Facial Procedures

Facial Procedures

Your face is the first thing people notice about you. Whether it is your eyes, your smile or expressiveness you are constantly aware of the impression you make on other people. When wrinkles, skin dicoloration, saging skin or other evidence of aging become more noticeable, cosmetic surgery may be the answer.

With cosmetic surgery you can turn back the hands of time. Not only will you look and feel younger you will also feel more confident an vibrant.

Below you will find some of the procedures that we offer that can help you look and feel years younger.

EYELID SURGERY / BLEPHAROPLASTY

Every year, one hundred thousand men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, you may also require a browlift, facelift, or skin resurfacing to achieve the best results.

Understanding the Blepharoplasty

In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.

In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.

What to expect After Blepharoplasty

Immediately after the surgery has been completed, you may have tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. You will usually be prescribed medication for discomfort.

For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eyedrops may be recommended. You will also be given a list of activities and environments to avoid in the weeks immediately following surgery. Permanent stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.

SCAR TREATMENTS

When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Once a scar forms, it is permanent but may be made less visible or relocated surgically.

With very few exceptions most people are self-conscious about facial scars. Some people may also experience diminished functioning of the eyes, mouth, or nose due to scarring. If you've wondered how facial scar revision could improve your appearance, your self-confidence, or your level of facial functioning, you need to know how scar revision works and what you can expect from this procedure.

Is Scar Revision Treatment Right For You?

Different types of scars respond to different plastic surgery techniques. Timing of surgery is another important choice. Some surgeons advise against any scar revision in cases of injury for a period that might extend up to a year after the injury. This interval allows the body enough time to heal fully.

Making The Decision For Scar Treatment?

Different scars require different treatments. For example, severe burns that destroy large sections of skin cause the skin to heal in a puckered way. As the skin heals, muscles and tendons may be affected in this "contracting" movement. Keloid scars are a result of the skin's overproduction of collagen after a wound has healed. These scars generally appear as growths in the scar site. Hypertrophic scars, unlike keloids, do not grow out of the boundaries of the scar area, but because of their thick, raised texture, can be unsightly and may also restrict the natural movement of muscles and tendons.

Some facial scars are unattractive simply because of where they appear on the face, while others affect facial expressions. All surgical possibilities will be discussed in the initial consultation along with risks involved for each type of scarring. The agreement between you and your surgeon on how to proceed is a prerequisite for successful surgery. After you both decide to proceed with scar revision, your surgeon will inform you about the anesthesia, the surgical facility, any supportive surgery options, and costs.

Because scars are highly individualistic and the patient's attitude toward scars is so personal, maximum improvement in facial scars may require more than one procedure, and more than one technique may be employed.

Understanding the Scar Revision Surgery

When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely. Skin flaps, composed of adjacent healthy, unscarred skin, are then lifted and moved to form a new incision line. Where a flap is not possible, a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another, and time must be allowed following surgery for new blood vessels and soft tissue to form. Z-plasty is a method to move a scar from one area to another, usually into a natural fold or crease in the skin to minimize its visibility. While Z-plasty does not remove all signs of a scar, it does make it less noticeable.

Dermabrasion and laser resurfacing are methods a surgeon uses to make "rough or elevated" scars less prominent, by removing part of the upper layers of skin with an abrading tool or laser light. Clearly, the scar will remain, but it will be smoother and less visible.

Keloid or hypertropic scars are often treated first with injections of steroids to reduce size. If this is not satisfactory, the scars can be removed surgically, and the incisions closed with fine stitches, often resulting in less prominent scars.

What to Expect After Scar Revision Surgery

You can expect to feel some discomfort after facial scar revision surgery. Some swelling, bruising and redness are generally unavoidable. It is important for you to follow your surgeon's after care recommendations to the letter. Though the sutures will be removed within days after the surgery, your skin needs time to heal. Surgeons generally insist on decreased activity after surgery and instruct the patient to keep the head elevated when lying down, to use cold compresses to reduce swelling, and to avoid any activity that places undue stress on the area of the incision. Depending on the surgery performed and the site of the scar, the facial plastic surgeon will explain the types of activities to avoid. No medication should be taken without first consulting the surgeon. It is important to remember that scar tissues require a year or more to fully heal and achieve maximum improved appearance.

FOREHEAD / BROWLIFT

The effects of aging are inevitable, and, often, the brow and forehead area show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Your tired, angry, or sad expression may not reflect how you actually feel. As a result, many people have opted for a procedure known as the forehead lift. Based on variations in how men and women age and on new advances in medical technology, different methods are used to perform this procedure.

