Facial Plastic Surgery Procedures

Why Consider a Brow Lift?

With aging we develop horizontal wrinkles in our forehead vertical lines between our eyes. In addition, the position of our eyebrows drops and causes hooding of the eyes due to excess skin. All of these changes can give an angry and tired appearance to the face. The goal of a forehead or brow lift should be to correct these changes giving a natural-appearing result. Over correction of the brow position can give an unnatural, startled appearance and must be avoided.

Brow Lift Procedures

A brow lift involves making five tiny incisions behind the hairline. An endoscopic, or minimal-incision brow lift, utilizes a slender endoscope, minimizing the size of the incision as well as the resulting scar. For patients with high hairlines, an incision can be made just at the hairline, maintaining the hairline position while providing all the cosmetic benefits of the brow lift. This is known as a tricophytic brow lift.

In order to exhibit facial harmony, all of the pieces of the puzzle must fit. Strong cheek bones and an adequately projected chin help to accentuate the qualities of the overlying soft tissue. Furthermore, the profile of the nose must match the profile of the chin to achieve balance. Therefore, chin augmentation may be recommended at the time of a rhinoplasty (nose surgery).

Chin and Cheek Augmentation Procedures

Cheek augmentation is achieved through hidden incisions inside the mouth. Synthetic, biocompatible implants that are well tolerated by the body are then placed gently over the bones of the cheek. These are customized for each patient to achieve symmetry and appropriate projection.

Chin augmentation is achieved through a small hidden incision below the chin in a natural skin crease. The synthetic implant is customized for each individual patient and is then gently placed over the bone of the chin. The incisions are then meticulously closed. The length of these procedures is generally under 1 hour. These procedures can be performed with local anesthesia, conscious sedation, or general anesthesia.

Protruding ears can lead to much social angst for children and adults. The most common reason for protrusion is underdevelopment of one of the cartilage components of the ear. Re-creation of this normal structure can be easily done to give the patient natural appearing, symmetrical, and properly positioned ears. Often only one ear protrudes or demonstrates an asymmetrical defect compared to the other ear, and this can also be easily corrected.

Correction of protruding ears generally requires removal of skin on the backside of the ear coupled with sculpting of the underlying cartilage through this hidden incision. The incisions are then closed to create symmetry. Otoplasty usually takes 1-2 hours and can be done under local anesthesia with or without sedation or general anesthesia. 

Although earrings serve to enhance the aesthetic appearance of the ears, they can lead to changes in the earlobes over time. They can cause stretching, enlargement, and tearing of the earlobes. Additionally, keloids can also occur. Surgery can easily correct these problems and restore the previous appearance of the ear(s).

Under local anesthesia, stretched or torn earlobes are reduced to their natural size through carefully placed incisions. If keloids are present, these are removed and the maximum amount of normal tissue is preserved. A new piercing can be performed at the time of the procedure. The procedure lasts 45 minutes or less and is performed right in our office.

Your eyes are your windows to the world. They also reflect your mood, telling people you are happy, tired, curious, awed, or perplexed. When the eyes show telltale signs of aging, they may affect the way you are perceived by giving people the wrong impression of your mood.

The procedure gives countless men and woman each year a renewed sense of self confidence. If you are concerned with sagging upper eyelid skin or bags beneath your eyes, blepharoplasty may be right for you.

Why Consider a Facelift?

As we age, various changes in our skin and underlying soft tissues occur. The skin loses collagen and its elasticity, and the fat beneath the skin atrophies and disappears. As these processes occur, the face appears more hollowed and the skin begins to sag. The once well-defined facial contours are hidden, making us look older. Additionally, the jowls and neck skin become more prominent and horizontal and vertical bands develop in the neck. A facelift corrects all of these issues. There are many types of facelifts depending on the patient’s age, motivations, skin type, and degree of skin laxity. These range from minimally invasive to more extensive procedures.

What Areas Does a Facelift Improve?

Strictly speaking, a facelift refers to a tightening of the skin and soft tissues from the cheek bones to the collar bones. Therefore, your cheeks, jowl line, and neck are all improved by this procedure. This procedure can be broken up into either a cheek lift or a neck lift if only one of these areas is in need of surgery.

How Facelift Surgery is Performed

The incision is tailored to the patient but is placed in natural creases in front of and behind the ear to make it unnoticeable. For males and females the incision is slightly different so as to not distort the hair bearing skin of the face in males. In order to address the neck muscles, fat, and skin, a small horizontal incision is placed beneath the chin in a natural crease where it cannot be seen. The skin and underlying soft tissue structures are elevated to provide for longer-lasting, more natural appearing results.

