Expression of the face occurs because small muscles pull on the skin, eyelids, corners of the mouth, etc. The muscle pull on the skin creates wrinkles, like the horizontal wrinkles on the forehead. Botox is injected into these muscles to stop the pull on the skin, decreasing or eliminating the wrinkling.
When the eyebrows are in a lower than normal position, raising them can result in a more youthful appearance and eliminate extra skin of the upper eyelids. This is most commonly done with an incision in the scalp, or through several small incisions using an endoscope (lighted telescope).
This 59 year old female was concerned
about the excess skin of her upper eyelids, and was
having trouble with her vision when looking up and to
the sides. Her problem was actually that because of
loosening of her skin with age, her eyebrows were now
lower. As a result, this gave the appearance of extra
skin on the upper eyelids.
She underwent an open browlift, with the incision right at the hairline, to avoid making her long forehead any longer. Repositionning the eyebrows eliminated the "extra" skin on the upper eyelids. The remaining fold of skin is necessary so there will be enough skin remaining to close her eyes.
The before picture has droopy eyelids. The after picture does not.
Extra skin and fat can be removed from both the upper and lower eyelids, eliminating bags and puffiness. This is accomplished through incisions whose scars hide in the natural fold of the upper eyelid and below the eyelashes of the lower eyelid. When it is only necessary to remove fat from the lower eyelids to eliminate the bags, this can be done through the inside of the eyelid, leaving no external visible scars. This operation has a fast healing time with an early return to normal activities.
This 54-year-old female had difficulty with her vision
when looking upward and to the sides. She had a
visual fields test which confirmed that she had a
decrease in her field of vision. She also wanted
something done for her crinkly lower eyelids.
She underwent a bilateral upper and lower eyelift, or blepahroplasty, on an outpatient basis under local anesthesia with intravenous sedation. After surgery she was extremely happy with her result, and had no further problems with her vision.
The face can be tightened and made to look more youthful by removing excess skin and removing or repositioning fat under the skin. The incisions are placed in front of and behind the ear in a manner that leaves inconspicuous scars. For people who need only a more limited improvement, smaller incisions are used.
Several different types of lasers can be used to provide different benefits. Some lasers are used for skin resurfacing or smoothing. The laser removes the upper layers of the skin, which then heals back smoother, a little tighter, and without superficial blemishes. Other lasers are more specific to remove red lines or brown spots.
Several different technologies can be used to remove the outer layers of the skin, along with blemishes. This can also decrease or eliminate some of the fine lines on the face. This procedure can be done in the office, allowing people to return to work the same day.
When the face sags in a vertical direction with prominent folds on the side of the nose and prominent jowls, this can be corrected by lifting the skin and the fat deposits on the face. Incisions which hide nicely underneath the eyelashes of the lower eyelids are used, and result in a more youthful appearance of both the face and eyes.
If the only part of the face that has severe sagging is the neck, it can be tightened without altering the rest of the face. This requires a small incision under the chin, and sometimes tiny incisions near or in the hairline.
Noses that are too big, too wide, crooked, or otherwise distorted can be reshaped. Through inconspicuous incisions, mostly inside the nose, the bones and cartilage that provide the shape of the nose are modified to make them less prominent.
Although many different types of doctors can remove skin cancers, plastic surgeons have the expertise to repair the defect after skin cancer removal in a way that will look as normal as possible. Some types of skin cancers can be immediately examined under a microscope at the time of removal, using a process known as frozen sections. Once the cancer has been removed a plastic surgeon can repair it at the same operation.
During brief office visits, treatments can be performed on the skin to freshen the complexion and decrease or remove superficial wrinkles. This is usually combined with a program of home care.
For mild to moderate folds on the face, when the skin is not very loose, Collagen, JuveDerm, Restylane and several other natural products can be used to fill out the folds. Different materiels can be used to fill out the fine wrinkles and to add volume to an area. These are often used in combination, filling out the wrinkles with one product and adding volume below with another product. After this office procedure people can return to work the same day.