Face Procedures
Eyelid Surgery (Blepharoplasty)
Procedure Overview:
Eyelid Surgery (Blepharoplasty) – A blepharoplasty is a procedure performed on the upper or lower eyelids that is designed to remove excess skin or bulging fat. An incision is made in the upper lid crease or just below the lash line on the lower lid. An alternative transconjuntival approach means an incision on the inside of the lower lid. It’s important to be aware that the many patients complaining of upper eyelid fullness actually need a brow lift as their eyebrows have descended over time and this is responsible for the upper eyelid fullness.
Anesthesia Options:
Local anesthesia (numbs the area around your eyes), or IV Sedation with local. Some patients prefer general anesthesia. Our anesthesiologist will discuss this with you. Many patients often prefer at least some sedation when considering a blepharoplasty because of the sensitive area being treated (no peeking!) If you are having multiple facial procedures done at the same time, general anesthesia is preferred.
Risks and Benefits:
Temporary discomfort, tightness of lids, swelling, bruising, temporary dryness, burning, itching of eyes, excessive tearing, sensitivity to light for first few weeks. Less common problems include temporary blurred or double vision, infection, bleeding, swelling at the corners of the eyelids, dry eyes, formation of whiteheads (milia), slight asymmetry in healing or scarring, difficulty in closing eyes completely (rarely permanent), pulling down of the lower lids (may require further surgery), and blindness (extremely rare).
The removal of too much skin or fat is undesirable. Lower eyelid retraction (the rounded eye appearance) is to be avoided by appropriate and conservative treatment. A canthopexy or lower lid tightening may be needed at the time of your procedure to minimize the potential for lower eyelid malposition. The benefit of a blepharoplasty is the removal of excess skin with a more “bright eyed”, youthful look. Removal of bulging fat will make your eyes appear less tired and old. What is the first thing you notice when you look at a persons face? Eyes are what others are going to notice immediately—beautiful eyes are at the epicenter of facial beauty.
Recovery:
After surgery, your eyesight will seem blurry, as lubricating ointment was placed in your eyes during surgery. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by us. You will be instructed to keep your head elevated for 7-10 days while in bed, and to use cold compresses to reduce the swelling and bruising. Bruising varies from person to person: it reaches its peak during the first 2-3 days and can last 2-3 weeks. Your eyes may be “gummy” for a week or so. We recommend eye drops, since your eyelids may feel dry at first and your eyes may burn or itch.
The stitches will be removed 3-5 days after surgery. Once they’re out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better. You should be able to read or watch television after two or three days. However, you won’t be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while. In about four to five days, depending on your rate of healing and your doctor’s instructions, you’ll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses. It takes about six months for all the swelling to diminish.
Dr. C’s Take:
In expert hands, an upper blepharoplasty is wonderfully refreshing with little downside. A lower blepharoplasty is performed in an area of sensitive anatomy that requires caution and conservatism. In general, less is more when it comes to blepharoplasty. Leaving enough fat and fullness to the lids is important in creating a more youthful result. An upper blepharoplasty is distinctly different from a brow lift and you should understand these differences. Combining a blepharoplasty with an acid peel is common as the acid is used to soften the fine wrinkling about the eyelids.
Eyebrow Lift
Procedure Overview:
Eyebrow Lift (“brow lift”) – An eyebrow lift helps restore a more youthful, refreshed look to the eyes. The procedure corrects drooping eyebrows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. In a forehead lift, muscles are reduced to smooth the forehead, raise the eyebrows and minimize frown lines. Your surgeon may use the conventional surgical method in which the incision is hidden just behind the hairline; or use an endoscope, a viewing instrument that allows the procedure to be performed with several small incisions. Both techniques yield similar results — smoother forehead skin, less heaviness of the brow area and a more “bright eyed” appearance. A drain may be used after surgery. Many patients think they need a blepharoplasty (eye lift) when they actually need a brow lift or both. Make sure your surgeon can perform a brow lift endoscopically so that your options are not limited by their skills. Some patients are better candidates for the “open” non endoscopic technique because of their tissue/forehead characteristics. Interestingly enough, endoscopic reduction of the muscles that cause frowning between the eyes has help many patients who suffer from migrane headaches. We don’t know the reason why, but it does. This is very good news for migrane sufferers.
