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Facial Rejuvenation There are many important considerations when a patient is evaluated for facial rejuvenation. The patient’s expectations must be realistic and the surgeon’s attainable goals must be thoroughly addressed. A patient often focused on one area of his or her face, which may readily be improved only to have a disappointed patient because another area appears to have aged. In reality, the entire face must be addressed at initial consultation. This allows the surgeon to objectively discuss disproportionately.
Blepharoplasty
Blepharoplasty is a surgical procedure to remove excess skin and/or muscle from both the upper and lower eyelids. Underlying fatty tissue that produces bagginess can be selectively removed or repositioned. Blepharoplasty can improve drooping skin and bagginess. It can help improve vision in older patients who have hooding of their upper eyelids. Although it can add an upper eyelid crease to the Asian eyelid, it will not erase evidence of one's racial or ethnic heritage. Blepharoplasty will not remove "crow's feet" or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows. Blepharoplasty surgery is customized for every patient, depending on his or her particular needs. It can be performed alone involving upper, lower, or both eyelid regions, or in conjunction with other surgical procedures of the eye, face brow, or nose. In some patients who have looseness between the lower eyelid and the eyeball, consideration for tightening of the lower eyelid (canthoplasty/canthopexy) at the time of blepharoplasty may be recommended. Eyelid surgery cannot stop the process of aging. It can, however, diminish the look of loose skin and bagginess in the eyelid region.
Blepharoplasty surgery is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Improvement of skin laxness, fatty deposits, and skin wrinkles may be accomplished by other treatments or surgery such as a brow lift when indicated. Other forms of eyelid surgery may be needed for disorders affecting eyelid function such as drooping eyelids from muscle problems (eyelid ptosis) or looseness between the eyelid and eyeball (ectropion). Minor skin wrinkling may be improved through chemical peel or other skin treatments. Risks and potential complications are associated with alternative surgical forms of treatment.
Brow Lift
The forehead and eyebrow region often show noticeable signs of aging. Looseness in these structures may cause drooping eyebrows, eyelid hooding, forehead furrows, and frown lines. In browlift surgery, the structures responsible for these problems are tightened or altered to smooth the forehead, raise the upper eyebrows, and improve frown lines. A browlift may be performed alone, or in conjunction with other procedures, such as a facelift or eyelid surgery.
Recent advances in browlift surgery make it possible to perform the procedure through a variety of approaches, including endoscopy. Browlift surgery is individualized for each patient. The surgical incisions used may vary with the technique selected by your surgeon to meet your needs. The browlift cannot stop the process of aging.
Browlift surgery is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Improvement of skin looseness and skin wrinkles may be accomplished by other treatments of surgery. Risks and potential complications are associated with alternative surgical forms of treatment.
Chemical Peel
Chemical skin-peel and other skin treatments have been performed for many years to treat a variety of skin disorders. Conditions such as sun damage, wrinkling, and uneven pigmentation may be treated with these non-invasive techinques. There are many different techinques and regimens for the application of chemical-peel and skin treatment medications. In some situations, chemical peels may be performed at the time of other surgical procedures.
Chemical skin-peel procedures are not an alternative to skin tightening surgery when indicated.
Chemical skin-peel and other skin treatments are elective procedures. Alternative treatment would consist of not undergoing such treatments. Improvement of skin lesions and skin wrinkles may be accomplished by other treatments such as dermabrasion, laser treatment, or surgery to tighten loose skin. Risk and potential complications are associated with alternative surgical forms of treatment.
Facelift Facelift, or rhytidectomy, is a surgical procedure to improve visible signs of aging on the face and neck. As individuals age, the skin and muscles of the face region begin to lose tone. The facelift cannot stop the process of aging. It can improve the most visible signs of aging by tightening deeper structures, re-draping the skin of face and neck, and removing selected areas of fat. A facelift can be performed alone, or in conjunction with other procedures, such as a browlift, liposuction, eyelid surgery, or nasal surgery. Facelift surgery is individualized for each patient. The best candidates for facelift surgery have a face and neck line that has begun to sag, but whose skin has elasticity and whose bony structure is well defined. Alternative forms of management consist of not treating the laxness in the face and neck region with a facelift (rhytidectomy). Improvement of skin laxity, skin wrinkles and fatty deposits may be attempted by other treatments or surgery such as laser resurfacing, chemical face peels or liposuction. Risks and potential complications are associated with alternative surgical forms of treatment. Fat Injection Fat injection is a procdure designed to remove fat from one area of the body and transfer it to another area of the body. The fat is harvested with a needle under local anesthesia and is reinjected through a syringe and needle. Common problems which may be associated with this are reabsorption of the fat with subsequent loss of the contour improvement. With any surgical procedure, bleeding and infection can be problems. Other less likely complications are deformity at the donor site and small scars resulting from the injection and harvesting. Laser Resurfacing Lasers have been used by plastic surgeons as a surgical instrument for many years. Laser energy can be used to cut, vaporize, or selectively remove skin and deeper tissues. There are many different methods for the surgical use of lasers. Conditions such as wrinkles, sun-damaged skin, scars, and some types of skin lesions/disorders may be treated with the CO2 and Erbium laser. Certain surgical procedures may use the CO2 laser as a cutting instrument. In some situations, laser treatments may be performed at the time of other surgical procedures. Skin treatment programs may be used both before and after CO2 laser skin treatments in order to enhance results. Laser resurfacing of the skin is an elective procedure. Alternative treatment would consist of not undergoing the procedure. Other forms of skin treatment (e.g. chemical peel, dermabrasion, excisional surgery) may be substituted. In certain situations, the laser may offer a specific therapeutic advantage over other forms of treatment. Alternatively, laser resurfacing procedures in some situations may not represent a better alternative to other forms of surgery or skin treatment when indicated. Risks and potential complications are associated with alternative forms of treatment. Neck Lift
A neck lift or contouring with liposuction alone may provide an enhancement to your appearance. The amount of redundant skin determines which procedure is the right one for you.
