FACE PROCEDURES

Face Lift

Recent studies have shown that looking good has a direct correlation to higher pay. Facelifts are performed by Dr. Robert Dryden for patients so that they can look younger and feel better and have a better self-image. Facelifts are extremely gratifying. People from every walk of life elect to have a facelift for cosmetic as well as economic reasons.  An aging neck or saggy jowls frequently are the most dramatic signs of aging.

Look as young as you feel with a facelift

If you have been considering a facelift to reverse the signs of aging, you should understand what a facelift can and can’t do. Although the incisions made for a facelift are hidden back in your hairline and around the ears, it does nothing to correct the visible signs of aging in the upper face where Botox, a brow lift or laser resurfacing is needed. A facelift provides an overall lift to the lower third of your face by tightening loose skin in the jowls, neck, and jaw line and removing adding or redistributing fat. 

A facelift alone will not remove forehead wrinkles, crow’s feet or bags under your eyes. These areas can, however, be treated at the same time as your facelift with a blepharoplasty or brow procedure. During your initial consultation, your surgeon will discuss your particular condition, your expectations, and the probable outcome of your various treatment options. You will be shown several before and after photographs of patients having similar conditions, and we will explain the details of your procedure. Before and after photos will be taken of your face to document your results.

The facelift procedure

A facelift procedure may be performed in an outpatient surgical facility. Premedication is generally recommended to relax the patient. The procedure is usually performed under local anesthesia with sedation or general anesthesia with the patient asleep. Your surgeon will operate on one side of the face at a time. The incision is placed in the natural crease of the facial skin and begins inside the hairline in the temple area above and forward of the ear. It continues inside the ear or in front of the ear around the earlobe and behind the ear. Incision is then directed immediately in front of the hairline or behind the hairline depending upon how you wear your hair. The skin is lifted outward and the surgeon tightens and repositions the underlying muscles and tissues. Excess skin and fat may be removed. The incision is then closed with fine sutures and/or metal clips. If metal clips are used, shaving hair from the incision site may be avoided. A facelift can take between 2 – 4 hours depending on the extent of the procedure. Alternatives to a full facelift include a minifacelift with or without the neck bands minimized or an S-lift depending the patient’s characteristics.  Tumescent solution utilized in the surgical areas minimizes swelling and bruising. You will be returning home after surgery within an hour or so.

How long will results last after my facelift?

Some relaxation of facial tissues will occur during the first few weeks. After surgery, the aging process does not stop. Your lifestyle choices, bone structure, skin type, sun exposure and heredity all play a role in determining how many years can be removed and for how long. In general younger patients enjoy longer-lasting results. If you are in your forties, the effects may last up to 10 years. If you are in your sixties, your results may last 5 – 7 years.  Each patient is different and may need a touchup in several years depending on how fast stretching occurs. 

 

What happens after my facelift surgery?

After your facelift, there may be bruising and swelling that will persist for a few days. Pain is normally minimal and can be controlled with oral nonnarcotic medication. We will take off your bandages in our office on the first day after surgery. You may then go home, take a shower and wash your hair. Sutures may be removed in stages to minimize scarring. We have had patients who go out to dinner the next night or back to work the next day.

Healing is a gradual process. After about 2 weeks or sooner, you will feel comfortable (with make-up). After 3 weeks or sooner you will look and feel confident enough to go out with friends again. Your face will feel completely “normal” in about 10 – 12 weeks. Direct sun should be avoided for several weeks. Most patients are delighted with their new, more youthful and relaxed.

Eyelid Surgery

Sometimes, even after a great night’s sleep, it can be hard to feel alive and vibrant when you see those tired, drooping eyes looking back at you from the mirror. The loose skin above or below your eyes and the fat bags under your eyes make you look much more tired and older than you feel inside.

If this sounds familiar, you’re not alone. Eyelid surgery, or blepharoplasty, is probably the most commonly performed cosmetic surgery in the world and corrects sagging eyelids with extra or stretched skin, removes fatty pouches beneath the eyes and removes the excess skin from the upper eyelids. Dr. Dryden has developed an international reputation for complicated eyelid problems and has a very special interest in this area. 