Anesthesia Options:
General anesthesia.
Risks and Benefits:
The immediate post-operative experience for a patient who has had a classic forehead lift may differ significantly from a patient who had the procedure performed endoscopically. Generally, all patients experience bruising, swelling, and tightness around the forehead. Some patients complain of a compression type headache. Most patients will have difficulty closing their eyes for several days after the procedure because of the swelling. There will be numbness along the incision lines and behind them for several months. Hair thinning at the incisions is not uncommon (one of the benefits of the endoscopic technique is much smaller incisions). Pruritis or itching behind the larger open incision is a possibility and can be bothersome. Many patients fear the “bug eyed” appearance that can occur with this procedure but if your doctor properly selects those who will benefit most this is very unlikely (particularly with the endoscopic technique).
The benefits from a brow lift are typically very exciting—a bright eyed youthful appearance and a less stressed or angry appearance. Since others see you through your eyes the results can be very gratifying. Creases about the forehead and between your eyes soften with time. In some cases headaches and even migraines have improved after this procedure.
Recovery:
You will be up and around on the day of surgery, but plan to limit your activity for at least the four days after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed. Most patients are back to work or school in a week. Endoscopic patients may feel ready to return even sooner. Vigorous physical activity should be limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Lubricating eye drops are used for a week or so after the procedure. Prolonged exposure to heat or sun should be limited for several months. Most of the visible signs of surgery should fade completely within about three weeks. Minor swelling and bruising can be concealed with special camouflage makeup.
Dr. C’s Take:
This is a powerful procedure as it improves a critical area of the facial anatomy–the eyes. A full “open” brow lift involves an incision across the entire upper head, ear to ear. An endoscopic brow lift uses limited incisions in the frontal hairline. The open technique is more powerful but has the drawback of the large incision and scarring and hair loss and numbness. The endoscopic is not as powerful but is excellent overall because it’s very limitations offer patients that rested and “non operated” look by not over elevating the eyebrows (deer in the headlights). There are also limited incision brow lifts as well that work to improve limited areas only. Your surgeon must have experience with the endoscopic technique to be proficient.
Nose Surgery (Rhinoplasty)
Procedure Overview:
Nose Surgery (Rhinoplasty) – Rhinoplasty reshapes the nose by reducing the size and or shape of your nose. Options with Rhinoplasty include, changing the shape of the tip or the bridge, narrowing the span of the nostrils, or changing the angle between your nose and your upper lip. It may also correct a birth defect or injury or help relieve some breathing problems.
Anesthesia Options:
IV sedation or General anesthesia is recommended.
Risks and Benefits:
Temporary swelling and bruising around the eyes nose and cheeks. Some people complain of headaches. If internal work was performed this could lead to temporary breathing compromise from internal swelling. Bleeding is a risk for 10 days to 2 weeks if internal work has been done on your turbinates. Infection is rare. Additional surgery is sometimes necessary to achieve the desired result. Having a qualified surgeon is of paramount importance in Rhinoplasty as inexpert surgery can result in contour irregularities and asymmetries or an undesirable shape.
The benefits include a more proportional nose with more desirable features or the improvement in undesirable features (such as a large hump or a wide nasal tip). Improvement in breathing can be very beneficial.
Recovery:
After surgery, particularly during the first twenty-four hours, your face will feel puffy, your nose may ache, and you may have a dull headache. You will be asked to sleep with the head of your bed elevated and apply ice to reduce bruising and swelling. You may have internal packing in your nostrils for 1-4 days. If a bone fracture was performed, a nasal splint is typically worn for about 5 days. All nasal swelling will be gone about 1.5 years after your procedure. Nasal saline spray is recommended for your comfort for about two weeks. You may be asked to follow up in the office weekly if internal work was performed to clean the inside to ensure unobstructed breathing.
