Facial Rejuvenation Surgery

Our generation, the “baby boomers’ have a completely different approach to aging than our parents and grandparents. Ours is a generation of active people, living in a youth orientated society. We try to live healthier, longer and better. We want to feel and look our best. It is no surprise therefore, to see the huge increase in the number of people choosing to undergo a surgical procedure to help repair the ravages of time. Facial rejuvenation surgery can help us look our best—whether the goal is for personal enrichment or professional advantage.

Multiple Facial Procedures

Most often, facial rejuvenation procedures can be combined. Although the operating time is somewhat longer, it does not generally lead to a longer recovery time for patients. There may be a financial benefit to doing more than one procedure at a time. Sometimes patients are concerned only with one area. If that is corrected, other facial features may seem out of synch, so remember to consider the face as a whole. You may wish to discuss this with the surgeon at the time of your consultation

Facial Rejuvenation Surgery

Face Lift
Forehead Lift
Eyelid Surgery (Blepharoplasty)
Ears (Otoplasty)
Lip Enhancement
Nasal Surgery (Rhinoplasty)
Chin Surgery
Cheek Procedure

Face Lift (Rhytidectomy)

The facelift is done to eliminate sagging jowls, restore cheek contours, soften harsh, deep folds above the mouth and tighten the neck area. If the neck contour is good, a more limited procedure known as temporal or mini lift is done to improve the jaw line and cheek area. However, tightening of the neck cannot be achieved without doing a complete facelift.

The degree of improvement is determined by physical factors and personal habits. Physical factors include age, heredity, bone structure and individual characteristics of the skin. Personal habits include alcohol intake, nutrition, and smoking. Surgery is not an exact science and some of the factors involved in producing the final result, such as the healing process, are not entirely within control of either the patient or the surgeon. Therefore, it is impossible to guarantee results. Surgery will not eliminate all evidence of aging, but will help restore a more youthful contour to the face and neck.

Facial surgery should not be undertaken when one is undergoing difficult times emotionally. An improved appearance is not the solution to one's life problems, but it can enhance one's appearance and help restore self-confidence.

Thousands of facial surgeries are performed successfully each year. Nevertheless, you should be aware of the potential risks of surgery and specific complications associated with facelift and eyelift surgery. The most common complications are small, localized collection of blood, delayed healing or minor infections. Poor healing is often related to drug and alcohol intake. Smoking and poor nutrition may increase scarring and occasionally necessitate a second operation. Vitamin E and aspirin should not be taken 2 weeks before the operation. Nerve paralysis, skin ulceration and scar over-growth (Keloid) are rare.

Surgery to improve sagging skin or wrinkles leaves scars. While such scars are permanent, they are rarely noticeable or cause any trouble. The job of the plastic surgeon is to place scars in natural lines of the face and eyelids, where they are least noticeable and can be more easily camouflaged by makeup or hairstyles.

The surgery can be done under either local anaesthesia, with sedation, or completely asleep (general anaesthesia). Inconspicuous incisions are made around the ear, both in front and behind. The extent of these incisions varies, according to the amount of correction required. The skin and deeper tissues of the face are repositioned in a more attractive and youthful position, and secured in place. The excess skin is removed, and the area of surgery is meticulously closed, resulting in scars that are usually imperceptible.

> back to top

The Forehead Lift

The forehead lift is a surgical procedure designed to smooth out the frown lines between the eyebrows, improve horizontal wrinkles, and restore the brows to a higher more youthful position. This elevation of the brows helps to restore a more youthful, pleasing contour to the upper eyelid. The forehead lift can be done either with a small telescope (endoscope) inserted through small incisions in the hairline, or with a more complete incision that extends across the top of your scalp. The choice of technique, and the placement of scars are dependent on several factors, including the severity of the brow sag, and the pattern of your hair. The decision as to which approach would be best for a given individual would be determined at the time of your consultation. Whichever method is chosen, the scars are generally inconspicuous and the results are pleasing and natural looking.

