Face lifting

In recent years, aging facial rejuvenation surgery has gained popularity. When we say this we mean that lately more men turn to cosmetic surgery. And even if facial lifting is the most popular method of creating beauty, facial rejuvenation surgery is not limited to losing skin, wrinkles and cheek shapes, with which they often work. While some patients are consulting their doctor for problems of appearance, others seek to correct certain operational difficulties that arise as time passes. Specialists say that many male patients, fed up with their tired appearance and functional difficulties which they have, regain their confidence in themselves right after the surgical correction. Although lifting is best known method from the beauty series of operations, facial rejuvenation surgery is not limited to the skin losing, supplemented by other operations and adjuvant methods to mitigate wrinkles or other defects. Some are visible to the naked eye, while others are not. Thus, the muscles lose their tonic, epidermis thickens, reduce subcutaneous fat, which makes the skin crossed by small wrinkles. Connective tissue fibers of the dermis lose their elasticity, pores expand, the skin loses its velvety appearance, whereas the amount of water is reduced and thus the phenomenon of dehydration occurs. This leads to formation of the swollen skin right under the eyes and the double chin appearance. Therefore, when we talk about aging skin, we refer usually to wrinkles. And this because they come more clearly highlighted.

Aging skin is observed at some people earlier in their life while at others later. Etiological factors of skin aging consist mostly of sun exposure, smoking, bone atrophy and subcutaneous fat, weight loss and accumulation, folds repeatedly produced by habitual facial expression (face mimics – crying, laughing, etc..), constant action of the gravity and heredity. Also to this we can add other factors such as excessive makeup in case of women, alcohol, tobacco, small hours of sleep and generally unbalanced life. For example, patients who live in a humid climate are protected by the climate, in comparison with ones living in an arid climate. The latter can determine deepening of the facial wrinkles. However, repeated exposure to sunlight is the most important factor contributing to the formation of wrinkles. Those who have thin and dry skin tend to show earlier signs of aging. However, they noted the best results after surgery with imperceptible incisions. Patients with thick skin, darker skin or fat people tend to age more slowly. In such cases more often deep scars remain after the surgery.

Patients who require a face lift surgery are generally middle aged or old people. They complain of a lowering fat and skin below the cheeks toward the neck. Cheeks begin to form even right from the chin, creating a lean line down the neck. Lax skin and excess fat at neck level may create the impression of a double chin. Lower under the nasal region the deep trench lines become more pronounced. Wrinkles are formed around the neck, mouth, forehead and eyes, where muscles pull the less elastic skin. Delimited fat from the neck muscles gives the appearance of “turkey goiter”, disorder that may offend some adults with aging. These tracks formed by muscular platysma can be observed through the weak connective tissue when the patient pushes his chin to and fro. Many of the patients will not only look younger, but also fresher. They spend more time in the front of mirror, strengthening by themselves their own facial skin, to see how it would look after a surgical intervention. Often, however, this does stress the defects, moving them lower. Excessive extension of the lower nasal region, cheeks shape and mouth gives an unnatural appearance. Using a lift to a higher floor of the face, associated with a stretch back, facial lift can restore the natural contour remarkably smooth, lower face, cheeks and neck line. Ideal candidates for facelift are the physically and mentally healthy persons, and even relatively weak. Correction to overweight patients only by lifting the skin is not permitted, but improvements can be obtained by the method of associative liposuction of the neck and cheeks.

Statistics show that every day the number of men who want to have a facelift is a growing. The process is almost similar to that performed in women; however, some local features require small deviations from classical techniques.
Men cut their hair short and do not use make-up. So they are disadvantaged in terms of postoperative bruising and scars. To keep favorites, preauricular incision will work in a way that they will go to temporal lobe region. An issue which lies at the opposite occurs in the auricular rotation flap which contains hair follicles and there is a probability growth of hair behind the ear. But this inconvenience can be resolved by an electrical depilation. To reduce wrinkles up front and eyebrows can be made an incision on the upper edge thereof and the flap is the normal traction in reverse.

Procedure

Facial implants are solid, pre-shaped, three-dimensional objects used to improve the size and appearance of different areas including the chin, jaw, nose, cheeks and beside the nose (paranasal). Facial implant surgery provides a more harmonious appearance to the face. There are different types of implant material used to achieve these contour changes. There are also different shapes of implants according to the area to be enhanced.