Dr. C’s Take:
Unfortunately, so many patients are aware of the nose jobs that “went bad” that they are afraid to consider this relativey popular procedure–”I don’t want a pig nose or something that looks unnatural”. An expert surgeon can often work wonders on improving facial balance and providing a refined nose with artistic rhinoplasty techniques. Stick with surgeons with experience and you will likely find this procedure very rewarding on many levels. The best results tend to be the very outcomes that “nobody noticed!”
Facelift
Procedure Overview:
Facelift (Rhytidectomy) – A facelift is a procedure that improves the appearance of the aging face. The procedure involves removal or redraping of excess skin, tightening of the underlying face muscles and other procedures to produce a younger more refreshed appearance. This is an artistic endeavor and every surgeon approaches the task in his or her own way. The exact placement of incisions and the sequence of events depend on your facial structure and your surgeon’s technique. Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin. A “suture” or “thread” type facelift involves the placement of long sutures beneath the skin so that the suture pulls the tissue into a more youthful appearance. A “mini” facelift typically involves limited incisions in front of the ear and a small limited one behind the ear.
Anesthesia Options:
Depending on the type of face lift and your own anesthesia desires, you may need local, IV sedation or general anesthesia.
Risks and Benefits:
Bruising and swelling is the most prominent part of the early recovery period. Numbness of the face is typical and temporary. The face will feel tight. Pain is not a sensation typically associated with a facelift. Face lifting in men will result in the permanent need to shave behind ears, where beard-growing skin is repositioned. Other risks include injury to the nerves that control facial muscles or feeling (usually temporary but may be permanent), infection, bleeding and hematoma, poor healing, excessive scarring, asymmetry or change in hairline. The benefit of a facelift is a more youthful and refreshed appearance and all that comes with it.
Recovery:
As a general rule, you will look worse before you look better! Your face will be swollen and have a somewhat “operated” look for the first two weeks or so. After 4-5 weeks you will look fairly natural and you will look your best about one year after your procedure. We usually recommend 2 weeks off work, but you will likely feel fine and may be out in public after 7 days, with mild swelling and bruising. Some people get back to daily activities relatively soon after a face lift because they don’t have any problem going into the public eye with imperfections. If drains are used they are removed within one week of your procedure.
Strenuous activity must be limited for at least 2 weeks. Bruising around the neck and chest can last 2 weeks or more. Sun exposure must be limited for several months. Sunscreen and a wide brimmed hat are recommended for at least 6-8 months. Most incisions heal very well after a year or so and are not noticeable. The key to a successful recovery from a face lift is to be patient and don’t be too critical (don’t spend a lot of time in the mirror checking for irregularities).
Dr. C’s Take:
There are many different types of face lifting procedures and it’s very easy for patients to get confused. Many non plastic surgeons have gotten into the mix offering all sorts of interesting procedures. Patients very much like the results of a good face lift but they fear surgery. Unfortunately, non surgical techniques have fallen far short of their expectations (despite the marketing promises). The “revolution” in facial plastic surgery is the creative and artistic application of the various procedures that when combined leave the patient with a beautiful, natural result, with little evidence of “surgery”.
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Neck Lift
Procedure Overview:
A neck lift includes any procedure to rejuvenate the neck by removing excess skin and fat, and tightening underlying muscles where applicable. Like a face lift, there are significant artistic options available to achieve a desired goal.
A full neck lift involves an incision beneath the chin and others around the ear and in front of the hairline behind the ear. Any procedure that offers smaller incisions would be considered a “mini” lift. Depending on the quality of your skin and your neck anatomy, your surgeon will make his/her recommendation as to the type of neck lift that would work best for you. In order to ensure total facial harmony, a neck lift is frequently performed in combination with a facelift and eyelid surgery. Drains are common in neck lifts.
Liposuction is also an option for those who have fatty necks and relatively good skin. Like all neck lifts, the goal is to reduce neck fullness, improve neck definition and improve the neck skin.
Anesthesia Options:
Local, IV Sedation and General Anesthesia.
Risks and Benefits:
The risks include bleeding with hematoma formation or a “blood collection” beneath the skin. Irregularities can occur as well as a “tight band” under the chin from the healing muscle edge. Infection is uncommon but can occur. The incisions are typically well hidden and fade with time. Smoking is a relative contraindication in a full neck lift. In the right candidate it can dramatically improve your appearance, restore a youthful jaw line and take years off your age.
