Alaplasty


This procedure is aimed to better the balance of nasal tip and also to give the person a more pleasant and appealing look in comparison with the other facial aspects. This procedure helps correct and upturned or a bulbous or a nose tip that is drooping. It also narrows the wide flaring and the large opening of the nasal nostrils, thus giving a better symmetry to the alar.


Procedure


The alar of the nose is reduced and suitably adjusted in shape. The excess tissue is removed and the alar is sutured to the new position. The surgeon would decide on the best shape using his or her skill and experience. Multiple options are discussed with the patient and the most suited one which harmonically blends with your other facial features is selected. A slight bleeding is common during the first few days following surgery.


Asprin or Heparin if used is to be discontinued for one week prior to surgery to decrease the risk of bleeding.


The operation is done under either local or general anesthesia.


The advantages of this procedure are that it is reversible in case the effects are not satisfactory.


After care


Normally pain is felt in the nose area that can be controlled by pain medications. To minimise swelling, the patient is adviced to position the head higher to the chest while resting. On the successive days the pain reduces but the swelling increases in the nose and the eyelid areas. One must refrain from blowing the nose for a week or so, while the tissues heals. Some stuffiness for several weeks after surgery is common. The nasal packing will be removed after a few days and by the end of one week, all dressings, splints and stitches will be removed.


Basic work can be resumed within about two days. Avoid jogging, swimming, bending, sexual relations or any activity that increases your blood pressure for two to three weeks. Care should be taken so that you avoid hitting or rubbing your nose or getting it sunburned, for eight weeks. For best results be gentle when washing your face and hair or using cosmetics for atleast 4 weeks. Most patients do not have to stay over-night at the hospital.


APTOS Procedures


The Aptos thread lift technique developed in Russia uses suture like threads made from a special bio-compatible material. These APTOS-Threads have tiny spikes in their entire length and are inserted under the skin at suitable angles to lift the sagging skin. This is a minimally invasive procedure that uses fine surgical threads to lift areas of the face that have sagged over a period of time.


As we begin to age the tissue becomes weakened, we lose facial fat and the underlying support structure typically in the cheeks, around the eyes, the brows, the jowls and neck creating a longer, older looking face. In the traditional facelift the excess and loose skin, fat and tissue are removed surgically. In the Aptos thread lift procedure the skin is pulled tighter without cutting.


This procedure can be used for brow, forehead, neck, jaw line and cheek lifting. It is ideal for nose-cheek folds, loosened cheeks and brows, and for tightening the neck area.


Procedure


The Aptos thread lift procedure is performed under local anesthesia in about 45 minutes. Best of all, The Aptos thread lift technique developed in Russia uses suture like threads made from a special bio-compatible materialunlike conventional face lifts, they leave no scars. The recuperation takes a maximum of 72 hours. The threads have cogs or barbs which are pointed in one direction and open up. Once inserted under the skin via a long needle, the barbs open much like an umbrella and are pulled tight. The threads are inserted through incisions approximately 1.5mm long in the hairline and then passed under the skin in precise locations using a small needle.This tension then creates a suspension that gently lifts soft tissue, creating a more uplifted and contoured look to the face. The tissue gets caught slightly in these cogs and is then suspended and lifted. The threads are placed in carefully predetermined areas of the face to support the tissue and lift it. Even better, the results are improved over time as your collagen encapsulates around the threads causing an even further lifting effect. This procedure gives an immediate result in comparison to a conventional face lift.


The Aptos thread lift can easily make a person look younger by upto 15 years from your apparent age depending on your current physiognomy. This is more suited for people in the age group of 30 and 45 years with fairly good skin elasticity. However for patients with very loose neck, this will not be a recommended procedure. This procedure merely redistributes existing skin to create more even contours, whereas a facelift removes the excess tissue and is longer lasting.


This procedure is considered much less invasive than traditional mid-face, face and brow lifts, requiring less operating room time and less downtime. The Feather Lift is also becoming popular with younger people wishing for subtle changes or to possibly delay the signs of aging such as facial drooping.


The advantages of this procedure are that it is reversible in case the effects are not satisfactory.


TIPS ON RECOVERY


After an APTOS procedure, the patient is to avoid manipulating the face muscles for a minimum of 2 weeks. Animated facial movements such as smiling should be avoided in order keep the Aptos threads in place during the process of fixing to the surrounding tissues.


Blepharoplasty


Blepharoplasty or Eyelid lift Blepharoplasty or Eyelid lift surgery is done to repair sagging or drooping upper eyelids (ptosis). An eyelid lift is done for cosmetic purposes and for those who have excessively drooping eyelids that may interfere with vision.Surgery is done to repair sagging or drooping upper eyelids (ptosis). An eyelid lift is done for cosmetic purposes and for those who have excessively drooping eyelids that may interfere with vision. In certain cases it is done along with other facial surgery such as a browlift or facelift.


Sagging or drooping of eyelids could occur naturally and with age. Some people have this at birth or develop diseases such as myasthenia gravis that cause eyelids to droop. This procedure is usually done with the patient awake. A medicine to relive anxiety is given. The area around the eyelids are numbed by injecting medicine so as to avoid pain during the surgery. Tiny cuts are made into the natural creases or folds of the eyelids and loose skin and extra fat tissue are removed. The stitches are closed after suitably tightening the eyelid muscles. This procedure is done as an outpatient and does not require hospitalization.


Procedure


People who suffer from Thyroid problems such as hypothyroidism and Graves' disease, Dry eye or lack blepharoplasty Surgeryof sufficient tears, High blood pressure or other circulatory disorders, Heart disease or disorders of the blood vessels and Diabetes are at risks as in the case with any surgical procedure


Scars may remain slightly pink for 6 months or more after surgery. They will fade eventually to a thin, nearly invisible white line. The more alert and youthful look usually lasts for years. Hospitalization is not required and patients can leave home the same day. The eyes will be covered with ointment and a bandage and may feel tight and sore as the local anesthesia wears off. Placing cold packs over the area helps control swelling and bruising.


Vision would be proper after 2 to 3 days. One needs to avoid wearing contact lenses for at least 2 weeks and keep activities that could raise the blood pressure for about 3 weeks which includes lifting, bending and rigorous sports.


