1plasticsurgery.info | Face Eyelids Wrinkles

Face

The face is probably the most visible aspect of our body.

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Face | Eyelids | Chemical Peel (Wrinkles)

Rhinoplasty
Cosmetic surgery of the nose has been addressed on our nose page.

Facelift
The facelift procedure is performed to tighten the skin of the face and neck area giving the patient a more youthful and rested appearance. Face and neck lifting is pursued both by relatively young patients to preserve a more youthful appearance and by older individuals to attain a younger and more rested look. Correspondingly, the results of a face-lift can range from subtle to dramatic according to the extent of aging changes present in the individual. As we age, our skin begins to wrinkle and lose elasticity. One of the first signs is "cheek creases" that appear without smiling. Further aging deepens the cheek creases and often creates "jowls" along the lower jawline. In advanced facial aging, skin and fat dangle from under the chin forming a "turkey gobbler" with vertically oriented bands and transversely running wrinkles. Because it is unusual to find aging changes isolated in the face without accompanying changes in the neck, the neck and face are usually treated simultaneously. The face- and neck-lift, which is medically termed a rhytidectomy, is performed through incisions that are made in existing skin creases and hair-bearing regions surrounding the ear. Minimal or no hair is trimmed from the scalp along the incisions. Then, the surgeon retracts and advances the skin and its underlying tissues to affect a smoother and more defined contour to the neck and jawline. If necessary, will trim or suction focal deposits of fat along the jawline or under the chin. This occasionally requires an incision in the shaded area under the chin. He then tightens the tissue by moving both the skin and often the deeper subcutaneous tissues and muscles. The excess skin is excised and discarded as the incisions are closed with sutures and staples. The tightening is performed symmetrically on each side of the face. Face and neck-lifting surgery takes four to five hours and can be performed either with local or general anesthesia. Patients usually are hospitalized for one night postoperatively for observation and can wash their hair on the first postoperative day. Dressings are rarely worn beyond two days, but swelling and bruising may be considerable for two to three weeks. Dr. Khoobehi will remove the sutures or staples in stages over the first five to ten postoperative days. Patients are generally encouraged to remain at home or within the local area over the early part of this interval. After the sutures are removed, patients are free to begin using cosmetics and usually return to their "routine" within two and three weeks. Because the face-lift procedure restructures large areas of tissue, you should be aware of several risks: blood collecting under the skin and compromised blood flow or healing of the skin. These complications can lead to irregularities in the skin or scarring. Patients can minimize these risks by avoiding tobacco products and aspirin-like medications that "thin" the blood. Because the skin is separated from the nerves and muscles, which animate the face, you may experience numbness or weakness in moving the eyebrow or corner of the mouth postoperatively. Fortunately, this usually is resolved within two to three weeks, but it occasionally can take several months to subside. Scars can require nearly a year to complete a cycle of fading and softening. Those in the scalp can occasionally be more visible due to thinning of the adjacent hair. You may be able to notice scars extending in front of the ear and around the earlobe if you look closely. However, all of these limitations can usually be minimized by using properly selected cosmetics, earrings and hairstyles. Rarely, poorly healed scars require additional measures to improve their appearance. There are some limitations to a facelift. First, a face and neck-lift procedure alone will not affect aging changes in the eye or forehead region, which may require eyelid surgery or a forehead lift. Second, the re-draping of the skin addresses skin laxity to a greater degree than wrinkling. Fine wrinkles, like those surrounding the lips and eyes, are due to alterations inherent to aging skin and usually must be addressed by a skin resurfacing procedure such and micro-dermabrasion, chemical peeling or laser treatment. Depending on the area of the face in question, resurfacing can be performed in the same setting as face lifting. The additional benefits of these skin-resurfacing procedures to the skin quality and tone greatly enhances the rejuvenating effect of the face and neck lift procedure. Finally, while the procedure renders a more youthful appearance, the extent of the enhancement will gradually diminish over time. The longevity of a face-lift is impossible to predict for a given patient since it is influenced by environmental factors such as continued exposure to tobacco products and sunbathing, as well as factors genetically unique to the individual. It can be said that the face-lifted individual will never look as aged as if the operation had never been done. As and individual ages, repeat face-lifting or "mini-lifting" operations may occasionally become necessary.

