Will eyelid surgery change the shape of my eye? Neither upper nor lower eyelid surgery should change the shape of your eyes. Upper eyelid surgery will remove the excess skin and fat that can cover your normal upper eyelid. After the surgery, your eyes will appear more refreshed similar to how they looked years ago. They will appear more open but will be the same shape as before. Often patients who lack an upper eyelid fold may request a change to their upper eyelid shape. You should discuss the shape of your eyes with your surgeon during your preoperative visit.
Lower eyelid surgery should not change the shape of your eyes either. Similar to upper eyelids, lower eyelids can make you look aged and tired because of extra fat and skin. Often lower eyelid surgery can be made through invisible incisions. Occasionally patients make a special request to have their eyes appear more almond shaped. This exception can be discussed during your consultation.
At what age should I have eyelid surgery? Really any age can be a good time for eyelid surgery. Some patients complain of lower eyelid puffiness or extra upper eyelid skin from their teenage years. The eyes tend to be the first spot where we notice aging so eyelid surgery is common for patients in their 30s and 40s. Since eyelid surgery produces such a natural and refreshed look, it's also a great choice for the older patient who wants a subtle rejuvenation without undergoing a lot of surgery.
A good rule of thumb for people who wear makeup: When your upper lid eyeliner is rubbing off on your upper lid and turning into eyeshadow... it might be time to consider an upper blepharoplasty.
How many days off from work do I need to take? The first two days after the procedure, I recommend staying home so you can apply ice & relax. Then you can pop on a pair of sunglasses and head outside. Since sutures are removed at postoperative day 3-5, you can be at work that soon. Otherwise, take a week, enjoy some time off and look amazing when you return to work.
When can I wear makeup? Makeup can be worn usually as soon as the sutures are out and the incisions are healed. The postoperative visit is 3-5 days after surgery and the decision to put makeup on is usually made at that time.
How long will I be bruised? Some patients bruise more than others but on average most bruising has faded by one week. I recommend a combination of vitamins and homeopathic medications which has been medically proven to help bruising fade faster.
Will insurance help pay for the surgery? Restylane under the eyelids is something I perform on a daily basis for my patients. I wholeheartedly recommend that this procedure be performed by only the most experienced physicians.
Just yesterday, I corrected a patient who had been injected with Perlane (the thicker cousin of Restylane) by a novice injector. Fortunately, an experienced physician knows how to undo the effects of Restylane. Once you are with a physician who you trust, the amount of Restylane required is much less compared to other areas of the face. This makes the procedure great and cost-effective. When you correct the tired, saggy look under the eyes, you will be so pleased with the result!
What are my options for treatment of crows feet if I've developed immunity or strong resistance to Botox A? I don't think Botox B is an option from where I come either. Occasionally, I come across a patient who has developed a "resistance" to Botox. Many times, the patient will respond to Botox as long as it is properly dosed. But beyond Botox, you can consider a fine injectible filler.
An example would be collagen or hyaluronic acid. You may also be a candidate for upper eyelid blepharoplasty. The heaviness of excess upper eyelid skin can make crow's feet look worse.
A blepharoplasty can help improve your appearance by removing the excess skin. You have several options from which to choose, so good luck!
Will my nose be packed? In the past, surgeons would pack the nose with gauze to prevent bleeding after surgery. Currently, with self-dissolving materials and newer techniques, nasal packing is almost always avoided.
Does it hurt? When we have surgery on our limbs or belly, every time we move the area we can experience pain. Fortunately we really don't move our nasal bones so most patients feel little pain after nasal surgery. For the first few days, the nose feels congested and gradually improves as swelling subsides.
Does insurance pay for the surgery at all? Insurances pay for functional surgeries. When patients have nasal obstruction due to a deviated nasal septum or turbinate hypertrophy, they may need nasal surgery to relieve their symptoms. Repair of nasal fractures are also frequently covered by insurance. Most insurances do not cover cosmetic procedures. Most patients prefer to have their functional and cosmetic surgeries to be performed at the same time shortening the anesthesia and recovery time.