Recovery:
Following surgery patients may experience discomfort, tightness, swelling and bruising, all of which typically resolve over time. The neck will feel somewhat “woody” for about six weeks or so. The patient can usually return to work after 1 week or longer depending on the individual. Exercise and strenuous activity may be resumed at 2 weeks following surgery. A neck support band is often recommended to ensure the best result.
Dr. C’s Take:
Improvements in the neck go a very long way to creating a youthful appearance. Full necks with no neck angle and no distinction between the face and the neck is unflattering. Improvements in neck procedures now include a “limited anterior neck” procedure. In properly selected patients, all the improvements that are needed can be performed though a small incision beneath the chin. A “full neck” procedure, with incisions around and behind the ears isn’t needed in many cases. You are wasting your time and money if you are considering a “weekend neck lift” or “thread lift” to achieve what you will be getting with an anterior neck lift from a reputable plastic surgeon.
Facial Liposuction
Procedure Overview:
Facial Liposuction is performed in the same manner as body liposuction—the use of a cannula beneath the skin to contour fat except it is on the face. Your surgeon may use a simple cannula or even a powered device such as a laser based system. In all cases however, this must be done carefully and expertly to minimize the potential for contour irregularities (dimples, divots or worse). It’s important to remember that as we get older we generally lose facial fat so you would not want to remove a lot of fat and then look “empty” or “drawn” as you get older. The most common area that I treat are the jowls, very large cheeks, the area in front of the ears and the neck.
Anesthesia Options:
Local, IV Sedation or General.
Risks and Benefits:
Temporary bruising, swelling, numbness, soreness, and burning sensation. Contour irregularities can occur. Temporary nerve and muscle weakness can occur. Removal of too much fat is a no-no as this can create significant skin irregularities. Liposuction will not tighten the skin. The benefits can be a very positive shape improvement of your face and the loss of fullness in areas that make you look older (like the jowls and neck). There will be improved facial definition.
Recovery:
Most patients can return to work within 2 days, but may still have some noticeable swelling. It takes a few months for all the swelling to disappear. Sometimes a compression garment is worn for several days after the procedure and then at night for a week or so.
Dr. C’s Take:
This is a nice procedure in the right patient. Again, your surgeon has to be experienced with this. You don’t want too much fat removed and it must be contoured to perfection. The results are subtle but real. People will wonder what is different but they won’t know why. This is commonly performed in the cheeks and jowl areas as well as the neck.
Chemical Peel
Procedure Overview:
Chemical peels consist of the application of an acid that improves the appearance and texture of the skin by removing its damaged outer layers. New skin then grows that is healthier and non sun damaged. It is helpful for those individuals with facial blemishes, wrinkles, and uneven pigmentation or hyperpigmentation from sun damage. Phenol, trichloracetic acid (TCA) and alphahydroxy acids (AHAs) are examples of common acids used for this purpose.
How deep the peel penetrates the layers of skin will determine how well it works and how long your recovery will last. Deeper peels offer greater results but longer recovery and greater potential for scarring and other complications. The procedure is part science and part artistry. Weak peels can be offered as a “lunchtime peel” with little discomfort and some improvement. Strong peels require some form of anesthesia for your comfort and will result in significant skin reaction such as swelling, crusting and redness. Peels should not be looked at as a one time treatment—most patients benefit from some form of peeling on an ongoing basis, with the lighter peels every six or so weeks and the deeper peels perhaps every other or as needed.
Peels are very popular because the treatment clearly makes your skin look much better. In fact, many patients who are considering facial plastic surgery are great candidates for a chemical peel. I consider the skin to be the “canvas” on which I will be working with. Great looking skin is a critical component of beauty. We all admire and take note of those who have an even skin tone with a natural healthy glow.
As a general rule, the more vigorous you react to your peel the better your outcome will be. Some individuals respond better to peels than others because of their skin type. Chemical peels do not “thin” your skin as layers are removed—it actually causes thickening of the skin in part because of increased collagen production (a building block of skin). Lasers used for correcting sun damaged skin work a bit differently than chemical peels and produce variable results.
