Facial Cosmetic Surgery

Eyelid Rejuvenation (Blepharoplasty)

Cosmetic eyelid surgery is designed to remove excess skin, fat and muscle from around the eyes to give a more alert and youthful appearance. The procedure can be done on the upper or lower eyelids or both at the same time or separately.

As you age, the skin around your eyes loses its elasticity. You may develop loose folds of skin on your upper eyelids and deep creases under your lower eyelids. Droopy eyelids can give a tired appearance as well as impair vision and cause frequent blinking and eye fatigue. Fatty bulges (‘bags’) can appear under the eyes when the structural muscles in this region weaken. Cosmetic eyelid surgery or blepharoplasty can remove the excess skin, fat or both from around the eyes resulting in a refreshed and younger appearing eye area.

Blepharoplasty is usually performed as a day case under general anaesthesia. Alternatively, the surgery can be performed under local anaesthetic. The eye area is anaesthetised with a local anaesthetic injection. A sedative may also be administered to allow the patient to relax. The surgeon will advise which type of anaesthesia is most appropriate for the individual.

Eyelid surgery takes one to two hours, or less if just the upper or lower eyelids are being done. For surgery on the upper eyelids, an incision is made into the natural lines and creases in your lids and in the wrinkles at the corners of your eyes. For surgery on the lower eyelids, the incision is made just below your eyelashes. This means your scars will run along the natural folds of your eyes. Excess fat, muscle and loose skin are removed and the skin is closed using fine sutures. If only fat is removed and there is no excess skin, the incision may be made inside the lower eyelids, leaving no visible scar. The blepharoplasty operation involves the eyelid structure and the surrounding soft tissues only. There is no interference with the muscles or organs of the eye itself. Therefore, there should not be undue concern about the possibility of any visual impairment.

After surgery, there will be some swelling and bruising around the eyes. This can be alleviated by the regular application of ice packs. It is also important to lubricate the eyes regularly with a lubricant eye ointment. Sutures and tapes are generally removed five to seven days after surgery. Eyelid surgery involves a relatively short recovery process with minimal discomfort.

Eyelid surgery cannot alter dark circles and fine lines around the eyes, nor can it change sagging eyebrows. Blepharoplasty is often performed as a single procedure, however, it can be combined with other facial rejuvenating surgery such as brow lift or facelift to create an overall more youthful appearance.

Browlift Surgery

A brow lift or forehead lift is a procedure that rejuvenates the area above the eyes by smoothing the horizontal forehead wrinkles, minimising vertical frown lines and elevating the eyebrow position to give a more youthful and attractive appearance.

In traditional brow lift surgery, the surgeon will make a full incision across the top of the forehead behind the hairline. Through this incision, muscles are tightened and excess skin and other tissues are removed in order to elevate the eyebrow line and eliminate horizontal wrinkles creating a smooth, youthful-looking forehead. A temporal or lateral brow lift is considerably less invasive as the incisions are placed in the hairline at the temples to lift the outer eyebrows exclusively. The temporal browlift will not elevate the middle of the brow but may alleviate crows feet.

Facelift Surgery

Rhytidectomy, commonly known as a facelift, is a surgical procedure that restores contour, vitality and renewed beauty to the face and neck by lifting and reshaping the visage.

Facelift surgery is successful in eliminating or reducing wrinkles, creases, jowl lines and skin folds around the face and neck due to the effects of loss of elasticity, muscle atrophy, stress and exposure to the sun. As you age, your facial muscles slacken and your skin becomes less elastic, creating folds and lines. When properly performed, facelift surgery turns back the clock, firming up muscle tone, smoothing the skin and restoring an attractive facial contour. Facelift surgery is not designed to make a person look like someone else, but to make that person look and feel years younger.

Unlike older, less sophisticated facelift techniques which only tightened facial skin, today's techniques

precisely rearrange the underlying structures of the face to restore a lasting and attractive facial contour. Gone are the days of an unnatural, ‘pulled’ facial contour after facelift surgery. A natural look is accomplished through careful tightening of the structures that tend to weaken as the face ages. The Sub-Muscular Aponeurotic System (SMAS), cheek fat and other structures of the face sag downward with age. These underlying structures are restored to their natural position before addressing the superficial layer of the face. Therefore, contemporary face lift surgery is the restoration of a youthful configuration to your face's muscles, fat and connective tissue as well as skin.

There are many names and variations to the traditional facelift (minifacelift, midfacelift, SMAS lift). The appropriate procedure will depend on the combination of facial areas that require rejuvenation, the amount of recovery time available and the expectations of the individual. A midfacelift restores a smooth, youthful look to the lower eyelids and cheeks. A lower facelift restores an attractive jawline contour, eliminates jowls and smoothes the neck. In addition, facelift surgery can be combined with other facial rejuvenating surgeries including blepharoplasty, browlift and chin liposuction.

The goal of the modern facelift is to restore a youthful appearance in a way that looks pleasing and natural - not tightly pulled or obviously surgical. The surgeon will strive for a harmonious, natural-looking correction of the aging changes in the cheeks, neckline and jawline.

Nose Reshaping (Rhinoplasty)

Cosmetic nose reshaping can lead to an aesthetically pleasing transformation of the entire face by redistributing the proportional size and shape of the nose to complement one's facial structure. The surgical role is to produce a natural appearance and profile whilst maintaining or improving breathing.

Most people who have rhinoplasty surgery are concerned about the size of the nasal hump (or bump) or the shape of the nasal tip. Usually modifications are made to both. Very minor and subtle modifications of the nose can have a large impact on overall facial harmony and beauty.

It is preferable to have rhinoplasty surgery after the nose has reached its full development. This is usually after mid-teens. The nose is reduced or in some cases built up by adjusting its supporting structures - either removing or adding bone and cartilage. In some instances, an internal deformity of the nose can affect breathing. Adjustment to these structures to improve the nasal airway can be made at the same time as alterations to the external appearance of the nose.

Recovery from cosmetic nose surgery varies tremendously between individuals. Most people experience some discomfort for approximately 48 hours. Patients with a sedentary job can return back to work after 2-3 days, however, most people prefer to allow the bruising and swelling to subside at 7-10 days before returning to work. Swelling also varies significantly from individual to individual. It is important to realise that although the overall shape of your new nose may become apparent early, it takes many months for all of the swelling to settle entirely and for the nasal features to become well defined.

A successful rhinoplasty is one that creates a natural, unoperated look, so that the nose fits in harmoniously with the other facial features.

Prominent Ear Correction (Otoplasty)

Prominent ear correction (otoplasty) is a procedure performed to reshape the ear and give it a more normal appearance. The surgery usually is performed on ears that are large or that protrude from the head. In many people, the problem is caused by an underdeveloped middle fold of the ear. This underdeveloped fold can be associated with other deformities. For this reason it may be necessary to perform several procedures on the ear at the same time. In most cases, patients need surgery on both ears so that they will be similar. Rarely, only one ear will require surgery.

Otoplasty is performed under general anaesthetic in children, whilst adults can have the procedure under general or local anaesthetic. Otoplasty requires only day surgery.

The procedure entails the surgeon making an incision behind the ear. The ear cartilage is then weakened and folded into an aesthetically pleasing position. This position is maintained with internal sutures. The surgeon may remove excess cartilage and/or skin. After surgery, a head dressing is applied for one week. Upon removal of the dressing, a head band is worn at night for a further 4-6 weeks to allow the ears to maintain their new shape. Swelling and discolouration will subside in a few weeks, whilst scarring is minimal.