Otoplasty
Otoplasty is a surgical procedure to reshape the ear. A variety of different techniques and approaches may be used to reshape congenital prominence in the ears or to restore damaged ears. Each individual seeking otoplasty is unique both in terms of the appearence of their ears and expectations for results following otoplasty surgery. It is important that you fully discuss your expectations with your plastic surgeon prior to surgery.
Otoplasty is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Risks and potential complications are associated with alternative surgical forms of treatment.
Rhinoplasty Surgery of the nose (rhinoplasty) is an operation frequently performed by plastic surgeons. This surgical procedure can produce changes in the appearence, structure, and function of the nose. Rhinoplasty can reduce or increase the size of the nose, change the shape of the tip, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This operation can help correct birth defects, nasal injuries, and help relieve some breathing problems. There is not a universal type of rhinoplasty surgery that will meet the needs of every patient. Rhinoplasty surgery is customized for each patient, depending on his or her needs. Incisions may be made within the nose or concealed in inconspicuous locations of the nose in the open rhinoplasty procedure. In some situations, cartilage grafts, taken from within the nose of from other areas of the body, may be recommended in order to help reshape the structure of the nose. Internal nasal surgery to improve nasal breathing can be performed at the time of the rhinoplasty. The best candidates for this type of surgery are individuals who are looking for improvement, not perfection, in the appearance of their nose. In addition to realistic expectations, good health and psychological stability are important qualities for a patient considering rhinoplasty surgery. Rhinoplasty can be performed in conjunction with other surgeries. Rhinoplasty is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Certain internal nasal airway disorders may not require surgery on the exterior of the nose. Risks and potential complications are associated with alternative surgical forms of treatment such as septoplasty to correct nasal airway disorders. Scar RevisionThe surgical treatment of scars is a procedure frequently performed by plastic surgeons. Scars are the unavoidable result of injuries, disease, or surgery. It is impossible to totally remove the presence of a scar, yet plastic surgery may improve the appearance and texture of scars. There are many different techniques for scar revision surgery. Other treatments including physical therapy may be needed in addition to surgery. Scar revision surgery is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure, injections of cortisone-type drugs in the scar, or the use of special compressive garments/devices worn over the scar. Dermabrasion, laser treatments, and other surgical techniques may be used to revise scars. Risks and potential complications are associated with alternative surgical forms of treatment. Septoplasty Surgery of the nasal septum (septoplasty) is an operation frequently performed by plastic surgeons. This surgical procedure is performed to correct breathing problems caused by a distorted (deviated) nasal septum, which divides the nostrils. Septal deviation can interfere with the passage of air through the nose. Distorted cartilage and bone is selectively removed beneath the mucous membranes of the septum in order to improve nasal breathing. There are a number of techniques and approaches for septoplasty. Septoplasty can be performed in conjunction with other nasal sugeries (rhinoplasty) that reshape the external appearance of the nose. A variety of conditions such as allergies, sinus disorders, nasal polyps, snoring problems, and breathing disorders form other causes may co-exist with a deviated nasal septum. Septoplasty is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Certain internal nasal airway disorders may not require surgery and can be treated medically. Other forms of surgery may be indicated to treat breathing problems caused by other conditions. Risks and potential complications are associated with alternative surgical forms of treatment. Tip Rhinoplasty Tip rhinoplasty is a surgical procedure that can produce changes in the appearance and structure of the tip of the nose. Tip rhinoplasty can reduce or increase the size of the nasal tip, change the shape of the tip, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This operation can also help correct birth defects and nasal injuries. There is not a universal type of tip rhinoplasty surgery that will meet the needs of every patient. Tip rhinoplasty surgery is customized for each patient, depending on his or her needs. Incisions may be made within the nose or concealed in inconspicuous locations of the nose in the open tip rhinoplasty procedure. Some techniques of tip rhinoplasty use cartilage grafts or other man-made materials to enhance the projection of the nasal tip. Internal nasal surgery to improve nasal breathing can be performed a the same time of the tip rhinoplasty. The best candidates for this type of surgery are individuals who are looking for improvement, not perfection, in the appearance of their nose. Tip rhinoplasty can be performed in conjunction with other surgeries. Tip rhinoplasty is an elective surgical operation. Alternative treatment would consist of not undergoing the surgical procedure. Risks and potential complications are associated with alternative surgical forms of treatment. Injectables The use of injectable materials has enhanced the field of facial aesthetics. It has a broad array of available materials; botox, collagen or fat. Treat the specific area of concern. Botox is a neurolytic agent which paralyzes the muscles in the forehead to reduce the wrinkles in-between the brows and minimize forehead lines. This is a painless office procedure, but temporary condition and requires annual visits. Fillers such as collagen or fat will fill in defects such as depressed acne scars or lines on the face to reduce the depth giving a more youthful appearance. Full lips can be achieved by injectable fillers or placement of graft materials.