Anesthesia Options:
Simple weak acid peels are performed without anesthesia. Stronger acid peels generally require topical anesthesia or even IV anesthesia provided by my anesthesiologist.
Risks and Benefits:
The risks of a chemical peel include scarring, pigmentation changes, prolonged redness, infection, allergic reaction to the peel, swelling and skin sensitivity, among others. The most common issue I see with chemical peels is excessive sensitivity to the peel with greater swelling and redness than typical. All patients with deeper peels will shed the outer layer of skin in the form of peeling and flaking which can last days (it looks like a sunburn).
Recovery:
Phenol Peel: You should plan to take at least 3 weeks off work, and you may not want to be seen by friends or neighbors for that time either. You will have significant sloughing of dead skin, crusting and scab formation, and severe swelling. The entire area must be occluded with a waterproof ointment such as Aquaphor. The ointment keeps the air and bacteria from the treated area. After several days you must start cleaning the area with a solution of vinegar and water. At first this may sting and burn, but eventually becomes soothing and helps control itching. You must refrain from strenuous activities, bending and lifting, or any activity that will cause increased pressure to your face for 2-3 weeks. Complete healing normally takes 3-6 months. Camouflage makeup can be worn once the skin is dry and red.
TCA Peel: While healing is faster than a phenol peel, you will still experience redness, swelling and sloughing of dead skin. Because it is not as deep as a phenol peel, these symptoms usually only last a few days. Vinegar and water can be used to cleanse the skin starting the same day. Once the peeling has stopped, your skin will remain red for another 3-4 weeks. It is important to wear a good sunscreen at all times to prevent hyper pigmentation. Most people require several days off work, again depending on the depth of the peel.
AHA peels or lighter peels are generally mild and require no recovery.
Dr. C’s Take:
Peels are wonderful and underutilized in my opinion. Lasers came into vogue fifteen years ago and we used acid peels less often but now there is a resurgence in their use because they are predictable, reliable and affordable. The greater the reaction to your acid peel the more likely you will get a good result. Recovery from the acid peel is the hard part as it takes five days or so of peeling until the pink skin appears. This is a great way to treat sun damage and precancerous lesions as well as dyschromia (blotchy skin discoloration).
Lip Augmentation
Procedure Overview:
A lip augmentation is a procedure that uses synthetic or biological products, or surgical restructuring to provide fuller more shapely lips. The easiest and most common lip enhancer is the use of the newer fillerson the market like Perlane and Restylane and many others. Fat can be taken from your body and injected into your lips. There are lip implantsmade from various materials that can be inserted as well (silicone, Gortex and others). Your own dermis can be inserted into your lips. There are surgical procedures that canrearrange the tissue about your lips that provides for some fullness.
Anesthesia Options:
Local anesthesia, or local with IV sedation.
Risks and Benefits:
We recommend that all of our patients start prophylactic antiviral medication 3 days before the procedure to reduce the chance of developing a cold sore or fever blister. You will be bruised and swollen for several days to a week. Soreness, bruising, stiffness, burning, numbness, prickling sensations, etc are all possible for a few days to weeks after this procedure.
Fat injections cause significant swelling that prolongs the recover time. Fat loss will occur over time and can completely disappear. Filler work well but they last only for months up to a year. Dermal grafts work well but they too tend to dissolve over time. Implants are permanent but they can also feel abnormally firm in some cases, can become infected and appear unnatural. Tissue rearrangement provides only a limited amount of improvement and usually is not recommended without the use of a filler as well.
The benefits are fuller more attractive lips.
Recovery:
Recovery varies based on the technique used. You may need an oral pain medication for a few days, but after that Tylenol is usually sufficient. You may need to continue your antiviral medication for another 5-7 days. Your lips may be purplish or blanched (white or pale) during the recovery period. We also recommend a soft diet and avoiding large facial/lip movements for a few days also.
For more thorough information, please visit our lip enhancement page.
