Facelift / Rhytidectomy
Blepharoplasty / Eyelid Surgery
Rhinoplasty / Nasal Surgery
Microfat Injections
Otoplasty / Ear Correction Surgery
Lip Enhancement
Botulinum Toxin (Botox)
Fillers

Facelift / Rhytidectomy

A facelift addresses the lower jowls and neck. A mid-facelift improves the upper cheek-bone (malar) area.

My “standard” facelift (rhytidectomy) involves skin excision and redraping and a limited shortening of the SMAS (a tissue layer over the facial muscles). I believe the best results come from concentrating on the finer details:

• Attention to concealing the scars
• attention to the ear position and occasionally reducing the earlobe size
• avoiding undue pulling on the mouth (the “face-lift look”)
• Staying well clear of the facial nerve branches
• Addressing the midline of the neck - this involves dealing with the platysma muscles in the neck and may be combined with conservative liposuction
• Microfat grafting - facial ageing involves loss of facial fat. For optimum results fat frequently needs to be replaced as part of a facelift.

Smoking causes a serious deficiency in blood supply to the tissues. It also causes thinning and wrinkling of the skin, poor wound healing, Vitamin deficiencies and increased risk of infections and other complications. If you smoke you risk losing areas of skin which will result in major scars. Therefore, I avoid facelifts in smokers and routinely do blood checks for traces of smoking in certain patients. I will only perform mini face-lifts in smokers. Should you be considering a facelift I would suggest that you quit smoking completely, start a healthy diet, consider vitamin supplements (especially Vitamin C which is deficient in smokers) and consult a cosmetic dermatologist. I require you not to smoke for a minimum of 6 weeks before and 4 weeks after surgery; but prefer 3 to 6 months of non-smoking.

Before facial surgery I suggest a six week course of a Vitamin A cream combined with a moisturizer.

Blepharoplasty/ Eyelid Surgery

Like the rest of the face, periorbital ageing involves a combination of fat volume loss (atrophy), loss of skin elasticity, thinning of the skin and descent of other tissue structures. Therefore, skin excision alone is often not enough.

Frequently, I like to combine skin excision with a canthopexy (tightening up of the lower lid) and carefully placed microfat grafts.

Depending on the pathology I will either leave an incision just beneath the lashes or within the eyelid itself.

Rhinoplasty/ Nasal Surgery

The nose is one of the central focal points of the face. Rhinoplasty requires an enjoyment of solving 3 dimensional puzzles involving many tissue planes and structures. It demands an in depth understanding of aesthetic and functional anatomy. There is little room for error. Every Rhinoplasty patient is a unique challenge

My Rhinoplasty Principles:

• Every individual facial feature needs to be considered when creating the correctly proportioned nose.
• Precise preoperative planning is the key to success.
• Ethnicity and patient desires are paramount.
• Where possible use only internal incisions.
• Seek to preserve or improve nasal function.

Microfat Injections

Fat loss in the face is one of the most telling signs of facial ageing. Microfat injection is a way of permanently returning volume and reshaping certain areas. The microfat grafts survive better than the traditional fat grafts. This results in less chance of overcorrection and fewer procedures. I will frequently combine face lift and blepharoplasty procedures with microfat grafting.

Otoplasty/ Ear Correction Surgery

My goal in correcting “Bat Ears” and other congenital ear conditions is to gain what is aesthetically the norm. Children whose looks deviate markedly from their peers are unfortunately exposed to ridicule. This can manifest as a lack of self-confidence and an unwillingness to participate in social activities. I operate on the cartilage framework through small incisions and incisions placed behind the ear.

Lip Enhancement

Voluptuous lips are extremely desirable. There is, however, a fine line between the perfect result and an obviously augmented lip. I recommend to my patients the following approach to lip enhancement.

First “try out” the shape and size you desire by using a filler to Augment your lips. The filler is reabsorbed over a period of 6 months to 2 years depending on the product used. I tend to “under-correct” and rather bring a patient back for additional minor adjustments.

Once a desirable result is obtained, I document the result with photographs and then later consider a permanent lip Augmentation with the use of microfat or dermofat grafts.

Botulinum Toxin (Botox)

I enjoy reshaping the face with the selective and judicious use of Botulinum Toxin.

While eliminating certain facial lines and wrinkles is one of the most desirable effects of its use, I think that the maximum benefit lies in balancing the brow and other facial structures and obtaining facial symmetry in a more youthful repose. Its use should be selected to those practitioners who have an absolute understanding of facial musculature and know how to treat complications and allergic reactions.

If there is any chance that you may be pregnant or are breastfeeding I will not treat you with Botulinum Toxin. There are several other contraindications in its use; these will be discussed with you in consultation.

I also use Botulinum Toxin to treat hyperhidrosis (excessive sweating) and in certain facial palsies.

Fillers

There are hundreds of fillers on the market. Incorrect choice of filler can have disastrous consequences. I only use approved fillers that have time and patient numbers behind their name. Like everything in cosmetic surgery; while occasionally you may pay a little extra for the best product, it is worth the decreased incidence of complications and usually ends up saving you money.