Improves sagging facial skin, jowls and loose neck skin.

Procedure

A full or complete facelift improves the skin and tissues of the lower two-thirds of the face, from the ears, across to the cheeks, and down to the jaw line, by removing excess fat, tightening muscles and re-draping skin.

TO REMEMBER:

	Length:	Approximately four hours.
	Anesthesia:	Usually general anesthesia is used or the patient may elect to have sedation and local anesthesia.
	Inpatient/Outpatient:	Usually this is an outpatient procedure, although some patients may require a short hospital stay.
	Possible Side Effects:	Temporary bruising, swelling, numbness and tenderness of the skin, as well as a tight feeling and dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.
	Risks:	Injury to the nerves that control facial muscles or feeling (which is usually temporary but in rare cases may be permanent), infection, bleeding, poor healing, excessive scarring, asymmetry and a change in the hairline.
	Recovery:	The patient may return to work after ten to fourteen days. More strenuous activity may be resumed after two weeks or more. Bruising should begin to disappear after seven to ten days. Sun exposure must be limited for several months after surgery. The use of a sun block that provides both UVA and UVB (ultraviolet) protection is recommended.
	Results:	Most facelifts can be expected to maintain optimum appearance for five to ten years.

Minimizes forehead creases, drooping eyebrows, hooding over the eyes, a furrowed forehead and frown lines.

Procedure

A forehead lift, also called a brow lift, is a procedure that removes excess tissue, alters muscles and tightens the forehead skin. This procedure may be performed using the traditional technique, with an incision across the top of the head just behind the hairline, or with the use of an endoscope, which requires three to five short incisions, but allows access to the relevant areas to be treated incorporating a camera and a monitor to visualize the dissected areas.

TO REMEMBER:

	Length:	One to two hours.
	Anesthesia:	General anesthesia or intravenous sedation and local anesthesia are options.
	Inpatient/Outpatient:	This is most often an outpatient procedure.
	Possible Side Effects:	When an endoscope is used the patient may experience temporary swelling, numbness, headaches and bruising. When the traditional method is used there is the possibility of itching and hair loss.
	Risks:	Injury to facial nerves causing loss of motion, muscle weakness, or an asymmetrical look, persistent areas of numbness and broad and occasionally excessive scarring
	Recovery:	The patient usually returns to work in seven to ten days and even sooner with an endoscopic forehead lift. The patient must limit more strenuous activities for several weeks. Full recovery from bruising takes from two to three weeks. One should limit sun exposure for several months to avoid hyperpigmentation of the forehead which can occur as a result of sunlight exposure during the first three to six months after the procedure has been performed.
	Results:	Most facelifts can be expected to maintain optimum appearance for five to ten years.

Tightens drooping upper eyelid skin and reduces puffy bags below the eyes.

Procedure

Blepharoplasty (eyelid surgery) rejuvenates the upper and lower eyelids by removing excess fat, skin and muscle.

TO REMEMBER:

	Length:	Approximately two hours.
	Anesthesia:	General anesthesia or intravenous sedation and local anesthesia are used.
	Inpatient/Outpatient:	This is an outpatient procedure.
	Possible Side Effects:	Temporary discomfort, feeling of “tightness” in the eyelid area, swelling or bruising. Excessive tearing and sensitivity to light for the first few weeks should be expected. Temporary dryness, burning, or itching of eyes may also occur but these side effects are rare.
	Risks:	Temporary blurred or double vision, infection, bleeding, swelling at the corners of the eyelids, dry eyes, formation of whiteheads, slight asymmetry in healing or scarring, difficulty in closing eyes completely (which is rarely permanent), and a lowered position of the lower eyelid of the lower lids which may require further surgery. Permanent loss of vision is a risk but this is extremely rare.
	Recovery:	The patient may begin reading after about two to three days and can expect to return to work at approximately five to ten days. Use of contact lens may be resumed after two weeks (upon re-evaluation by the physician). The patient should not consume alcohol after the surgery. More strenuous activities and alcohol consumption may be resumed after three weeks. Bruising and swelling should be gone after several weeks.
	Results:	For some, the improvements from this procedure will last several years and may be permanent for others.

Improves the external shape of the nose

Procedure

Rhinoplasty, also called nose surgery, reshapes the nose by reducing or increasing the size, removing a hump, changing the shape of the tip or bridge, narrowing the span of the nostrils, or changing the angle between the nose and upper lip. This procedure may also relieve some breathing difficulties when combined with surgery performed on the nasal septum.

TO REMEMBER:

	Length:	Surgery takes approximately one hour or more.
	Anesthesia:	General or intravenous sedation and local anesthesia are used.
	Inpatient/Outpatient:	This is an outpatient procedure.
	Possible Side Effects:	Temporary swelling, bruising around the eyes and/or nose, and some bleeding and nasal stuffiness.
	Risks:	Infection, asymmetry, unsatisfactory nasal shape and incomplete improvement (which would require additional surgery) are possible.
	Recovery:	The patient may go back to work after one week. Activities that are more strenuous may be resumed after two to three weeks. The patient should avoid any activity that could impact on the nose or allow it to become sunburned for at least eight weeks. The use of a sunblock that provides both UVA and UVB protection is useful. The final results may take one year and sometimes longer to achieve.
	Results:	Permanent.

Improves the appearance of the ears.

Procedure

Otoplasty, also called ear surgery, sets prominent ears back closer to the head and/or reduces the size of large ears. Cosmetic ear surgery is most often performed on children between the ages of four and fourteen and may be covered by insurance.