Dr. C’s Take:
I was not a big fan of lip augmentation because the various implants that were recommended didn’t give me confidence. Now with the Permalip implants (soft, silicone implants) I have been getting impressive outcomes with happy patients and few, if any complications. It’s a permanent fix to the problem of shrinking lips as we get older. Nothing beats a beautiful pair of full lips. “Duck” or “sausage” lips are created only by those who go overboard. If you want to see what your lips will look like fuller before you consider an implant simply use the off the shelf injectable products.
Chin Augmentation
Procedure Overview:
Chin Augmentation (Genioplasty) – A procedure that reshapes or enhances the size of the chin to achieve facial harmony and chin projection. The facial profile can be balanced by extending the chin in relationship to the nose. Two different surgical approaches are available. One is an incision made in the mouth, and the other is an incision in the natural chin crease. The implant is then placed on top of the bone. It’s not uncommon to combine a chin implant with a “nose job” or a procedure on the anterior part of the neck to create a more youthful contour (like liposuction.)
Anesthesia Options:
General or IV Sedation.
Risks and Benefits:
There is a risk of numbness on the chin if the nerve is compressed. This is typically temporary but in rare cases is permanent. Infection with implant removal is a possibility as is implant migration or displacement. Some patients can palpate their implant. There is some post-surgical discomfort and soreness, which is easily controlled by medication. A liquid diet may be advised for a day or two. The benefits are an enormous yet subtle improvement in your facial harmony. Profile views are in balance. Loose skin below the chin area is tightened. The neck contour looks more youthful. The mandibular border is more defined and sculpted.
Recovery:
Light activity can resume the same day as surgery. Return to work and usual activity is allowed within 2-3 days. Talking should be limited for several weeks to minimize movement in the area. Numbness in the area recovers after several weeks. It takes several weeks for most patients to “adjust” to the chin implant and their new look.
Dr. C’s Take:
This is a powerful and impressive technique to enhance a small chin and facial symmetry and balance. I have had tremendous success with the POREX implants as they adhere to the surrounding tissue and bone very well and they rarely displace. Patient satisfaction is very high as long as the implant is not too large when used in females. Males who request a chin enhancement must be questioned carefully as their expectations can be very difficult to manage (often there are other issues besides a small chin). A chin implant works to change the appearance of the entire face and not simply the chin. Rhinoplasty (nose job) and chin implants work well together in many patients.
Ear Surgery (Otoplasty)
Procedure Overview:
Ear Surgery (Otoplasty) – An otoplasty (“ear job”) will set prominent ears back closer to the head, or reduce the size of large ears. Although commonly believed to be performed mostly on children, this is also performed on adults who never addressed it when younger. The procedure is typically performed through an incision behind the ear, removing some cartilage and placing sutures so the ear is smaller, less prominent and set closer to the head.
Anesthesia Options:
General for young children. IV sedation or straight local for adults.
Risks and Benefits:
Temporary pain or discomfort, swelling, bruising and numbness are most common. Less common problems would include infection of cartilage, excessive scarring, hematoma formation and asymmetry of the ears. There is the possibility that the surgery will not correct the problem, as cartilage has “memory” and the problem may recur to a limited degree requiring an additional procedure or “touch up”. The benefits include less prominent, normal looking ears and greater self esteem and less self consciousness about your ears.
Recovery:
Adults and children are usually up and around within a few hours of surgery. Most children go back to school in a few days, but need to refrain from contact sports for 1-2 months. The ears may throb or ache for a few days, but this can be relieved by medication. In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. A compression headband must be worn as much as possible for the first several weeks.
Dr. C’s Take:
This is a straight forward relatively simple procedure in good hands. It’s a great way to reduce large or prominent ears. The incisions are behind the ears and not visible. The problem with the procedure is the possibility of some recurrance of the prominence as the cartilage springs back (this is easily treated with an additional suture). This is a high benefit low risk type of procedure.
Cheek Augmentation
Procedure Overview:
Cheek Augmentation – A relatively uncommon procedure to bring balance to the facial structure by way of correcting a deficient cheek area due to congenital deficiency, age-related bone loss or facial trauma. The procedure is typically considered by patients who seek the “high cheek bones” typical of models and actors.
Anesthesia Options:
General or IV sedation.