Stitches will be removed within a week, though some discomfort may last for 2 to 4 weeks. You may notice increased tears, increased sensitivity to light and wind and temporary vision changes (such as blurring or double vision) for the first few weeks.


ASSOCIATED RISKS


Possible risks of an eyelid lift may include:


▣ Double or blurred vision
▣ Temporary swelling of the eyelids
▣ Uneven healing or scarring
▣ Tiny whiteheads after stitches are removed
▣ Difficulty closing the eyes while sleeping (rarely permanent)
▣ Slow healing


Brow Lift(Forehead lift)


Brow Lift helps reduce expression lines or other signs of aging in the forehead and brow region.


A brow lift:

Minimizes the creases that develop across the forehead known as frown lines


▣ Reduces the folds on the bridge of the nose, between the eyes
▣ Helps reposition a low or sagging brow that is partially covering the upper eyelid
▣ Give a more youthful and alert appearance to the brow


A brow lift is designed to correct all of these aging symptoms and restore a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.


Procedure


Brow lift surgery is performed through multiple limited incisions hidden within the hairline or through a Brow Lift or Forehead liftsingle incision in the natural crease of each upper eyelid. The procedure can also be performed through an endoscope. An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct. This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp.


Results of a brow lift may be enhanced through laser resurfacing or a chemical peel that can further improve skin tone and surface appearance.


When there is significant excess skin in the forehead, an alternate technique using a wide incision across the top of the scalp may be recommended. The incisions are closed with removable or absorbable sutures, skin adhesives or a surgical tape. The elevation of the brow may be maintained by using a permanent suture or absorbable fixation devices.


TIPS ON RECOVERY


Swelling generally subsides within 2-4 weeks and visible results may appear within a couple of months. Incision lines will fade in 1 year.


Cheek Implasts

Cheek augmentation surgery (Cheek implant surgery) is a cosmetic procedure that involves placing implants in the cheeks in order to have a more balanced and appealing appearance. People who have experienced facial trauma or those who were born with certain facial defects are those who undergo this surgery.


Procedure

The implants are selected based on the required results and the current cheek bone structure. Once the exact placement position is selected an incision either right above or below the cheekbone is made. The exact location of the incision could be near the gums or on the outer cheek or at the top of the upper lip or right below the eyelid.


Once the implant is placed inside it will be repositioned several times in order to get the desired look. The implant is locked to the desired postion with the help of a titanium screw which anchors it to the bone below. In most cases, cheek implant surgery takes about two hours to complete. If the augmentation is done to correct damage caused by an accident, bone grafts may be needed to correct damaged bones.


This procedure is generally performed on an outpatient basis.


ASSOCIATED RISKS

Some of the potential complications that are specifically associated with cheek implant surgery include:


Asymmetrical appearance of the face and cheeks


Capsular contracture, which is the tightening of scar tissue around the implant and requires additional surgeries to correct Change of sensitivity in the cheek area, though this usually returns to normal within a few months


Implant rejection


Shifting of the implant


TIPS ON RECOVERY

The treated area may feel tight, swollen and uncomfortable in the days following the surgery; necessary pain medications may be used to ease the situation. You may be placed on a liquid diet for several days until adequate healing happens. Also since there are stitches inside the mouth, there are chances that food particles may come in contact with the stitches. These stitches dissolve in approximately 10 days. Swelling also decreases quickly and till such time, the results of the surgery may not be plainly visible for as long as three or four months. Scars are well hidden.


Chelioplasty


Lip Reduction, also called reduction cheiloplasty, is the procedure to remove excess lip tissue to reduce the appearance of overly large lips. The procedure is normally performed under local anesthesia although some surgeons may choose to perform it under Light Sleep anesthesia. The procedure takes only about 20 to 40 minutes with a healing time of 2 weeks. If you find that your lips are too large and interferes in speach you may wish to consider this procedure. Though not invasive, the procedure will cause discomfort and swelling.


Procedure


If you are administered a IV Liquid Sedative, a hypodermic needle is inserted into the tube Lateral lip Reduction Surgery Reduce the appearance of Cverly Large Lipsthat you are attached to.The surgeon will take an incision the length of your lip inside of your mouth and a suitable strip of skin from one or both lips are removed as required.


The surgeon then closes your incisions with a non-dissolvable type suture, though some surgeons may use a dissolvable type. An antibiotic-soaked piece of gauze may be placed between your lips and your gums. Once awakened you are monitored in the recovery room until you are ready to be released. Your lips and mouth may feel tight and quite tender as the anesthesia wears off.


Prescribed medication will be given to alleviate this pain and discomfort.


Recovery


Typical recovery would be for one to two weeks. Sleeping with the head in a raised position is advised during this time. Your face will look even more swollen in the first 3 days, but gradually reduce as the days go on along with light bruising if any. There would be discomfort for several weeks with restrictions on oral diets. Food which has higher content of bacteria, namely fish and meat is best avoided during the healing period. Eating foods such as this may increase your risk of infection due to the incisions being in the mouth. An antibacterial mouth wash is recommended to be used several times a day. DO NOT PICK or tongue your incisions or sutures!


Sutures will be removed in a week to 10 days postoperatively, even though you may feel better, one must avoid any stenuous activity for the first 3 weeks that could raise the blood pressure as this could cause internal bleeding at your treatment area.


Chin Augmentation


Chin Surgery is a surgery that is performed to reshape a chin. A chin surgery may be performed to reclaim the profile of the chin after an accident or for aesthetic purposes. Chin surgery will also affect the look of the nose, cheeks and face. Chin surgery can reduce (mentoplasty) or augment (genioplasty) the chin to give your face a more balanced appearance. An individual facial bones shift, reduce, or enlarge with age and hence most chin surgery patients are adults.Chin surgery is usually performed in an outpatient surgical center or hospital. The procedure may be performed under local anesthesia.


Procedure


Implants Chin Surgery teatment


FIXING THE IMPLANTS

An incision is made on the site of the implant and is placed on the surface of the bone. It is then stitched, sutured or screwed into place. Sometimes the implant is not sutured, but is simply placed in a pocket and the body's collagen keeps it in place. For some implants, like silicone implants, titanium screws may sometimes be used.


