FACE

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Blepharoplasty

Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty can be combined with BOTOX treatments to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes.

The procedure is usually performed in an office with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. The effects of blepharoplasty can last for a long time and are sometimes even permanent.

Facelift

In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jawline slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look — after surgery, some patients appear as much as ten or 15 years younger.

Facelifts are most often performed on people in their 40s-60s, those in their 70s or 80s can have facelifts as well. The procedure can be combined with others (browlift, eyelid surgery, nose reshaping) for more dramatic results, or it can be restricted to the neck (necklift) if the patient’s problems center there.

Facelifts are usually outpatient procedures and may be performed in an office-based facility, surgery center or hospital, typically under local anesthesia combined with a sedative. The procedure itself varies depending on the surgeon and the patient’s facial structure (i.e. where the incisions are placed, whether one or both sides of the face are worked on at once, in which order the steps are performed).

A facelift improves the look of the lower and middle areas of the face, and the neck. It is most effective for correcting the following:

  • Mid-face sagging
  • Deep creases under the eyes
  • Nasolabial folds
  • Jowls
  • Sagging fat
  • Loose skin and fat under the chin and jaw

Although a facelift removes or reduces signs of aging, over time, they will gradually reappear. A facelift does not improve the look of the brow, eyelids and nose, and some parts of the mid-face. A patient who wants to improve those areas might combine facelift with a brow lift or eyelid surgery, and/or with injectable soft-tissue fillers, facial implants and skin resurfacing.

The best candidates for a facelift want to correct one or more of the signs of aging indicated above; have some facial sagging, but still have elasticity in their skin; are generally healthy; do not smoke; and have realistic expectations about what rhytidectomy can do.

A facelift is typically performed as an outpatient procedure in an office-based facility, surgery center or hospital. Patients may have a choice of IV sedation or general anesthesia. The procedure takes about 2 hours. The way a facelift is performed depends on the surgeon, the patient’s facial structure, and the extent of correction desired. The types are traditional facelift and limited-incision facelift. In both methods, incisions are closed with stitches or tissue glue. Scars are hidden in the hairline and natural contours of the face.

After facelift, the surgeon wraps the incisions in bandages, and may place drainage tubes. The tubes are taken out the next day, when the hair is carefully washed. If surgical clips are holding some incisions closed, they are removed, along with any stitches, one week after the procedure. Swelling, numbness, bruising and a feeling of tightness or tension in the face and neck may be felt. The face may look uneven or distorted, and facial muscles may feel stiff. Most of these side effects resolve within 3 to 6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy and itchy over time.

Results of a facelift are not permanent, and some patients choose to undergo another in 5 or 10 years. In some sense, however, effects are permanent; years later, the face continues to look better than if rhytidectomy had not been performed.

Rhinoplasty

One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes.

Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.

Dr. Orseck may use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an “open” procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed.

Otoplasty

Otoplasty, or cosmetic ear surgery, is used to reshape one or both ears. Patients who are dissatisfied with the size, shape or orientation of their ears can alter their appearance through this outpatient procedure. Otoplasty also includes ear/earlobe reduction and cauliflower ear surgery to remove and recontour excess skin and cartilage.

Because the ears are very prominent, many cosmetic ear surgery patients experience a significant increase in confidence and self-esteem once their ears have been given a more desirable appearance.

Child patients tend to have otoplasty around the age of six, when their ears has developed to a size relatively close to an adults.

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