modified to make it more attractive or regular. The surgery is done under local anesthesia and an intravenous sedative. It may also be performed using general anesthesia. The patient is able to recuperate, with adult assistance, at home or in a nearby hotel. This procedure may be performed at the same time as other cosmetic facial procedures.
The procedure involves making incisions inside the nose or through small cuts beside the nose. Any scars are usually out of sight or inconspicuous. The skin is separated from the supporting bone or cartilage, which is then reshaped to the desired profile. Natural elasticity of the skin allows it to take its new position. To conclude the procedure, a small splint is placed over the nose for support and to reduce swelling. Gauze to absorb bleeding may be packed into the nose, and is removed after one or two days.
The splint is taken off after five to seven days. Stitches to close incisions remain in place for about ten days. Swelling and bruising around the nose and eyes is normal for several weeks following the surgery. Temporary loss of feeling or sense of smell usually returns gradually over this period. Swelling may take as long as six months or more to go down completely. Depending upon the final result, a second, revision procedure may be required to correct minor irregularities.
In rare cases, infection or bleeding may delay the healing or result in scar tissue. Thick or oily nose skin may be less adaptable in cosmetic surgery. Back
Wrinkle treatment with Botox
Botox injections have become increasingly popular for reducing wrinkles of the forehead and face. Today, injections of botulinum toxin type A provide a nonsurgical cosmetic technique for treating frown lines, forehead furrows, "crow's feet" and other lines of the face.
The injection causes temporary weakness of only those muscles injected. Although the weakness is temporary, the benefits last from three to six months.
Not all facial wrinkles will benefit from Botox injections. Your skin type, skin thickness and degree of wrinkling all play a role in determining whether Botox will be effective for you. A careful history and physical exam of the face will be done to determine whether the treatment is right for you.
Botox treatments are attractive because they are relatively inexpensive and require no recovery time. Injections are done with a fine needle and require topical anesthetic.
By carefully choosing the muscles to be treated with Botox, the physician weakens only the wrinkle - producing muscles while preserving natural facial expression.
Patients should avoid strenuous physical activity for the first 24 hours after the injection. The effect of Botox is not immediate. It usually takes three to five days to reduce muscle movement. Back
Autogenous fat treatment
As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs. Soft-tissue fillers, such as Teosyal® or Restylane® or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks.
Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift. Teosyal® or Restylane® can help fill out facial wrinkles, creases and furrows, "sunken" cheeks, skin depressions and some types of scars. They can also be used to add a fuller, more sensuous look to the lips.
Injectables are usually not sufficient for severe surface wrinkles on the face, such as multiple vertical "lipstick lines" that sometimes form around the mouth. Deep folds in the face or brow caused by overactive muscles or by loose skin may be more effectively treated with cosmetic surgery, such as a facelift or browlift. Injectables are sometimes used in conjunction with facial surgery procedures; however, injectables alone cannot change facial contour the way surgery can.
The most important fact to remember about injectable fillers is that the results are not permanent. Injected material is eventually metabolized by the body. When injectables are administered by a qualified plastic surgeon, complications are rare and usually minor in nature.
Allergic reaction is not a factor for fat because it's harvested from a patient's own body. Topical cream anesthetic and/or nerve block may be used to numb the injected area.
Immediately after the treatment, you may notice some minor discomfort, stinging or throbbing in the injected area. Occasionally some bruising or swelling may occur, but it is usually minor. Any redness that appears in the injected site usually disappears within 24 hours. However, in some individuals, particularly fair-skinned patients, this redness may persist for a week or more. There may be some temporary swelling and redness in the treated area which should dissipate within a few days. Back
Fat injection procedures (Microlipoinjection)
The fat-injection procedure is known as autologous fat transplantation or microlipoinjection. It involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips.
The procedure is performed as following. After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. Then the fat is prepared and injected into the recipient site. Sometimes an adhesive bandage is applied over the injection site.
As with collagen, "overfilling" it is necessary to allow for fat absorption in the weeks following the treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this overcorrection of newly injected fat, may temporarily make the face appear abnormally puffed out or swollen.
Many patients are able to resume normal activity immediately. You can expect some swelling, bruising or redness in both the donor and recipient sites. The severity of these symptoms depends upon the size and location of the treated area. You should stay out of the sun until the redness and bruising subsides - usually about 48 hours. In the meantime, you may use makeup with sunblock protection to help conceal your condition.
The swelling and puffiness in the recipient site may last several weeks, especially if a large area was filled.
The results and duration of the fat injections varies significantly from patient to patient. Though some patients have reported results lasting a year or more, the majority of patients find that at least half of the injected fullness disappears within 3-6 months. Therefore, repeated injections may be necessary. Back
