Eyelid surgery (blepharoplasty) is designed to remove excess skin and fat from the upper and lower eyelids. The procedure can correct drooping upper lids that tend to sag with time and the puffy bags below the eyes. The procedure usually takes about 1 hour and can be performed in the office using local anesthesia. Stitches can be removed after three or four days.
Blepharoplasty can be done as a single procedure, or in conjunction with other facial surgery such as a facelift or a browlift.
A forehead lift or "browlift" is used to correct a drooping brow line (eyebrow area) reducing the horizontal lines and furrows (worry lines) that often make a person appear angry, sad or tired. The procedure creates a refreshed, youthful appearance to the forehead area above the eyes.
When performing a forehead lift procedure, muscles and tissue areas that droop or cause creases are removed or corrected to smooth the skin on the forehead to reduce frown lines and raise the eyebrows. There are two surgical methods, and during your initial consultation the procedure that works best for you will be recommended. The first is the most conventional method where a surgical incision is hidden just above the hairline. Browlifts are also performed using an endoscope which enables the procedure to be performed with a minimal number of incisions. While the traditional method can sometimes attain more lift, both methods create smoother, flatter skin on the forehead.
Full and vivacious lips have always been recognized as aesthetically important features. Some of us however, are born with thin, ill-defined lips. But the appearance of our lips is now within our control. During this procedure, a piece of tissue is borrowed from somewhere in your body and grafted into one or both lips.
When the tumescent technique is used in the liposuction of your neck and chin, the areas of fat are injected with an anesthetic which causes the fat to become swollen, or "tumesced".
The resulting expanded molecules make the fat particles easier to remove. You will begin to notice the difference in your new look almost immediately after surgery. The tumescent method results in less post-operative bruising, swelling and pain. A significant improvement in your appearance is apparent within 3 weeks of your surgery, when most of the swelling has subsided.
Otoplasty, or ear pinback, is performed to correct protruding ears. It happens to be one of the few cosmetic surgeries performed on children.
An incision is placed in the natural creases behind the ear and the cartilage of the ear is weakened so that it bends into a new shape. The cartilage is also stitched into position to hold the ear into position.
Recovery normally takes one to two weeks and results can be noticed after a few months.
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VIDEO: Facial Injectables
LENGTH: 02:05 minutes
Facial wrinkles are the result of several factors, both environmental and intrinsic (genetic). The intrinsic factors include action of the muscles of facial expression, which cause us to frown, raise our eyebrows and squint. These effects on wrinkle formation can be eliminated with the injection of Botox Cosmetic to paralyze the offending muscles. Botox is a protein substance that may be injected into the specific muscles causing wrinkle formation to stop their action. The most commonly treated areas are the frown lines, forehead wrinkles, and Crow's feet (area around the eyes) and Botox Cosmetic is very effective in eliminating the signs of aging in these locations. In addition, Dr. Francis is highly experienced in specialized injection of Botox Cosmetic into other areas of the face and neck. "Bunny" lines or "Wolf" lines, neck bands, and drooping mouth corners may all be effectively treated in Dr. Francis' hands.
The paralytic effect of Botox was introduced into the cosmetic arena about a decade ago after many years of use for correction of eye and neck muscle spasm. It still maintains a place in the treatment of these conditions, as well as, for muscle contractures after stroke, excessive sweating of the palms of the hands, soles of the feet and underarms (hyperhidrosis), and for the treatment of migraines.
The procedure for facial rejuvenation is performed using very small needles (about the size of acupuncture needles) and is relatively painless when coupled with topical anesthetic creams. Each area to be injected takes less than 15 minutes and return to normal activities is immediate. The effects of the Botox treatment may be visible anywhere from one to 10 days after injection and last an average of 3 months. This means that it may wear off anywhere starting from 2 months or may last up to, on occasion, 6 months and is dependent on how the body processes the protein. Risks include redness, swelling, bruising, and infection, all attributable to a needle being inserted into the skin. More serious risks attributable to the material itself, such as eyelid drooping are extremely rare and usually temporary. Millions of Botox Cosmetic injections are performed each year in the United States.
Dr. Francis has had some of the most extensive experience in the United States with injection of this recently introduced, volume enhancing, facial and hand rejuvenation product. In fact, he has been recognized as one of only a few select aesthetic plastic surgeons chosen to teach the injection technique of the material to other aesthetic surgeons throughout the country by Dermik/Sanofi Aventis, the manufacturer of Sculptra.
