Noses come in all sizes and shapes. Unfortunately, some of these sizes and shapes aren't a good fit for the person who owns the nose. Rhinoplasty is the process by which the structure of the nose is altered to bring the nose more into harmony with the rest of the face.
Some nasal conditions such as humps or a crooked shape occur as a result of trauma. Other features such as a bulbous tip, a long nose, or excessively broad nose are gifts from our parents.
The best candidates for rhinoplasty are those with fairly stable personalities and realistic expectations. A rhinoplasty will not cure depression, bad relationships, or an overall poor self image. The best candidates can be very specific about what they want different in their nose (please get rid of the hump) as opposed to non specific (I don't know, I just have never liked my nose.) Be sure to tell the doctor about any breathing problems related to your nose, as rhinoplasty might have an effect on them. The procedure can be done under general anesthesia or under local anesthesia with sedation.
Perhaps the most dramatic aspect of our appearance are the eyes. They convey emotion very acutely, and unfortunately aging eyes can convey things that aren't appropriate to our moods at all. Droopy brows or lids can make us look tired, aged, or angry when we're not. It seems silly that a few grams of skin in the wrong place can be such a big deal, but that is the reality.
Restoring the proper position of the brow, removing excess lid skin, or tightening skin with removal or a laser, perhaps even a filler, can be as dramatically rejuvenating as anything we do.
Removal of excess skin and fat from the upper and lower lids is called blepharoplasty. This takes away the heavy, tired look from the eyes and can also improve vision if the skin is obstructing the eye. In some cases, insurance coverage is available for this procedure. Incisions are hidden in the natural folds of the eyes and are rarely visible. Laser resurfacing is often a very useful addition to these procedures.
If the brows are sagging down over the eyelids, or have a sad appearance, elevating the brows can really lighten a person's look. This procedure is usually done with an endoscope for milder cases, or an incision at the hairline when skin removal is required. Both tend to heal quickly and make an immediate impact. This is often combined with upper lid skin excision (blepharoplasty) to obtain the sharpest, cleanest result. These procedures are most commonly done with sedation and local anesthesia, so recovery from the anesthetic is minimal.
Most ear surgery is done for prominent ears-ears that stick out. This happens for two reasons-either the bowl of the ear is too big and too deep, or the outer fold of the ear doesn't form properly. Sometimes both are present. Prominent ears can be corrected by recreating the outer fold of the ear, and reducing the size of the bowl of the ear.
Incisions are made, usually on the back of the ear, sometimes just inside of the bowl of the ear, where they are not typically visible. Stitches are used to recreate the cartilage folds, and also to hold the ear back against the head. Sometimes excess cartilage in the bowl (concha) is removed. This procedure can be done under either local anesthesia with sedation, or with general anesthesia.
We will ask you to wear some surgical earmuffs for a week or so to protect the tender ears. You may remove them to shower the next day. The ears are swollen for a week to 10 days, and the swelling isn't really totally gone for a few months, so don't worry if your ears seem a little big. Exercise is OK if contact is avoided.
Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. Scars are by definition permanent, but surgery can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands.
There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, flap surgery and Z-plasty (repositioning a scar so that it aligns with the face and is less noticeable). The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, your body's healing mechanism, the size and depth of the wound, how much blood supplies the area and the thickness and color of your skin.
The Fractional CO² laser is an FDA-approved system with many different treatment applications, including acne scarring, wrinkles, looseness and other effects of aging and sun damage. This safe, effective laser can be used to treat nearly any skin on the body, and is most commonly used on the face, neck, chest and hands.
The fractional laser is a carbon dioxide laser, which have been used for many years for effective skin resurfacing. While traditional CO² lasers remove the entire surface of the skin in order to reveal fresh, new layers underneath, the fractional CO² laser uses fractional laser technology to effectively resurface the skin with minimal side effects and risks.
With fractional laser technology, the laser penetrates only small areas of the skin, depending on the size of the laser beam. This allows the laser to penetrate the skin deeper than before without scarring. Depending on the goals of the individual patient's procedure, different hand pieces may be utilized for this treatment.
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