Cosmetic Surgery

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 because of the presence of wrinkles at rest. BOTOX® Cosmetic is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

POST-PROCEDURE INFORMATION

After the injection, patients may experience slight bruising around the area that should fade quickly. Normal activities can be performed immediately. Possible side effects are headache, bruising, temporary weakness of nearby muscles or in rare cases, an eyelid may droop. BOTOX® Cosmetic is completely reversible so any side effect is only a temporary condition. The doctor will explain all risks associated at the time of your consultation.

Many factors cause the skin to wrinkle and sag; i.e., exposure to the sun, genetics as well as the natural aging process. Children and young adults have smooth, round faces due to fatty tissue that is evenly distributed throughout the contours of the face. As you age the skin sags and fits more loosely forming folds. These folds become prominent, especially around the chin, the jaw line, and along the neck.

Dr. DiPasquale performs rhytidectomies, or facelifts, to enhance your appearance and correct these conditions. A facelift involves tightening of the facial and neck muscles as well as the removal of any excess skin. The procedure is often performed in conjunction with additional cosmetic surgeries such as blepharoplasty (eyelid surgery), forehead lift, chin augmentation, liposuction, and/or rhinoplasty (nasal surgery). These procedures can be performed any time after signs of aging appear in order to attain a more youthful appearance.

Before surgery

Your medical history will be evaluated in order to determine your overall health. Dr. DiPasquale will discuss with you what you can expect from surgery. The objective is to create a natural appearance that is pleasing to you. Photographs are taken to determine the amount of improvement after surgery.

Preoperative instructions will be provided to you. Specific drugs containing aspirin may be eliminated several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection. You may be instructed to shampoo your hair the night before surgery.

Surgery

A rhytidectomy can be performed under IV Sedation or general anesthesia in an outpatient surgical facility. These options will be discussed in detail with you.  Incisions are made inside the hairline at the temple, running in front of the ear then around the earlobe and behind the ear, ending in the hair of the scalp. The loose skin is separated from underlying tissue and is pulled up and back. Excess skin is removed. Sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck. Small sutures are used to close the incisions. The procedure may take up to five hours depending on whether any other procedures are performed at the same time.

Postoperative Care

It is recommended that you stay for several hours after surgery in the recovery care center to receive specialized care from the nursing staff. Bandages are applied to the area of surgery and are removed within a few days. Pain is moderate and controlled with oral medications. Your sutures are removed within the first 5 to 10 days. In order to minimize scarring, the doctor may remove the sutures in stages. Scarring fades quickly. Swelling and discoloration decrease within two weeks. Tightness in your face will be present for several weeks and there may be slight changes in your hair pattern around the incision.

It is recommended that you avoid the sun for several weeks after surgery. Healing is gradual so you will not notice final results for up to 6 months. Improvement varies, depending on the your initial condition. In most cases, a single procedure achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.

As we all know, the eyes are a prominent facial feature. Although the eyes are expressionless structures, the surrounding skin conveys emotion. The tissue, muscle, fat, hair, and lashes all contribute to the wide array of expressions. Unfortunately, wrinkles and deep lines as well as puffiness under the lids develop as you age. In addition, exposure to the sun and hereditary factors contribute to the aging process, resulting in changes of expression. In many cases, people may look fatigued, worn out and older than their true age. Beyond possible visual impairment, these changes in your appearance can cause stress and anxiety.

Dr. DiPasauale is trained in several surgical procedures, such as blepharoplasty, forehead lift, and brow lift in order to eliminate the majority of these problems.

Before surgery

To better understand your overall health, an evaluation of your medical history will be made prior to surgery. In addition, a complete examination of your eyes and face are made in order to take the most effective surgical approach. The amount, distribution, and type of excess skin to be removed are carefully reviewed.

Dr. DiPasquale 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.

A blepharoplasty is used to correct sagging eyelids, bags or pouches beneath the eyes, as well as excess folds around the eyes. This surgical procedure involves the removal of excess skin and fat on upper and lower eyelids and is often performed in conjunction with other surgical procedures including facelifts, eyebrow and forehead lifts. Blepharoplasty can be done under general anesthesia (with you asleep) or under IV sedation. Both are very comfortable options. Pre-medication is utilized prior to surgery to decrease swelling after the operation.

Dr. DiPasquale will trace the natural lines and creases of your face and make incredibly fine incisions from the inner to the outer edge of the eyelid. Surgery on the upper eyelid is performed first with the incision made in the fold of the lid. The incision is made below the eyelash on the lower eyelid. Some cases will allow for the incision to be made inside the eyelid with the laser; therefore, no visible scar is created. Any excess fat and skin are removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is applied to the area. Small sutures are used to close the incision and special ointments and dressings may be applied. The surgery can take up to 2 hours. In certain cases, lower eyelid incisions are made inside the lid. A laser may be used at the same time to reduce wrinkles.

