Facial Surgery

Rhinoplasty

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). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes.

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.

Surgeons use 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.

For a short time after surgery you may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.

Complications are rare and, when they occur are minor. These may include infection, nosebleed, or a reaction to the anesthesia.

Blepharoplasty

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 face lift and Botox® treatments to achieve these results.

The blepharoplasty procedure is usually performed in an office with local anesthesia and lasts 45 minutes to a few 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). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. Eyes can be sensitive to light and wind and may be slightly irritated for a short while; your surgeon may prescribe eye drops and cool compresses to counteract these discomforts.

Complications from the procedure are uncommon, but can 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.

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