If you are wondering how a forehead lift could improve your appearance, you need to know how these procedures are performed and what you can expect.

Is Forehead Lift Right For You

When a surgeon tightens loose skin and removes the excess, forehead wrinkling and drooping brows are modified. The procedure is called a forehead lift or brow lift. If necessary, the surgeon removes part of the muscle that causes vertical frown lines between the brows. The result can be a smoother brow and a more youthful expression. To see what a forehead lift can do for your face, put your hands above your brows and outside the edges of your eyes and gently raise the skin upwards. Forehead lifts are an option if you have a sagging brow or deep furrows between the eyes. This procedure is usually done between age forty and sixty-five, although it may be necessary at an earlier age.

Incisions can be placed at the hairline, behind the hairline, or in some cases, above the brow or in the mid-forehead.

Making The Decision For Forehead Lift

During the consultation, we will examine your facial structure, the condition of your skin, and your hairline in order to decide where incisions should be made. A thorough medical history will be obtained so that we can consider any medical conditions that may heighten surgical risks. A detailed description of the procedure will also include a discussion of risk involved.

Understanding the Surgery of Forehead Lifting

The main difference among the various options for forehead lifting consists of the placement of the incision.

The original technique is the coronal incision, which is made slightly behind the natural hairline. An alternative is the pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline. This incision generally heals favorably and has the advantage of lowering the hairline. The disadvantage could be noticeable scarring. An option is to place the incision within the midforehead creases. This is primarily used in men with deep pre-existing forehead lines.

The newest apporach is endoscopic surgery. Several small one-half-inch to one-inch incisions are placed just behind the hairline. Although this technique may require more surgery time, it is less invasive and results in a smaller chance of temporary scalp numbness.

This procedure takes between one to two hours to perform. It is most commonly performed under IV sedation or twilight anesthesia.

What To Expect After Forehead Surgery

You will experience a certain amount of swelling and bruising in the 10-day period following surgery. In some patients, this condition may include the cheek and eye area as well as the forehead. You will be advised to keep your head elevated in order to reduce swelling. Cold compresses may further reduce swelling. As the incisions heal, you may experience some numbness as well as itching, both of which will diminish with time. The sutures are usually removed within seven to 10 days following surgery. If bandages have been used, they are removed in one to three days. It is important to follow the advice of your surgeon on resuming normal activities. For most patients, the recovery time will not exceed two weeks, but patients may still be advised to avoid strenuous activities for longer periods. Any prolonged bruising can be camouflaged with standard make-up techniques.

Not infrequently, a brow lift is combined with Blepharoplasty (an eyelid tuck) or face lift to provide a harmonious rejuvenation.

NOSE SURGERY / RHINOPLASTY

Every year, half a million people who are interested in improving the appearance of their noses seek consultation with facial plastic surgeons. Some are unhappy with the noses they were born with, and some with the way aging has changed their nose. For others, an injury may have distorted the nose, or the goal may be improved breathing. But one thing is clear: nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration can greatly improve one's appearance.

If you have wondered how nose surgery, or rhinoplasty, could improve your looks, self-confidence, or health, you need to know how rhinoplasty is performed and what you can expect.

Is Rhinoplasty For You?

Since there is no ideal in rhinoplasty, the goal is to improve the nose aesthetically, making it harmonize better with other facial features.

Skin type, ethnic background, and age are important factors to be considered in discussions with your surgeon prior to surgery. Before the nose is altered, a young patient must reach full growth, usually around age fifteen or sixteen. Exceptions are cases in which breathing is severely impaired.

Understanding Rhinoplasty Surgery

The definition of rhinoplasty is, literally, shaping the nose. First, incisions are made and the bone and cartilage support system of the nose is accessed. The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, certain amounts of underlying bone and cartilage are removed, added to, or rearranged to provide a newly shaped structure. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The tissues are then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed.

What To Expect After Rhinoplasty Surgery

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structure stable for at least five to eight days. If packing is placed inside the nose during surgery, it is removed the morning following the surgery. Your face will feel puffy,especially the first day after surgery. Pain medication may be required. You should avoid blowing your nose for seven days after surgery. In the immediate days following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort. Absorbable sutures are usually used that do not have to be removed. Nasal dressing and splints are usually removed six or seven days after surgery.

It is crucial that you follow your post operative directions, especially instructions to keep your head elevated for a certain period after surgery. Some activities will be prohibited in the weeks after the procedure. Sun exposure, exertion, and risk of injury must be avoided. If you wear glasses, special arrangements must be made to ensure that the glasses do not rest on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.

Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should be reported immediately. It is essential that you keep your follow-up appointments.