Will everyone know that I had my nose done? The art of rhinoplasty (cosmetic nasal surgery) is to bring out the patient's best features and give the patient a natural, non-operated look. A good surgeon has to have the skill to tailor the surgery to the patient. One type of "nose job" does not fit all patients and can give the stereotypical artificial look. The key to a successful surgery is discussing with the patient what they want and bringing those dreams to reality.
What kind of anesthesia do I need? General anesthesia is my choice for nasal surgery. General anesthesia allows for the patient to be comfortable and fully monitored for the utmost safety. Occasionally limited nasal procedures, such as small adjustments to the tip, can be performed under local anesthesia.
I'm looking into getting my deviated septum fixed in the near future. Would that be considered cosmetic even though I have trouble breathing and therefore makes it seem medically required? Correcting a deviated septum is a medical not cosmetic procedure. When a patient has nasal obstruction despite medical therapy such as nasal steroid sprays, that patient may need to turn to a surgical approach to straighten the septum and improve the nasal airway.
Usually correcting the septum does not change the cosmetic appearance of one's nose. Consult with your local board-certified otolaryngologist (ENT) surgeon. If you are interested in having a rhinoplasty to change the cosmetic appearance of the nose and the septoplasty at the same time, then consider visiting a double boarded ENT-facial plastic surgeon.
When I smile, my nose tip droops down. I read about the depressor septi being cut but I think my doctor does not want to cut any muscle. he wants to attach a cartilige or something to the septum. Which way is better? My sister had the muscle cut and her results are good. Her nose tip no longer drooped, but that was 8 years ago and things have changed. A nice alternative to try before surgery is a small injection of Botox. A skilled physician who understands Botox and facial anatomy can put a small amount of Botox into the muscle and this can give you the "fix" you are looking for before turning to surgery.
As a facial plastic surgeon, I can recommend rhinoplasty as the more permanent alternative. Of course, cutting the muscle is one option but muscles do heal. There are pros and cons to putting a cartilage graft to elevate the tip. It really depends on your individual nasal tip. Factors like skin type, shape of your nasal cartilages, septal deviation can all play a role. You can try the Botox and schedule your consultation with an expert.
What is a facelift? Nowadays a facelift can mean many things. The traditional facelift involves rejuvenation of the cheeks, jaw line and neck. Importantly, it does not include the eyes, eyebrows and forehead. Today, targeted facelifts can mean rejuvenation of isolated areas. These targeted facelifts can mean less downtime and can be broken down to the "cheeklift"or the "necklift". When deciding between the procedures, consider what area needs attention, how much downtime is needed and what you want.
Will it look natural? After a full physical examination of your face and an in-depth consultation, the right surgery for your face will be determined. Today most patients want the natural look and that means treating the face on many different levels. Aging in the face results from skin, muscle and fat changes and addressing each of them individually results in a natural look.
Does it hurt? Actually, not really. Unlike chest or belly surgery where you can't help but move the incision every time you breathe or laugh, facial surgery is not really painful. Most patients will complain about the swelling and bruising but most do not report pain.
How long will I be bruised? Bruising is most severe the first two weeks with dramatic improvement over the first few weeks. In our practice, we encourage the patient to use a homeopathic regimen that we have found very effective in shortening recovery time.
I'm open to a facelift or facial plastic surgery but wanted more opinions on a variety of skin tightening options to tighten jowls and skin laxity in the face in general. With every patient that comes into my practice, it is important to evaluate three key components of aging:
Skin
Gravitational changes
Volume loss
If your problem is sun-spotted, wrinkled skin with mild laxity, then skin resurfacing with either laser or chemical peel should be considered.
If the issue is gravity, then the answer is surgery to restore the skin & underlying structures to their former position. The aggressiveness of the facelift (from "mini" to traditional) will be determined by your expectations and your own physical characteristics.
An open & honest conversation with your facial plastic surgeon is incredibly important. Sometimes the sagging cheeks & early loose jowls can be corrected with volume replacement, better known as injectible fillers. As we age, we lose fat & volume from where we would like it & seem to collect where we don't! Fuller, higher cheeks are youthful and early jowls can be "hidden" with a small amount of filler.
Before jumping ahead with any of these approaches though it is essential that you have a consultation with an honest, versatile facial plastic surgeon who will really discuss with you your options.