Genioplasty is another way of improving a weak chin. A section of the jaw is removed with an oscillating bone saw. The bone is then moved forward and kept in place with metal screws and plates.


CHIN REDUCTION SURGERY

With cosmetic surgery to reduce the chin, an incision is made in the chin and the bone is sculpted. The excess is removed from it and the incision is stitched up.


DOUBLE CHIN PLASTIC SURGERY

Double chin plastic surgery is a different type of cosmetic chin surgery. It gets rid of the excess skin and fatty tissues that result in a double chin. Patients may be treated with Tumescent Liposuction, which removes the excess fat through a small incision.


MENTOPLASTY: CHIN REDUCTION

During mentoplasty surgery, the surgeon makes an incision in one of two possible locations:


▣ under the lower lip inside the mouth
▣ under the chin in an inconspicuous location


The surgeon will then use an electrical instrument (a bone burr or a drill) to reduce and reshape the bone to create a more natural appearance. The surgeon will stitch the incision closed and apply tape to the chin area.


GENIOPLASTY: CHIN AUGMENTATION

Genioplasty is performed by using a chin implant to augment a receding chin or by the surgical advancement of the bone itself. Your surgeon would suggest if you need a silastic chin implant or to advance your own bone. The incision will then be chosen.


If you choose a chin implant, the incision is in one of two possible locations:


▣ under the lower lip inside the mouth
▣ under the chin in an inconspicuous location


The implant is placed in an appropriately sized pocket. Sizers are used to achieve the best appearance; then the actual implant is carefully placed and the incisions are closed.


If you choose to advance bone in the chin, the surgeon makes an incision under the lower lip inside the mouth using a powered saw with a special blade to separate the edge of the chin bone. The surgeon moves the separated chin-bone tip forward and positions it with wires or special bone plates and screws. Finally, the surgeon stitches the incision closed and applies tape to the chin area.


TIPS ON RECOVERY


You may also experience significant swelling or discoloration in the treated area, which will subside over the course of several weeks. The stitches are typically removed within seven days of the procedure.


Follow your doctor's postoperative instruction list to help reduce the risk of complications. There may be some pain, which can be managed with oral medications. The surgeon may have recommendations to reduce swelling, such as elevating your head. Normal activities can be resumed typically within seven days.


Demple Creation


Dimples are considered as a sign of good luck, apart from adding beauty to a smile. Dimples are formed when there is a defect in the cheek muscle (buccinator muscle). The skin overlying this defect is stuck down to the underlying connective tissue which creates a dimple in the skin with change in facial expression, like smiling. Dimples can be created on other parts of the face like the chin without any external incisions. The surgeon would advice you with the best position and size for your dimple.


Procedure


A dimple creation procedure takes an approximate 30 minutes to complete. This is carried out under local anesthesia. The incisions are made in the inside of the cheek and there are no scars or incisions on the outside surface. A punch biopsy instrument is placed alongside the inner cheek (buccal mucosa) in lines with the location of the dimple and circular motions are made which cuts through the inner cheek, sub-mucosal and cheek muscle.


The circular tissue is removed and the skin is left intact. The skin is positioned appropriately to create a dimple and the cylindrical gap is closed with absorbable sutures. The sutures are placed through the cheek muscle connecting the dermis layer of the skin. A surgical knot is then tied which dimples the skin without a smile.


The sutures dissolves and absorbs in 2 weeks and the skin flattens out creating a normal appearance as earlier. When the internal scar heals it connects the cheek muscle to the skin thus creating a dimple when smiling. This period could vary from a few days to several weeks depending on the healing and the extent of tissue removed. A dimple creation surgery can be performed both on cheeks that are chubby or not. The size of the dimple determines the amount of tissue to be removed.


Post surgical care as always has to be maintained. The oral cavity is a source of bacteria and hence great care has to be maintained. An anti-septic mouth wash has to be used a couple of times a day to keep the site as germ free as possible. Suitable antibiotics will also will be prescribed to help with faster healing. Pain medications will be taken after consultation if needed to reduce pain. Mild to moderate inflammation will remain for a few days. Over animated facila expressions should be avoided for better results during the healing phase.


In certain rare cases there could be a temporary weakness of the cheek muscle after the surgery that could last for weeks. This is a totally reversible procedure.


Dermabrasion


The face is the most common site for treatment, but other areas of the skin can be treated as well. Dermabrasion is used most often to improve the appearance of acne scars and fine lines around the mouth. Dermabrasion is a cosmetic medical procedure that uses a wire brush or a diamond wheel with rough edges,with which the surface of the epidermis of the skin (the stratum corneum) is removed by abrasion (sanding). The instrument used to perform the procedure is called a dermabrader.


The brush or burr rotates rapidly, taking off and leveling (abrading or planing) the top layers of the skin. This process injures or wounds the skin and causes it to bleed.It is used to remove sun-damaged skin and to remove or lessen scars and dark spots on the skin. The procedure is painfull.Afterward, the skin is very red and raw-looking, and it takes several months for the skin to regrow and heal.As the wound heals, new skin grows to replace the damaged skin that was removed during dermabrasion.


Factors that affect the depth of the resurfacing include how coarse the burr or brush is, how quickly it rotates, how much pressure is applied and for how long, and the condition and features of your skin.


Procedure

Prior to surgery, a complete medical history is taken and a careful examination is done by doctor, in order to evaluate the general health of the patient. After examiniation the surgeon explains the procedure and the type of anesthesia that will be used during the procedure


The areas that has to be treated are cleaned with an antiseptic cleansing and marked first, then local anesthetic (lidocaine) is used to numb the skin before treatment, and ice packs are applied to the skin for up to 30 minutes.Only one area is treated first,the area being treated is sprayed for few seconds and then the rotating burr or brush is used to take off the top layers.In this procedure a high-speed rotary instrument with an abrasive wheel or brush removes or abrades the upper layers of the skin and improves irregularities in the skin surface.


