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In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jawline slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look -- after surgery, some patients appear as much as ten or 15 years younger.
Facelifts are most often performed on people in their 40s-60s, although those in their 70s or 80s can have facelifts as well. If you feel as if your skin is starting to sag around the jowls, the forehead and generally "all over," if you look tired and physically exhausted and you, in fact, are NOT, a facelift may be right for you. The procedure can be combined with others (browlift, eyelid surgery, nose reshaping) for more dramatic results, or it can be restricted to the neck (necklift) if your problems center there. Patients who smoke, take medications or have certain medical conditions such as high blood pressure, blood clotting problems or the tendency to form excessive scars should discuss potential risks with Dr. Conkright.
During your consultation, Dr. Conkright will discuss whether a Facelift/Necklift is right for you.
Facelifts are usually outpatient procedures and may be performed in an office-based facility, surgery center or hospital, typically under local anesthesia combined with a sedative. The procedure itself varies depending on your facial structure (i.e. where the incisions are placed, whether one or both sides of the face are worked on at once, in which order the steps are performed).
In most facelifts, incisions are made from the temples down in front of the ears and back behind the earlobe to the lower scalp. Dr. Conkright lifts the skin, suctions fat, tightens muscle, trims excess skin and then stitches the incisions closed. In some instances, the deeper tissues may also need to be repositioned to restore a more youthful contour to your face. If necessary, a small incision beneath your chin permits the removal or fat and smoothing of the cord-like structures in your neck. Sometimes metal clips are also used to hold incisions firmly closed on the scalp, and bandages are often wrapped around the head to reduce bruising or swelling.
There are many variations to the facelift procedure and the placement of incisions. The goal of every facelift technique is to keep the incisions hidden as much as possible. Following surgery, scars will be concealed by your hair or with makeup.
Patients may temporarily need a thin surgical drainage tube which is placed behind the ear. Any numbness, bruising, or thinned hair around the scar will fade in a few weeks; bandages, stitches and clips are removed within a day to a week. Most patients are back on their feet in a day or two, although the face may appear distorted and feel stiff, and many return to work within 10 to 14 days. At first you should be gentle with your skin and hair, and men may need to shave behind the neck and ears where areas of beard-growing skin have moved.
After facelift surgery, you will experience temporary skin discoloration and some tightness or numbness in your face and neck. Your skin will remain somewhat sensitive for a few months. Protection from the sun, including daily use of a sun block is essential. You can wear cosmetics after a few days and patients often are back to work within a week.
Some scarring is necessary, usually hidden in the hairline, behind the ears or under the jaw line. The surgery is individual to your needs and Dr. Conkright can discuss with you the techniques that he uses.
Results of a facelift do not last forever; you may want to have another procedure in five or ten years. But in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.
Possible side effects include, but are not limited to: temporary bruising, swelling, numbness and tenderness of skin; tight feeling; and dry skin. For men, a permanent need to shave behind ears, where beard-growing skin is repositioned, may occur.
Complications are rare but may include hematoma, temporary or permanent nerve injury, infection, and allergic reactions to anesthesia.
Several factors such as aging, sun damage, smoking, stretching and obesity can cause the eyelids to droop and sag as the supporting tissues deteriorate. This area is often one of the first to deteriorate, as the skin of the eyelid is thinner than the rest of the face. Eyelids that droop or bulge can cause people to appear much older or fatigued than they actually are.
By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes, but the procedure can be combined with others such as a facelift and Botox® treatments to achieve these results.
The best candidates for blepharoplasty are individuals who are in good overall health, and do not smoke or have any serious eye conditions. If you have loose, sagging skin or puffy bags around your eyes, this procedure can help reduce these unwanted effects and leave the eyes looking young and fresh.
It is important for patients to have realistic expectations before undergoing surgery in order to be satisfied with their results. While this procedure can enhance your appearance and may improve self-confidence as a result, it cannot alter your entire appearance or change the structure of your face.
During a scheduled consultation, Dr. Conkright will determine whether you are a qualified candidate for Blepharoplasty/Eye Lid surgery.
The procedure is usually performed in the doctor’s office with local anesthesia, and lasts one to three hours, depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). Dr. Conkright removes fat and loose skin from your upper eyelid area through an incision that is hidden within the natural eyelid fold. The incision extends slightly beyond the outside corner or your eye where it easily blends into existing laugh lines or other creases. If your upper eyelid problem is aggravated by sagging at your eyebrows, then Dr. Conkright may recommend a brow lift.
