Surgical options for reshaping the face.
Face Lifts are done to tighten the loose skin of the face and neck. It does not remove fine wrinkle lines, these require resurfacing of the skin. The forehead and eyelids are not tightened by a facelift. At the same time as facelift the surgeon can correct other causes of fullness in the face and neck. One of the most difficult areas to treat is the nasolabial fold, the crease between the nose and the corner of the mouth. The incision is placed in the natural creases in front of the ear and inside the ear. It extends above the ear into the scalp and behind the ear on the hairline. The operation is done under either local anaesthetic (you are awake) or general anaesthetic (you are asleep). You can choose. Most of the time this is an outpatient operation and a stay in the hospital is not needed. It is common to perform neck liposuction at the same time as a facelift. Some variations of the facelift use a smaller scar. There are various names including short-scar facelift and MACS-lift. Complications: all operations have some risk. The risks of surgery are divided into two groups. First those that are seen in all operations and second those that are unique or special for this operation. In the first group, the main risks are swelling, bruising, bleeding, infection, a scar and numbness or change in feeling. The main problem which is special for this operation is damage to the facial or VIIth nerve. This nerve controls movement of the face. Postoperative care: The recovery takes one to two weeks. Most people are happy with the result and back to work within a week or two.
Brow lift is done to tighten the skin of the forehead. This serves to reduce lines and raise the brows. It does not remove fine wrinkle lines, these require resurfacing of the skin. The face and eyelids are not tightened by a forehead lift, although the upper lid skin may be stretched. Sometimes part of the muscle of the forehead is removed or divided to make it less strong. The incision is usually placed in the hairline or an inch (2.5 cm) or so back in the scalp. It extends from one side to the other. The operation is done under either local anaesthetic (you are awake) or general anaesthetic (you are asleep). You can often choose. Most of the time this is an outpatient operation and a stay in the hospital is not needed. In younger patients, the operation may be done using the endoscopic or keyhole approach so that there is less scarring but the result may be less long lasting. The main problem which is special for this operation is damage to the nerves of feeling of the scalp which causes numbness behind the incision, this risk is reduced but not eliminated with endoscopic forehead lifting. Also, the scar can stretch and because scar does not grow hair this may be noticeable in those with thin hair.
Blepharoplasty is done to reduce excess skin and fat around the eyes. In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar. In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows.
Rhinoplasty (nose job). You may be born with a nose that seems too large or you may have had an injury that changes the shape. In either case there is an operation to change the appearance of the nose. This is a Rhinoplasty or nose job.
Otoplasty (ear pinback or bat ear correction). Many children are born with ears which protrude too far from the head. This causes the "dumbo ear" appearance and is often very embarrassing. The problem is corrected by a combination of stitching and reshaping the ear cartilage, to bring it closer to the head.
Genioplasty (chin implantation or reshaping). If the chin does not develop fully it may appear receding or weak. To correct this problem the chin is brought forward by adding an implant over the prominence of the jaw or reshaping the underlying bone.
Malarplasty (cheek implantation). In some people the prominence of the cheek is underdeveloped and this leads to flat cheek bones. For some people this can accentuate the effects of ageing. It is corrected by placing an implant over the prominence of the cheek.
Liposuction. As with many areas of the body the fat can be suctioned to reshape the face. The most common areas are in the neck under the chin, the fold between the nose and the corner of the mouth and the jowl area.
