cosmetic surgery

Facial Plastic and Reconstructive Surgery

A facial plastic surgeon specializes in performing cosmetic, functional and reconstructive surgery on the face, head, and neck region. This includes; deviated nasal septum repair, rhinoplasty (nosejob), face and brow lift, drooping eyelid surgery (blepharoplasty), and protruding ear surgery (otoplasty). Noninvasive procedures such as Botox Cosmetic®, filler injections and laser treatments are also performed. Our physicians are board certified in facial plastic and reconstructive surgery. Computer Simulation

Using Alterimage software (© 1999-2001-Seattle Software Design) and digital photography, facial images can be altered by a technique known as morphing. Patients can view before and potential after images of themselves through simulated procedures of facial plastic surgery. Facial wrinkles, folds and jowls can be removed, eyebrows and faces lifted and noses changed through this simulation technique. This will allow an understanding of what facial plastic surgery could offer and potentially achieve and is a more effective tool than looking at before and after pictures of other patients.



Facelift (Rhytidectomy, Mini-lift)

A facelift cannot stop aging, nor can it turn back the the hands of time. The goal of surgery is to improve the overall facial appearance with natural looking results.

At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure. We primarily perform what is known as a mini-lift which accomplishes what a traditional facelift can with less surgery, downtime and bruising.

Many patients decide to have facial liposuction to remove excess fatty deposits in conjunction with a facelift. If other areas need correction, more than one procedure may be necessary for the best overall result.

The rhytidectomy procedure begins with an incision in the area of the temple hair, just above and in front of the ear, and then continues around the ear lobe, circling the ear before returning to the point of origin in the scalp. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage. The skin is elevated and underlying muscle and connective tissues are tightened. Some fat may be removed, as well as excess skin. After trimming the excess skin, the incisions are closed with fine sutures. Depending on the extent of the surgery, the process can take several hours. Following the surgery, a dressing is applied to protect the surgical area for one to two days. Postoperatively, a minor amount of swelling and bruising may occur and will usually resolve in 5-7 days. Recovery usually takes two weeks, although many patients go back to work after one week.

Risks and complications of rhytidectomy


Nasal surgery (rhinoplasty, nose job)

Aesthetic nasal surgery (rhinoplasty) refines the shape of the nose, bringing it into balance with other facial features. Before surgery, it is very important that the patient have a clear, realistic understanding of what surgery can accomplish and the risks of the procedure. We are trained in both ear, nose, throat, and facial plastic surgery, which provide the highest level of training and expertise in rhinoplasty surgery both internally and externally.

At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure. Nasal obstruction caused by a deviated nasal septum and enlarged inferior turbinates can also be addressed during a rhinoplasty. One procedure commonly performed during a rhinoplasty is chin augmentation (mentoplasty) which is an implant used to harmonize the facial profile.

The procedure to reshape the nose can be performed by two basic approaches; endonasal and external. The endonasal approach does not require external incisions; the entire procedure is performed inside the nose. The external approach uses an incision on the undersurface of the nose to lift the skin exposing the nasal cartilages and bone. In both approaches, bone and cartilage are removed or rearranged to alter the nasal shape. A nasal splint is placed on the outside of the nose to help retain the new shape during healing and is removed seven days after surgery. If nasal packing is placed inside the nose, it will normally be removed the morning after surgery.

Risks and complications of rhinoplasty

Rhinoplasty postoperative instructions

Rhinoplasty postoperative nasal care


Surgery of the Eyelids (Blepharoplasty)

Blepharoplasty removes the excess fat, muscle, and skin from both upper and lower eyelids. This removes the puffiness and bags around the eyes that make you look worn and tired. The results will be a more refreshed appearance, with younger, firmer eyelids. At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure. A browlift may be recommended as well to correct a drooping brow, heavy upper eyelids and smooth forehead wrinkles.

The procedure for the upper eyelid begins by first marking the creases of the lids in order to keep the scars as invisible as possible along natural skin folds. The incision is made, and excess fat, muscle, and skin are removed. Fine sutures are then used to close the incisions.

The procedure for the lower eyelid begins by making an incision in an inconspicuous site along the lash line of the lower eyelid. Excess fat, muscle, and skin are then removed before the incision is closed with fine sutures. Lower eyelid puffiness caused by excess fat may also be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fat is removed. A blepharoplasty can take one to two hours to perform. After surgery, a certain amount of swelling and bruising is normal. Non-absorbing sutures will be removed seven days after surgery and self-absorbing stitches will dissolve on their own.

