The facelift as well as the facial rejuvenation procedures that are commonly performed alongside it such as eyelid surgery and brow lifts remain the only viable option to restore a youthful appearance to the lower face and neck. A facelift can tighten loose skin and muscle and remove or reposition excess fat to eliminate sagging. The most significant degree of improvement is usually seen in the jowls, lower face and neck. Reversal of facial aging is not achieved through surgical rearrangement of the deep tissues and skin excision alone.



Facelift procedures are constantly changing and the actual concept of facial rejuvenation has evolved to encompass more of a remodeling, not just pulling skin more taut. Facial shaping by removing, repositioning or adding soft tissue, rather than by tightening the skin and muscles alone, is considered the key to achieving optimal results in facial rejuvenation.

Facelift surgery can be performed under local anesthesia with sedation or general anesthesia. Your hair will be held back with rubber bands during surgery, but the hair does not need to be shaved. Traditional facelift incisions generally start above the hairline at the temples and continue along a line in front of the ear or just inside the cartilage at the front of the ear, behind the earlobe and back into the scalp.

Another small incision is often made under the chin to address the neck. We separate the skin from the underlying fat and muscle. The underlying muscle fascia is tightened along with the platysma muscle in the neck, and excess fat is removed. After the deep tissues are tightened, the excess skin is pulled up and back and then trimmed.

The incisions are closed with stitches and/or staples on the scalp. A dressing is applied to protect the entire area. Most people can return home after the surgery or stay in the hospital for the first night.

Rhinoplasty can be used to improve the way the nose looks in proportion with the other facial features, as well as functional problems including breathing obstructions and traumatic injuries. When we evaluate the nose, we will study both the frontal view and the profile in addition to the shape and projection of the chin, cheekbones, and upper lip.

We usually recommend that patients wait until they are at least age 16 and possibly older for boys, before undergoing rhinoplasty. The nose may not be fully developed at a younger age. Assuming you are in good health, there is no upper age limit for having your nose reshaped. With age, gravity and the diminishing supportive structures of the nose, the shape and position of the nose will ultimately change.

The nose may appear longer and the tip eventually droops, thus is not unusual to have nasal refinements done at the time of a facelift procedure or later in life. A simple elevation of the nasal tip may result in a younger and more attractive appearance. View before and after photos of rhinoplasty.

The most common aesthetic complaints regarding the nose are: the nose appears too large for your face, there is a bump on the nasal bridge, the profile is out of proportion, the nose seems too wide when viewed from the front, the tip droops downward, the tip is too thick, the nostrils are excessively flared, and the nose is crooked.

Modern rhinoplasty techniques allow us many more options for reshaping the nose. Some noses need to be lengthened, augmented, or narrowed for the best aesthetic result. A large portion of the rhinoplasties we perform today are revisionary operations to improve a previous surgical result.

The major limitations in terms of what you can expect as a result of a rhinoplasty procedure have to do with your skin type, skin thickness, the thickness and position of your nasal bones, as well as the skill of the surgeon you select. We will carefully review all your options at the time of your consultation.

Droopy eyelids or puffy lower eyelids often run in families, and are as common in men as in women. Protruding fatty tissue from your eye sockets that causes bags can be an inherited trait that shows up early in life, as well as the result of aging.

Eyelid skin thins and a stretch as it ages, becomes loose and with time, muscles weaken, and the fat that cushions the eyeball moves forward around the eyes. Puffiness results when a fat pad that cushions the eye begins to pull away from the bone of the lower eye and sags. Gravity has its effects on the eyes as well. Sagging upper eyelids may result in hooding where upper lids become heavier and fuller.

Blepharoplasty can reduce droopy or hooded eyelids, restore the contour to the lids and eliminate the protruding fat bags under the eyes. In some cases, eyelid surgery may also correct severe hooding of the upper eyelids called ptosis, which can obstruct peripheral vision and reduce the range of upward vision.

The procedure is usually performed under local anesthesia with intravenous sedation. The incision typically extends into the crow's feet where lines already exist. The most common methods of performing lower blepharoplasty are the traditional approach, sometimes called a skin-muscle flap, and the transconjunctival approach.

For the traditional approach, we make an incision adjacent to the lower lashes to be as inconspicuous as possible. We lift the skin and muscle to remove a small amount of fat. Excess skin and muscle are then trimmed from the lower lid. If you have a pocket of fat beneath your lower eyelids, but do not have any loose skin, a transconjunctival blepharoplasty may be used. This method utilizes an incision hidden inside the lower eyelid, which leaves no visible external scars.

Through this incision, the excess fat is trimmed. The incision is closed with self-dissolving sutures or it is left to heal on its own. A lid tightening procedure may also be performed at the same time if there is muscle laxity. The transconjunctival technique is commonly combined with resurfacing using lasers or chemical peels to tighten and smooth loose skin.

Tear troughs, or deep grooves that form when there is an obvious demarcation between the lower eyelid area and the cheeks can be improved by moving around fatty deposits, removing excess fat or replacing fat.

For upper eyelid blepharoplasty, we make an elliptical incision across the eyelid crease, in the natural skin fold. Surgeons draw a line to identify the lower edge of the skin to be excised, which will eventually become the scar that remains. Excess skin and fatty tissue are removed along with a thin strip of muscle to give the eyelid crease more definition.

The incision is closed with a single layer of sutures, usually hiding the scar within the natural fold of the upper eyelids. In some cases, a transconjunctival approach may be used for the upper eyelids as well. This procedure leaves no visible scar and a small amount of fat may be removed from the inside of the upper eyelid.