Postoperative information

Initially, drying of the eyes can occur after blepharoplasty. This condition can be alleviated with medication. In addition, you may be sensitive to bright light and wind for a period of time. Numbness and itching may also occur during the healing process. A final evaluation may occur within several months from the initial surgical procedure.

Dr. DiPasquale performs brow and forehead lifts to raise eyebrows and reduce ridges and furrows on the forehead, creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries.

Newer techniques allow for minimally invasive forehead lifting through small incisions in the scalp by using an endoscope and specialized instruments. This accelerates the healing process.

Post-operative information

Antibiotics may be prescribed for several days following surgery. Sutures are generally removed within one week. Swelling and some bruising may occur which should subside within a few weeks. Ice compresses and eye exercises are prescribed to reduce swelling and regain mobility. Women are not to use eye cosmetics up to two weeks after surgery. Normal daily activities can be resumed within 1 to 2 weeks. A final evaluation may occur within several months from the initial surgical procedure.

Facial liposuction is a very common, 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 done under general anesthesia or intravenous sedation on an outpatient basis in a hospital or surgical center. Small (less than 1/2 inch), discreet incisions are made 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.

Following liposuction, the scar will go through a maturation process – during the first 8-12 weeks they may be red and possibly raised. The scars will mature over 6-2 months and become pale, flat and soft. You may experience numbness, burning, tingling around the incision site. These symptoms are almost always temporary.

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.

The doctor should be advised if you are prone to keloid scars.

Dr. DiPasquale performs rhinoplasty in order to reshape the nose. Appearance can be improved for those people who are dissatisfied with the shape and size of their nose. Nasal reconstruction was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging, or reshaping bone or cartilage.

Reasons for surgery

Reasons include reducing the size of the nose, removal of bumps as well as improving the angle of a nose. Conditions may be natural or due to external trauma to the face. This operation will also help patients who have difficulty breathing. The procedure can be performed on all age groups, including teens and the elderly.

Before surgery

A medical history along with a careful examination is conducted in order to evaluate your general health. We will discuss with you the way your nose can look in relation to your other facial features. Digital photographs and computer imaging allow Dr. Griffin to evaluate the appropriate procedure to achieve the desired results. Pre-operative instructions may include eliminating certain drugs that contain aspirin to minimize the possibility of excess bleeding. Antibiotics may be prescribed before surgery to prevent infection.

Method of surgery

Surgery is usually performed under general anesthesia, which is more comfortable. In most cases involving a reduction in shape or size of the nose, angle or removal of a hump, the skin of the nose is separated from the underlying skeleton of bone and cartilage. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum may benefit by correction of this problem. The incisions are placed inside the nose, unless the surgeon uses an open approach, in which case the incisions are made across the columella (the tissue between the nostrils). In cases where the nostrils flare, the surgeon may make an incision at the junction between the nose and the skin of the upper lip to narrow the flared appearance. It is not unusual to combine rhinoplasty with chin augmentation to improve the profile.

Post-operative information

The recovery takes one to two weeks. Most people resume their normal activities within a week or two. Following surgery, a lightweight splint is applied to maintain the new shape of the nose. Nasal splints may be inserted at the time of surgery to protect the septum. These are removed within a week. There is always some stuffiness of the nose, especially when work has been done on the nasal septum.

Pain is minimal and is controlled with medications. Bruising occurs around the eyes and begins to fade within a few days. Discoloration usually disappears in two weeks.

Your insurance company may pay for all or part of the costs associated with your surgery if it is performed as a result of nasal obstruction. It is recommended that you check with your insurance carrier to determine if there is coverage.

In cases of protruding or over-developed ears, the procedure of otoplasty may be an option. Otoplasty is commonly referred to as “pinning back” the ears. It is available for children once their ears have stopped developing around the age of six. Over-developed ears can be the cause of psychological stress and trauma and should be treated at a young age before it becomes a serious issue. Dr. DiPasquale  is trained in surgical procedures to eliminate the majority of the problems related to protruding ears.

Before surgery

To better understand your overall health, evaluation of your medical history will be made 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. DiPasquale 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 procedure can be performed under IV sedation or general anesthesia and the doctor will discuss this option with you. The doctor has the option of either folding the cartilage located on the back of the ear or removing excess cartilage. Sutures are placed and bandages applied to speed the healing process. The procedure typically takes only a few hours.

Post-Operative Information

After the operation patients should expect bruising around the area that fades in 2 to 3 weeks. Pain associated with the procedure is minimal and can be easily treated with oral medication. The bandages are only needed for a few days and should be replaced with a lighter dressing. Refraining from sleeping on the ears is required and patients are advised to use a very soft pillow. Showering and shampooing may begin after a few days. Expect 2 to 3 days of recovery before normal activities can be performed. Consult with Dr. Griffin before attempting any athletic or precarious activities that may affect the healing process.

Chemical peels are 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 remove superficial wrinkles; medium peels and deep peels are 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.

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. The patient follows it at home 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.