Description of Procedures

The following section of this Web site discusses many of the procedures performed by our facial plastic surgeons. Please proceed to the portions of particular interest to you.

Rhinoplasty: Creating the Nose You Always Wanted
Mentoplasty: Creating Facial Balance through Chin Augmentation
Malar Augmentation: Highlighting the Cheeks
Protruding Ears: Making Them Inconspicuous
Facial Sculpturing
Facelift Surgery: A Younger Looking You
Forehead Lift: An Upper Facelift
Blepharoplasty: Creating Less Tired Eyes
Facial Skin Resurfacing: Freshening Tired Skin
Collagen Injections: Removing Fine Lines
Dermabrasion and Scar Revision
Excision: Removing Skin Cancers, Moles and Tattoos
Laser Surgery: Removal of Prominent Blood Vessels
Reconstruction of Facial Skin Defects

Facial Sculpturing/Liposhaving

This is a method of removing fat from the neck to redefine the jawline. Sculpturing is performed either by direct fat removal, with liposuction, or the newer form of liposhaving and is most often done together with facelift surgery. In some patients, liposhaving may be done by itself without a facelift.

The bandages are removed three to five days after outpatient surgery and you are allowed to resume easy activities. Within a week you can return to work and commence full activities.

Facelift Surgery: A Younger Looking You

Facelift surgery has become one of the most popular and well-known forms of cosmetic surgery. More and more aging people want to look as youthful as they feel physically and mentally.

The surgery is designed to remove or reduce wrinkling caused by loose skin, and to lift and tighten sagging tissues of the lower face and neck. The incisions are placed in front of and behind the ear in the natural creases of the skin and in areas which help hide the scars. The skin is separated from the underlying tissues and gently smoothed back to relieve the redundant folds. We will often perform tightening of the underlying muscles of the face in order to provide this smoother skin a solid foundation to rest upon. The excess skin then is removed and the remaining skin is brought back into position.

The degree of improvement depends upon the amount of wrinkling and sagging of tissues present. The results can be dramatic if wrinkling is marked, but may be more subtle if the patient is younger and has only early sagging. No operation, of course, can permanently prevent aging, but with surgery you can be restored to a more youthful appearance. As the years go by you may wish to have additional rejuvenation procedures to lessen other signs of aging. The facelift does not speed the aging process and actually serves to help slow the sagging.

The surgery is performed on an out-patient basis. You can resume non-stressful activities during the first week. In about 10 days you can wear makeup and resume most normal activities. Final healing can take several weeks. It is important to understand what a facelift can and cannot do. It can smooth the skin on the face, cheek, and neck areas. However, it does not improve the eyelids, eyebrows, horizontal forehead creases, or the small vertical creases about the lips. Other procedures discussed here may be combined with a facelift to give a rejuvenated appearance to the entire face.

Forehead Lift: An Upper Facelift

One of the earliest signs of aging is the drooping of the eyebrows. This causes the eyes to appear smaller or deeper set and accentuates crowsfeet (the wrinkles often found at the outer corners of the eyes). In addition, furrows may appear horizontally and vertically as the brow descends. These conditions can be dramatically improved with a forehead lift. We often will recommend this in conjunction with or in place of a facelift to help in facial rejuvenation. In appropriate patient candidates, this procedure can be performed using the endoscopic approach.

The incisions are made in such a way so that they are hidden. The skin is separated and tightened. Some of the smaller muscles in the forehead which cause the deep furrowing may be weakened to reduce the severity of the frown lines. The procedure is frequently combined with a blepharoplasty in opening up and rejuvenating the eyes.

For the first week after outpatient surgery you may engage in relaxed activities, and then begin to resume normal activities the following week. Final healing may take several weeks.

Blepharoplasty: Creating Less Tired Eyes

Age brings changes to the eyes much as with other facial features. The muscles around the eyes often weaken, allowing fatty tissue to protrude through them, producing the commonly seen bags or pouches. Although this often is associated with the aging process, it also may be an inherited characteristic, or related to certain diseases. In addition, as the eyebrows descend, an accumulation of excess skin above the eyes can lead to a tired, hooded appearance.

Blepharoplasty (eyelift surgery) is designed to eliminate excess skin and fat in your upper and lower eyelids.

Most commonly, both upper and lower lid corrections are done during the same procedure. The incisions are hidden in the skin creases or on the inside surface of the lower eyelids. After the excess tissues are removed the wound is meticulously closed.