After the procedure the skin feels as though it has been severely brushed and burned,for few days.Medication is given to the patient to avoid sever pains. Healing usually occurs within 7 to 10 days.The newly formed skin, which is pink at first, gradually develops a normal appearance.Patients are instructed to avoid unnecessary direct and indirect sunlight for three to six months after the procedure and to use a sunscreen on a regular basis when outdoors.


Dermal Fillers


Dermal fillers are becoming increasingly popular as a means to help reverse the changes associated with aging.Cosmetic dermal fillers include collagen, hyaluronic acid, fat and other substances.Collagen acts as the major support protein for our skin, elastin allows our skin to stay firm and resist wrinkles, and hyaluronic acid helps to trap water and add volume and shape to our skin.The goal of dermal fillers is to return the dermis to its original youthful state, dermal fillers can give a more natural appearance than surgical face lifts.The main purpose of dermal fillers is to add volume to specific areas, in order to eliminate wrinkles such as crow's feet or enhance a feature such as cheeks and lips.


Dermal Fillers are generally are made of several types of materials of synthetic, man-made and natural categories, and they have been developed into various standards depending on the level of usage.They are often a kind of soft tissue designed in such a way that enables injection into the skin for purposes of improving the appearance.


Dermal fillers are injected, usually without the need for local anaesthetic, into lines and wrinkles to plump them out. The dermal filler then remains in the skin, where it binds water to produce a lift and give firmness to the treated area.


The fillers can last upto six to seven months .The filler is gradually broken down and absorbed by the body, so the lines, wrinkles or lips will ultimately return to their previous appearance without top up treatments.


Face Lift


A Face Lift or rhytidectomy, is a cosmetic procedure designed to remove wrinkles from the face and neck in order to reduce the signs of aging. One gets a more youthful appearance by tightening the skin on the face and the neck. Results are best to those who have maintained some skin elasticity, though anyone with loose skin on the face or neck may consider getting a face lift in order to improve his or her overall appearance.


Procedure


The excess or loose skin from the chin, face, cheeks and neck are removed to give the face a "lift". Suitable incisions are made near the temple area and around the curves around the earlobe on both sides.


Sometimes other suitable incisions are made below the chin in order to remodel the face. Metal clips hold the skin in place for the surgeon to get the desired effect before the incision is stitched. The procedure takes only two to three hours to complete, overnight stay in the hospital is advised.

As with any surgical procedure, there are potential side effects associated with the face lift surgery including bleeding, infection and scarring.


Associated Risks


Broken capillaries, which occurs most often in the neck and cheeks that need laser surgery treatment


▣ Temporary crusting of the incision area
▣ Temporary discoloration of the skin
▣ Unsatisfactory results
▣ Temporary hair loss in the area of incisions
▣ Temporary or permanent Nerve damage
▣ Partial Numbness in the incision area


The results are long-lasting however it may be necessary to undergo an additional surgery in a few years in order to maintain the results.


Facial Implants


Facial implants are designed for augmentative, reconstructive or rejuvenative purposes. These are used to restore contour or proportion and come available in a wide range of sizes and styles for the chin, jaw, nose and cheek.Facial implants can enhance your appearance and bolster your self esteem. If you desire to improve your appearance and are realistic in your expectations, you may find that a facial implant is the right choice for you.These implants are used to bring better balance to the features of a patient. A nose can be reshaped or a chin brought forward for better looks and proportions. The more mature patient may choose to have an implant placed in conjunction with another cosmetic procedure. For example, during a facelift, a patient may wish to have implants placed over the cheekbones to help restore a more youthful appearance. Implants may also be selected to fill out a face that appears "sunken" or tired.


Facial implants can produce some remarkable changes.


Procedure


The procedure follows a similar pattern for all facial areas. The surgeon makes a small incision near where the implant will be placed, either in a crease or inside the mouth at the gum/lip junction. Then a pocket is made in the facial tissue, the implant inserted and the incision is stitched. The process generally takes 1-2 hours, usually with general anesthesia. The incision is bandaged or taped and stitches are removed in 5-10 days (sutures placed inside the mouth will dissolve in a similar period of time). Sometimes facial implants are inserted at the same time as a facelift, nose or eyelid procedure is performed.


Chin Implant


Insertion of a chin implant takes about 30 minutes to an hour. An implant of the proper size and shape to enhance your appearance is inserted into a pocket over the front of the jawbone. The small incision to create the pocket and insert the implant is placed inside the mouth (along the lower lip) or in the skin just under the chin area.


The chin is taped after surgery to minimize swelling and discomfort. Sutures in the skin will be removed in five to seven days. If an intra-oral incision is used, the sutures will dissolve. You will experience some discomfort and swelling in the affected area for several days. It is normal to experience some temporary difficulty with smiling and talking.


Cheek Surgery


Cheek implant surgery usually takes about 30 to 45 minutes. When cheek implants are being placed in conjunction with another cosmetic procedure, such as a facelift, forehead lift or eyelid surgery, the implants may be inserted through the incisions made for those procedures. Otherwise, an incision will be made either inside your upper lip or your lower eyelid. A pocket is then formed and an implant is inserted.After surgery, a dressing will be applied to minimize discomfort and swelling. The severity and duration of such side effects may vary, especially if another cosmetic procedure was performed at the same time. Stitches used to close the incisions inside your mouth usually dissolve within about 10 days.


Lower-Jaw Surgery


Insertion of a jaw implant usually takes about one to two hours. Internal incisions are made on either side of the lower lip to provide access for creating a pocket into which the lower-jaw implant can be inserted. Dissolving sutures are used to close the incisions.


There would be swelling for 2 to 3 days although most of the significant swelling will subside over a period of several days, prolonged mild swelling may prevent your final facial contour from becoming apparent for several months.


During the healing phase, your activities and diet will be restricted. Your ability to smile, talk or move your mouth in any way may be limited for several days to weeks following surgery. Your plastic surgeon will instruct you about dental and oral hygiene during your recovery.


One would look better in a short period of time. Avoid sports or other activities that may result in the face being jarred or bumped till such time as advised by the surgeon.