TO REMEMBER:

 

Length:
 The procedure takes approximately one to two hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are used.
Inpatient/Outpatient:
 May be either an inpatient or outpatient procedure depending upon whether other procedures are being performed at the same time.
Possible Side Effects:
 Temporary swelling, numbness, weakness of facial muscles or dry eyes.
Risks:
 Infection, persistent swelling, persistent dry eyes, permanent muscle weakness or areas of permanent numbness are possible.
Recovery:
 The patient may resume work in seven to fourteen days. More strenuous activities may be resumed after three weeks.
Results:
 The results are usually permanent.

Face lift Full

A full or complete facelift improves the skin and tissues of the lower two-thirds of the face, from the ears, across to the cheeks, and down to the jaw line, by removing excess fat, tightening muscles and re-draping skin.

TO REMEMBER:

                 
Length:
 Approximately four hours.
Anesthesia:
 Usually general anesthesia is used or the patient may elect to have sedation and local anesthesia.
Inpatient/Outpatient:
 Usually this is an outpatient procedure, although some patients may require a short hospital stay.
Possible Side Effects:
 Temporary bruising, swelling, numbness and tenderness of the skin, as well as a tight feeling and dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.
Risks:
 Injury to the nerves that control facial muscles or feeling (which is usually temporary but in rare cases may be permanent), infection, bleeding, poor healing, excessive scarring, asymmetry and a change in the hairline.
Recovery:
 The patient may return to work after ten to fourteen days. More strenuous activity may be resumed after two weeks or more. Bruising should begin to disappear after seven to ten days. Sun exposure must be limited for several months after surgery. The use of a sun block that provides both UVA and UVB (ultraviolet) protection is recommended.
Results:
 Most facelifts can be expected to maintain optimum appearance for five to ten years.

Forehead Lift

 

A forehead lift, also called a brow lift, is a procedure that removes excess tissue, alters muscles and tightens the forehead skin. This procedure may be performed using the traditional technique, with an incision across the top of the head just behind the hairline, or with the use of an endoscope, which requires three to five short incisions, but allows access to the relevant areas to be treated incorporating a camera and a monitor to visualize the dissected areas.

TO REMEMBER:

 

 

 
Length:
 One to two hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are options.
Inpatient/Outpatient:
 This is most often an outpatient procedure.
Possible Side Effects:

When an endoscope is used the patient may experience temporary swelling, numbness, headaches and bruising.

When the traditional method is used there is the possibility of itching and hair loss.
Risks:
 Injury to facial nerves causing loss of motion, muscle weakness, or an asymmetrical look, persistent areas of numbness and broad and occasionally excessive scarring
Recovery:
 The patient usually returns to work in seven to ten days and even sooner with an endoscopic forehead lift. The patient must limit more strenuous activities for several weeks. Full recovery from bruising takes from two to three weeks. One should limit sun exposure for several months to avoid hyperpigmentation of the forehead which can occur as a result of sunlight exposure during the first three to six months after the procedure has been performed.
Results:
 Most facelifts can be expected to maintain optimum appearance for five to ten years.

 Blepharoplasty

Aesthetic Blepharoplasty is cosmetic surgical procedure which removes excess skin and fat (which comprise the tightening the muscle and wrinkles of the eyelids), thus removing aged appearance, the look of tired eyes and raising fallen eyebrows.

Emotional state is one of the most important factors to be established before any aesthetic surgery. After you were examined, the surgeon will expose and explain a multitude of other factors that influence your decision, such as: age, skin condition and other medical considerations. On young people, Blepharoplasty for instance is used to remove fat tissue, on the other hand older people use it lose the skin tone and the excess of it. During a consultation, the surgeon will expose all the specific details of your case, including surgical procedure to be used, type of anesthesia recommended. Also, you will discuss other details which include the risks that must be taken into account before choosing blepharoplasty. Each year thousands of blepharoplasty operations are carried out and the potential risks and specific complications associated to it in the Postoperative period such as hematoma and other side effects can be observed.

Blepharoplasty is used usually to remove excess skin, tighten the muscles, lifting the external corner of the eye or in some instances is the same procedure for lifting the eyebrows down. Exact location of the incisions will be chosen based on considerations of the surgeon. This can be done so under local anesthesia and under general anesthesia. Blepharoplasty surgery usually is performed from the upper eyelid and ending with the lower. In both areas compartments, subjacent fat will be removed by making incisions on both eyelids according to natural skin lines and folds. Generally, they can extend the natural creases in the outer edge of the eye. Through these incisions the surgeon separates the tissues underneath the skin, thus the fat layer and a part of the excess skin is removed. The type of suture is chosen according to surgeon’s decision. Once cured suture (thin as a hair) will be hard visible, especially after 6 to 8 weeks. Immediately after surgery, wet compresses on the eyes will be applied. This type of surgery may take 1 to 2 hours or even more, it all depends of the magnitude.