Another common problem that is often confused with the excess skin problem (treated with an upper eyelid blepharoplasty) is the actual drooping of the upper eyelid (blepharoptosis).  This problem of ptosis (drooping) of the eyelid is very common and is treated with a specific surgical blepharoptosis procedure frequently.

Blepharoplasty can be done alone or in conjunction with other facial surgery procedures such as a blepharoptosis repair, facelift, a brow lift or laser skin resurfacing.

 

Your eyelid surgery consultation 

During your initial cosmetic consultation, your doctor will discuss your particular condition, your expectations, and the probable outcome of treatment. You will be shown several before and after treatment photographs of patients having similar conditions, and you will receive an explanation of your treatment. Before and after photos will be taken of the area to be treated to document your situation and results.

 

The eyelid surgery procedure 

Blepharoplasty and blepharoptosis repair can be performed in your doctor’s office, an outpatient surgical facility or a hospital. It is generally performed under local anesthesia, but blepharoplasty can be performed under general anesthesia.  Blepharoptosis repair generally needs the patient awake to cooperate in order to achieve the best symmetry of shape and position. The surgeon places fine incisions in the crease above each eye to correct problems of the upper eyelids. Then a thin crescent of excess skin and muscle is removed. If blepharoptosis repair is being performed, the surgery is carried more deeply into the eyelid to alter the relationship between the lifting muscle and the lower part of the upper eyelid.  The incisions are closed with very fine sutures.

To remove the fatty deposits beneath the eyes, the incisions are placed just inside the lower eyelid or just beneath the eyelashes on the outside of the eyelid. After the fat is removed or moved, the incisions may be closed with absorbable sutures or may be left to heal naturally if performed on the inside.  The more common external approach needed when there is excess lower eyelid skin requires sutures to be placed and removed at about one week. When excess skin and muscle needs to be removed from the lower lids, the incisions are placed in a small groove immediately below the lash line as mentioned above. The procedure can take between 1 – 2 hours, depending on the extent of the surgery.

What about insurance for eyelid surgery? 

Eyelid problems are common even in younger people. Correcting eyelid problems that interfere with your vision may be covered by your health insurance with documentation with side vision testing and photographs. However, when eyelid surgery is performed for cosmetic reasons, it will not be covered by your health insurance. It is the patient’s responsibility to check with their insurance provider for the information on the degree of coverage. We will be happy to answer any questions.

What about recovery for eyelid surgery?

When Dr. Dryden performs your eyelid surgery, it is generally done under local anesthesia. After the surgery, the area around your eye may be bruised and swollen for about 2 weeks. Patients should keep their heads up and place cold compresses on their eyes as much as possible for the first 48 hours.  Heat subsequently will decrease the swelling more quickly. Antibiotic eye drops or ointment or a silicone film may be prescribed. Patients can’t wear contact lenses for about 2 week. Make-up may be worn after about 10 days. The resulting hairline scars which follow the natural contour of the eyelids tend to fade in about 2 months.

After cosmetic surgery, our patients have a softer, more youthful look to their faces. Many seem to have a new spring in their step after facing their fresher reflections in the mirror.

Cheek & Chin Beautification

The saying is that “Beauty may only be skin deep.” However, for centuries, the well-defined facial features of chin and cheeks have been considered features that contribute to physical beauty. Prominent cheek bones and a strong chin provide balance and definition. For those seeking these important facial features, make-up was their only alternative.

Chin augmentation, or “mentoplasty”, and cheek implants or injected fillers for “malar augmentation”, may produce dramatic results in your beautification. They could provide a more vibrant and attractive look as they replace the lost midfacial fat that occurs with aging. These procedures can also benefit those with asymmetries or congenital defects such as no chin.

Chin implants are often recommended for patients undergoing nose surgery to achieve better facial balance. An implant produces a dramatic change in your appearance. Cheek implants or filler augmentation also can improve the midfacial contour and restore sagging midfacial soft tissues. They may actually contribute to lifting the cheeks and jowls. Cheek implants can ensure longer-lasting results.  Cheek augmentation may also be successfully performed with the patient’s own fat or fillers such as Voluma and long lasting Bellafill.