Benefits:


▣ Return to work and other normal activity within a week
▣ Generally performed in the surgeon's office or an outpatient surgical center
▣ Adds aesthetically pleasing contour to the face
▣ Results are essentially permanent


Other Considerations:


▣ As with any surgical procedure, infection may occur. If the infection persists, the implant may have to be removed and replaced at a later time.
▣ Shifting of the implant is another possibility. Should the implant become slightly misaligned, a second procedure might be necessary to reposition it.
▣ Postoperative bruising and swelling. Mild/moderate discomfort for 1 to 2 days.
▣ Strenuous activity and rough contact to the implant area must be avoided for 4 to 6 weeks
▣ Patient problems will want to confer with their dentist


Associated Risks


A facial implant can shift slightly out of alignment and a second surgery may be required to re-position it. Infection is another risk that can happen with any operation. If an infection does happen after an implant and does not clear out even after medication with antibiotics, the implant will have to be temporarily removed and replaced at a later time.


Facial Peels


A chemical peel is a treatment in which an acid solution is used to remove the damaged outer layers of the skin.It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. In general, patients with fair skin and light hair are the best chemical peel candidates.


Although chemical peel may be performed in conjunction with a facelift. However, patients with other skin pigmentation and hair color can achieve good results as well. Ideal candidates for the chemical peel procedure are individuals who are unhappy with the appearance of their skin, have realistic expectations of their procedure, and do not smoke.


There are risks included like scarring, infection, swelling, changes in skin tone, and cold sore outbreaks. You can reduce the risks associated with facial peels by following all of the doctor's instructions completely and by providing your doctor with a complete medical history.


Gummy Smile Palate Repair


Gummy smile has a negative affect on the esthetics that can be corrected through surgical treatments Gummy Smiles "A Surgical treatments to improve the smile"to improve the smile.


Causes


There are several possible causes of gummy smile, including:

Abnormal erruption of teeth can lead to excessive gums covering them. These teeth though of correct length appear shorter as they are covered by gums The muscles controlling the upper lips causes them to rise up higher than normal. When this occurs, more of your gum tissue is exposed when you smile The upper jaw bone development could cause the appearance of a gummy smile


The smile line is determined by several factors, including:

▣ The shape and size of your lips
▣ The facial muscles
▣ The shape and size of your teeth
▣ Gum tissue


The optimal smile line appearance should reveal the least amount of gum tissue possible. Gum tissue visible in the smile line should have balanced, even contours that are in harmony with the upper lip. It is for this reason that many people with a gummy smile or excessive gingival display feel their smile to be unattractive, oftentimes feel reluctant to smile at all.


However, depending on the factors causing a gummy smile, more serious underlying dental conditions could be present. For example, if you have a gummy smile caused as a result of how the teeth erupted and how the jaw developed, you may also have an uncomfortable or improper bite (see occlusion) that could ultimately affect your long-term oral health.


PROCEDURE


An examination by the dentist will determine the extent of the excessive gingival display and any Gummy Smilepossible causes. This examination may involve conventional and/or digital impressions of your teeth and gums. You may also need X-ray imaging so that the tooth roots and jaw bone can be carefully examined. You may then be referred to a specialist. Depending on the nature of your specific clinical condition, treatment for your gummy smile could include one or more of the following:


▣ Same-day laser treatments (in minor cases)
▣ Surgical lip repositioning
▣ Orthodontics (braces) to move the teeth into more suitable positions
▣ Surgical Sculpting of the gingival tissues and bone to create healthier and more attractive looking gum contours
▣ Maxillofacial surgery to reposition the bone


Hair Transplantation

Unit follicular hair transplant has emerged as the most reliable hair transplant procedure of hair transplantation surgery. The graft in this case consists of a single follicular unit with adjoining sebaceous glands, the surrounding adventitial sheath and the supportive nerve and blood tissue. It needs to be extracted as an intact unit and transplanted as intact unit, to be able to grow into a hair. This in fact is the fundamental concept of follicular hair transplant..


Procedure


Follicular Hair Transplant:hair implant/graft


Since the success rate of follicular hair transplant is nearly 100%, it closely follows the aesthetic pattern chalked out by the hair transplant surgeon for the hairline design and the graded areas posterior to it. The hair transplant procedure is quite laborious and takes a long time to complete. Moreover, it also requires a well-trained team of skilled surgical assistants to dissect them out. After the introduction of stereoscopic microscope for dissection, the results of follicular hair transplants have further improved. The larger magnification helps a surgical assistant to avoid the damage to the follicle unit and prepare the follicular hair transplant with the least amount of scalp skin.


Due to its small size, it requires only a very small incision for transplant. Small incision for a follicular hair transplant causes less damage to the recipient site and produces result which is undetectable to the casual observer. Another advantage of follicular hair transplant is that due to less damage to the recipient site, the grafts can be placed very close to each other resulting in a more denser and natural growth. Microscopically separated single haired follicular transplants allow the hair transplant surgeon to define the irregular hairline with the highest degree of precision so as to give his patient the most natural look.


Hair transplant surgery with follicular hair transplants takes 3 to 5 hours to perform and one can leave the center without any bandage on his/her head. One can also wash the transplanted hair carefully after 3 days. In a week's time complete healing would be produced.


Disadvantages of the procedure


Requirement of long hours of time and skilled team of more assistants for the preparation of 3, 000 odd follicular hair transplants through dissection is the biggest disadvantage of the follicular hair transplant procedure. The disadvantage also leads to manifold increase in the cost of hair transplant surgery.


There are ways through which the follicular hair transplant procedure can be modified so as to be completed in less time. The hair transplant procedure, which involves use of natural grouping of hair follicles, has already been discussed. The above-said procedure, if used in conjunction with the follicular hair transplant, can save a lot of time for the hair transplant surgeon who through skilled planning can limit the use of these follicular hair transplants for the frontal hair transplant and the hair line design.


Use of Follicular Unit Extraction


Another innovative hair transplant procedure for follicular hair transplant is the Direct Hair Implants (DHI) technique which is the minimally invasive hair transplant procedure available today; it does not use scalpel, stitches or a donor strip for preparing follicular hair transplants. The DHI is based on the use of hair transplant procedure known as follicular unit extraction (Fue). Follicular unit extraction is the state-of-the-art extraction technique for preparing follicular unit transplants.