After the surgery, you will feel unpleasant burning sensations. If there is a slight pain, it can be controlled with medication. You will be recommended to hold your head high and the application of cold compresses will contribute to reducing of swelling and bruising. You need to use drops (eye instillations), for several days. Eyelids tend to regain the original color and 5-7 days after surgery, the suture threads are removed, swelling and blue-black color will alleviate bruising and marks can easily be covered with makeup. Other short-term postoperative effects are excessive tearing and sensitivity to bright light. The next day after surgery, you may go home, but the recommendations of the surgeon must be completely fulfilled. To allow a fast healing, avoid excessive effort and leaning for 2 -3 weeks. To protect eyes from sun and wind, you should wear sunglasses. Integration into your normal activities depends on how fast the healing process evolves and also how you feel.

 

Procedure

Blepharoplasty (eyelid surgery) rejuvenates the upper and lower eyelids by removing excess fat, skin and muscle.

TO REMEMBER:

 

 

Length:
 Approximately two hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort, feeling of “tightness” in the eyelid area, swelling or bruising. Excessive tearing and sensitivity to light for the first few weeks should be expected. Temporary dryness, burning, or itching of eyes may also occur but these side effects are rare.
Risks:
 Temporary blurred or double vision, infection, bleeding, swelling at the corners of the eyelids, dry eyes, formation of whiteheads, slight asymmetry in healing or scarring, difficulty in closing eyes completely (which is rarely permanent), and a lowered position of the lower eyelid of the lower lids which may require further surgery. Permanent loss of vision is a risk but this is extremely rare.
Recovery:
 The patient may begin reading after about two to three days and can expect to return to work at approximately five to ten days. Use of contact lens may be resumed after two weeks (upon re-evaluation by the physician). The patient should not consume alcohol after the surgery. More strenuous activities and alcohol consumption may be resumed after three weeks. Bruising and swelling should be gone after several weeks.
Results:
 For some, the improvements from this procedure will last several years and may be permanent for others.

Rhinoplasty

 

Rhinoplasty is one of the most requested operations. Rhinoplasty is a surgical technique that restructures and restores the natural shape of the nose by correction of the nasal septum trauma or hereditary deformations.

Which patient can benefit from rhinoplasty? Rhinoplasty can be done for purely aesthetic. Rhinoplasty can improve appearance and self confidence.

Surgery risks. When the operation is done by an experienced surgeon, complications are rare and usually minor.

Preoperative TIPS – same as in other operations.

Rhinoplasty surgery is performed under general anesthesia or local anesthesia combined with a mild intravenous anesthesia. The operation takes about 1 hour, more complicated procedures may take longer.

In the first days after surgery, the patient may feel swollen, with swelling and bruising in particular the lower eyelid. In this case it appropriate to apply cold compresses to reduce the symptoms. During 2 weeks, activities that can increase blood pressure should be avoided.

CONCLUSIONS – Rhinoplasty brings a facial equilibrium, resulting in increased confidence in you.

Procedure

Rhinoplasty, also called nose surgery, reshapes the nose by reducing or increasing the size, removing a hump, changing the shape of the tip or bridge, narrowing the span of the nostrils, or changing the angle between the nose and upper lip. This procedure may also relieve some breathing difficulties when combined with surgery performed on the nasal septum.

TO REMEMBER:

 

Length:
 Approximately one and a half hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are commonly used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort and swelling, mild bruising.
Risks:
 The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
Recovery:
 The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
Results:
 The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.

Otoplasty

Otoplasty (ear correction) the purpose of the surgery is to bring closer ears to the head or to make them smaller. Usually the ears are asymmetrical, one being more off than the other, also there may be differences of magnitude between the two ears. The goal of surgery is to restore this symmetry, or make them look symmetric.

Which patients may benefit from Surgery?
The operation is done after the age of 14-15 years, when the size of the ear is close to that of an adult. It is recommended to perform such surgery before the patient goes to (kindergarten, school), to avoid psychological trauma due to bad attitude of others. It is desirable that the child wants the operation for himself because they are more cooperative and thus more satisfied with the result.