The forehead lift may be done at the same time as other facial rejuvenation surgery. It will not increase your recovery time, and can enhance the rest of the facial rejuvenation

> back to top

Eyelid Surgery (Blepharoplasty)

Puffiness of the upper and lower lids can be corrected by removing excess skin and/or fat the lid area. The incision in the lower lid is placed just below the eyelashes, and result in a scar that is all but invisible. Sometimes the incision is made on the inner surface of the eyelid (the conjunctiva) if there is only fat to be removed. This means there are no visible external scars. The upper lid incision is placed in the natural fold crease of the upper lid.Age related changes of the muscle and fat are dealt with through these incisions.

When you are assessed with regards to you upper lids, the doctor will also assess the position of the eyebrows. Often with time and gravity, the eyebrow sits lower than it did when one was younger. This can leave a patient looking sad or angry. Correction of poor position is not part of the eyelid procedures, but is treated by a forehead lift.

Blepharoplasty procedures are well tolerated by most patients. However, if you have had any eye or visual problems, such as glaucoma, or suffer from dry itchy eyes, excessive tearing you should let your doctor know.

Most people recover from eyelid surgery in about ten to fourteen days. Makeup and mascara cannot be worn for fourteen days, as it could cause discoloration of the scar line. Bending over, and heavy lifting must be minimized for the first 3 to 4 weeks after surgery.

> back to top

Surgery for Outstanding Ears (Otoplasty)

Otoplasty is a surgical procedure to correct the outstanding ear. It does not make the ear smaller, but does reposition the ear closer to the skull, making it appear smaller. An elipse of skin is removed from the underside of the ear, allowing the surgeon access to reshape the cartilage, or framework of the ear. In most instances, a portion of the cartilage is removed or softened with small surgical incisions. Permanent sutures are then put into place to help the ear retain its new shape. The dressing is usually removed after one week. A ski band or headband is worn at night for six weeks to protect the ears during sleep.

At the present time, this surgical procedure is covered by the Ontario Health Insurance Plan (OHIP) through the age of 17. The surgery is considered a cosmetic procedure for an adult, and would not receive any coverage, unless there is a co-existing birth defect of the ear.

Otoplasty is usually performed under a general anaesthetic in children. The ideal time to operate on a child’s ear is generally considered to be at 5 or 6 years of age. Most of the growth of the ear has been obtained by that age. With modern anaesthetic techniques, there is little cause for concern about the effects of a general anaesthetic on a child of that age.

Adults are usually operated on under local anaesthetic with intravenous sedation to help relieve tension and anxiety. The surgery is done on an outpatient basis, and the patient may go home the same day.

> back to top

Cheiloplasty (Lip Enhancement)

The commonest method of aesthetically enhancing the lips of course, is by applying lipstick. Some ladies will have a line tattooed at the junction of the pink and white line of the lips.
Lip augmentation creates a fuller, more plump looking lips and can also reduce the fine lines around the mouth.

Increasing the volume of lip is done with fat grafting but in the majority of patients, however this tends not to be permanent. The insertion of a dermis graft (lower component of skin) is more permanent. The use of foreign materials is not advised in such a mobile structure as is the lip.

Cheiloplasty is a surgical procedure where a portion of the white of the lip just above the mucutaneous junction is excised. The vermillion is advanced in the closure and this increases vermillion show and thereby makes the lip look bigger but does not increase the volume of the lip. Cheiloplasty is especially advantageous in ladies in whom the vermillion tends to lessen with time, the white part tends to sag down. While the procedure does leave a scar, it looks like the liner that some ladies place on their lips. Moreover, the older the patient, the better the scar.

> back to top

Nasal Surgery (Rhinoplasty)

Rhinoplasty is one of the most requested cosmetic surgical procedures. The change in appearance can be profound or subtle, depending on the type and magnitude of deformity. Aesthetically speaking, the nose must balance the face, and when you are seen for your consultation, the surgeon will be looking at the balance between the nose and chin, and how they relate to the face. A small underdeveloped chin will make a nose seem larger than it really is.