Follicular unit extraction does not require a donor strip to be excised from the donor area and therefore does not involve any dissection of follicular units. The follicular units are instead directly extracted one-by-one using custom-made, precise micro-surgical tools less than a millimeter in diameter. Follicular unit extraction is simple, painless, with the donor area healing within 2-4 days as compared to 7-8 days required for follicular hair transplants using the graft extraction technique . There is no risk of nerve damage being caused by the hair transplant procedure.


Advantages of Using Direct Hair Implant


Hair transplant procedure for direct follicle hair transplant is a very simple one. The follicular hair transplant is performed only with state-of-the-art instrumentation. The standard instruments for the procedure consist of custom cut lateral slit blades, hypodermic needles and the innovative DHI implanter. A hair restoration surgeon prepares a protocol of follicle hair transplant specifically for each patient so as to ensure perfect and most natural looks. The non-invasive hair transplant procedure of direct placement of follicle hair transplants causes minimal trauma to the scalp and does not cause any pitting, indentation or scarring.


The greatest benefit of Follicular unit extraction and DHI technique is the possibility of quality control during the hair transplant procedures, the hair transplant doctor needs only a single surgical assistant to help him during the follicle hair transplants. The procedure also ensures maximum care to the grafts. The hair transplant doctor can decide upon the exact number of grafts to be removed while he is removing them one-by-one.


The best thing about Direct Hair Implants is that the hair from all over the body can be used. The technique has received much favor with the patients because it helps them to remove the excess body hair and at the same time allows them to restore hair without any surgery being performed on them.


Body hair follicular grafts removed through the follicular extraction technique are utilized only for enhancing the density in the posterior region of the scalp and not for the hair line. The outcome has been quite positive for many patients where it is hard to differentiate between body hair transplants from the head hair. It has been noticed that body hair transplants show similar growth patters when compared to the head hair with no difference in texture. Another advantage of the Direct Hair Implants Technique as a hair transplant procedure is that it lets the surgeon to extract as many grafts as required. The transplant surgeon can extract upto 1200 grafts per day and subsequent follicular hair transplants can be done immediately after the first session.


Oculoplasty

Oculoplasty is surgery with relation to the eye and surrounding structures. Oculoplasty surgery may be performed in order to improve function, comfort and appearance.


For the Eyelids


As people age, they develop droopy eyelids which can impair vision due to the eyelid covering the front of the eye. Excess skin and fat in the upper eyelids is another cause for droopy eyelids. The treatment will be suggested based on examination for your particular situation. Surgery is performed using a local anesthetic.The incision usually placed in a naturally occurring crease in the upper eyelid skin serves to hide the incision. Typically duration for surgery is 1-2 hours and the patient is discharged the same day. Sutures will be removed after a week and other bruising around the eyelids typically resolves over a 1-2 week period.


Procedure


Tear Drainage Problems


The reasons for watery eyes vary across people. In certain cases, surgery helps reduce the amount of watering. The tears normally drain from the surface of the eye through the eyelids and into the nose. If the drainage system is blocked, the tears spill onto the cheek. If a blockage is present where the drain starts, then, a procedure to widen the drain opening ("punctoplasty") is done. This usually takes 20-30 minutes and is performed with local anesthesia. If the blockage occurs further in the drainage system pathway ("nasolacrimal duct"), you may require surgery to bypass the blockage and create a new pathway for tears to drain into the nose. The surgery, called DCR ("dacryocsytorhinostomy") takes approximately 1 hour and is typically performed while you are under general anesthesia. The procedure has a very high success rate (>90%), but some patients may require additional surgery to improve their tearing.


Eyelid Malposition


The eyelids are designed to protect the eyes. As we age, the lids may stretch and pull away from the surface of the eye, and may also turn in ("entropion") or turn out ("ectropion"). This may cause the surface of the eye to become irritated and may cause the eye to water. Surgery can often restore the normal position of the eyelid. The procedure is performed under local anesthesia and typically takes under an hour. Most patients notice improvement of their symptoms in the first few weeks after surgery.


Skin Cancers of the Eyelid


We are all at risk for developing skin cancer. Fair skin and increased exposure to sunlight increases this risk. The eyelids and face are common locations for skin cancers to develop. The most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. You should inform your doctor about any growths on the eyelid or face that you are concerned about, whether they be new or old, especially if they have increased in size. Each lesion will be evaluated and your doctor will discuss with you if they should be biopsied and/or removed. In most cases, the diagnosis cannot be made until a biopsy is performed. The biopsy usually takes 15 minutes and is performed using local anesthesia. If the biopsy shows skin cancer, additional surgery may be necessary. The amount of additional surgery depends on the type and extent of skin cancer present, with the goals of removing the entire tumor and to reconstruct the eyelids to protect the eye. With these goals in mind, surgery will be planned to offer the best cosmetic outcome possible.


The Orbit("Eye Socket")


The eye socket contains the muscles that move the eye and the bones and fat that protect it. Sometimes, the socket can be affected by injury, inflammation, tumors or any medical disorder. Your doctor would generally suggest a CT or MRI scan in order to evaluate an orbital problem. This is done to determine the location and cause of the problem. The thyroid gland is overactive in people suffering from Graves' disease. Many patients with this problem have manifestations in their eyelids and orbits, including bulging of the eyes ("proptosis"), restriction of eye movements and double vision, abnormal eyelid position, irritation of the eye surface, and occasionally vision loss. Some patients with eye manifestations of Graves' disease will be required to have additional surgery in order to decrease the risk of vision loss, reduce the bulging of the eyes, straighten the eyes and reduce double vision, and/or reposition the eyelids to a more normal location. Manifestations of Graves' disease vary from case to case and your doctor will discuss your specific findings and treatment plan with you.s of Graves' disease vary widely and your doctor will discuss your specific findings and treatment plan with you.


Anophthalmia (Loss of an Eye)


The loss of an eye, understandably, is very difficult for the patient. The oculoplastic surgeon is one member of a team to assist with this transition and assist in ensuring the best possible outcome. After the eye has been removed, an implant is placed in the eye socket and the muscles that moved the eye are usually attached to the implant. After the socket has healed, the patient is seen by an "ocularist" who fits them with prosthesis. This is referred to as a "glass eye", although they are not glass and have excellent cosmetic appearances. Patients typically continue to see the oculoplastic surgeon periodically after surgery in order to ensure the health of the socket. Your doctor will make sure that you have a comprehensive eye care professional involved in your care to assist in maintaining the health of the remaining eye.