TO REMEMBER:

	Length:	Approximately two hours.
	Anesthesia:	Young children are usually given general anesthesia. For older children or adults, a general or local anesthesia can be used along with sedation.
	Inpatient/Outpatient:	Usually this is an outpatient procedure.
	Possible Side Effects:	Temporary throbbing, aching, swelling, redness and/or numbness.
	Risks:	Infection of cartilage, excessive scarring, blood clots that may need to be drained, mismatched or artificial-looking ears, or the recurrence of the protrusion, which requires repeat surgery.
	Recovery:	The patient may return to school or work within five to seven days, and resume strenuous activity, such as contact sports in one to two months. A compression garment is required to use for 4 weeks.
	Results:	Usually permanent.

Enhances the face and body using fat collected from another area of the body.

Procedure

Fat transfer, also called fat grafting, fat injections and lipofilling, is a procedure that uses a person’s own fat to fill in irregularities and grooves. This is now a well-established technique that was perfected in the early nineties to a predictable procedure.

Aesthetic indications for undergoing lipofilling include sunken cheeks, the disappearance of fat from the cheekbones, deep grooves running from the nose to the corners of the mouth, and in some instances of lines between the lower eyelids and the cheek. It is also one of the most common methods used for lip enhancement. In addition, lipofilling can be used to smooth out all types of irregularities such as those resulting from poorly performed liposuction or injuries.

The necessary fat is obtained by a limited liposculpture through one or several 3 to 5 mm incisions. It is normally taken from the abdomen or inner thigh. The aspirated fat is processed by centrifuging, filtering or rinsing. Pure liquid fatty tissue ready for injection is the result.

The fat is then injected where needed. The fat is evenly distributed into the area by injecting minute amounts in the tissues so that the injected fat is well surrounded by healthy tissue. This ensures that the transplanted fat remains in contact with the surrounding tissues that must supply it with oxygen and nutrients.

TO REMEMBER:

	Length:	About an hour, depending on the size of the areas to be treated.
	Anesthesia:	Local infiltration anaesthesia of the donor area and the area to be treated.
	Inpatient/Outpatient:	Either.
	Possible Side Effects:	Donor area: bruising, swelling, tenderness, up to 24 hours drainage of anaesthetic liquid. Treated area: bruising, swelling (especially the lips if treated), tenderness. The areas that have been treated will be rather swollen immediately after the operation, especially the lips if they have been treated. It is therefore important to use a cold pack and a compress in the first few hours to minimize the swelling. A cold pack is a freezer bag filled with ice cubes and water. The swelling will increase until about the third day, but will then gradually subside. After about a week to ten days patients feel confident about going out and resuming a normal social life. If any bruises have developed, they might remain visible for a little longer but can be hidden reasonably well with makeup. Patients should have a check-up with the surgeon after five to seven days and again three weeks later. By then most of the swelling will have subsided, but the correction may still look rather exaggerated. Surgeons usually over-correct, which means injecting more fat than is actually needed because 25 to 30% of the transplanted fat cells do not survive. The final result is assessed after three months. The surgeon will then take photographs to be compared with those taken before the procedure. A second session may be scheduled to top up any shortfall in volume.
	Risks:	Asymmetry, irregularities, overcorrection, and infection.
	Recovery:	Swelling usually diminishes from the third day on, and social activities can be restarted after about one week, sometimes with the help of some make-up.
	Results:	Correction of deep wrinkles and folds. Correction of the treated irregularities and dents. Volume augmentation of the treated areas such as cheekbones, cheeks, and the chin. Improved quality of the overlying skin can be a positive side effect. After the body absorbs a percentage of the fat (between 20 and 50%) the correction can be considered permanent.

Removes areas of excess fat from the face and neck.

Procedure

Facial liposuction has become a common cosmetic procedure, either on its own or in conjunction with facelift or other facial procedures. It consists of the removal of unwanted fatty tissue with a cannula and vacuum device promoting and improving facial shape like jaw line or even using laser lipolysis approach.

TO REMEMBER:

	Length:	Half an hour to one hour approximately.
	Anesthesia:	Depending on the patient, intravenous sedation, local or general anesthesia can be used.
	Inpatient/Outpatient:	Outpatient procedure.
	Possible Side Effects:	Swelling, soreness, and a temporary burning sensation are usually experienced in worked areas. Perfectly controllable with outpatient treatment.
	Risks:	Infection, asymmetry of the face, pigmentation changes (hyper or hypo) and decreased sensibility of the areas.
	Recovery:	Full recovery time is between twenty to twenty-eight days, during which the patient will be asked to wear a compression garment.
	Results:	The procedure achieves good results in patients with excess fat along the jowl and in the neck, good skin elasticity, and minimal platysmal banding.

Provides a more harmonious appearance to the face.

Procedure

Facial implants are solid, pre-shaped, three-dimensional objects used to improve the size and appearance of different areas including the chin, jaw, nose, cheeks and beside the nose (paranasal). Facial implant surgery provides a more harmonious appearance to the face. There are different types of implant material used to achieve these contour changes. There are also different shapes of implants according to the area to be enhanced.

TO REMEMBER:

	Length:	Approximately one and a half hours.
	Anesthesia:	General anesthesia or intravenous sedation and local anesthesia are commonly used.
	Inpatient/Outpatient:	This is an outpatient procedure.
	Possible Side Effects:	Temporary discomfort and swelling, mild bruising.
	Risks:	The implant may need to be removed and/or replaced to treat problems including: implant rupture, infection and implant misplacement. Implant rejection is a risk but is extremely rare.
	Recovery:	The patient can return to work and normal activities within in few days. The patient should not consume alcohol after surgery. Bruising and swelling should have disappeared after several weeks.
	Results:	The outcome varies from patient to patient, but results are essentially permanent. The overall effect is an enhancement of the deficient contours of the face with an improved appearance.