Treatment of the lower eyelids often requires an incision that is hidden just below your lower lashes. Through this incision, excess skin, muscle and fat are removed or adjusted; sometimes fat may be repositioned to eliminate puffiness or bulges. If your lower eyelid is not excessive, Dr. Conkright may decide to use a different technique that removes fat through an incision placed inside the lid. A laser is sometimes used, if necessary, to resurface the lower eyelid skin and to achieve a small degree of skin tightening.
Eyelid surgery is often performed along with a facelift or other facial rejuvenation procedures. Some people have inherited traits that cause them to have eyelid surgery as early as their 20s or 30s.
After surgery, patients can expect some swelling that may persist for a week or longer. Your vision may be somewhat blurry for a few days, and you will want to wear dark glasses to protect your eyes from wind and sun. Your stitches are normally removed within 3 to 7 days of the procedure. The removal process may sting a little bit as the tight, fine sutures are very small and require very fine tweezers and scissors for removal. Eyes can be sensitive to light and wind and may be slightly irritated for a short while. Dr. Conkright may prescribe eye drops and cool compresses to counteract these discomforts. Within a week, you can wear makeup to conceal any remaining discoloration. You should be back to work within 7 to 10 days.
Results of a blepharoplasty procedure are visible as swelling and bruising subside, and will continue to improve for up to a year after surgery. This procedure is designed to produce long-lasting results. While surgery cannot prevent your eyes from aging, most patients are satisfied with their results and do not seek repeat procedures. The scars from the blepharoplasty procedure are usually well concealed and will fade with time until they are virtually unnoticeable. The incision is hidden in the crease of the eyelid in an upper blepharoplasty, and just below the lashes in a lower blepharoplasty.
Complications from the procedure are uncommon, but may include: infection, reaction to anesthesia, double or blurred vision for a few days, temporary swelling of the eyelids, tiny whiteheads and difficulty closing eyes when going to sleep. Uneven healing and scarring, and ectropion (pulling down of the lower lids) are very rare and may require surgical correction. Patients with thyroid problems, dry eye, high blood pressure, diabetes, detached retina, glaucoma or other health problems should consult with an ophthalmologist about eligibility.
Browlifts can revitalize drooping or lined foreheads, helping you to look less angry, sad or tired. Some people have inherited traits that cause them to have a brow lift as early as their 20s and 30s.
Using either traditional or minimally invasive (endoscopic) methods, browlifts involve the removal or alteration of the muscles above the eyes to smooth lines and raise the eyebrows for a more youthful appearance. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.
While browlifts are typically performed on patients aged 40-60 to counteract the effects of aging, anyone with lined or inelastic skin on the forehead – whether it’s caused by muscle activity or inherited conditions – is eligible.
The procedure is usually performed in an office-based facility or surgery center under local anesthesia and sedation. After the hair is tied as with the traditional procedure, the surgeon makes three to five short incisions (less than an inch long) behind the hairline. The endoscope is placed in one of these incisions so that Dr. Conkright can see beneath the skin without having to make a large incision, while he lifts the skin and adjusts muscles through the other incisions. If the eyebrows are lifted, they will be stitched or screwed (temporarily) into place. The site is washed and the rubber bands are removed. Dr. Conkright will protect the stitches with gauze or bandages.
After surgery, you will have temporary puffiness and discoloration that may involve your eyelid and cheek areas as well. You may experience numbness and itchiness of your scalp. Most patients will be on their feet and able to wash their hair in a day or two, and many patients return to work or school in 7-10 days or less. Swelling and bruising should fade by the third week. Dr. Conkright asks all Endoscopic Browlift patients to avoid strenuous activity for several weeks. Most patients experience a full recovery from bruising within 2 to 3 weeks. Dr. Conkright also requires that patients limit sun exposure for several months
Complications are rare and usually minor but may include temporary numbness, nerve injury, hair loss along scar edges, formation of a broad scar requiring surgical correction, and infection and bleeding.
Laser skin resurfacing, commonly called a laser peel, removes the damaged outer layer of skin to reveal a smoother, younger look. Laser resurfacing can reduce the appearance of sun damage, wrinkles, fine lines, uneven pigmentation and superficial scarring, usually on the face.
A carbon dioxide (CO2) laser beam of precisely focused light vaporizes the skin surface and reveals the undamaged layer beneath. Procedure time varies depending on the size and condition of the area being treated. The procedure is usually an outpatient surgery, unless combined with other surgical procedures that require hospitalization, which is performed under local anesthesia with IV sedation or general anesthesia. The procedure length can vary from 30 minutes to two hours, and some patients may require more than one session.
