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Eyelid Surgery

Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes. This can create a tired or aged appearance. An eyelid lift, or blepharoplasty, is designed to restore a more youthful and rested appearance to your eyes. It can also improve your scope of vision if you have excessive upper eyelid skin that interferes with peripheral or superior vision. A blepharoplasty can involve the upper lids, the lower lids, or both.

The surgery can be done under sedation or general anesthesia and can take 1-2 hours depending if just upper lids or upper and lower lids are being addressed. Incisions are made in the natural creases in the upper and lower lids and are very well hidden once healed. The surgery typically involves some skin and excess fat removal and resuspension of the muscles and fat surrounding the lids. While not a very painful operation, there is a fair amount of bruising and swelling which can last about 1 week. Sutures are generally removed 7 days after surgery and make up can be worn once the stitches are out. Contact lenses can usually be worn again about 2 weeks after surgery.

Facial Implants

Facial implants are specially formed solid, biocompatible materials designed to enhance or augment the physical structure of your face. The precise type and size of implants best suited for you, requires an evaluation of your goals, the features you wish to correct and your surgeon’s judgment.

Chin implants can increase the size and projection of a chin that does not project in proportion with the forehead and mid-face. A small or recessed chin can also be described as one that seems to disappear into the neck of an individual of normal weight, rather than appearing as a distinct facial feature.

Jaw implants increase the width of the lower third of your face. Much like the chin, a weak jaw can be thought of as one that is not well-defined and distinct from the neck, or one that slopes rather than angles from the ear to the chin. In some cases, both the chin and jaw can contribute to facial imbalance.

Cheek implants increase the projection of the cheekbones. They add volume to areas which may be recessed or flat.

If symmetry among facial features is part of your goal, facial implants may be recommended to augment more than one facial region. It’s important to remember that all of our faces are asymmetric to some degree and your results may not be completely symmetric. The goal is to create balance and proportion. Your procedure may be performed alone, or as a complement to other facial contouring procedures such as nose or ear surgery.

Botox

This procedure relies on injections of botulinum toxin into the muscles of the face that are responsible for squinting and frowning. By rendering these muscles inactive, there will be a softening or in some cases elimination of the wrinkles along the forehead, between the eyebrows and at the outer corners of the eyes. («Crow’s feet»)

The results take effect 1 week after the injection and last between 3-4 months. At that time, the Botox injections can be repeated. It is the most common cosmetic procedure in the world, it is safe, effective and has a high degree of satisfaction among patients.

It can be done also in the neck to eliminate muscle «bands» and improve the jaw line (Nefertiti lift).

Polylactic acid

Polylactic acid is a synthetic dermal filler that is injected into your face, causing your body’s own production of collagen. This type of dermal filler is known as a stimulator. This non-toxic, biodegradable substance has been used for more than 40 years as suture material.

It’s known to work particularly well in the lower half of your face, to fill the lines caused by laughing and fill out deep nasolabial folds. It’s also working well over the cheek area to augment the lost volume. This substance is unlike other dermal fillers because it doesn’t produce immediate results. Instead, it stimulates your own body’s collagen production, so results appear gradually over a period of a few months.

Voluma

There are different types of hyaluronic acids that are used in the global market of injectable fillers, which are classified according to their density. Those with thin density are designed for fine wrinkles and those with thick density for deep folds. Voluma is the thickest in density hyaluronic acid that is used in the facial area.

Hyaluronic acid is a natural substance found in your body. High concentrations are found in soft connective tissues and in the fluid surrounding your eyes. It’s also in some cartilage and joint fluids, as well as skin tissue. It is extracted and reformulated and now has become one of the most popular kinds of injectable fillers. If the term sounds familiar, it’s because the same substance is often injected into the aching joints of people with arthritis to ease pain and provide extra cushioning.

Voluma is not derived from animal sources. When this gel is injected, it acts like an inflated cushion to support facial structures and tissues that may have lost volume or elasticity due to normal aging. It also brings water to the surface of skin to keep it looking fresh and supple. Voluma as a thick in density hyaluronic acid is used mainly for cheek augmentation and for reconstruction of facial areas that present volume loss

Topical anaesthetic cream is used before application of Voluma to minimize or eliminate pain during injection. Some bruising and swelling may appear after the injections, which can be covered with your make-up. The results from application Voluma last for 14-18 months.

Otoplasty

An otoplasty is done on prominent ears in order to set them back closer to the head or to decrease the size of large ears. Surgery can be done on adults as well as children, although children should typically wait until age 5 or 6 when the ear is fully developed. The procedure involves working on the cartilage that gives structure to the ear in order to correct ear prominence.

An otoplasty is done under general anesthesia and usually takes 1-2 hours. The incision is made behind the ear and is inconspicuous once healed. Following surgery, a head wrap is placed to protect the ears. Once the wrap is removed in the office, patients are often asked to wear a headband for several weeks to maintain the new ear position and prevent injury particularly when sleeping.

Rhinoplasty

For those patients dissatisfied with the size or shape of their nose, a rhinoplasty can be performed for reshaping purposes. In cases where there is some associated breathing obstruction, internal nasal surgery such as a septoplasty may need to be performed. A rhinoplasty often involves removal of a hump, refining a bulbous or thick tip, and narrowing a nose. This can improve the proportionality of the nose to other facial features and thereby create a more smooth and harmonious appearance.

The surgery is done on an outpatient basis under general anesthesia. In addition to the nose itself, the eyelid region may become quite swollen and bruised. Patients often have nasal packing which is removed in the first few days. There is usually some type of external splint which adheres to the nose; this is removed 7-10 days after surgery. Any stitches inside the nose dissolve, while those externally are removed a week after surgery. The incisions are very well hidden across the columella, the fleshy structure between the nostrils, and internally in the nose. The final result may not be apparent for several months and it usually takes a full year to completely appreciate the final result.