Botox Clostridia boulina bacteria produce a class of chemical compounds known as "toxins". The Botulina Type A Toxin (Botox) is processed and produce a sterile product suitable for specific therapeutic uses. Once the diluted toxin is injected, it produces a temporary paralysis (chemodenervation) of muscle by preventing transmission of nerve impulses to muscle. The duration of muscle paralysis generally lasts for approximately three to four months. Botox has been approved to treat certain conditions involving crossed eyes (strabismus), eyelid spasm (blepharospasm), cervical dystonia (spastic muscle disorder with the neck) and motor disorders of the facial nerve (VII cranial nerve). As of April 2002, it has been PDA approved for the cosmetic treatment of forehead wrinkles caused by specific muscle groups. Other areas of the face and body such as crows feet wrinkles headaches, colorectal disorders, excessive perspiration disorders of the armpit and hands, and musculoskeletel pain disorders. BOTOX injections are customized for every patient, depending on his or her particular needs. Theese can be performed in areas involving the eyelid region, forehead, and neck. BOTOX cannot stop the process of aging. It can however, temporarily diminish the look of wrinkles caused by muscle groups. Botox injections may be performed as a singular procedure or as an adjunct to a surgical procedure. Alternative forms of management include not treating the skin wrinkles by any means. Improvement of skin wrinkles may be accomplished by other treatments or alternative types of surgery such as a blepharoplasty, face or brow lift when indicated. Other forms of eyelid surgery may be needed should you have intrinsic disorders affecting the function of the eyelid such as drooping eyelids from muscle problems (eyelid ptosis) or looseness between the eyelid and eyeball (ectropion). Minor skin wrinkling may be improved through chemical skin-peels, lasers, injection of filling material, or other skin treatments. Risks and potential complications are associated with alternative forms of medical or surgical treatment.
Restylane
Restylane is a stabilized hyaluronic acid used to smooth moderate to severe facial wrinkles and folds around the nose and mouth or shape facial contours. Restylane had been FDA approved for the cosmetic treatment of moderate to severe facial wrinkles and soft tissue depressions. Hyaluronic acid is a naturally occuring substance that is found within all mammals. It is a material that is contained in various soft tissues. Hyaluronic acid can be synthetically produced from a process of bacterial fermentation, chemically stabilzed, and purified for use as an injectable soft tissue filler (non-animal, stabilized hyaluronic acid, Medicis Aesthetics). The hyaluronic acid in Restylane is biocompatible and is a totally non-animal product; there is little risk of amimal-based disease transmission or allergic reaction.
Restylane injections are customized for every patient, depending on his or her particular needs. These can be performed in areas involving the face and eyelid region, forehead, and lips. Restylane cannot stop the process of aging. It can however, temporarily diminish the look of wrinkles and soft tissue depressions. Restylane injections may be performed as a singular procedure, im combination with other treatments such as BOTOX, or as an adjunct to a surgical procedure. Restylane injections require regional nerve blocks or local anesthetic injections to diminish discomfort. Soft tissue fillers, including Restylane, produce temporary swelling, redness, and needle marks, which resolve after a few days time.
Continuing treatments are necessary in order to maintain the effect of Restylane over time. Restylane once injected will be slowly absorbed by the body. The length of effect for Restylane injections is variable.
Alternative forms of management include not treating the skin wrinkles or soft tissue depressions by any means. Improvement of skin wrinkles and soft tissue depressions may be accomplished by other treatments: laser treatments, chemical skin-peels, dermabrasion, or other skin procedures, alternative types of tissue fillers, or surgery such as blepharoplasty, face or brow lift when indicated. Risks and potential complications are associated with alternative forms of medical or surgical treatment.
Before/After Photos
Advisories/Consent Forms
Disclaimer This information is only intended as an introduction to the various procedures. It should not be used to determine whether you will have the procedure performed nor to guarantee the result. The best method of determining your options would be to see a board-certified plastic surgeon for a thorough history and physical examination. Only at this time could your candidacy for any procedure be determined. The information provided is not intended to serve as medical advice.
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