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Facial Cosmetic Surgery

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  • Facial Cosmetic Surgery

    Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age, the skin becomes lax, and there may be drooping or hooding of the upper lids, and bags on the lower lids. Eyelid surgery may be functional, cosmetic, or both. It usually involves removing or repositioning excess skin and fat, and the procedure may reinforce surrounding muscles and tendons.

    Surgery can change the shape of the face or tighten the skin.

    In Rhinoplasty, also known as a “nose job,” the surgeon reshapes the patient’s nose to improve the appearance and often breathing, too. It may involve reshaping the tip and reducing the bony hump at the upper aspect of the nose.

    It can be performed with small incisions that are well hidden, often inside the nostrils. Surgeons do not recommend rhinoplasty until the patient is at least 15 years old, to allow for full growth of the cartilage and bone of the nose.

    Otoplasty, or ear surgery, treats prominent or misshapen ears by surgically “pinning” the ear closer to the head with sutures, reshaping the cartilage, or both. One or both ears may be treated. It is most commonly performed in children after of 5 or 6 years as the ears have essentially reached adult size by that age. Rhytidectomy, also known as a facelift, aims to surgically remove wrinkles and tighten facial skin in order to achieve a more youthful appearance. Typically, the incision is placed in front of and behind the ears, extending into the hairline in the temple area. The skin is lifted off the deeper facial tissue, redraped more tightly, and the excess skin is removed. The incisions are then closed with sutures.

    The deeper tissues of the face and neck may also be tightened. Blepharoplasty, or eyelid surgery may be done at the same time.

    A Brow Lift, browplasty, or forehead lift aims to remove signs of aging by raising drooping eyebrows and removing forehead wrinkles, or worry lines. It is often done alongside other cosmetic procedures to achieve a more harmonious facial appearance.

    Chin Augmentation aims to make the chin more prominent and provide a better balance of facial features. It may be done at the same time as rhinoplasty, depending on the measurements taken before surgery. It can be performed with either a prosthetic implant or through manipulation of the chin bone.

    Malar, or Cheek, Augmentation can make the cheekbones more prominent. The surgeon may place an implant at the top of the cheekbones.

  • Peels, Fillers, Grafts, and Laser Treatment

    Less invasive treatments may include peels, fillers, injections, grafting, and laser treatment. Share on PinterestFillers can be used to iron out wrinkles and to make the lips look plumper. Chemical peels may help treat acne, pock marks, scars, or wrinkles. A number of active agents may be used.

    A light or superficial peel uses Alpha Hydroxy Acids (AHAs) such as glycolic, lactic, or fruit acids to treat the outermost layers of the skin. The treatment is not as deep as with some peels, so the recovery time is minimal.

    A medium peel usually involves TCA (tri-chloroacetic acid) of various concentrations. It penetrates the dermis, or deep layer of the skin, to a greater depth than the light peels. The recovery and pain are more significant than the lighter peels. Redness and flaking may persist for several days or weeks.

    A deep peel, or phenol peel, penetrates the skin to the deepest extent. As a result, it has the greatest impact on resurfacing the skin, but it also has the longest recovery time, and it can causing scarring and skin lightening.

    Chemical peels have been shown to be safe and effective for both light and darker skin types.

    Botulinum Toxin, or Botox, is the brand name of a toxin produced by the bacterium Clostridium botulinum (C. botulinum), first approved by the FDA in the 1980s for muscle spasm. A range of cosmetic surgery procedures aim to improve appearance.

    It is used to treat wrinkles and facial creases. It acts by blocking the signal from nerves to the muscles that are injected. The injected muscle can no longer contract, or tighten, as forcefully as before, and this leads to a controlled relaxation of the muscles.

    It is approved for treatment of frown lines on the forehead, crow’s feet, or lines around the eye, and axillary hyperhidrosis, or increased sweating of the armpits. Apart from “botox,” several other brand names of botulinum toxin are now commercially available.

    Soft tissue fillers, or dermal fillers, are medical device implants approved by the FDA for use in helping to create a smoother, fuller appearance in the face. They can be used to treat nasolabial folds, cheeks, and lips, and to increase the volume of the back of the hand.

    They can also reduce wrinkles, lines and scars, and augment soft tissue contours. They are not permanent, but they are degraded by the body, so repeat treatments may be necessary to maintain the effect.

    Commercially available products include hyaluronic acid, poly-L-lactic acid (PLLA), calcium hydroxyapetite, and polymethylmethacrylate beads (PMMA). These products normally come in a gel formulation that fine needles can inject into the deeper layers of the skin and underlying soft tissue of the face. Collagen injections are no longer performed because some patients experienced allergic reactions, some of them serious.

    Complications can occur with facial fillers, and especially permanent fillers. Clinicians and patients are urged to check the contents of a filler and discuss all the implications of surgery before going ahead with a procedure.

    In 2015, the U.S. Food and Drug Administration (FDA) warned that rare but serious problems may arise if soft tissue fillers are accidentally injected into blood vessels in the face.

    Fat injections and fat grafting have broad applications in cosmetic surgery. The patient’s own fat is collected from one part of the body using liposuction, and it is injected into areas requiring volume enhancement. It is usually applied to the face, including the lips, the hands, and depressions in skin contour.

    The results are generally safe and long lasting, and it can have the additional benefit of removing fat from a place where it is not wanted. The fat is removed, washed, and purified and then carefully re-injected with specially designed needles. Sometimes the procedure needs to be repeated several times for best results.

    Stem-cell enriched fat grafts have been trialed for reconstructive surgery, with promising results, suggesting that the procedure is reliable, safe, and effective. However, tumor growth may be an adverse effect, so further research is needed before stem cells can become central to plastic and reconstructive surgery.

    Lasers and light-based facial treatment, also known as facial laser resurfacing or laser skin treatment, can help reduce fine lines, wrinkles, and abnormal pigmentation, such as sunspots. Treatment utilizes concentrated, pulsating beams of light.

    A variety of laser types are used, and these vary in aggressiveness and downtime. It may take several sessions to see results.

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