Face surgery

Eyelid Lift

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 TIVA 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 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 1-2 weeks.  Sutures are generally removed 4-7 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.

Facelift

A rhytidectomy or facelift is designed to restore a more youthful appearance to the neck and jowl 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 and reestablishing defined contours along the neck and jawline.  It is often done in combination with other procedures including a browlift and eyelid surgery to create an overall harmonious, youthful result.

The surgery is done under general anesthesia and typically takes 4-6 hours.  Incisions are made in the natural crease in front of the ear, around the earlobe, and behind the ear extending into the hairline.  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 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 several weeks. Sutures are usually removed 7-14 days after surgery but it is usually 2 to 3 weeks before most patients feel socially presentable.

Midface Lift

This procedure is designed to correct hollowing beneath the lower eyelids and deep nasolabial folds which run from the base of the nose to the outer corners of the mouth.  It creates a more youthful appearance by smoothing the transition between the lower eyelids and upper cheek region.  If improvement in the neck or jowl region is desired, a Midface Lift can be combined with a more standard facelift.

The procedure is done under general anesthesia.  The incision is made underneath the lower lid lash margin and usually extended out to the lateral eye region.  A fair amount of bruising and swelling are normal for 1-2 weeks after surgery.  Ice and ocular lubricants can be helpful early on.  Stitches are usually removed 7-10 days post op.  There can be a period lasting several weeks of an overcorrected or “Asian” appearance to the eyes which relaxes over the first 4-6 weeks.

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.

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.