Cosmetic plastic surgery of the face can "turn back time" by reducing the appearance of wrinkles and lines, sun damage and sagging skin that can make you look angry, sad or tired. Listed below are some of the procedures we offer to help you look as young and energetic as you feel.
In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jawline slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look -- after surgery, some patients appear as much as ten or 15 years younger.
Facelifts are most often performed on people in their 40s-60s, those in their 70s or 80s can have facelifts as well. The procedure can be combined with others (browlift, eyelid surgery, nose reshaping) for more dramatic results, or it can be restricted to the neck (necklift) if the patient's problems center there.
Facelifts are usually outpatient procedures and may be performed in an office-based facility, surgery center or hospital, typically under local anesthesia combined with a sedative. The procedure itself varies depending on the surgeon and the patient's facial structure (i.e. where the incisions are placed, whether one or both sides of the face are worked on at once, in which order the steps are performed).
In most facelifts, incisions are made from the temples down in front of the ears and back behind the earlobe to the lower scalp. Dr. Orseck lifts the skin, suctions fat, tightens muscle, trims excess skin and then stitches the incisions closed. Sometimes metal clips are also used to hold incisions firmly closed on the scalp, and bandages are often wrapped around the head to reduce bruising or swelling. Patients may temporarily need a thin surgical drainage tube which is placed behind the ear.
Any numbness, bruising, or thinned hair around the scar will fade in a few weeks; bandages, stitches and clips are removed within a day to a week. Most patients are back on their feet in a day or two, although the face may appear distorted and feel stiff, and many return to work within two weeks.
In addition to being located in inconspicuous places such as behind the hairline and in natural folds of the face and ears, scars fade to near invisibility in time.
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A neck lift or chin liposuction is performed to remove excess fat beneath the chin and tighten loose skin in the neck. A less invasive alternative to a facelift, the procedure can produce dramatic results in the patient whose chin and/or neck has sagged with age or after weight loss.
A neck lift may also be part of a combination treatment plan, in conjunction with a forehead lift, facelift, or eyelid surgery.
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One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person's nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient's nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes.
Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.
Dr. Orseck may use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an "open" procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed.
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Browlifts can revitalize drooping or lined foreheads, helping you to look less angry, sad or tired. Using either traditional or minimally invasive (endoscopic) methods, browlifts involve the removal or alteration of the muscles above the eyes to smooth lines and raise the eyebrows for a more youthful appearance. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.
While browlifts are typically performed on patients aged 40-60 to counteract the effects of aging, anyone with lined or inelastic skin on the forehead - whether it's caused by muscle activity or inherited conditions - are eligible. The procedure is usually performed in an office-based facility or surgery center under local anesthesia and sedation.
First, the patient's hair is tied with rubber bands near the incision site. Then Dr. Orseck makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. The incision may be placed further back or made along the skull bone joints to minimize visibility in patients with thinning hair or who are bald. Then the forehead skin is lifted, tissue is removed, muscles are adjusted and the eyebrows may be lifted. Excess skin is trimmed and the incision is closed with stitches or clips. The site is washed and the rubber bands are removed. Some surgeons will protect the stitches with gauze or bandages.
After the hair is tied as with the traditional procedure, Dr. Orseck makes three to five short incisions (less than an inch long) behind the hairline. The endoscope is placed in one so Dr. Orseck can see beneath the skin without having to make a large incision, while he lifts the skin and adjusts muscles through the other incisions. If the eyebrows are lifted they will be stitched or screwed (temporarily) into place. The site is washed and the rubber bands are removed. Some surgeons will protect the stitches with gauze or bandages.
With both procedures, you will be on your feet and able to wash your hair in a day or two, and many patients return to work or school in 7-10 days or less. Swelling and bruising should fade by the third week.
Complications are rare and usually minor but may include temporary numbness, nerve injury, hair loss along scar edges, formation of a broad scar requiring surgical correction, and infection and bleeding.
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Blepharoplasty (Eyelid Surgery)
Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision. Blepharoplasty can be combined with BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes.
The procedure is usually performed in an office with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.
Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. The effects of blepharoplasty can last for a long time and are sometimes even permanent.
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