Facial Cosmetic Surgery

Eyelid Lift (Blepharoplasty)

The incision for the upper eyelid is usually made along the eyelid crease. The incision for the lower eyelid may be made inside the lower eyelid, avoiding external scars (transconjunctival) or externally just below the eyelashes. Excess skin along the outside of the lower eyelid region may be "tightened" with a chemical peel or ablative laser.

Who is a Candidate?

• If you have excessive, sagging or wrinkled upper or lower eyelid skin.
• If you have excess upper eyelid skin that interferes with vision.
• If you have lost your natural upper eyelid crease.
• If you have puffy pouches of fat in the upper or lower eyelids that create a tired or aged appearance.

Intended Result

• A more youthful and rested appearance of the eyes.
• Widening of visual fields if excessive upper eyelid skin has partially blocked vision.

Procedure Description

• The operation is usually done on an outpatient basis under local anesthesia alone or conscious sedation.
• Either a "Colorado" needle or scalpel is used for skin incisions to minimize scar and bleeding during the procedure.
• The incisions are made where the natural crease should be in the upper eyelids. Excess fat and skin are removed.
• The incision for the lower eyelids is usually inside the lower lids, avoiding external incisions and scar (transconjunctival).
• If there is significant "laxity" of the lower eyelid, a canthopexy or tightening procedure may be done at the same time. The incision is along the outer portion of the lid just below the eyelash line.

Recuperation and Healing

• All sutures are usually removed within 7 days.
• Initial discomfort is usually mild and controlled with oral medication.
• Bruising and sensitivity to light usually subside within 1-2 weeks.
• Swelling usually disappears within 2 weeks.
• Eye makeup may be used following suture removal and healing of the incisions. Old makeup should be discarded as it may promote bacterial growth and postoperative infection.
• Contact lenses can be worn when comfortable and sutures have been removed-usually 7-10 days.

Other Options

• Additional procedures that may enhance the result are: forehead lift (endo eyebrow lift), facelift, carbon dioxide laser resurfacing, chemical peel, and Botox.

Notes

• The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Face/Neck Lift

A facelift-necklift helps improve the most visible signs of aging through removal and redistributing excess fatty deposits, tightening underlying muscles and removing sagging skin. The standard facelift addresses the lower 1/3 of the face and the upper neck.

Variants include the mini and extended facelift-necklift procedures. Procedure choice depends on your needs and must be discussed with your surgeon. Surgeons have recognized the three dimensional nature of the facial structures and often complemented this procedure with others to restore volume and address cosmetic issues throughout the facial-neck structures.

Often other facial procedures are performed at the same time including forehead lift, eyelid lift (blepharoplasty), chin and cheek implants, nose reshaping (rhinoplasty), liposculpture, chemical peel, laser resurfacing and lipotransfer.

Who is a Candidate?

• Men and women with jowl formation (the lower cheeks and jaw line are saggy).
• Men and women with a poorly defined jaw line.
• Men and women with wrinkled saggy and fatty neck.

Intended Results

• A sharper and better defined jaw line.
• Improved neck and chin angle.
• Less tired look with more youthful appearance.
• This does not treat the lines around the mouth and will not improve skin surface defects and discoloration.

Procedure Description

• Face Lifts are usually performed in an accredited office facility, outpatient surgical facility or in the hospital.
• They may be performed under local anesthesia with or without oral sedation, conscious sedation, and general anesthesia.
• The surgeon usually makes incisions in front and behind the ear. This should be discussed with your surgeon.
• Sutures and/or staples are used for closure followed by placement of an elastic dressing around the face and neck.

Recuperation and Healing

• Recovery may be at home with a responsible adult, in a recovery facility or overnight in the hospital.
• A compression garment may be worn around the lower face and neck for approximately one week.
• Bruising and swelling are normal and may take several weeks to resolve.
• Stiffness in the neck and some soreness with swallowing and eating is common.
• Sutures and staples are removed within two weeks.
• Drains, if used are usually removed 1-3 days after the procedure.
• Make-up can be applied over the skin immediately but not over the incisions for 2-3 weeks.

Other Options

• Chemical peels, laser resurfacing and microdermabrasion to improve the skin appearance and texture.
• Botulinum toxin and fillers.
• Lipotransfer and implant insertion to restore lost volume.
• Eyelid and forehead rejuvenation.
• Rhinoplasty.