Does it hurt? Many patients report a headache the first night. After the first evening however, patients report they feel swollen and bruised but not real pain.
Will I have a surprised look? The goal of surgery today is to have a natural look. Patients should look refreshed and rejuvenated not frightening or frightened. During your initial consultation, you will be able to discuss your concerns and expectations. The key is to feel comfortable that your surgeon and you share the same vision.
How many days off from work do I need? To recover comfortably, take 10 days off from work. After the first few days you will be able to work from home but another 5-7 days will be needed to have the most obvious swelling and bruising disappear.
Will I lose normal facial expression? No. Great botox means looking younger but not looking frozen. Botox can be carefully placed so it minimizes facial muscle contraction and the overlying wrinkles but still allows you to show the world your smile or your anger.
Will I have to use it forever? Botox lasts anywhere from 3-5 months. The muscles are not permanently paralyzed so your muscles will regain their function. At that point, you can choose to have the injections again. Some patients have reported that after several repeat injections, their lines never return as deep.
What is the difference between peels? A whole host of chemical peels exist to refresh skin, treat disease and turn back the aging process. A chemical peel can be superficial which only removes the very top surface of the skin. These superficial peels can be performed monthly and often contain the "fruit" acids, salicylic acid, glycolic acid, nutrients and vitamins. There is usually no recovery time needed. Medium depth chemical peels penetrate deeper in to the skin and cause an actual peeling of the skin which occurs over a one week time period. After the week, the skin looks dramatically younger with less brown spots and wrinkles. This is great procedure for a patient who want their skin to look years younger and be make-up free. Deeper peels and certain lasers will really remove blemishes from the skin but generally require anesthesia and a minimum two week recovery time.
Will I have Huge Scaring or Huge Sores where the hair will be implanted after my procedure? Well Actually there will be some minor scabbing and crusting during your healing process, which goes away within 8 days. But the instrument used for placement of the hair grafts is 0.8 millimeters. One of the smallest tools used in this industry that we are aware of.
Will it look natural? Yes. The days of hair plugs are over. Now, the hair is carefully dissected down to individual hair shafts, called follicular unit or micrografts. The individuals hairs are then placed in the area of thinning. The hairs look and grow looking the same as the surrounding hairs. The results are excellent.
How much hair do I need? The donor hair should come from the back of the head where the hair tends to remain thicker. How much hair that is needed depends on the individual patient. Sometimes only a few hundred individual hair grafts can be used to make a thinning area appear denser. For patients who want to fill in a larger area, more than a thousand individual hair grafts can be used to create a very natural coverage.
What is the recovery time like? For the first few days you may have some localized swelling. The tiny grafts will look like multiple little scabs covering the recipient area. The scabs will generally require one week before they disappear.
What is an otoplasty? Otoplasty is cosmetic surgery of the ear to reduce the appearance of a protuberant ear. One or both ear may look to big for multiple reasons. Commonly, the ear is missing an extra fold or bend which makes the ear "stick" out too much. Sometimes, one ear is simply bigger than the other. At your evaluation, your surgeon will be able to exam your ear and detail for you the best way to repair and improve the appearance of your ear.
Does insurance cover the procedure? Sometimes. Some insurance carriers recognize the emotional trauma that children go through by being made fun of by other children for "looking different." Your case would need to be evaluated by your insurance on a case-by-case basis.
What is incisionless otoplasty? Some ear deformities can be corrected with this minimally invasive technique. With this technique, the surgery is performed without the traditional incision behind the ear. Therefore, the recovery time is quicker with decreased risk.
How does it work? The laser, which is an intense single wavelength of light, passes through your skin surface without creating harm, and finds its target. Its target is the color or pigment in your hair root.
Will all the hairs be gone after one treatment? No, since the hairs in a region can go into a resting phase, laser treatments need to be repeated monthly over a period of 4-5 months to insure that the maximal number of hairs have absorbed the laser energy effectively. Some areas need only three treatments. You will be better able to determine the number of treatments and the time of your consultation.
Are the hairs permanently gone? You will have a permanent hair reduction not removal. Some patients with hormonal imbalances can see a regrowth of hairs in a region especially if they are not controlled on their medications.