Risks and Benefits:
Infection, hematoma and seroma, implant shifting (displacement) and asymmetry, and possible loss of sensation (numbness). Implants can be palpable and appear “stuck on” when the tissues are thin. Patients may not be completely pleased with their appearance (too drastic a change). Patients are encouraged to give this procedure serious consideration before electing to have it done. Appropriate psychological screening is important. The benefits include balance and symmetry to the face as well as psychological benefits.
Recovery:
Your face will be swollen and bruised for several days, but this dissipates over time. You will experience some discomfort for several weeks. A liquid or soft diet may be advised for several days. You will be up and around on the day of surgery, but must refrain from bending, lifting and strenuous activities for 10 days to 2 weeks. You may notice a change in your smile, odd sensations of “tightness”, tingling, sporadic sharp pain, pulling, burning or cold sensations. These effects usually subside within the first few weeks, but some swelling will be present for several months. There is a period of several weeks where you psychologically adjust and adapt to your new appearance.
Dr. C’s Take:
This procedure is not as common as a chin implant. The ability to enhance cheek bones is a big time improvement in those who have none. The key is appropriate patient selection and proper technique. Because fillers and fat injections are temporary in this area, many patients who have enjoyed the benefits of fuller cheek bones are now looking at something that is also permanent.
Skin Lesions and Moles
Procedure Overview:
Skin Lesions and Moles – While skin lesions and moles (including skin cancer) can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous. A plastic surgeon or a dermatologist removes most skin cancers surgically. If the cancer is small, the procedure can be done quickly and easily. The procedure may be a simple excision, which usually leaves a thin, barely visible scar. Another method is curettage and cautery. In this procedure the lesion is scraped to remove it and then cautery (electric current) is used to control bleeding.
Anesthesia Options:
Local.
Risks and Benefits:
Depending on the location and severity of the lesion, the consequences may range from a small barely visible scar, to permanent changes in facial structures such as your nose, ear, or lip. This would be extremely rare.
Recovery:
Minimum down time if any required.
Dr. C’s Take:
Take a moment and read my “moles and lesions” article on my website. I don’t want to “make a mountain out of a mole hill.”
Endoscopic Surgery
Procedure Overview:
Endoscopic Surgery – Endoscopy is a surgical technique that involves the use of an endoscope, a special viewing instrument that allows a surgeon to see images of the body’s internal structures through very small incisions. Endoscopic surgery has been used for decades in a number of different procedures, including gallbladder removal, tubal ligation, hernia repairs and knee surgery. Plastic surgeons have been using it for brow lifts, breast augmentations, and facelifts. An endoscope consists of two basic parts: A tubular probe fitted with a tiny camera and bright light, which is inserted through a small incision; and a viewing screen, which magnifies the transmitted images of the body’s internal structures. During surgery, the surgeon watches the screen while moving the tube of the endoscope through the surgical area. It’s important to understand that the endoscope functions as a viewing device only. To perform the surgery, a separate surgical instrument–such as a scalpel, scissors, or forceps–must be inserted through a different point of entry to manipulate the tissues.
Anesthesia Options:
General anesthesia.
Risks and Benefits:
All surgery carries risks and every incision leaves a scar. However, with endoscopic surgery, your scars are likely to be hidden and much smaller. Some of the after effects of surgery may be minimized. Because the incisions are shorter with endoscopy, the risk of sensory loss from nerve damage is decreased. Also, bleeding, bruising and swelling may be significantly reduced. With the endoscopic approach, you may recover more quickly and return to work earlier than if you had undergone open surgery. Some procedures lend themselves to the use of an endoscope better than others. In plastic surgery, this is typically an option in use for an Endoscopic forehead lift. Some surgeons might also use an endoscope when performing a breast augmentation through an incision in the axilla or armpit.
Recovery:
Variable, depending on which surgery is performed; however, recovery is often shorter than with traditional methods.
Dr. C’s Take:
Endoscopic techniques have found a role mostly in the upper forehead as described for a brow lift. It’s role in the face and neck is limited at best. Although we would all love to obtain the results of standard surgery with the small incisions needed using an endoscope, this simply hasn’t been the case (in this case less is less).