There is no surgery without risks. When the operation is done by an experienced surgeon, complications are rare and usually minor. There are differences between patients with regard to healing ability so the outcome is never completely predictable. In a small percentage may appear small blood clot behind the ear, the small incision or infection localized to the skin or cartilage, which is treated with antibiotics.

Do not eat or drink anything after midnight before the operation, it is prohibited to take aspirin and drugs at least for 2 weeks before the surgery.
Normally the surgery in women must be performed when they are out of menstrual period;
You must notify your surgeon and anesthesiologist if you have medical problems (hypertension, vascular problems, heart failure, diabetes, lung problems, bleeding problems, epilepsy, neurological problems, allergies to various medications);
Should tell your doctor if you wear dentures or contact lenses;
If you smoke you must plan giving it up for at least 1-2 weeks before surgery and additionally 2 weeks after the surgery;
Avoid extra sun exposure before the surgery, especially facial region;
Do not follow a strict diet before the surgery because it may delay healing, if you catch a cold or make any infection, the surgery should be postponed.

The operation takes approx. 1 hour. The incision is made behind the ear to expose the cartilage. Subsequently, using absorbable thread, cartilage is being remodeled by stretching toward the head. After checking the homeostasis, the skin is sutured.

Children may return to the community after a week (but should be monitored during the first month) on the other hand adults may resume work after 2-3 days.

The results of this operation are very good, but you should not expect that after the surgery your ears are going to be perfectly symmetrical, which is rather absurd. Let us not forget that normally there is a difference between your right hand and the left one and in the same manner your legs are, eyes and so on….

Procedure

Otoplasty, also called ear surgery, sets prominent ears back closer to the head and/or reduces the size of large ears. Cosmetic ear surgery is most often performed on children between the ages of four and fourteen and may be covered by insurance.

TO REMEMBER:

Length:
 Approximately one and a half hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are commonly used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort and swelling, mild bruising.
Risks:
 The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
Recovery:
 The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
Results:
 The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.

Lipofilling

Fat transfer, also called fat grafting, fat injections and lipofilling, is a procedure that uses a person’s own fat to fill in irregularities and grooves. This is now a well-established technique that was perfected in the early nineties to a predictable procedure.

Aesthetic indications for undergoing lipofilling include sunken cheeks, the disappearance of fat from the cheekbones, deep grooves running from the nose to the corners of the mouth, and in some instances of lines between the lower eyelids and the cheek. It is also one of the most common methods used for lip enhancement. In addition, lipofilling can be used to smooth out all types of irregularities such as those resulting from poorly performed liposuction or injuries.

The necessary fat is obtained by a limited liposculpture through one or several 3 to 5 mm incisions. It is normally taken from the abdomen or inner thigh. The aspirated fat is processed by centrifuging, filtering or rinsing. Pure liquid fatty tissue ready for injection is the result.

The fat is then injected where needed. The fat is evenly distributed into the area by injecting minute amounts in the tissues so that the injected fat is well surrounded by healthy tissue. This ensures that the transplanted fat remains in contact with the surrounding tissues that must supply it with oxygen and nutrients.

TO REMEMBER:

 

Length:
 Approximately one and a half hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are commonly used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort and swelling, mild bruising.
Risks:
 The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
Recovery:
 The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
Results:
 The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.

Facial liposuction

Facial liposuction has become a common cosmetic procedure, either on its own or in conjunction with facelift or other facial procedures. It consists of the removal of unwanted fatty tissue with a cannula and vacuum device promoting and improving facial shape like jaw line or even using laser lipolysis approach.

TO REMEMBER:

Length:
 Approximately one and a half hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are commonly used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort and swelling, mild bruising.
Risks:
 The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
Recovery:
 The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
Results:
 The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.

Facial Implants

Facial implants are solid, pre-shaped, three-dimensional objects used to improve the size and appearance of different areas including the chin, jaw, nose, cheeks and beside the nose (paranasal). Facial implant surgery provides a more harmonious appearance to the face. There are different types of implant material used to achieve these contour changes. There are also different shapes of implants according to the area to be enhanced.

TO REMEMBER:

Length:
 Approximately one and a half hours.
Anesthesia:
 General anesthesia or intravenous sedation and local anesthesia are commonly used.
Inpatient/Outpatient:
 This is an outpatient procedure.
Possible Side Effects:
 Temporary discomfort and swelling, mild bruising.
Risks:
 The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
Recovery:
 The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
Results:
 The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.