Risks and complications of blepharoplasty



Surgery of the forehead and brows (forehead lift, browlift, browplasty)

The effects of aging result in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. As a result, many people have opted for a procedure known as a browlift to correct a drooping brow, heavy upper eyelids and smooth forehead wrinkles.

At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure. The procedure involves tightening loose skin and removing forehead wrinkling and drooping brows. If necessary, part of the muscle that causes vertical frown lines between the brows is removed. The result will be a smoother forehead, lifting the heaviness of the upper eyelids and brows and a more youthful expression.

The procedure begins with incisions that can be placed at the hairline, behind the hairline, or in some cases, above the brow or in the mid-forehead. The incisions are camouflaged and designed in a way that hair grows through the scar further concealing it. The forehead skin and brows are then elevated and excess skin and tissue removed before fine sutures or staples are applied. The procedure usually lasts two hours.

After surgery, you will experience a certain amount of swelling and bruising for seven days. As the incisions heal, you may experience some numbness as well as itching, both of which will diminish with time. The sutures are usually removed within seven days following surgery. If bandages have been used, they are removed in one to two days. Not infrequently, a brow lift is combined with a blepharoplasty or a face lift to provide a full facial rejuvenation.

Risks and complications of browlift


Surgery of the Chin (Mentoplasty, Chin implant)

A well defined chin helps give balance to the face and creates a major part of one's profile. Changes in chin size or shape may enhance a profile as much as a rhinoplasty. Another possibility for improvement through chin surgery is submental liposuction in which excess fatty tissue is removed to redefine the chin or neckline. In some instances, we will suggest chin surgery as a supplement to rhinoplasty because a small chin can make the nose appear larger. At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure. The procedure begins by making an incision either in the natural crease line just under the chin or inside the mouth, where the gum and lower lip meet. By gently stretching this tissue, we create a space where an implant can be inserted. After implantation, fine sutures are used to close the incision. The procedure takes less than an hour to perform. Immediately after surgery, a dressing is applied that will remain in place for two to three days.

Risks and complications of mentoplasty


Otoplasty (prominent ear surgery)

Protruding and prominent ears are a physical characteristic that can easily be treated with surgery. Children, long the victims of cruel teasing are the most likely candidates for otoplasty, but this surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Having the procedure at a young age is highly desirable since the cartilage is extremely pliable, thereby permitting greater ease of shaping. Not only is it possible to pin back ears, but ears can also be reshaped, reduced in size, or made more symmetrical.

At your consultation, we will describe the technique we use, the type of anesthesia, any additional surgery, possible complications, and costs of the procedure.

The procedure begins with an incision just behind the ear which is concealed. Skin is then removed and cartilage reshaped to achieve the desired effect. Cartilage is rarely removed and sutures are used to reshape and pin back the ears. The otoplasty procedure takes about two to three hours to perform. A dressing is applied to the ears for a few days. Headbands are recommended to hold the ears in the desired position for four weeks after surgery or may be prescribed for nighttime wear only.

Risks and complications of otoplasty


Earlobe surgery (torn earlobes, earlobe reduction or enlargement procedures)

Torn earlobes are usually caused when earrings are pulled through or from wearing heavy earrings for long periods of time. These tears can be easily repaired in our office with specialized suture techniques under local anesthesia. Earlobes usually heal quickly with minimal scarring. In most cases, the earlobe can be pierced again in six weeks after surgery to receive light-weight earrings.

Earlobe size can also be altered. Long floppy earlobes can be surgically reduced in the office using similar techniques as in torn earlobe surgery. Small earlobes can be augmented using filler injections described in the filler section.


Skin lesions

Moles, skin tags, benign and malignant skin lesions can be removed in our office. The procedure is performed under local anesthesia and may require sutures. If there is any uncertainty about the lesion, a biopsy might be performed for diagnosis before fully excising the lesion.


Botox cosmetic®

Botox cosmetic® is a purified protein produced by the bacterium Clostridium botulinum and has been used safely by doctors for many years. The drug works by relaxing the overactive muscles that cause wrinkles, lessening the appearance of frown lines, forehead lines and crows feet. This reduces or eliminates wrinkles without surgery. Botox cosmetic® is FDA approved for treating wrinkles and has grown to become one of the most popular cosmetic procedures.

