Facial Cosmetic Surgery

BOTOX® Cosmetic

BOTOX® Cosmetic treatment is a revolutionary approach to reversing the affects of facial wrinkles. Crow’s feet, worry lines, and laugh lines can all be a thing of the past. These are referred to as dynamic wrinkle lines and all are treatable with this procedure. Cosmetic denervation is the process of injecting BOTOX® Cosmetic into the tiny facial muscles that create the wrinkles.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes is made in order to decide the most effective injection sites. All issues and concerns will be discussed.

The areas that will be treated are marked and digital photographs are taken in order to determine the amount of improvement after surgery.

The BOTOX® Cosmetic Procedure

BOTOX® Cosmetic injections are performed without anesthesia because they are virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long-term use of the injections leads to a longer duration of each treatment’s effect. Patients over the age of 65 may not experience such dramatic results. BOTOX® Cosmetic is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

Restylane®, Perlane®, Juvaderm® injectable Facial Fillers

Injectable Fillers are used to fill out wrinkles and depressions. Aging can cause the face to “hollow out” giving a wrinkled older look. Injectable fillers are used to plump” out deep laugh lines, wrinkles, or even cheekbones. They can be used to augment the lips, chin, and give volume where it’s needed to the face. These injectables include but are not limited to Restylane, Perlane and Juvederm. To find out which one is right for you call for a consultation today.

Cosmetic injections are performed without anesthesia because they are virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long-term use of the injections leads to a longer duration of each treatment’s effect. Patients over the age of 65 may not experience such dramatic results.

Facial Liposuction

Facial liposuction is a very common and popular procedure. It is designed for the permanent removal of fatty tissue from your cheeks, chin, and neck. It is an elective procedure that allows the surgeon to remove undesirable, subcutaneous fat in specific areas that do not respond to diet and exercise.

Patients with good skin tone who have fatty deposits receive the best results from facial liposuction. It is not a treatment for obesity. If weight gain occurs following liposuction, the fat will be deposited in areas that have not been treated. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time. A variety of factors can affect the results: physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, and skin elasticity.

The Procedure

Facial liposuction is performed under general anesthesia on an outpatient basis in a hospital or surgical center. The surgeon makes small (less than 1/2 inch), discreet incisions in the face or neck. A cannula is inserted in a small incision and attached to a suction machine. The procedure may take an hour or more.

The results of liposuction are permanent. If you were to gain a large amount of weight, you might note rippling in the treated areas, depending on your skin elasticity.

Following liposuction, the scar will go through a maturation process. During the first eight to twelve weeks, they may be red and possibly raised. The scars will mature over six to twelve months and become pale, flat, and soft. You may experience numbness, burning, and/or tingling around the incision site. These symptoms are almost always temporary. Please let us know if you are prone to keloid scars.

Otoplasty

In cases of deformed or torn earlobes or ears, the procedure of otoplasty may be an option. Otoplasty is commonly referred to as cosmetically repairing of the ears. It is available for children or adults once their ears have stopped developing around the age of six. Deformed ears or earlobes may be a result of trauma or scarring to the ears or earlobes. Dr. Rutner is trained in several surgical procedures that eliminate the majority of the problems related to protruding or deformed ears.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your ears is made in order to take the most effective surgical approach. All issues such as shape and types of anesthesia used will be discussed.

Dr. Rutner will provide you with preoperative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection.

The areas that will be excised are marked and digital photographs are taken in order to document the amount of improvement after surgery.

Chemical Peels

Chemical peel is helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots. Pre-cancerous conditions such as keratoses (thick, rough, reddish growths) also respond well to this procedure.

There are several types of chemical peels:

  • Light peels to remove superficial wrinkles
  • Medium peels
  • Deep peels for more severe conditions.

After thoroughly cleansing the skin, a small applicator is used to apply the chemical solution to an area of the face. Excess solution is removed and the procedure is repeated on other areas.

The amount of improvement varies and depends upon the initial condition of the patient’s skin. Significant improvement of damaged skin has been achieved, which can produce dramatic results.

Skin Rejuvenation

A skin rejuvenation program is often used in conjunction with either chemical peels or laser wrinkle removal to reduce the fine wrinkles of the face, lighten areas of hyperpigmentation and produce a softer texture to the skin. The program can be accomplished separately or in conjunction with the other procedures listed here and is followed at home by the patient after a consultation and a treatment plan is established for the patient’s cosmetic needs. Our skin care department is dedicated to providing you with the latest and most effective skin treatments available.

We invite you to inquire about laser skin resurfacing and hope it can help you achieve smoother, fresher, younger-looking skin.

Eyelid Surgery (Blepharoplasty)

Eyes are a prominent facial feature. It is the surrounding skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes.

The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and older than we really are. These changes in appearance can cause emotional distress and sometimes even visual impairment. An eyelid lift, or blepharoplasty, is designed to restore a more youthful appearance to your eyes. It may involve the upper lids, the lower lids, or both.

New and Traditional Techniques

Traditional Blepharoplasty: An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed.

The Transconjunctival Approach: This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated.

Laser resurfacing of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not effect the fat around the eyes and may even accentuate it.

Please ask your doctor if you have any questions about which procedure is right for you.

The Surgery

Local anesthesia is given around the eyes. An intravenous line is started so that sedation may also be given. During the procedure you will be awake but comfortable and relaxed. General anesthesia is rarely used.

This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours.

Complications are unlikely when performed by a surgeon with experience in blepharoplasty. These include: bleeding and swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, double vision and dry eyes.