Insider's Guide To Facial Plastic SurgeryChapter X

Facial Reconstruction FAQs

Who is a candidate for reconstruction after skin cancer removal?

Facial plastic surgeons are often asked to assist in the reconstruction to optimize the cosmetic result. Any patient who plans to undergo removal of a skin cancer on their face and is concerned about the appearance of the eventual scar is an excellent candidate for a reconstruction by a facial plastic surgeon.

Why is the choice of surgeon important for a facial reconstruction after skin cancer surgery?

Removal of facial skin cancers can sometimes lead to very large and complex defects. These can affect the function of facial structures such as the lips, eyes, and nose. Reconstructing these surgical defects takes a significant amount of skill. Dr. Corrado is a board certified facial plastic surgeon and has extensive experience reconstructing these defects.

Where are facial reconstruction procedures performed?

Small defects can be reconstructed under local anesthesia in our office surgical suite. More extensive defects are reconstructed under IV sedation in an outpatient surgery center. The most advanced cases will sometimes require treatment by a specialized team, and are performed in a hospital setting.

What is the length of the procedure?

The time of surgery can vary significantly, depending on the extent of the defect.

How is facial reconstruction performed?

Dr. Corrado utilizes a number of different techniques to reconstruct facial defects. He will sometimes use a local flap, in which he uses skin next to the defect for coverage. This involves carefully placed incisions to help move the skin over the defect. At times, a skin graft is used to cover the defect. This graft is taken from the skin around the ear or at the base of the neck. For very complex defects on the nose, multiple surgeries may be necessary.

What is recovery like after facial reconstruction?

Recovery typically takes less than one week. Bandages are removed after one to two days, and sutures are removed within one week. Discomfort is usually easily controlled with medication. While final scar maturation can take up to one year, the incisions should look well healed within two to three weeks. For most patients, we recommend the use of a medical-grade scar cream to allow for the most aesthetically pleasing results. Patients should also apply sunscreen while outdoors to optimize the appearance of the scar.

Facelift FAQs

How Long Until the swelling goes down after a Face Lift?

I usually tell patients that by 3 months after surgery most if not all swelling will be resolved. Although, it is not uncommon for the patient to see subtle swelling or facial changes that my take more time to disappear.

Is it abnormal to feel tightness in my neck and face after a Facelift?

It is not uncommon for patients to initially experience some discomfort or tightness in the neck and face following facelift surgery. During a face/neck lift the underlying neck muscles (platysma) and SMAS are tightened. This tightening in conjunction with postoperative swelling can give you a “constricted feeling”. As time progresses, the swelling will resolve and these abnormal sensations will subside. Lastly, over time the neck and face will relax to a degree to also provide relief.

Can I fix a “turkey neck” with lasers or do I need a face/neck lift?

There are many lasers and radio frequency modalities which can provide minimal degrees of skin tightening, but none will help to tighten the neck dramatically, in cases of severe neck laxity. In cases of severe neck laxity a lower face/neck lift is needed. During this procedure the neck muscles can be tightened, excess fat can be removed by liposuction, and excess skin can also be removed.

If I have a facelift will I be left with terribly visible scars?

On the contrary, most good facelifts should not leave obvious scars. A skilled facial plastic surgeon can rejuvenate your face and neck using well hidden incisions, when closed with good surgical technique, will heal well enough that they should not be obvious. There is always a possibility that wound healing issues may exist, but this should be the exception not the norm. I suggest you seek out a skilled surgeon who performs many facelifts a year, and ask to see before and after pictures to see if results of postoperative healing are acceptable to you.

How long does it take for the bruising to go away after a facelift?

Each patient heals at varying rates after surgery. No two patients are a like. Typically bruising can take up to two weeks to resolve. I suggest certain medications such as Arnica Montana be given before and after surgery to lessen swelling and bruising. I also have my patients use topical Arnica Montana gel which can be applied to the bruised areas to hasten their resolution.

When is the best time to have a facelift, What is the best age?

I tell my patients that the correct time to have a facelift is “when the mirror tells you its time”. If you are unhappy with your appearance, and you have visited a qualified facial plastic surgeon who has found areas of your face that can benefit from surgical rejuvenation, then you are a good candidate. The advantage to correction at an earlier age is that most likely you will require less surgery to achieve your desired level of rejuvenation. This will equate into decreased downtime, decreased risk of complication, and usually decreased cost.

Why Do My Ears Appear to be “Pulled Down” and “Stuck” to my face after my facelift?

