Oral and Facial Surgery Facial Surgery

Eyelid Surgery (Blepharoplasty)

Eyelid surgery is often performed for eyes that look tired. The common complaints are of a hooded upper lid and a baggy lower lid; the desire is often to look more refreshed. The eyebrows also form an integral part of the eyelid appearance, as do the position of the eyelids in relation to the eyes (including the iris) and the bones around the eyes. All these are considered as part of eyelid surgery, and with so many different types of treatments to the eyelids, the consultation forms an integral part of the planning process for what will be best for you.

Eyelid surgery can usually be performed under local anaesthetic in the Centre, sedation can be provided if required.

Risks and Recovery Time

Successful eyelid surgery can make a big difference to the appearance of the eyes and surgery is usually very successful. It does, however, require a recovery period of around 1-4 weeks, depending on the exact procedure. Most surgery causes bruising and swelling of the eyelids which settles after a few weeks. Other, rarer, side-effects will be discussed with you at your consultation.

Nose Reshaping

A nose job can be performed with all the surgical incisions on the inside or with some on the skin; it can be performed with or without using cartilage or bone grafts; it can be performed for breathing difficulties and can also be performed completely non-surgically using injections of skin fillers to fill out some of the nose skin to hide minor imperfections in the nose.

Assessment of the Nose

Before you have a rhinoplasty, your surgeon will assess your nose. You will need to say what you would like to achieve and what you do not like about your nose. It is quite important to be very clear about this, because there is so much we can do on a nose, and being very specific is helpful to the surgeon. Your surgeon will ask you about your general health and whether you have any previous relevant issues with your nose (operations, injuries, breathing difficulties, and so on).

The examination involves looking at and feeling the nose internally and externally along with a breathing assessment. Your surgeon will also have a look at the skin of the nose and will assess the size and shape of the rest of your face. Most people are looking for a nose that is in harmony with their face. If, for example, the chin is too small, this may give the nose an apparently prominent appearance in the face. So, sometimes your surgeon may talk about other additional procedures.

Expected and Unexpected Results

Although the final results are not seen for at least a year after a rhinoplasty, there are some things we expect during the recovery and some things we hope not to see. We expect a change in the shape of the nose; we want this to be your expected outcome, but everyone needs to be realistic about the exact size and shape of the final result.

Most of the time we cannot give someone the ideal nose they have pictured in their mind as their perfect nose. We often aim for improvement rather than perfection. Sometimes, also, the nose needs a further operation to tweak the final results. Finally, your nose actually continues to grow throughout your life so it will change shape as the years go by.

There is, of course, a recovery period after a nose job and possible complications – these will be discussed fully with you by your surgeon.

Ears

Prominent ears can be a source of worry for both children and adults, and the operation to correct prominent ears is associated with high levels of satisfaction. The aim of the operation is to make it look as if the ears have not had any surgery on them; and also to make it look as if the ears do not need to have any surgery performed on them.

The ears are reshaped by making small incisions at the back of the ear. The cartilage (which makes up the framework of the ear) is resculpted and reshaped to create a more natural look. After closing the incision, a head bandage is placed on the area for a few days. The newer techniques for ear reshaping do not require a head bandage for 10 days and are not associated with some of the more devastating complications of ear reshaping. The effects are permanent and there are some risks associated with the operation which your surgeon will discuss with you.

More minor operations to the ear can be performed under local anaesthetic and these include ear lobe reduction and split earlobe repair.

Facelift

A facelift is a procedure to rejuvenate the face and give the person a younger fresher look. In the UK, we often want a result which will remove many of our wrinkles but, at the same time, avoid the windswept Hollywood look. Most people are looking for a natural and freshened look, rather than an extreme tightening of the face.

There are several different types of facelift and each varies according to what we do with the skin, and what we do with the underlying tissues (mainly the underlying muscles and fat pockets). In addition, facelifts vary in the parts of the face they address - the upper, middle or lower face (including the neck). At the same time, many people ask for their eyelids to look a little younger too (removing some of the hooding and bagginess), to make the eyes look less tired. Fat grafts, where fat is taken from one area and injected in to another, can also be done to restore fullness and volume.

With so many variations and requests available, the consultation is paramount in determining your wishes and relating these to your particular features. At your consultation, we will discuss the right facelift for you and also talk about any additional treatments that will be of help. We will individualise your treatment to your face and your requirements.

In the first few days after a facelift, there will be bruising and swelling. The amount depends on exactly what's been done. You may also have drains and dressings on the area to help reduce bruising and swelling. At around a week or two your stitches and clips are usually removed and this is when you start the second phase of the recovery. At this stage, you should start to see the results you were hoping for. The bruising and swelling will gradually subside and we begin to see more of the benefits of the procedure. You'll probably be quite aware of the changes in your face at this stage, so you might be more aware of minor areas of asymmetry and areas which have swollen differently from one side to the other. Your scars may also be red and swollen at this stage. As the months go by, you will see the final results of your facelift. Your skin will relax a little and some of the youthful swelling will be beginning to subside. Most of the temporary side effects will have gone by this stage, but if there are any permanent adverse effects from your lift they are unlikely to get much better. The surgeon will discuss all the possible side-effects with you.

Facelifts can be carried out under local anaesthesia and sedation in the Centre, or under general anaesthetic in a hospital.

Mini Lifts

If you prefer to have a more gentle procedure, with less recovery time, then you might be suitable for a mini lift. These can either be short scar facelifts with minimised bruising and swelling, such as the MACS lift, or can be ribbon lifts (Endotine Lift)

Mini lifts are less invasive and have quicker recovery times, but tend to last for a shorter time than full facelifts. Some endotine and mini facelifts can be performed under local anaesthetic but other mini lifts require an anaesthetist to help you with relaxation or sleeping during the procedure.

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