Otoplasty

Otoplasty is an ear surgery to correct protruding, large, cupped, shelled ears or otherwise deformed earlobes. The surgery is best recommended for children as they near total ear development at age fiveOtoplasty is an ear surgery to correct protruding, large, cupped, shelled ears or six. This procedure can also help in situations after an injury. Adults may also have their ears reshaped.


In the case of protruding ears, the supporting tissue of the ears, called cartilage, is reshaped in order to position your ears closer to your head.


This usually is accomplished through incisions placed behind the ears. The scars will be concealed in the natural skin crease. In some cases, especially in ears that need to be reduced in size or are protruding in the middle 1/3 of the ear, external incision of the front of the ear will be necessitated. Usually these are placed in areas where they will heal in a more inconspicuous manner. In ear reductions, skin as well as cartilage will most often need to be removed.


Usually the final results of the ear surgery are very long lasting.


It is best to discontinue aspirin and anti-inflammatory drugs that can cause increased bleeding prior to surgery. Your surgeon will provide you with additional preoperative instructions. Aesthetic ear surgery is usually performed on an outpatient basis. Necessary medications are administered for your comfort during the surgical procedure. A combination of local anesthesia and intravenous sedation are used for patients undergoing ear surgery. In younger children general anesthesia may be desirable. In certain general anesthesia cases, an overnight hospital stay may be appropriate. Under normal conditions, time in surgery is about two hours. As in the case with any surgical procedure the vital parameters like ECG, blood pressure, pulse and oxygen saturation are continuously monitored.


Procedure

Techniques vary among surgeons the factors that may impact the choice of technique include the general anatomy of the ears, the extent of the ear cartilage, excessive skin in the surrounding area or level of deformity in other areas of the ears.


There are two common otoplasty techniques:


The most inconspicuous site for incision on the back of the ear is first located. Once the incision is made, cartilage is sculptured and re-positioned closer to the head for a more natural appearance. In most cases non-removable stitches are used to help the cartilage maintain its position. Depending on the anatomy in certain cases, the surgeon may choose to remove excessive cartilage in order to enhance the ultimate appearance of the ear.


In the second technique, the cartilage is left untouched, the skin is removed and the ear cartilage is folded back. Non-removable stitches are used to help the cartilage maintain its position. Dissolvable or removable stitches are used for the incision location, which are removed or dissolve within a week.


For total ear reconstruction, otherwise known as congenital microtia (ear absence), a common approach begins with developing a framework from the ribs, then elevating the back and placing a skin graft. It would be necessary (in most cases) to rotate the lobule in order to carve out the ear canal. Ears that are malformed due to trauma (including burns) may undergo a reconstruction process, possibly with more extensive skin grafting, depending upon the extent of the tissue damage.


After the procedure you will be taken into a recovery area where you will continue to be closely monitored. You probably will be permitted to go home after a short period of observation, although some patients may stay overnight in the hospital or surgical facility.


ASSOCIATED RISKS

There are no major complications following Otoplasty. Every year, many successful cosmetic ear surgeries are performed, without experiencing any major problem.


TIPS ON RECOVERY

It is important to realize that the amount of time it takes for recovery varies greatly among individuals.The first several days you should maintain head elevation as much as possible. Remember, you must not take aspirin or certain anti-inflammatory medications.


Initially, pain is usually controlled with oral medication. Some patients find that mild swelling persist for many weeks. Bruising typically disappears within seven to ten days. Stitches are usually removed within a week of surgery.


After surgery, you may be instructed to wear gauze dressing or bandage for a few days or up to several weeks to ensure that your ears heal in their new, corrected position. Often a ski band to cover the ears is worn at night to prevent the ears from bending during sleep.


Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less. Most people return to work at 7- 10 days.


Reshaping Septal Deviation correction(Nose)


Septoplasty is an operation that corrects any problems in the wall (nasal septum) that separates theSeptoplasty is an operation that corrects any problems in the wall (nasal septum) two sides of the nose.


The goal of septoplasty is to straighten out and change the position of the septum inside the nose to relieve blockages or other structural problems. It could be performed along with rhinoplasty, which is a cosmetic procedure. Unlike rhinoplasty, septoplasty may be performed in order to improve the efficiency of the nose by making it easier to breathe.


The procedure involves making changes to the septum, which is the firm yet flexible wall that is located in the center of the nose. For those requiring a septoplasty, the septum may be located to the left of the right side of the nose rather than in the middle. Therefore, the job of the surgeon is to re-center the septum so the nose can efficiently inhale and exhale air.


Procedure


A cut is made inside the wall of one side of the nose. The mucus membrane is lifted up and away and anything that is blocking the area is removed or moved as needed. Then, the mucus membrane is put back in its original position. The tissues covering the wall are held in place by either stitches or packing. The main reasons for this surgery are:


▣ Deformity of the wall between the nostrils
▣ Obstruction to nasal airway
▣ Headache due to Septal spur
▣ Uncontrollable nosebleeds


Nasal airway blockage is usually the result of a deformed septum. People with this condition usually breathe by mouth and get nasal infections. A septal spur headache is a headache caused by pressure from the inside of the nose (septal impaction), which goes away when an anesthetic is placed on the area.Chances of excessive bleeding, infection and return of the nasal obstruction are the other possible risks associated with this.


RECOVERY


The nostrils will be tightly packed (stuffed with cotton materials) to avoid nosebleeds. The material is usually removed 24 - 36 hours after surgery.


Blowing of the nose or holding your breath has to be avoided and tightening your muscles while bearing down for a bowel movement for a few days after surgery. Ice packs on the nose may help relieve pain.