Can people of all skin types be treated? Yes, the technology exists so that the laser can transmit its energy to the hair follicle and not the skin. Patients with darker skin types should have a test spot to determine the safest energy level for them.
Does it hurt? We offer numbing cream to the treatment area for all our patients. Most patients feel very comfortable with the numbing cream. Some patients have their treatments without any topical anesthesia at all. The sensation of the laser has been compared to the snap of a rubber band.
Do I need to grow my hairs for the treatment? No. The laser is designed to pass through the skin surface and treat the hair root under the skin. It is much less effective if the hair is long and above the skin. Please shave before your appointment. Do not pluck, tweeze or use a depilatory cream however for three weeks prior to your laser appointment because you will remove the hair root which the laser needs to treat you effectively.
I am considering Laser hair removal, and I want to know the best laser to use for light brown skin. Please advise. Thank you. Dear Sweeta,
Excellent question! The answer is clear that laser is more effective than IPL for permanent hair reduction.
In particular, the Cynosure Elite laser which has both Alexandrite and NdYag wavelengths. These wavelengths are specific for the melanin in dark hair follicles & will have less chance of unnecessarily having an effect on the surrounding skin.
For light brown skin such as yours, the NdYag is the best choice. A big word of caution however, go to an experienced physician for your treatments! Especially here in NY, a lot of these laser centers do not even have a physician overseeing the treatments.
Darker skin is at greater risk for absorbing the laser or IPL energy & therefore get burnt or darken. You want to be treated by a caring physcian only. For instance, in my office, I personally treat all the patients. The treatments are comfortable, painless and very effective.
Many physician offices offer prices comparable to these laser centers so do not be lured by low prices. Your safety is the most important. Laser hair removal is absolutely great & with the right machine & right physician, you will do great!
What are injectable fillers? Currently, there are several substances available to improve the appearance of folds and wrinkles. They can also successfully increase lip size and fill in facial defects. Current fillers include Restylane, Collagen, Hylaform, Sculptra, and Radiance. Discuss with your physician which is the best choice for you.
Do the injections hurt? Numbing cream can be used to anesthetize the area before the treatment begins. We use the smallest needle size possible to strive for your comfort.
Are there any contraindications to injections? Any history of allergies to the ingredients is the main contraindication.
Will I bruise? Anytime an injection is performed, bruising may occur. To decrease the chance of developing a bruise, avoid Vitamin E, aspirin, ibuprofen and naprosyn which can thin the blood making bruising more likely.
I seem to have a depression in the tear trough area and would like to fill it instead of undergoing surgery, which scares me. Will Restylane really work for these problems? Restylane is an excellent option. The wonderful thing about trying Restylane in this area is the effect will last for 6 months so it gives you just enough time to "try out" the effect. Also, Restylane is reversible and can be dissolved if for some reason you do not like the result. You should choose an experienced physician however. This is a delicate area & you want someone who really understands the anatomy. Best of luck!
I know it doesn't last as long, but is chin augmentation using Radiesse or Restylane less effective or not as natural as a surgical implant? Both Radiesse and Restylane are great options for augmenting the chin temporarily. Many of my patients have been extremely pleased with the result. You could also consider Sculptra which can give you customized augmentation for up to two years. Just pick an experienced physician, as not everyone may be familiar with the technique. Good luck!
I have very sensitive and fair skin, and I would like to get rid of the vertical lines around my mouth permanently with a wrinkle treatment that has few side effects. What do you recommend? You have several options to help improve those vertical lines above your lip. Botox is a possibility because it will help relax the muscle responsible for pursing your lips. However, you may notice when you try to drink from a straw or whistle, that you are not able to move the same way! You can also try filling the lip lines. This should only be done with a hyaluronic acid filler like Restylane or Juvederm.
Thicker fillers are not appropriate in the lip or for superficial lines. A third approach is try to skin resurfacing. Several lasers can improve the area with or without downtime. These include fractional CO2, erbium, or the Affirm by Cynosure. Being fair actually makes you a good candidate for laser procedures. And to keep from making those lines worse, wear sunscreen and avoid drinking from straws!