Brow lift

A brow lift is done to raise the eyebrows and reduce ridges and furrows on the forehead, thus creating a smoother, more youthful appearance. This procedure is typically done with other facial surgeries, namely those on the eyelids. The originally described brow lift involved an incision in the hairline extending from one ear to the other. More typically today, the brow lift is performed endoscopically using 3-5 smaller incisions in the scalp and specialized instruments to elevate the skin and muscles of the forehead and resuspend them.

A brow lift can be done under sedation or light general anesthesia and takes 1-1.5 hours. The upper eyelids can become bruised and swollen for 1 week following surgery. Most often there will be staples and palpable screws in the scalp which are removed in the office 10-14 days after surgery, a painless procedure.

 

Facelift

A rhytidectomy or facelift is designed to restore a more youthful appearance to the neck, jowl and cheek region by removing major wrinkles and sagging skin. If there is excess fat in the neck or chin region, this can simultaneously be addressed with liposuction or direct excision. A facelift can improve a tired facial appearance by smoothing the skin, reestablishing defined contours along the neck and jaw line and resuspending the cheek to its original position. It is often done in combination with other procedures including a brow lift and eyelid surgery to create an overall harmonious, youthful result.

The surgery is done under general anesthesia and typically takes 4 hours. The modern facelift pulls the face vertically and includes incision in the natural means, only in front of the ear (short scar facelift) and that avoids incisions behind the ear. This new technique provides more natural appearance and not the «lateral pull of the face». It involves elevation of the skin, tightening of the facial and neck muscles and redraping and removal of any excess skin.

Postoperatively patients may have a small silicone drain in overnight as well as head and neck wrappings. After these are removed, patients are often required to wear a removable chin strap for one week. Sutures are usually removed 7 days after surgery but it is usually 2 to 3 weeks before most patients feel socially presentable.

Fat Transfer

Fat and its application is the new tool of plastic surgeons with which they can correct multiple problems. Fat transfer is a relatively easy procedure that can be performed on an outpatient basis with local anaesthetic or sedation.

During surgery, the plastic surgeon uses blunt cannulas to aspirate fat from different areas of the body, areas where fat is excess. Fat is then washed, centrifuged and undergone specific procedures in order to get prepared for reapplication to different facial areas with the use of small specific cannulas.

Fat is used nowadays to correct volume deficits, to emphasize characteristics, to soften deep folds and achieve total facial rejuvenation in order to obtain natural beauty.

Fat transfer as a procedure cannot replace hyaluronic acid, because is injected into deeper skin layers than fillers are. On the contrary fat and hyaluronic acid can be combined with safety in order to correct difficult facial problems and deal with small defects.

Facial fat transfer is now a common aesthetic procedure with remarkable results and patients that undergo this surgery have high level of satisfaction which leads to repetition throughout the years

 

Hyaluronic Acid

Hyaluronic acid is a natural substance found in your body. High concentrations are found in soft connective tissues and in the fluid surrounding your eyes. It’s also in some cartilage and joint fluids, as well as skin tissue. It is extracted and reformulated and now has become one of the most popular kinds of injectable fillers. If the term sounds familiar, it’s because the same substance is often injected into the aching joints of people with arthritis to ease pain and provide extra cushioning. Brand names include: Allergan, Juvéderm, Perlane and Restylane.

Hyaluronic acid is not derived from animal sources. When this gel is injected, it acts like an inflated cushion to support facial structures and tissues that may have lost volume or elasticity due to normal aging. It also brings water to the surface of skin to keep it looking fresh and supple.

There are hyaluronic acids with different concentrations, used in specific facial areas. There are the nasolabial folds, the perioral lines (smoking lines), marionette lines and other facial deficits. Hyaluronic acid is also used for lip augmentation. Topical anaesthetic cream is used before application to minimize or eliminate pain during injection. Some bruising and swelling may appear after the injections, which can be covered with your make-up. The results from application of hyaluronic acid last for 9-12 months.

Facial mesotherapy

Have you ever noticed that young skin has a special glow? Skin that is firm and smooth is skin that is fully hydrated. Over the years, skin may dry out as its natural levels of hyaluronic acid diminish due to age, smoking, sun exposure, and environmental factors. This is most noticeable in areas that are more exposed to these elements, such as the face, neck, décolletage and hands.

Skin hydration is fundamental to a fresh appearance, but the lack of it deep down can betray other efforts you may use to reduce and repair the signs of skin damage.

Mesotherapy is called the aesthetic procedure during which small amounts of thin in density hyaluronic acid is injected to the superficial skin layers in order to achieve the necessary deep hydration. The majority of cosmetical and pharmaceutical products that are used daily offer temporary and superficial skin hydration. Using mesotherapy hydration infiltrates deeper offering natural and healthy skin glow.

Topical anaesthetic cream is used before application to minimize or eliminate pain during injection. Small wheals (like mosquito bites) may appear after the injections, which disappear in 24 hours but can be covered with your make-up.

Chemical peel

Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation.

The chemical solutions used is phenol, trichlwriko acid (TCA) and the alpha hydroxide acids (AHAs). The dosage of each solution identified for each patient depending on the existing skin needs and depth of the lesion. Although chemical peelings can be combined with various interventions in all parts of the body, they cannot replace a surgical intervention nor may prevent or delay the aging process.Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient’s needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process.

Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand. The plastic surgeon will estimate the problem and will advice on the right therapy taking under consideration your personal, professional and social life, the weather conditions and your sun exposure.
The plastic surgeon will estimate the problem and will advice on the right therapy taking under consideration your personal, professional and social life, the weather conditions and your sun exposure.

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