The material itself was first introduced in Europe a decade or more ago as New Fill and has a long history of safety. The base material, poly-L lactic acid, is a substance that has been used in dissolving sutures (stitches) for several decades. Its migration to the United States has been accompanied by its application to the cosmetic and facial rejuvenation population, although its strict FDA approved use, at this time, remains only that of facial fat loss in the HIV patient.
Sculptra is a useful tool in the armamentarium of the cosmetic surgeon for rejuvenation of the face and hands. It is considered a volumizing agent and is effective in thickening skin and producing collagen to return the face and hands to their fuller, more youthful appearance. Once injected into the face or hands the material promotes a growth of the patients’ own natural collagen, which we all know by now, is the building block of the skin and synonymous with youthfulness. Its use is becoming commonplace in aesthetic surgery circles throughout the world and an FDA cosmetic indication approval is currently anticipated. Sculptra affords an essentially “no downtime” facial rejuvenation. Patients usually return directly to work or other activities immediately after a treatment session. As with ANY treatment the risk of adverse events is present, but is mainly limited to the consequences of inserting a needle into the skin. These risks are similar to the risks of almost any facial injectable material and may include redness, bruising, and infection. Risks specific to the Sculptra material itself are extremely rare and may include small bumps or papules under the skin, which subside over time as the material is dissolved by the body. To achieve maximal effect, several Sculptra treatment sessions may be required, depending on the amount of aging or volume loss. In general, younger patients require fewer treatment sessions. Once maximal effect has been achieved, results may last up to 2 years, with maintenance touchup treatments recommended annually after that.
Sculptra is a highly versatile material, which can be used in rejuvenation of many areas of the face, including the temples, brows, lower eyelids, cheeks, perioral area (mouth), upper lip, and jowls, as well as, the hands. Each treatment session with Sculptra takes approximately 30 minutes or less and, as mentioned, return to work or activities is relatively immediate depending on whether bruising occurs. Repeat treatment sessions are usually scheduled for 4-6 week intervals. Sculptra is not used to the exclusion of other injectable products and may be combined with hyaluronic acid fillers (Restylane, Perlane, Juvederm), Radiesse, Botox, and Artefill to offer an all inclusive approach to rejuvenation of the face.
Radiesse is a facial filling material that may be used to rejuvenate the face. Its primary use is in the nasolabial folds (deep lines extending from the nose to the corners of the mouth), but it may also be used to enhance the perioral (mouth) area, cheeks and jowls. Radiesse is a calcium and phosphate containing material and has a composition very similar to naturally occurring calcium and phosphate in the body. It is therefore very well tolerated and it is absorbed naturally by the body over time. A treatment may take approximately 30 minutes and return to full normal activities is immediate. The risk of adverse events is similar to other injectable treatments and includes redness, swelling, bruising and infection, all of which may be attributed to insertion of a needle into the skin. Risks attributable to the material itself are extremely rare and consist mostly of small bumps, which may develop under the skin and dissolve with time. Results of a Radiesse treatment may last approximately 12 to 15 months.
The hyaluronic acid fillers are a class of facial injectable materials that include Restylane, Perlane, Juvederm, Juvederm Ultra, Juvederm Ultra Plus, Captique, and Hylaform, which are used for rejuvenation and enhancement of the face and facial structures. Hyaluronic acid is a naturally occurring substance in humans, which forms part of the basic construct of the skin. These products are injected into the skin to increase its bulk and volume. Restylane, Perlane, Juvederm products, and Captique are all produced synthetically (non animal derived) in a laboratory, while Hylaform is derived from the combs of roosters. These materials are most commonly injected into the nasolabial folds (deep creases extending from the nose to the corner of the mouth) and into the lips for lip enlargement, although they may be used in the lower eyelids and other areas of the face. They are commonly coupled with other injectable materials (Sculptra, Botox, Radiesse) to provide an overall facial enhancement and rejuvenation. The most common risks of treatment include bruising, swelling, redness and bumps, which may form in or under the skin/lip. These products will last varying lengths of time depending on the part of the face into which they are injected, lips approximately 3-6 months, nasolabial folds approximately 6-9 months. They are all generally well tolerated and provide effective, although relatively short lived results.
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