Are chin and cheek facial implants for you?

During your initial cosmetic consultation, our physician will assess the nature of your facial structure and discuss your concerns about your face, your expectations, and explain the probable outcome of your procedure. If your nose is prominent, you may particularly benefit from a chin implant. Look in your mirror and look at your profile.

We may show you several before and after treatment photographs of patients having similar facial structure, and we will explain the treatment you can expect to receive. Before and after photos will be taken of your face to celebrate and document your results.

 

Are chin and cheek implants safe?

Facial implants have proven to provide a safe, predictable, low-cost, low-risk cosmetic surgical procedure. To date, millions of facial implants made from non-toxic materials such as silicone, porous polyethylene and expanded polytetra-fluoroethylene (ePTFE) have been implanted, with no reported cases of allergic reaction. In our office, we favor the use of solid and malleable silicon customized by the surgeon.

The implants, designed specifically for use in the midfacial cheek area and the chin come in a wide variety of shapes and sizes. These implants could be custom-trimmed by your surgeon for a more natural fit.

The actual chin and cheek implant procedure

Both chin and cheek implantation procedures can be performed on an outpatient basis. They can be performed with the use of general anesthesia. They can also be performed with the patient “awake” with a sedation cocktail and accompanied by the use of local anesthesia to numb the treated area.

After cleansing the area, your surgeon will place small incisions either in the natural crease lines under the chin, within the eyelids, in the crow’s feet lines or inside the mouth depending on what implant is to be inserted. The implants are placed through the incision and into position. The incisions are then closed using tiny sutures.

If you have been wondering if could have more distinctive facial features to enhance your appearance and improve your self-confidence, you should schedule a consultation with our surgeon.

How will my face feel after my chin and cheek implants are placed?

After a chin or cheek augmentation, you may experience some discomfort and, perhaps, numbness along with some temporary swelling. Keeping your head elevated and applying cold compresses during the first 48 hours will help keep these to a minimum. This should then be followed by heat to keep swelling to a minimum. Post-operative discomfort can also be controlled with medication. Chewing food and brushing your teeth might be a little uncomfortable for a week to 10 days. A soft food diet may be required for a few days as chewing may be limited. All swelling should be gone within 6 weeks. External scars are minimal and will fade significantly over time. Strenuous activities should be avoided for several weeks to avoid the possibility of bleeding.

Rhinoplasty

Nose surgery is performed for patients to improve their self-confidence, and breathing may be enhanced.

Hundreds of people elect to improve the appearance and/or function of their noses through nose surgery or rhinoplasty every year. Some people want a different size or shape. Others ask to repair damage caused by an injury, and some just want to breathe easier.

Your nose is the 2nd most prominent feature on your face second only to your eyes. Its size and shape may be the most defining characteristic of your face. If you are unhappy with your nose, you’re not alone.

The ideal nose varies from face to face depending on skin type, ethnic background, age, and other variables. During your initial cosmetic consultation, our physician will discuss your concerns about your nose, your expectations, and explain the probable outcome of your procedure.

We may show you several before and after treatment photographs of patients having similar noses, and we will explain the treatment you can expect to receive. Before and after photos may be taken of your nose to document your results.

Other considerations with nose surgery

Before making the decision to have a rhinoplasty, ask our surgeon if there are any additional facial procedures that may enhance the effects of your nose surgery. Many patients elect to have chin implants or cheek augmentation to enhance and balance their facial features.

The nose surgery procedure

Rhinoplasty is the reshaping of the nose. It can be performed on an outpatient basis under local or general anesthesia, but it is one of the procedures that probably benefits from having general anesthesia. The procedure usually takes up to 3 hours depending upon the complexity of the nose revision. Most incisions are made inside the nose, where they are invisible. The skin and tissues of the nose along with the underlying bone and cartilage are sculpted by the surgeon to your desired new shape.

If your nose is too large, for example, your surgeon may sculpt away cartilage and possibly bone to reduce its size. Noses that point up or droop down can be redirected by trimming the septum which divides the two nasal passages. Sometimes the contour can be improved by adding tissue.

