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Face

Facelift

Today's facelift is more effective and natural looking than ever before. The goal of a facelift is not to give you a different look, but rather help you look as you used too - turn back the clock. The facelift (rhytidectomy) is a surgical procedure used to reduce the most apparent signs of aging in the facial area giving you a more youthful appearance. The procedure involves reducing the creases from the nose and mouth, the slacking jaw line and sagging jowls and fat deposits around the neck by removing excess fat tightening underlying muscles, and redraping the skin on the face and neck. Though the procedure cannot give you a completely new look it can give you a younger, fresher look. It can also have a positive effect on your self confidence. The drawings featured depict the traditional facelift procedure.

The best candidate for a facelift is a man or a woman whose face and neck have begun to sag, but whose skin has elasticity and whose bone structure is strong and well defined. Most patients are in their forties to sixties, but facelifts can be done successfully on patients in their seventies and eighties.

Facial rejuvenation can be accomplished utilizing a number of different techniques. At the time of a consultation the patient's concerns about their appearance are discussed in detail. A plan for facial rejuvenation is formulated and the best technique to accomplish these goals are discussed at the time of consultation. The procedure can be performed under general or twilight anesthesia. Most patients are back to work 2 weeks after surgery. Other activity will be limited for a few more weeks. Depending on the technique required to achieve the formulated goals, the recovery time may be less than anticipated.

The greatest risk of complication with the facelift procedure can occur in people who smoke. Smoking decreases a patient's wound healing capacity and may lead to tissue loss and poor scar quality. Patients who smoke must stop 3-4 weeks prior to the procedure and not resume until 4 weeks after the procedure.

All of the potential risks of the procedure are discussed at the time of the consultation.

Necklift

Loose, excess skin and fatty tissues beneath the jaw lead to a double chin deformity. Many patients with this problem can be treated by the removal of excess fat utilizing liposuction to contour the chin and neck areas creating a more youthful appearance. This can be accomplished through a very small incision under the chin without the need for a facelift.

Depending on the degree of neck laxity, a technique to tighten the sagging superficial neck muscles may be incorporated with liposuction to reshape and contour the neck and jaw line. There are no visible scars with this procedure. The result is a tighter, more youthful neck and jaw line that can take years off one's appearance. The procedure is performed under sedation or general anesthesia. Patients are typically back to work within a week. Recovery can be brief and discomfort is minimal. Details of the procedure will be discussed at the time of the consultation.

Rhinoplasty

Surgery of the nose is one of the most common of all plastic surgery procedures. The best candidates for a rhinoplasty, or a "nose job" as it is so commonly called, are those people who are looking for an improvement in the way they look, not those searching for perfection. This surgery can reduce or increase the overall size of your nose, change the shape of the tip or bridge, narrow or widen the nostrils, and even improve the angle between the nose and upper lip.

At the time of consultation the nose will be analyzed critically and a plan for correction will be formulated. Computerized imaging may be used to try to predict the appearance of the nose following surgery. Depending on which areas of the nose require correction, the incisions may be placed inside the nose or an "open", external approach may be recommended.

The surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then redraped over the new framework. Many plastic surgeons prefer an "open" procedure, usually in the more complicated cases where the surgeon makes a small incision across the columella; this is the vertical strip of tissue that separates the nostrils. After the surgery is complete, a splint is then applied to help the nose maintain its new shape. Nasal packs or soft splints may be placed in the nostrils to stabilize the septum and/or the nasal bones.

After surgery, especially during the first twenty-four hours, the face will feel puffy, the nose may ache, and the patient may experience a dull headache. The patient should plan on resting with their head elevated for the first day. There will be swelling and bruising around the eyes, reaching a peak after two to three days. If the patient has nasal packing it will be removed after a few days and the patient will feel more comfortable. By the end of one week all packing, dressings, splints and stitches should be removed.

This procedure is performed in a surgery center or hospital under sedation or general anesthesia. Physical activity will be limited for 4-6 weeks. Patients can return to work within 5-7 days.

Eyelid Surgery (Blepharoplasty)

More than any other facial feature, the eyes have a tremendous impact on your appearance. The eyes are often the first place to show signs of aging. Blepharoplasty or eyelid surgery can enhance your appearance and your self confidence by eliminating droopy or sagging eyelids. Many people complain that they always look tired. As people age the eyelid stretches, muscles weaken, and fat accumulates around the eyes, causing "bags", or excess skin to become prominent. During your consultation with the doctor, he will assess which of the four eyelids (top and bottom for both eyes) require the procedure. Because eyelid surgery may help to correct interference with vision, it is possible that it is considered a medical procedure, and may be covered by insurance. The drawings featured depict the traditional blepharoplasty procedure.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Generally patients for this procedure are 35 years or older. However, if sagging eyelids run in your family, it may be advisable to have eyelid surgery at a younger age.

The procedure involves the removal of excess skin and redundant fat if it is present. The upper eyelid crease is recreated as it was prior to the development of the excess skin. The lower eyelids may be treated by making an incision below the eyelashes resulting in an external scar or from the inside of the lower eyelid called a transconjunctival approach. This allows for removal of excess fat without an external incision. If utilizing the transconjunctival approach, the skin is tightened by laser resurfacing. Any and all scars will usually fade and become barely noticeable over 1 to 2 months.

The procedure is done as an outpatient typically with twilight anesthesia. The procedure takes 1-2 hours depending on what is being done. The patient can expect swelling and bruising post-operatively. In our practice the laser is used for the procedure and this helps to reduce the overall amount of bruising and swelling significantly. Despite this some patients will bruise or swell more than others. You will be amazed at how a little improvement in your eyes can have such a dramatic impact on your appearance. This procedure does not remove crow's feet or eliminate dark circles under your eyes.

The potential complications of the procedure are discussed in detail with the patient prior to surgery.

BOTOX® Cosmetic Injections

BOTOX® Cosmetic injections have become a popular new treatment for certain types of facial wrinkles. BOTOX® Cosmetic acts differently than traditional fillers such as collagen. BOTOX® acts to temporarily weaken the facial muscles in the treated area relaxing the skin's surface thus "removing" the wrinkle.

The type of lines and wrinkles that respond best to this procedure are those muscles that are repeatedly over contracted during facial expressions such as frowning or squinting. BOTOX® Cosmetic injections have been very effective in reducing the appearance of frown lines, forehead furrows, "crow's feet", lines and wrinkles of the lower face, and even prominent vertical bands in the neck.

The injections take effect in 3 to 5 days, and last between 3 to 6 months. BOTOX® Cosmetic injections tend to work best on men and women between the ages of 30 and 60. The injections are done in the office, and there is no downtime.

Contour ThreadLiftTM

The Contour ThreadLiftTM is used to lift sagging eyebrows or adjust asymmetric eyebrows. This procedure is also used to lift drooping soft tissue of the mid and lower face and neck as well as reposition sagging cheeks. The procedure is performed under local anesthesia and takes from 30 - 60 minutes depending on the number of threads used. Patients are able to go home soon after the procedure and generally return to work in 2-3 days after the procedure.

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