Eyelid Surgery (Blepharoplasty)
Blepharoplasty describes the surgical excision of skin with or without fat of the upper or lower eyelids. It may be performed through incisions which are concealed within the eyelid crease in the upper lids and just below the eyelash or behind the lower lid. The procedure dramatically addresses folds of the upper lids, bags and sagging skin of the lower lids, which result in a constantly "tired" look. The procedure, which takes approximately 45 minutes, may be performed in the office under local anesthetic. It may also be performed under IV sedation or general anesthetic in an outpatient surgical center.
There will be some swelling and bruising of the eyes and cheeks which may last 2 to 3 weeks. Pain level is described as 3 out of 10 and most patients note a very dramatic improvement.
Surgery of the Ear (Otoplasty)
Surgical correction of the ears are performed to correct either congenital or traumatic deformities. The most common procedure performed is surgical correction of ears which appear too forward. This is usually treated in the pre-teen years. This may be performed under local anesthetic in the office or general anesthetic in a surgical facility. Reconstruction for congenital deformities of the ears are performed on patients between the ages of 3 to 5 years old in the hospital. Surgical treatment of traumatic deformities are tailored to the reconstructive needs of the deformity.
Surgery of the Nose (Rhinoplasty)
Surgery to correct nasal imperfections is very commonly performed and can dramatically alter facial appearance. Results are usually best when there are very selective changes desired. For example removal of a dorsal hump, raising, lowering or narrowing the tip. Patients who are dissatisfied with all aspects of their nose or desire someone else's nose may not be good candidates. Nasal surgery may also be performed to straighten the septum to assist with breathing or to correct an deformity secondary to nasal fracture. The procedures may last from 15 minutes to 2 hours depending on what is desired and is usually performed under a general anesthetic. Expect significant facial swelling and bruising which may last 2 to 3 weeks. The complete resolution of nasal swelling will take approximately one year.
Cheek Augmentation (Malar/Submalar)
Cheek augmentation may be performed by a variety of methods including implants, fat injections, injectible fillers, and midface lift. These procedures all increase the prominence of the cheek (malar/submalar) areas which improves the appearance of the face by restoring the youthful fullness and vitality of the midface. The appearance of sunken tissue below the cheek bone is associated with an aged, withered face as well as with severe weight loss or illness. Sagging tissue of this area is one of the first signs of facial aging. Our preferred methods of treatment are RadiesseT injectible fillers and submalar implants. Augmentation with fillers is performed in the office and requires only 15 to 20 minutes to perform. Augmentation with implants is one of the most precise and predictable methods. It is also the only one which can be immediately reversed. The 40 minute procedure is performed in an outpatient surgical facility and involves an incision in the mouth which is completely hidden beneath the upper lip. Through this incision, a solid silicone implant can be placed after it is custom carved to create the desired appearance. The recovery involves swelling of the facial area for approximately 7 to 10 days. It is rated a 3 out of 10 on the pain scale. Risks of the procedure include infection, implant malposition, or asymmetry. Patients with dentures may have to be refitted after undergoing this procedure.
Chin augmentation may be performed by injectible fillers, bone advancement or placement of an implant. In some cases where dentition and occlusion is not properly aligned, cutting and advancing the bone is necessary. Most other cases can be treated by fillers such as RadiesseT or placement of implant. Injectible fillers are placed in the office as a 20 to 30 minute procedure. Implant placement is a 45 to 60 minute procedure which requires a general anesthetic in a outpatient facility. The implant is placed through small incisions in the mouth behind the lower lip or a small incision below the chin depending on the location and size of the implant.
"To age is graceful, to look aged is not"
Facelift is a surgical procedure performed to restore the youthfulness of the aging face. There are multiple variations of the procedure such as superficial, deep and midface lifts. The procedure therefore must be tailored to the individual. Facelifts should restore the former youthfulness by winding back the hands of time. A facelift should make you appear younger and accentuate some of your baseline features. The selection of the proper procedure to address the needs of the patient is therefore more important in Dr. Coleman's opinion than having the latest or newest technique. The specifics of the standard procedure involve elevation of the skin of the face to trim excess and diminish wrinkles, folds, jowling and sagging around the ears, mouth, chin and neck. Midface lift is performed in younger patients who have good skin tone but early sagging of the facial fat in the cheek area. Most patients who request facelift come to the office simulating the pulling of skin which they desire. Patients who are good candidates for a facelift are non-smokers, with poor skin tone but good bone structure and skin quality. Individualization of the facelift procedure may include combination procedures such as brow lift, blepharoplasty, cheek implants, or injectible fillers to optimize results. The procedure is performed under IV sedation or general anesthetic. The recovery process will include significant facial swelling for 10 to 14 days during which you will appear socially unacceptable. Most patients will be able to attend social functions 2 to 3 weeks after surgery. Facelift may effectively restore youthful appearance for 10 to 15 years.
The signs of facial aging in the neck include sagging skin, jowling and widened platysmal bands. These may be addressed with a neck lift which is an surgical procedure designed to eliminate the widened bands in the front of the neck in order to improve the appearance of the chin and jawline. Some patient benefit from a chin implant in addition to the neck lift to address a "weak" chin. These procedures are also frequently requested in patients who have sustained significant weight loss and desire removal of the skin laxity at the neck. Younger patients with a "double chin" are usually treated with liposuction of the neck.
The use of nasal implants in plastic surgery has been performed for decades in many countries. Unfortunately, this has resulted in less than optimum results in some cases due to both surgeon's errors and flaws in implant design. Dr. Coleman feels that the new generation of soft silicone implants which can be carved to custom fit the patient's requirement are significantly improved over prior models. In his experience they have been most effective when used to create a more prominent nasal dorsum in Asian and African-American patients.
Ear Lobe Repair
Plastic surgical repair of earlobes is a commonly performed office procedure to correct post-traumatic deformities of the earlobes. The usually mechanism of injury is traumatic enlargement or tears of the earlobes from inadvertent blunt trauma or earrings. The repair is performed in the office under a local anesthetic and requires suture removal approximately 7 to 10 days later. Patients are advised to avoid contact sporting activities for 3 weeks and refrain from piercing of ears or use of heavy earrings for 6 months.