Rhinoplasty can be performed once the nose has reached its adult size and shape, usually after the age of sixteen, although if the deformity is severe, consideration could be given to younger patients

Chin Surgery
Some people seeking an improvement in their appearance will benefit by a surgical procedure to the chin. Unfair though it is, character traits are sometimes attributed to a person based not on their personality but on the size of their chin. If the chin is small and underdeveloped, the person may be considered to be weak and passive. If however they have an excessively prominent chin, they are seen to be strong, assertive and masculine. Although surgery to the chin won’t alter one’s personality, it may help restore balance and beauty to the face.

In some individuals, the chin will be underdeveloped and out of balance with the rest of their face. They may benefit by building the chin up, most commonly by the use of a small chin implant or prosthesis, rarely by advancing or moving the bone. The implants used are a smooth rubber-like material that is contoured to hug the bony contours of the jaw. Its edges should be undetectable when properly positioned. It can make a dramatic improvement in ones appearance, considering that it is a relatively minor procedure.

Aesthetic nasal surgery
Aesthetic nasal surgery, or rhinoplasty, is reshaping the nose to improve its appearance. This type of surgery is typically performed to reduce the overall size of the nose, reshape a tip, remove a nasal hump or improve a poor angle between the nose and the upper lip. In some patients, it is necessary to add tissue in order to improve contour.   One or all of these changes can be made during a single operation.

Reconstructive rhinoplasty is performed to correct birth defects and disfigurement resulting from injury.   It may also be done in conjunction with an operation performed to relieve nasal obstruction due to an internal deformity.

TempPic1In certain cases where the nose requires building up for definition, some cartilage is taken from the ear.   This does not distort or change the appearance of the ear.   The nose is one of the main balancing features of the face and sometimes an alteration of the size and shape of the nose should also be accompanied by appropriate changes in other facial structures to obtain the best results.   The chin is often augmented or altered along with the nose, particularly if it is recessed or small in size. During examination, your facial structure will be evaluated and other appropriate recommendations made.

Surgery is altogether not an exact science. Because some of the factors involved in producing the final result, such as the healing process, are not entirely within the control of either the surgeon or patient, it is impossible to guarantee results. Results from surgery on the nose however, are more predictable in some patients than in others.   This is determined by a number of factors, such as thickness and shape of the bone and cartilage, the shape of the face, heredity, age, and the thickness and condition of the skin. The skin is highly important factor influencing the result of nasal surgery, for thick skin precludes a delicate nasal tip. Every nose has certain combinations of these anatomical features, which influence the outcome of the surgery and the predictability of the results.

> back to top

Chinplasty (Chin Enhancement)

TempPic1Facial implants are designed for augmentative, reconstructive or rejuvenative purposes. Implants are available in a wide range of sizes and styles and the most appropriate size and type can be discussed with your surgeon during your consultation. Some people have a very large dominant chin. This can be reduced through an incision that is placed underneath the chin. This will establish harmony with the face. Other patients, have a recessive or small chin and this can be built up with a silicone rubber implant. The incision is below the chin. A wrap around implant is used. This is placed on the apex of the chin but the sides of the implants are placed along the front boarder of the mandible. This gives a more angular jaw. Implants add or restore contour and /or proportion to the face. The procedure generally takes 1-2 hours usually under a general anaesthetic. The incision is dressed with a bandage or tape and these are removed in approximatey 5-7 days.

> back to top

Malar Augmentation (Cheek Enhancement)

TempPic1Facial implants are designed for augmentative, reconstructive or rejuvenative purposes. Implants are available in a wide range of sizes and styles and the most appropriate size and type can be discussed with your surgeon during your consultation. People who have a narrow face with under developed cheek bones can be improved upon by malar (cheek) implantation. Most commonly, silicone rubber implants are used for this purpose. Sometimes fat grafting will also suffice. This type of procedure will establish harmony with the face. Implants add or restore contour and /or proportion to the face. The procedure generally takes 1-2 hours usually under a general anaesthetic. The incision is dressed with a bandage or tape and these are removed in approximatey 5-7 days. These procedures allow balancing of the facial harmony.

> back to top


Surgical ProceduresAboutContactHome