Note

• The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Forehead Lift

In some instances a forehead lift will be recommended to improve some wrinkled skin and in many instances can help reduce the appearance of a high hair line or a high forehead. There are a number of different approaches for a Forehead Lift, including the direct lift, the mid-forehead pre-tracheal (at or in front of the hair line), coronal (behind and in the back of the hair line) or an endoscopic (minimal incision) approach.

Who is a Candidate?

• Those who have a low eyebrow position.
• Those who have eyebrow asymmetry.
• If you have excessive, sagging or wrinkled upper eyelid skin.
• If you have excess upper eyelid skin that interferes with vision.
• If you have puffy pouches of fat in the upper eyelids that create a tired or aged appearance.
• Those with excess forehead wrinkles.
• Those with a high hair line or high forehead who wish to lower the hairline.

Intended Results

• Improved eyebrow position.
• Reduced appearance of wrinkles in the forehead.
• Reduced appearance of wrinkles between the eyebrows.

Procedure Description

• Incisions may be made above the eyebrows in a skin fold, in front of the hairline, in the hair line or endoscopically (minimal incision).
• The procedure is usually performed as an outpatient under local anesthesia or conscious sedation.
• Attempts are made to correct eyebrow asymmetry although some asymmetry is the rule.
• The procedure is often combined with blepharoplaasty and facelift-necklift.

Recuperation and Healing

• All sutures are usually removed within 7 -10 days.
• Initial discomfort is usually mild and controlled with oral medication.
• Bruising usually subsides within 1-2 weeks.
• Swelling usually disappears within 2 weeks.
• Makeup may be used following suture removal and healing of the incisions .Old makeup should be discarded as it may promote bacterial growth and postoperative infection.
• Contact lenses can be worn when comfortable and sutures have been removed-usually 7-10 days.
• There is usually some numbness (usually temporary) due to stretching of the sensory nerves in the region of the forehead.

Other Options

• Additional procedures that may enhance the result are: blepharoplasty, facelift-necklift, carbon dioxide laser resurfacing, chemical peel and Botox.

Notes

• The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Genioplasty

A small incision is made either underneath the chin or inside the mouth. A sterile implant, similar to the consistency of a normal chin, is placed in front of the bone to increase the projection of the chin. The implant is secured and the incision is sutured closed. Alternatively, a bony osteotomy may be performed and the chin and soft tissues are advanced to create facial balance and a natural, improved appearance.

Some swelling and bruising can be expected and usually subsides within the first two weeks. A tape of elastic dressing may be recommended for a period of time. Mild discomfort is usually easily controlled with medications prescribed by your surgeon.

After healing, the skin drapes smoothly over the implants. The implants themselves conform to the bone and are usually undetectable. The added projection of the chin results in significant improvement which is especially apparent in profile.

Lip Implant

A significant development has occurred in lip enhancement surgery. The new Advanta lip implant has proven to be an exciting alternative to other lip implant materials. The Advanta implant is a similar material to Gore-Tex, but it is smoother and pliable and the "next generation" facial implant. The unique one piece construction offers patients a softer, more aesthetic and more comfortable implant with a more natural look and feel. These silky properties allow the implant to be placed in the lips and smile lines and remain virtually undetectable.

Malar Augmentation

A cosmetic surgeon may be able to add facial implants to the facial skeleton to accentuate the areas of the cheek bone, chin, nose, and angle of the lower jaw. These skeletal augmentations redrape and tighten the skin of the face. This provides a more healthy and youthful appearance without the need for a more extensive skeletal lift procedure. The surgery is performed from within the mouth with no visible scars. Immediate results are evident.

Otoplasty

Otoplasty is usually performed under sedation with local anesthesia and takes less than two hours to complete. Postoperative discomfort is usually minimal.

Rhinoplasty

Rhinoplasty is performed under sedation with local anesthesia. The surgery takes approximately one and one-half to two hours. The use of "seamless" nose surgery allows for no visible external scars and with this type of seamless nose surgery discomfort is minimized because no plates, tubes or painful packaging are used.

Rhinoplasty is often an enhancement to facial rejuvenation, particularly in the correction of the aging nose (drooping of the tip). A significant "combo" effect is seen with facial augmentation in conjunction with cosmetic nasal surgery.

In most instances, change in appearance can be seen immediately.