Face Procedures

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Facelift

A facelift, or rhytidectomy, is a surgical procedure designed to smooth and soften changes in facial tissues that result from aging, solar damage, daily stress and other factors. Over time deep creases and sagging skin begin to take form, especially between the nose and mouth, the jaw line and neck. Though these changes are gradual, wrinkles and other signs of aging can make individuals feel older than they really are. A facelift improves the most obvious signs of aging by removing excess fat deposits, tightening underlying muscles, and redraping the skin of the face and neck.

A facelift is often performed in conjunction with other facial procedures, in order to maintain facial harmony. Often the aged, tired look someone notices in the mirror results from sagging eyebrows and skin excess around the eyes, as much as the loose skin about the mouth, jowls and neck. Procedures such as a browlifts and eyelid surgery help address these often associated problem areas and are performed in conjunction with a facelift.

Facelift surgery is helpful when
• Face and neck skin, muscles and fat are sagging.
• Excess neck skin is present.
• Heavy jowls are formed at the corners of the mouth to the jaw line.
• Deep creases have developed along the nose to the mouth.

Surgery for a facelift typically involves incisions above the hairline at the temples, tracing the curve in front of the ears, and then continues around the earlobe and behind the ear. “Mini-facelifts” involve more limited incisions when less suspension in needed. Tissues of the face are then separated, stretched and resuspended, and excess skin is removed. Redundant neck skin is addressed with a small incision under the chin as well, to help redrape and remove loose skin.

A facelift usually takes several hours, depending on the number of procedures completed at the same setting. Recovery typically involves keeping the head elevated fitted with bandages in a restful, relaxed environment. Surgery can be outpatient with monitoring or a short overnight stay as an inpatient. Any discomfort is treated with oral medication. Return to work is generally between 10-14 days but some bruising may still be present for up to 3-4 weeks; return to more strenuous activity after 4 weeks. Complications are rare, however bruising, swelling and numbness can be transient and patients can minimize potential problems by carefully following the directions given before and after their surgery.

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Forehead Lift / Brow Lift

A forehead lift or “browlift” is a surgical procedure designed to smooth the forehead and correct the sagging or low position of the eyebrows. It is effective in restoring a refreshed alert appearance and eliminating a “tired or angry look.” Forehead lifts are often combined with eyelid surgery and/or facelift surgery to enhance the overall appearance of the face symmetrically if needed. Often patients have inherited low set brows, or very high hairlines that can be ameliorated with the proper browlift technique.

You may be a good candidate for a forehead lift if:
• You have sagging or low position of the eyebrows, creating a tired, angry or sad appearance.
• You have deep horizontal creases across the forehead.
• You have frown lines, or furrows, between the eyebrows and sometimes across the top of the nose.

Forehead lift procedures vary depending on the patient’s needs, an individual’s hairline and the laxity of skin. Limited incision lifts can be performed, hiding the incisions within the hair bearing scalp. More extensive lifts are performed through a limited “open” technique with multiple smaller incisions or a full “coronal browlift,” which involves an incision just behind the hairline or at the hairline, depending on the patient’s specific concerns. The forehead muscles that cause wrinkling are removed or softened, and the excess laxity removed. The brows are then elevated to give a natural smooth arch without a “surprised” look, and the tissues suspended and closed. Surgery usually takes from 1-2 hours and is an outpatient procedure, unless combined with other techniques.

Generally the recovery involves 3-4 days for limited procedures up to a 14 day period of rest to allow swelling or bruising to dissipate for more extensive lifts. The procedure can be outpatient, or inpatient if combined with other techniques at the same time. Bandages are fitted to reduce swelling and cold compresses applied. Oral medications are prescribed for any discomfort. Complications are rare, however bruising and numbness can be transient and patients are encouraged to follow post operative instructions carefully to minimize potential problems.

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Eyelid Surgery / Blepharoplasty

Eyelid surgery or blepharoplasty, is a corrective procedure of the upper and lower eyelids that can eliminate excess sagging skin, “bags” under the eyes, remove excess wrinkles, and provide a more youthful, alert appearance. One of the first things noticed about a person is their eyes. This is a powerful technique available that makes a dramatic difference in one’s appearance.

As people age, wrinkles, lines and puffiness contribute to a tired, sleepy or even angry look. Blepharoplasty can improve these problems areas however will not fully eliminate all crow’s feet, dark under eye discoloration or elevate low set eyebrows. It is also often performed in conjunction with other facial procedures such as a face lift or brow lift, in order to address these separate areas when needed. The blepharoplasty surgery can be performed on either the upper eyelids, the lower eyelids, or both. Surgery is often 1-2 hours on an outpatient basis.

Generally recovery involves 3-7 days of rest and relaxation. One call return to reading in 1-2 days. Back to work in 3-7 days. Contact lens wearers should switch to glasses for about 2 weeks after their procedure. Strenuous activity and exercise can resumed after 1-2 weeks. Complications are rare, however bruising, swelling and minor eyelid irritation can be transient and patients are encouraged to follow post operative instructions carefully to minimize potential problems.

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Rhinoplasty / Nose Reshaping

Rhinoplasty, or surgery to reshape the nose, is one of the most popular plastic surgical operations. It involves a variety of techniques in order to create a more pleasing look to the nose. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle of the nose. The results are unique to each individual, and the sculpting of nasal tissues depends on factors such as skin thickness, nasal and face bony structures, and inherited characteristics. The goal is to provide better facial balance and improve the overall appearance.

Typically, the complexity of an individual’s transformation will determine the length of surgery, however a 2-3 hour procedure is not uncommon. Small incisions are made inside the nostrils and across the underside of the nose which allow the surgeon access to the underlying structures. The cartilage and bone of the nose is then sculpted and reshaped to establish the new contour. Rhinoplasty surgery can either be an “open” technique which opens the nose and allows optimal visualization and control during the procedure, or it can be a “closed” technique where all the work in done from the inside only. Discussion with your surgeon can best determine which procedure will give you the optimal outcome.

Rhnoplasty surgery is usually outpatient. Post-operative instructions call for rest and limited movement to speed up the healing process and reduce recovery time. Swelling is to be expected, especially at the tip, and can last several weeks. A splint and bandages are applied to the outside of the nose for 5 days. Sometimes internal splints are also needed for 3-5 days as well. Return to work is common after 7-10 days. Care must be taken to avoid injury to the nose for several weeks and glasses should be taped up off the nose for about 10 days to avoid injury.

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