These tissues are then re-draped and the redundant tissue is removed. This is done in a way to restore the natural youthful appearance and to avoid a surgical appearance. The best results in a facelift, occur when the patient has a well-defined bony structure and excellent skin quality. Therefore, we may recommend additional procedures such as facial resurfacing, liposuction, fat augmentation, or chin augmentation to guarantee the best results.

The length of the procedure can vary from 2-5 hours, depending on the exact facelift procedure and additional complementary procedures. It can be performed under conscious sedation or general anesthesia. 

With aging we develop horizontal wrinkles in our forehead vertical lines between our eyes. In addition, the position of our eyebrows drops and causes hooding of the eyes due to excess skin. All of these changes can give an angry and tired appearance to the face. The goal of a forehead or brow lift should be to correct these changes giving a natural-appearing result. Over correction of the brow position can give an unnatural, startled appearance and must be avoided.

A brow lift involves making five tiny incisions behind the hairline. An endoscopic, or minimal-incision brow lift, utilizes a slender endoscope, minimizing the size of the incision as well as the resulting scar. For patients with high hairlines, an incision can be made just at the hairline, maintaining the hairline position while providing all the cosmetic benefits of the brow lift. This is known as a tricophytic brow lift.

Benefits of a Neck Lift

We perform neck lifts using the most advanced technique which gives you the very best results. Neck lifts are popular particularly with men, who want to get rid of that “turkey neck” but do not need a complete face lift. Actually, both men and women can have a tighter, better looking neck without the full face lift and the incisions are hidden back behind your ears and in the hair lines. In addition, a small horizontal incision is hidden under the chin.

What Causes a "Turkey Neck"?

The flat elastic platysma muscle that lies under the neck skin is actually two muscles that are naturally separated along the midline. The inner edges of the two muscles are linked to the overlying skin by fine connective tissue fibers, so that as we age, the relaxed skin-muscle complex sags into recognizable vertical cords or wattles that produce the so-called turkey gobbler neck.

A Neck Lift Procedure Explained

Dr. Feldman invented this surgical procedure adopted by surgeons around the world called the CORSET PLATYSMAPLASTY that is performed through a small horizontal incision hidden under the chin that eliminates these muscle cords by joining the two muscle edges together to create a single sheet of platysma that resists the reappearance of muscle bands and improves the shape of both the jawline and the waistline of the neck.

Nose reshaping is performed for both cosmetic as well as functional concerns. Rhinoplasty is done to correct distracting features of a nose and/or to improve breathing. The nose lies centrally, unlike other parts of our body and face. Therefore, even slight asymmetries in the nose can be immediately apparent. The goal of a rhinoplasty or revision rhinoplasty should be to eliminate a distraction so that the other more aesthetically pleasing facial features become more noticeable. Because rhinoplasty can improve (or worsen) breathing, it is important that the patient seeks a surgeon who is specially trained in facial cosmetic procedures and understands the intricacies of nasal anatomy.

How Rhinoplasty Surgery is Performed

There are several approaches to reshaping the nose during rhinoplasty surgery. The majority of incisions are made inside the nose, where they are invisible. In certain cases, the incision will be made in the skin separating the nostrils. Following the first incision, the skin is lifted and nasal cartilage and bone are manipulated to create a well-defined, proportionate shape, then the skin is re-draped over the new frame and the incisions are closed. To aid in the healing process, a nasal splint is applied to maintain the new shape. Additional soft materials may be put inside the nose to support the new structure and protect the air passages.

Whether you are unhappy with the appearance of a mole, a post-surgical scar, or a one from an accident, scar revision surgery or non-invasive revision can be done to significantly improve the appearance of an unsightly scar.

There are various scar removal surgery modalities and non-surgical options for you to improve skin texture, contour, and color. This includes surgical excision or revision, skin resurfacing, steroid injections, medical interventions, fillers, or any combination of the above. After a consultation, we will recommend a plan on how to improve the appearance of the scar. Scar revisions can usually be performed under local anesthesia in less than 1 hour.

Learning that you have a skin cancer can be difficult news. When it is in a cosmetically sensitive area on your face, preserving normal tissue and restoring a natural appearance is imperative. 

The size and location of the cancer will dictate the recommended closure and repair technique. The general principle of closure is to borrow extra, unnecessary tissue from other similar or nearby locations. All layers of the defect and all tissue types that are removed must be replaced. Skin grafts and cartilage grafts from other regions of the head and neck or body are often necessary. For places on the nose, multiple surgeries may be necessary to provide optimal results. The procedure length varies from 15 minutes to 3 hours. depending on the exact location and situation. Generally, the closure can be done under local anesthesia or conscious sedation.