 

What about insurance for nose surgery?

Breathing problems are common even in younger people. Correcting problems that interfere with your breathing may be covered by your health insurance. However, when a rhinoplasty is performed for cosmetic reasons, it may not be covered, in part or in whole, by your health insurance. It is the patient’s responsibility to check with their insurance provider for information on the degree of coverage. We will be happy to answer any questions you have regarding payment.

What will my recovery from nose surgery be like?

After a rhinoplasty, patients are up and active within 2 days. You may wear a small splint over your nose to protect it and keep it stable for a week or so. Your nose and head will probably ache and your face will feel puffy. This discomfort can be alleviated with medication prescribed by your surgeon. After about 3 days, the swelling and bruising around your eyes will begin to subside. It should be almost completely gone in about 2 weeks. Cold compresses applied to the area will help reduce the swelling.

Some bleeding is common the first few days after surgery, along with some stuffiness that could last a few weeks. It is recommended that you not blow your nose during the first week while the tissues are healing. After 7-10 days all dressings, splints, and sutures should be removed and you can return to a normal life. Strenuous activities, rubbing or bumping your nose should be avoided for several more weeks.

Otoplasty

For some, protruding ears can be a cause for embarrassment. Many say that large or protruding “bat ears” can lead to a lack of self-confidence.

Many children experience teasing and being bullied for their ears and may have lower self-esteem and self-confidence. This can also lead a child to misbehave or become introverted. An otoplasty for patients creates a more pleasing size and shape for protruding ears.

Otoplasty

Studies have shown that the emotional benefits from an Otoplasty procedure include:

  • Immediate increased confidence
  • Immediate increase in self esteem
  • Negative attention ceases

How long does Ear Surgery take?

Most Otoplasty procedures are performed in 1-2 hours.

Otoplasty or ear reshaping is performed on an outpatient basis with local anesthesia with sedation or with a general anesthetic, and general anesthesia is usually used for children so they don’t feel any pain or anxiety.

An Otoplasty is performed by making a small incision at the back of the ear to reveal the ear cartilage, and then the surgeon reshapes the cartilage inside the ear. Stitches will hold the patient’s ears back; thus the term “ear pinning”. The marks from the incision are naturally hidden within the crease or area behind the ear.

Ear surgery recovery period

Once the stitches have closed the incisions, a soft bandage or head wrap will be wrapped over the ears and around the head to keep them in the desired position and protect them until they heal. The bandages will be removed in a week or so along with the stitches. The shape of your new ears will be visible immediately.

Brow Lift

Your forehead skin can stretch and droop with time, lowering your eyebrows. Often we use our muscles to elevate our eyebrows thus forming wrinkles in the folded skin. Squinting to reduce the sunlight can also lead to frown lines. Early in the process, Botox helps to smooth out these wrinkles. Later, as the Botox relaxes your muscles, it leaves you with so much extra skin that you can hardly open your eyes and see well.

This problem can be remedied with a forehead lift or eyebrow lift that remove skin and smooth out the wrinkles and elevate the heavy lids. The result is a younger, friendlier appearance and more young looking eyes.

Happily, a browlift can be performed alone or with other cosmetic procedures such as a facelift, eyelid surgery or laser skin resurfacing or even breast or body surgery.

Cosmetic surgery used to be for the over fifty crowd. Years ago patients waited until they saw wrinkles everywhere and then asked for “the works.” Their results were dramatic, but unfortunately, everyone could tell they just had had surgery. Today, nearly one-third of those seeking facial rejuvenation surgeries are between 35 and 50 years old in the early stages of aging and often the first aging repair surgery is to their eyelids.

Browlift or Forehead Lift Procedure

A browlift can be performed as an outpatient procedure under local anesthesia with deep sedation, or general anesthesia, and may take 1 – 2 hours. With the classical or “open” method the incision is hidden just inside or by the hairline across the scalp and between the ears as a continuation of a facelift incision. . If you have a particularly high hairline, incision might be made immediately in front of your hairline so that your facial balance is improved and your hairline is not made even higher.