After outpatient surgery some temporary swelling and bruising of the eyelids may develop. Minimal restrictions are placed on activity for one week and you may resume normal activities the following week. Eye makeup may be worn after the first week.

Facial Skin Resurfacing: Freshening Tired Skin

Aging skin develops fine lines and wrinkles along with changes toward a more sallow complexion. Although surgery is available to remove the deeper lines, improvement of the finer wrinkles and facial color can be best achieved through facial skin resurfacing. We will often recommend a home skin care treatment program before and after the resurfacing, as well as light facial peels to improve and maintain their beneficial effects.

After thorough cleansing, a beam of laser light or the new coblation radiofrequency wave is applied to the areas of the face to lift off the superficial layer of the skin. Depending upon the depth level of the resurfacing, the healing period may range from a few hours to a few days. For the in-office facial peels, we usually recommend a series of three peels, spaced four to six weeks apart for optimal improvement, followed by periodic maintenance peels. These office peels are associated with minimal discomfort and minimal recovery time so that patients may return to work immediately. When satisfactory healing has occurred, you may resume wearing facial makeup. Physical activity should be limited for approximately five days following facial skin resurfacing procedures.

Collagen/Botox Injections: Removing Fine Lines

Collagen/botox injection is a useful means of improving specific wrinkles and scars. It can be used to refine improvement of other cosmetic procedures as well. It is most helpful in improving vertical furrows between eyebrows and creases about the lips. Botox is most helpful in improving the vertical furrows between the eyebrows. Collagen is used to fill out small skin surface defects, as well as the creases about the lips.

A test injection of collagen is done before treatment to detect any allergic reaction to the collagen. If there is no allergic reaction, the treatment can begin one month later. The collagen is injected into the wrinkles and scars. Additional treatment may be necessary over time since the collagen gradually absorbs into the tissue and its effect disappears. This treatment can provide some improvement in about eighty percent of patients and is done in the office with local anesthesia. You can immediately resume full activities. Botox is a medication which is injected directly into the muscles to weaken the activity of the muscle. This in turn will result in a smoother appearance on the skin surface. The duration of the effect for botox varies from individual to individual but is usually in the range of three to six months. The treatment can be repeated as often as desired. There is no restriction on activities following either collagen or botox treatments.

Dermabrasion and Scar Revision

Different types of scars can be improved by using a variety of techniques.The overall goal of improvement is to minimize the appearance of the scars.You must realize that it is not ever possible to completely remove all traces of the scar since the body can only heal by forming a new scar. The goal of scar revision and dermabrasion is to render a scar less conspicuous.

Scar revision and dermabrasion procedures are done either in the office setting or in the outpatient surgery area. Healing generally takes several days and there usually is minimal restriction on activities. On occasion a scar revision surgery is combined with dermabrasion in a staged fashion to achieve the best results possible.

Dermabrasion is an excellent means of providing overall improvement in acne scarring. The scarring cannot be completely removed, but when combined with other minor procedures and, rarely, a complete facelift, dermabrasion can provide excellent smoothing of noticeable acne defects. The acne itself must be quiescent or inactive prior to dermabrasion.

Excision: Removing Skin Cancers, Moles and Tattoos

If you have skin cancer, blemishes, moles or tattoos, surgical excision may be an option. Even though most moles are not dangerous, a certain type of flat, deeply colored variety may precede a highly malignant skin tumor.

There usually is a small scar which results from this type of surgery, but these generally blend well with the surrounding skin.

Laser Surgery: Removal of Prominent Blood Vessels

Congenital birthmarks, hemangiomas and prominent facial blood vessels maybe treated by laser applications. The laser is a special focused beam of light used to seal off the tiny vessels without injuring the surrounding normal skin. The results of this treatment usually are a nearly normal appearing skin area but vary with the particular patient and the particular process.

After outpatient laser surgery there usually is no restriction on activities. Some patients may require more than one treatment for satisfactory improvement.

Reconstruction of Facial Skin Defects

Reconstruction of the skin and deeper tissues of the face may be necessary because of injury or following removal of skin tumors, or even with congenital facial deformities. The reconstruction usually is performed in our outpatient surgery suite. We usually will use tissue from an adjacent region to repair the defect so that the tissue matches the surrounding areas as closely as possible. More than one operation may be necessary to achieve the best result. Since these reconstructions can vary depending upon the defect, we will discuss with you all of the steps planned for your reconstruction at the time of your pre-operative visit to our office.

In Conclusion