At NYHNI, emphasis is placed on minimally invasive techniques using instruments and procedures that lead to the least amount of damage to surrounding normal tissues, resulting in a faster and less complicated recovery. These techniques often allow office or same-day procedures, which means less expense and disruption of our patients' lives.
The following are just some of the more common aesthetic plastic surgery procedures we offer at the Center:
A rhinoplasty (nose straightening), often called a "nose job," is an operation performed through the nostrils to straighten and narrow the nose, open the nasal airways, restore normal nasal breathing, and if a hump on the bridge of the nose is present, it is reduced for a more straight profile. It is usually done as an outpatient under local anesthesia with sedation or general anesthesia.
Brow and forehead lift
A brow and forehead lift is done to literally lift and remove excess, sagging and wrinkled tissue of the forehead and eyebrows. The procedure results in the flattening of the wrinkles and furrows of the forehead and lifting of sagging eyebrows, restoring a more youthful appearance. Today, it is most often performed with a minimally invasive technique using a small fiberoptic telescope passed through very small incisions in the eyebrows or forehead behind the hairline. It may be done in the office or as an outpatient under either general or local anesthesia.
If an "open procedure" is to be performed through a larger incision in the scalp, the sagging skin of the forehead and eyebrow is raised up from the underlying tissues and tacked with sutures to the dense fibrous tissue under the skin at a higher position on the forehead. The excess skin that has been lifted is then removed and the edges of the skin sutured together within the hairline, thus hiding the incision. This results in the raising and flattening of the eyebrows and forehead.
Eyelid rejuvenation is performed on sagging upper lids and bags under the eyes. It is usually done through small incisions in the lash line or inside the eyelids. Excess skin of the upper lid is removed, making the upper lid appear more youthful. Removal of the bags of the lower eyelid is done by removing the fat pads around the eyeball itself that have bulged into the lower lid, creating the bag. At the same time, the excess skin over the fat pads is removed and the incision closed. It is usually performed in the office as an outpatient procedure under local anesthesia with a light sedative. It may be done under general anesthesia if the patient desires.
Other additional techniques may be performed at the same time as the excision of skin and excess fat detailed above. For instance, to treat "crow's feet" at the edges of the eyes, treatment of the skin with a laser may be done to cause contraction of the fibrous tissue under the skin, resulting in less apparent wrinkles. Another technique called dermabrasion may be added. In this procedure, a salt crystal or very fine sand is used to "sand out" the fine wrinkles by lessening their depth. Also, chemicals that result in a "skin peel" may be used to flatten wrinkles of the lids and surrounding the eyes.
Facial fat grafting
This procedure is done to "plump out" hollow cheeks that occur with aging. Fat is harvested, usually from another part of the body, and then placed into the cheek through a small incision on the inside of the cheek. It may also be done by harvesting fat with a needle and injecting it into the hollow area of the cheek. It is done in the office as an outpatient under local anesthesia.
A facelift (rhytidectomy) is an operation to remove wrinkles and tighten sagging facial skin, such as jowls under the jaw and sagging skin under the chin. Traditionally, it is done through one continuous incision that begins in front of the ear in the hairline, continuing directly in front of the ear where it attaches to the side of the head, going under the earlobe and around behind the ear, and finally ending up in the hairline behind and above the ear. The upper layer of the face is dissected free of underlying connective tissue and the entire face "lifted" above and behind the ears. The excess skin is cut off and the incision closed.
Today, with minimally invasive techniques, it can be done through small fiberoptic telescopes (endoscopes) using small incisions. It is usually performed under local anesthesia or general anesthesia depending on the patient's desires.
Facial rejuvenation is the use of a skin laser with or without skin abrasives that smooth the face to improve facial wrinkles (rhytids). The laser causes a superficial burn, so that when the skin heals the connective tissue beneath the skin tightens, thus flattening out the wrinkle. It may be done under local anesthesia or cream anesthesia applied before the procedure.
With dermabrasion (skin abrasives), there is only light "sanding" of the face to soften small wrinkles and superficial scars. Anesthesia is not needed. Often after surgery, an aesthetician will give the patient, under the surgeon's directions, creams that tighten the face and affect the deeper layers of the skin, slowing the wrinkling process.
Liposuction means removal of fat under the skin by suction. A hollow tube with a vent in the side (a liposuction wand) is connected to a high-pressure suction pump, and by moving the wand back and forth through the fat under the skin, the fat is sucked into the vent and removed by a sharpened portion of the vent. It may be done under local anesthesia as an office procedure or outpatient. Some patients desire general anesthesia for the procedure.
Chin and face implants
Chin and face implants are inert, in that they are man-made materials that have been shown over many years to be safe without interfering with surrounding tissues. The implants are introduced through incisions under the skin or inside the mouth. The cuts are made in front of the jaw below the chin to improve projection when the patient's chin is too far back in profile.
To achieve "high cheekbones," implants may be placed through incisions inside the cheek to increase the prominence of the cheekbones. The procedures are usually performed under local anesthesia or with light sedation.
Cosmetic ear surgery
This operation is done to correct ears that are too far from the head (lop ear deformity), which is a congenital (born with) condition. It is usually performed on children before they start school to prevent teasing from other children and damage to self-esteem. Also, ears may need to be repaired when earrings are torn out of the earlobe or other trauma to the ear occurs.
Botox and facial filler injections
Botox is a compound that causes paralysis of the muscles and is made by the bacteria that cause botulism or fatal food poisoning. Very small concentrations are injected into facial muscles next to a deep wrinkle, which paralyzes the muscles next to the wrinkle, making it appear less deep. It is particularly effective for "frown lines." The effect usually wears off in 12 to 18 months.
Filler injections are injections of inert, synthetic materials into wrinkles to fill them up, making them level with the surrounding skin. Both of these procedures are done in the office and usually do not require anesthesia.
Patients are urged to contact the Center with their particular questions.