Your surgeon may lessen the appearance of wrinkles by removing selected muscles and releasing the tissues which contribute to the wrinkles. The eyebrows may also be elevated, and excess skin at the incision will be removed to allow a gentle redraping of your forehead skin. If you’re a male with a receding hairline, surgery may be made through your eyelids or immediately above your eyelids to anchor the brow tissues at a higher position.

Endoscopic Browlift Procedure

Endoscopic or minimal-scar browlift is performed using a tiny fiberoptic lens inserted through half-inch incisions placed above the hairline. The lens is attached to a camera, which is connected to a television allowing the surgeon to visualize the surgery. Additional half-inch incisions are made for the insertion of his tiny instruments. Your surgeon performs the procedure while viewing the television monitor and manipulating the instruments.

This endoscopic browlift is particularly useful with younger patients where the removal of excess skin is not required. With an endoscopic browlift, loss of sensation or hair at the incision site is minimized. Because an endoscopic browlift can significantly reduce the frown lines between the eyes, it is often performed with upper eyelid surgery to achieve the best results.

What are the benefits of Endoscopic Browlift Surgery?

  • Smaller incisions
  • Minimal scarring
  • Less bleeding
  • Less hair loss
  • Minimal numbness
  • Quicker recovery

What will your Browlift surgery recovery be like?

After a browlift, there is a minimal amount of discomfort. However, there may be swelling and bruising that could last from 7 – 10 days. For some patients the swelling may involve the cheeks and eyelids. Keeping your head elevated and applying cold compresses will help to reduce your swelling. As your incisions heal, you will notice some itching and possibly some numbness. These symptoms will diminish over time.  Numbness behind the incision may be present with some of the browlift procedures and is generally temporary.  Happily, if necessary, you may wear make-up over the incisions after they are healed. Your sutures will be removed in 7 – 10 days. Strenuous activity is restricted for 3 weeks to reduce the chance of bleeding.

Miniface Lift

Not long ago, a facelift was the principal means used to restore a youthful appearance to one’s face but today there are other options including a minifacelift, fat augmentation, laser resurfacing,. Etc.

Back then, facial surgery was considered reserved for the rich and the famous. However, recent studies have shown that there is a direct correlation between looks and higher pay and social acceptance. Maybe that’s one of the reasons why we find that younger and younger patients, including men are requesting cosmetic surgery.

A minifacelift is performed to lift sagging cheeks, smooth out nasal furrows, pull up the corners of your lips and tighten the upper part of your neck.

Is a minifacelift for me?

The minifacelift procedure is particularly useful for patients with sagging cheeks, deeper nasal furrows and early laxity of the upper part of the neck and under the chin. During your initial cosmetic consultation, our physician will discuss your goals for the surgery and explain your probable outcome of treatment. If you have excess skin in the lower part of your neck, a facelift would be a better procedure for you than a mini facelift. You may be shown several before and after treatment photographs of patients having similar conditions, and doctor will explain the treatment you can expect to receive. Before and after photos may be taken of your area to be treated to document your results.

The minifacelift procedure

A midface lift can be performed as an outpatient procedure under local anesthesia with sedation or general anesthesia and may take several hours. A minifacelift is performed very much like a facelift except that the incision behind the ear is not carried down the hairline or within the hairline behind the year. The undermining of the neck skin is less with the minifacelift Also, and the area under the chin may need to be added to the procedure. The major difference from a facelift is that the redundant skin of the lower part of the neck is not tightened in the same manner.

What will recovery be like from my minifacelift?

After a minifacelift, there is a minimal amount of discomfort similar to having a full facelift. Dressings around your face and upper neck are usually present from the 1st night. Just as with a facelift. It is not unusual for a patient to return to work the next day after a minifacelift or a facelift. There will be some swelling and bruising that may last from 7 – 12 days. Keeping your head elevated and application of cold compresses will help to reduce swelling. As your incisions heal, you will notice some itching and possibly some numbness. These symptoms will diminish over time. You may wear make-up immediately on areas other than your incisions, and your sutures will be removed in 9 – 10 days. Strenuous activity is restricted for 3 weeks.

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