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Information on Surgical Procedures -
FACE
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Blepharoplasty (Eyelid Surgery)
As we grow older, the combined effects of aging,
gravity, and weight gain cause the skin on our eyelids
to lose its elasticity, and to make various collections
of fat visible around the eyes. This leads to drooping
eyelids, or baggy eyelids, asymmetrical lid folds, and
eyebags. Other patients, because of a genetic trait, may
have no visible lid folds, yet desire the creation of
one.
Blepharoplasty is the procedure to correct these
deformities. Usually performed under local anesthesia,
the surgeon can perform this on the upper or on the
lower lid, or both, depending on the area of concern.
This procedure can be combined with other surgeries,
such as a facelift, or a rhinoplasty.
In the upper lid, the surgeon removes a strip of
redundant skin, and a strip of the eyelid muscle
underneath. This creates a crisp lid fold. He can also
remove fat, or change the height of the eyelid fold, if
it is not on the same level as the other side.
In the lower lid, the surgeon also removes a redundant
strip of skin, but not muscle. Fat removal depends on
the extent of deformity present. Additional procedures
such as canthopexy or canthoplasty may be performed to
restore a youthful slant to the eyes, to prevent
complications, such as sagging of the lower lid.
In the first few days following surgery, there may be
some swelling and bruising, but these usually do not
last for more than a week.
Rhinoplasty (Noselift)
In the Philippines there are two cosmetic surgical
procedures commonly done on the nose: Nasal Dorsum
Augmentation and Alar Base Trimming.
Nasal Dorsum Augmentation
This is also called dorsal augmentation, augmentation
rhinoplasty, Oriental rhinoplasty, or noselift. It is a
technique to increase the height of the dorsum of the
nose, especially the bridge. This improves upon the
feature of a low nose bridge (Tagalog term: pango) seen
in some patients.
The procedure is commonly done under local anesthesia.
An incision is made just inside the nostril, and a space
is created between the skin of the nose and the nasal
bone and cartilages. A biocompatible material is placed
in this space to elevate the nasal profile. The most
commonly used material is silicone elastomer, (also
called silicone rubber), which is a firm, rubbery
substance, but is well tolerated by the body. The
incision is sutured closed. This procedure may also be
combined with alar base trimming.
In the same operation, the surgeon can also modify the
nasal tip by working on the tip cartilages, or by adding
cartilage grafts to the area.
The results are immediate, and expect some swelling and
bruising for a week. Patients are advised to refrain
from activities which may cause trauma to the facial
region in the first 2 months, to avoid displacing the
implant.
NOTE: Other materials aside from silicone rubber may be
placed, such as Alloderm, Goretex, MedPor, SMAS, Scalp
tissue, cartilage. However, PAPRAS cautions the public
regarding the use of any injectable substance to augment
the nasal dorsum. There are reports of the use of
silicone and “collagen” for noselift, injected by
individuals who are not plastic surgeons, and done
outside surgical operating rooms. The results of this
injections are very disappointing, and are difficult for
plastic surgeons to correct.
Alar Base Trimming
This procedure is done to change the shape of the
nostrils – from a flattened oval shape to a round or
triangular one. This is done under local anesthesia, and
can be performed on its own, or with a Nasal Dorsal
Augmentation.
Wedge-shaped pieces of tissue are removed from the alar
side wall, near its junction with the cheek. The
remaining pieces are sutured together, and this results
in a change in shape of the nostril. A secondary benefit
is that it also lifts the nasal tip up a bit.
Recovery from the procedure is quick, and swelling and
bruising is minimal.
Facelift
The forces of aging and gravity act to pull the soft
tissues of the face downward. We see this in the
formation of the jowls, and the lowering of the malar
fat pads in the midface.
A facelift is done to correct these changes. Its aim is
to elevate the malar fat pad to its youthful position,
and remove the unsightly jowl along the jawline.
The procedure is usually performed under general
anesthesia. An incision is made in front of the ear,
curving around behind it. The facial skin is lifted from
its underlying structures. The underlying structures are
modified to restore to their youthful position. They may
be lifted, or sutured together to remove sagging. The
final phase is the removal of excess skin. The skin is
then sutured back into place.
Postoperatively, the patient may remain for a few days
in the hospital, and expect swelling and bruising in the
operated area to remain for a week. There will be
bandages and drains around the face.
Some surgeons perform a limited form of facelift, using
barbed suspension sutures (such as Aptos thread). These
are not applicable to all facelift patients, and it is
best to contact your surgeon regarding this.
Temporal Lift
In certain patients, skin at the sides of the forehead
may sag, along with the outer part of the eyebrow. This
causes a sleepy or depressed look upon the eyes, with
the upper eyelid skin having a fold large enough to
obstruct vision.
A temporal lift is performed to remove the excess
sagging skin, lift the eyebrow, and eliminate excess
drooping eyelid skin. It may be performed at the same
time as a blepharoplasty. If performed alone, it can be
done under local anesthesia.
An incision is made in the hairline or within the scalp,
and the excess skin is removed, elevating the upper lid
and eyebrows.
Recovery is rapid, and minimal complications are
expected. |
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