Causes of wrinkles
Frown lines (vertical lines between the eyebrows); forehead lines and crows feet are caused by the constant movement of muscles beneath the skin. For example, a wrinkle in the area between the eyebrows may appear and persist because of repeated frowning. These lines can produce an angry or frustrated look on the face. This is the same for lines around the eyes called crow’s feet, which are caused by smiling or squinting. Raising our eyebrows often will result in horizontal forehead lines.

Botox cosmetic® uses
The most common areas that are treated are frown lines, horizontal forehead lines, laugh lines on the nose and crows feet. Other areas that can be treated include the lips, mouth and neck.

How does it work?
Botox cosmetic® is injected into the muscle that creates a wrinkle. This blocks the nerve impulse from reaching that area and as a result the muscle relaxes. As the muscle relaxes, the skin overlying the muscle relaxes and the wrinkles gradually soften, become less visible and often disappear.

When does it start to work?

You will notice Botox cosmetic® beginning to work in 3-5 days. It will improve over the following 7-10 days.

How long will it last?
The improvement you will achieve from Botox cosmetic® will last anywhere from 3-6 months. You will notice a gradual fading of its effect after 6-8 weeks, at which point, you may return for re-injection. Some patients find that the treatments last longer after having multiple treatments.

How is Botox cosmetic® injected?
Botox cosmetic® is injected into the muscles through localized pinpoint injection. The procedure takes about 10 minutes to perform. A topical anesthetic is applied to numb the skin. Our doctors will determine which muscle to treat and with what quantity of Botox cosmetic® to give you the best result.

Other uses for Botox cosmetic®
Botox cosmetic® is used for many other reasons besides wrinkles. A chemical browlift can be performed using Botox cosmetic® that will elevate the brows. Patients who suffer from excessive sweating known as hyperhydrosis can be treated with Botox cosmetic® which dramatically reduces sweating.

Consent form for Botox cosmetic®

Post injection instructions for Botox cosmetic®


Fillers (Juvederm®, Sculptra®)

Fillers are materials that are injected to fill in wrinkles and folds and provide volume to deficient areas of the face. In the past, fat and collagen were used. Technology has brought new classes of fillers that last longer with natural appearing results. Hyaluronic acid fillers like Juvederm® injectable gel offer a safe and effective nonsurgical option for smoothing facial wrinkles and folds.

Juvederm® filler
Juvederm® is made of hyaluronic acid, a naturally occurring substance in your skin that helps to add volume and hydration. Juvederm® can be injected under the skin to instantly restore skin's volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds, the creases that run from the bottom of your nose to the corners of your mouth), and "marionette lines" around your lower mouth. Lips can be augmented and made fuller and scars can be filled.

Juvederm® injection procedure
Because Juvederm® is a simple, nonsurgical wrinkle treatment; there is minimal recovery or downtime. The procedure is performed under topical and/or local anesthesia and takes about 15 minutes to perform. The results can last approximately 8-12 months.

You should see an immediate improvement in the treated areas. Most patients need one treatment to achieve wrinkle smoothing. Supplemental “touch up” treatments may be required to achieve and maintain results.

Juvederm® injection consent

Juvederm® postinjection instructions



Sculptra® injection 
Sculptra® is fast becoming a favorite filler for rejuvenating facial skin. Sculptra® also known as the liquid facelift works by stimulating the body to produce new collagen and underlying tissue, thereby creating a fuller, more youthful appearance and filling in wrinkles and lines.

Sculptra® is a FDA-approved filler and is an injectable form of poly-L-lactic acid, a biodegradable, biocompatible synthetic material that has been widely used for many years in dissolvable sutures, bone screws, and facial implants.

The effects are long lasting and were shown in a clinical study to last for up to 2 years after the first treatment session.

Sculptra® works by restoring the fullness of the face by providing a 3-fold increase in skin thickness. This treats the deepest of wrinkles and restores a youthful full appearance to the face. Sculptra® is injected below the surface of the skin using a very fine needle and provides a gradual increase in skin thickness over time to correct the depression in your skin.

Multiple treatments are needed, usually 3 sessions. Once the desired look is achieved, the treatment lasts up to two years, but could require minor touch-ups over time.

Sculptra® injection consent

Sculptra® postinjection instructions

 

 

T) 203.319.1900 F) 203.256.0629 1275 POST ROAD FAIRFIELD, CT 06824

 

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