The best candidates for Laser Skin Resurfacing are generally patients with fair-to-medium complexions and general good health. During your consultation, Dr. Conkright will discuss whether or not Laser Skin Resurfacing is right for you.
Most patients return to work within 10 to 14 days. Dr. Conkright asks patients to avoid strenuous activities for 4 to 6 weeks. Most patients experience complete fading of redness with in six months or less. Return of pigmentation may take between six to 12 months. Dr. Conkright requires limited sun exposure for six to 12 months
Possible side effects include: temporary swelling, discomfort, lightening of treated skin, acute sun sensitivity, increased sensitivity to makeup, and pinkness or redness in skin that may persist up to six months.
Risks include: burns or injuries caused by laser heat, scarring, abnormal changes in skin color, flare-up of viral infections (“cold sores”) and in some rare cases, other types of skin infections.
The results of Laser Skin Resurfacing are long-lasting, but the procedures does not stop the aging process. New wrinkles and expression lines may form as the skin ages.
The goal of rhinoplasty is to reshape your nose so that it compliments you other facial features. One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt).
The earliest recommended age for rhinoplasty is the mid-teens, when the nose is near full development. The best candidates for rhinoplasty are generally in good health, do not smoke, and have realistic goals for the procedure. As long as you are in good health, there is no upper age limit for nose reshaping.
Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done. Dr. Conkright uses one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery; or across the columella (the vertical strip of tissue separating the nostrils) in an "open" procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed. The resulting scars fade and ultimately should be barely visible.
Your nose can be reduced or built up by adjusting its supporting structures. This is done by either removing or adding bone and cartilage. Your skin and soft tissues will assume their new shape over this “scaffolding”.
If you have breathing problems because of irregularity in the internal structures of your nose, adjustments can be made to improve your nasal airway. This can be done at the same time as alterations to the external appearance of your nose.
After surgery, some discomfort, swelling and bruising can be expected. You may be instructed to wear a nasal dressing for a week or longer. You can begin wearing cosmetics as soon as it is removed. Your routine will be severely restricted for only a day or two, but it will be a few weeks before you can resume bending, lifting, and exercise. As long as your job does not involve activities that raise your blood pressure, you should be able to return to work within 10 days. Minor swelling of your nose may persist up to a year, but most likely this will not be noticeable to others.
Many patients complain of runny noses after rhinoplasty surgery--some over two years after their procedure. Most of the excess mucous production ceases after nine months, but can continue well after that. For now Dr. Conkright can only advise you to carry more Kleenex, around as it may persist for several more months.
Possible side effects include: temporary swelling, bruising around eyes, nose and headaches and some bleeding and stiffness.
Complications are rare and, when they occur, minor. These may include infection, nosebleed, reaction to the anesthesia and small burst blood vessels resulting in tiny, permanent red spots.
Otoplasty can improve the shape or positioning of your ears. It also can reduce the size of your ears if they are large in proportion to your other features. Surgery may also be helpful for "lop ear," "cupped ear" and "shell ear," large or stretched earlobes, and lobes with creases and wrinkles. If your ears protrude more than normal, surgery can reposition them closer to your head.
Candidates for Otoplasty may be anyone who feels self-conscious about their ears and wants to improve their appearance. Ear surgery often is recommended for children as they near total ear development at age five or six. Correction of the ears prior to the child entering school helps to eliminate potential psychological trauma from the teasing of classmates. Adults may also have their ears reshaped.
It is also important that you are in good general health and have realistic expectations about the outcome of the procedure. Discuss your goals of Otoplasty with Dr. Conkright so that you can achieve the results you desire.
The procedure lasts from two to three hours and may be performed in a hospital, office-based facility or an outpatient surgery center under general or local anesthesia. The supporting tissue of the ears, called cartilage, is reshaped in order to position your ears closer to your head. This usually is accomplished through incisions placed behind your ears. Subsequent scars will be concealed in the natural skin crease.
After surgery, you may be instructed to wear a gauze dressing or bandage for a few days or up to several weeks to ensure that your ears heal in their new, corrected position. You will need to avoid strenuous exercise and contact sports for several weeks. You can resume most non-strenuous activities within a week and most patients return to work or school within five to seven days.
Possible risks include: infection of cartilage, excessive scarring, blood clots that may need to be drained, mismatched or artificial-looking ears, and recurrence of the protrusion requiring repeat surgery.