Chemical Peel
Chemical peels are one of the most effective techniques available for alleviating fine wrinkles and giving the face a long-lasting youthful appearance. People with fine wrinkles; sun damage or color abnormalities of the skin are candidates for a chemical peel. A consultation with your doctor can be arranged to determine the best type of peel to suit your individualized needs. The results of this procedure are often dramatic and usually long lasting.
A chemical peel is an applied, controlled chemical burn to the top layers of your skin. Chemical peels are categorized into superficial, medium and deep peels depending upon the severity of the patient's wrinkles and the degree of sun damage present. The depth of the burn depends upon the concentration of acid that is used. The peel itself should take no more than 30 to 60 minutes and may be painful for the first few minutes to an hour following the procedure. This pain is usually very well controlled with oral pain medicines. After receiving a chemical peel, patients usually are sent home with supervision. The skin will begin to peel 24 to 48 hours following the application of the acid. New skin will replace the peeled skin within seven to ten days. However, chemically peeled skin takes longer to look normal. A pink hue to the skin can be expected for 2 to 4 weeks, often necessitating blending with makeup. The procedure is usually done as a full-face peel. Before you have a chemical peel, it is important for your plastic surgeon to know if you have a history of cold sores. Medication may be administered to prevent them. He may also recommend two to six weeks of pretreatment with Retin A before your chemical peel. Also, notify your doctor or one of his/her staff if you've taken Accutane. Patients who have taken Accutane for acne can have problems with scarring following some peels.

Eyelid
Surgery to reduce the amount of excess tissue around the eyes (blepharoplasty) may be performed in conjunction with a face-lift operation or, more frequently, as a separate procedure. When a patient wants both a face-lift and a blepharoplasty, the operations may be performed together or in stages, according to the patient's personal preferences or financial considerations. In most cases both eyelids (upper and lower) are operated on at the same time. However, it is not uncommon to do only the upper eyelids or the lower eyelids, as the patient wishes.
To remove excess skin and other tissue from the upper eyelids, incisions are made in the eyelid fold and extended laterally toward the smile lines. Fatty tissue from the lower eyelids may be removed either through an incision in the skin (just below the eyelashes) or through an incision in the back surface of the eyelid (the transconjunctival approach). Some patients have droopy lids from a weak eyelid muscle (with or without excess eyelid skin and fat). If this problem, which is called blepharoptosis, is diagnosed, it often is amenable to surgical correction. The operation takes from 30 minutes to two hours and usually is performed using local anesthesia. Intravenous sedation may be given if the patient wishes. General anesthesia often is used if blepharoplasty is performed at the same time as a face-lift. Sutures typically are removed four to seven days after surgery. Although discoloration around the eyes usually resolves in 1 to 3 weeks, swelling (edema) may persist for several weeks. The skin scars heal as inconspicuous thin lines in nearly all patients within a few weeks to months. Some patients may experience dryness of the eyes after surgery. This symptom may be caused by incomplete closure of the eyelids during the healing phase and usually resolves within a few weeks. Within the interim, the eyes may be soothed by using artificial teardrops and ointments. Because people who have dry eyes before surgery have a greater chance of experiencing this problem postoperatively; we recommend an examination by an ophthalmologist before blepharoplasty is performed. Rarely, there may be other problems after surgery such as persistent drooping or retraction of the eyelids or darkening of the lids because of permanent retention of blood pigments in the skin. These undesirable side effects frequently can be treated satisfactorily. Complete loss of vision in an eye is an extremely rare complication of blepharoplasty. Temporary visual blurriness, occasionally may occur, after surgery because of alterations of the tears, but the problem typically is short-lived. Most patients indicate that their eyes look and feel more rested and youthful after blepharoplasty. In general, it is a relatively safe and straightforward operation.