Rhinoplasty

Nose augmentation (technically called rhinoplasty) by using a silicone implant is a cNose augmentation (technically called rhinoplasty) by using a silicone implant is a cosmetic procedureosmetic procedure to improve the nose aesthetically, by harmonizing it with other facial features. Surgery of the nose improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural defects in the nose. After the rhinoplasty, one will have a beautiful profile, without conspicuous sign of surgery. There are a number of procedures within the scope of nose reshaping, so the exact nature of the treatment will depend on the desired result. Depending on the extent of the surgery, the operation may take place under a general or local anesthetic and will take around two hours.

Procedure

There are two main techniques used in nose reshaping operations: Open and Closed. Open means that some or all of the cuts are made outside the nose; closed means all cuts are made inside the nose.


A nose reshaping operation normally involves separating the soft tissue that lies on top of the nose from the bone and cartilage underneath. Depending on the operation, the surgeon might break the nose bone and reposition it and/or reshape the cartilage. This may include lowering humps, narrowing of nasal bones, shaping of the nasal tip or nostril size and improving the angle between the nose and the upper lip. Adding tissue to enhance certain features of the nose can also occur.


The procedure takes one hour and is done under either local anesthesia or general anesthesia. Post operation the nose would be covered with a metal or plastic splint or plaster to maintain its shape and position of the nasal bones. Patients are advised not to undergo any severe exertion for 2 to 3 weeks.

Tip Plasty


Tip-plasty is aimed at changing the shape of the nasal tip to improve the appearance of the nose. A changing the shape of the nasal tiptip-plasty may be performed to reduce a large, square or bulbous nasal tip, to treat an upturned or sagging nasal tip, or just to refine the tip of the nose.


Tip-plasty is one of the most challenging aspects of nose surgery as disruption of the cartilage that supports the tip of the nose can cause the tip to collapse, rotate or lose projection.


The surgery includes realignment of alar cartilage by resection and suture, fibroareolar and subcutaneous tissue resection, tip graft, and columellar strut. The nasal tip is positioned high and elegant, methods such as cartilage suture, cartilage grafting and blocking up the nasal septum etc. are opted as decided by the surgeon. The ideal shape can be achieved only if the nose has the adequate length.


Therefore, the operation of embedding the supporting platform is often included. The tips of nose are made high and straight by suturing cartilage, performing cartilage grafting on sutural cartilage or embedding allroderm. In order to support the structure, the process of embedding nasal septum is very important. The embedding of nasal septum can also optimize the angle shaped by lips and tips of nose, and enhance the effect of nose augmentation operation.


A round or bulbous nasal tip, is due to a well-developed and large cartilage at the nasal tip. This cartilage widens the tip of the nose and makes it less defined. This is corrected through a tip-plasty procedure that excises the excess cartilage at the tip of the nose to narrow it down and give it more definition. Tip-plasty also increases the projection of the nasal tip, something much needed in an Asian nose which is usually deficient in height at the nasal tip.


Procedure


This procedure is generally under local or general anesthesia and usually takes around 1 hour depending on the surgical treatment. The surgeon would choose the approach that is most suited depending upon the extent of reshaping required.


TIPS ON RECOVERY


The typical recovery would be aound 3 weeks. Sutures are removed within 10 days after the procedure.


The patient can be discharged from the hospital on the same day of the surgery. The patient is recommended to be on the bandage for a period of 3 days after the surgery.


Wrinkle Smoothing


Crow's feet are fine lines and wrinkles radiating outwards around the eyes. These are commonly known as crow's feet or worry lines. Years and years of smiling and squinting can also play a part in how they're formed. Sun exposure, frequent squinting, smoking and even sleeping on your face promote the formation of crows feet. Naturally, people who spend a great deal of time outdoors are at higher risk. Applying sunscreen, quitting smoking and wearing sunglasses and hats are the key ways to avoid crows feet.


Procedure


Causes


▣ Thin Eyelid Skin- The skin of our eyelids is the thinnest skin on our face and is most susceptible to sun damage and aging changes
▣ Eyelid Muscle Action- Because the skin of the lid is so thin, it is easily deformed by the underlying muscle, the Orbicularis Oculi. When this muscle contacts it pulls this skin into folds. As the skin ages and looses collagen, these folds and lines become permanent
▣ Sun Exposure- The upper portion of our face, the forehead, eyes and cheeks get the most sun exposure of any area of the body. UV radiation from the sun destroys collagen in the skin and causes aging changes.


Prevention


You can minimize the depth of existing crow's feet by treating the area with an eye cream that contains glycolic acid. One of a group of alpha hydroxy acids- originally derived from sugarcane is what studies suggest to do.


It's worth noting that most over-the-counter eye creams contain glycolic acid.


Stay out of the direct sun during the most dangerous hours of the day, since crow's-feet appear only after direct sunlight has begun to destroy the skin's elastin and collagen fibers as time passes, the best way to prevent crow's-feet is to apply a good amount of sunscreen on your face.


Treatment


▣ Quiet the Muscle Pull- Botox is truly a miracle drug for treating aging changes around the eye. Botox weakens the muscles of facial expression, allows the muscle to relax and results in the disappearance of the lines and folds caused by the muscle pull. Small amounts work very well and are safe to use on the cheek. Botox injections as crow's feet treatment may last about 3 months. Some people enjoy the lasting effects of Botox on their crow's feet for 6 months and onwards


▣ Resurface or Remove Sun Damaged, Aged Skin- New fractional laser resurfacing can be done on the peri-ocular (around the eyes) skin to remove wrinkles and sun damaged skin. Newer fractional Erbium laser resurfacing results in much quicker recovery in 5-7 days, than older CO2 laser resurfacing which often took 3 weeks to heal. Eye protection is required during treatment.


▣ Non-ablative fractional Laser resurfacing- Non-ablative Erbium Laser treatments do not peel the skin so there is minimal recovery time. These techniques can be used in the crow's feet area but not on the eyelid. Eye protection for 3-4 weeks are required.


Non-surgical methods are the Best for these Skin Changes


The plastic surgery operation called a blepharoplasty does not remove eye wrinkles. Blepharoplasty does remove puffiness and bags and dark circles under the eyes. But the skin aging changes described earlier are not corrected with Blepharoplasty. The non-surgical methods including Botox and laser resurfacing or a chemical peel are necessary to correct skin aging changes of the eyelid skin.


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