This description appears to be a “Pixie Ear” deformity which is regularly seen after excess tension is placed on the earlobe during closure of facelift incisions. During closure of a facelift, much attention is placed on the final position of the earlobe in order to prevent this abnormality. Care should be taken to prevent excess skin tension on the earlobe. This is one area that when not properly sutured can result in the “Pixie Ear” a tell tale sign of facelift. Revision procedures can be done to “reset” the position of the earlobe.

Plastic Surgery FAQs

I want to look a lot thinner; would liposuction work for me?

Liposuction has helped a lot of people over the years. Good candidates generally hold realistic expectations about the results of the procedure as well as a few basic qualities such as good skin elasticity and good overall health. Liposuction candidates should want the procedure to remove stubborn pockets of concentrated fat that are resistant to diet and exercise. Patients exhibiting poor skin quality such as cellulite should not consider liposuction as it can result in further irregularities. Liposuction is not intended for and should not be used as a substitute for a regular diet and exercise plan.

Can a forehead or brow lift make me look younger?

As time progresses, forehead wrinkles develop and the eyebrows begin to sag. Heaviness and sagging of the forehead or eyebrows can give you a tired and haggard appearance. Many Forehead and Browlift techniques seek to improve your looks by elevating the eyebrows to rejuvenate the eyes, improve hooding of the upper eyelids, and decrease the appearance of persistent forehead wrinkles. The result is you will look great!

Is a traditional facelift really worth it?

Long lasting elective cosmetic procedures are consistently among the most popular rejuvenation techniques, and for good reason. The plain and simple truth is: cosmetic procedures such as facelifts really work. Face and neck lifts are most commonly requested to correct features including sagging cheeks, jowls, and deeply creased facial folds and wrinkles, as well as excess neck fat and skin.

I have heard a lot about fat grafting; what exactly is it?

Facial fat grafting is a somewhat new technique that uses a three dimensional approach to make people look years younger. While many conventional facelifts involve the removal of sagging skin, this procedure involves adding volume of supporting facial structures. Looking older is a result of volume loss and sagging on a holistic level. Often times this aspect of facial aging is overlooked, but facial fat grafting can make you look a lot younger.

I don’t like my nose job; is there any way to fix it?

Yes there is and it is called a revision rhinoplasty. In most cases, a revision is done to a nose where a green surgeon has taken too much away from the nose or has failed to adequately build up the internal supporting structures. A revision rhinoplasty is then performed in order to fix the natural appearance of a previously failed nose job.

I have drooping eyelids that sometimes obscure my vision; is there anything I can do?

A procedure known as a blepharoplasty can correct the natural fatty deposits that surround the eye can also bulge from its normal position leading to upper eyelid puffiness and obstructed vision. The ultimate goal of a blepharoplasty is to remove excess skin and bulging fat in order to give the upper lid an unrestricted movement allowing the patient a considerably more refreshed appearance. An upper eyelid blepharoplasty can also accomplish a widening of visual fields by removing excessive upper eyelid skin that has partially blocked vision.

What are my options for skin resurfacing?

In 21st Century medicine, lasers have become one of the most effective tools for eliminating a wide array of wrinkles. The unique advantage that lasers have over other types of resurfacing methods is their ability to tighten the skin during the surgery. A successful laser treatment can help you look ten to twenty years younger, and the results can last for up to a decade.

My face has been severely affected by a traumatic injury, what can be done?

There are quite a few options for facial reconstruction following a traumatic event. Traumatic injuries, cancerous tumor removal, and other types of disfiguring events often lead patients to seek out facial reconstruction from a professional plastic surgeon. Many times, these types of procedures also involve correction of defects found on the surface of the skin, the facial soft tissues, or the underlying bone structure.

How do I get fuller, sexier lips?

There are as many techniques to lip augmentation surgery as there are unique patients. The methods of lip augmentation are specifically designed to reduce fine lines and wrinkles around your lips while plumping the look around your mouth. Lip augmentation is done using artificial injectable fillers or through a technique known as fat grafting. While synthetic fillers are most commonly used, fat augmentation through grafting provides an option for individuals seeking a more permanent result.

What can I do if I want to look great, but don’t have time for a full facelift treatment?

In this case, a mini-lift might be the answer. This procedure provides many patients with a more defined jaw line while also improving the appearance to the neck in order to achieve a smoother and slender appearance. The mini-lift generally enhances these facial areas with a decreased risk and stress than a traditional facelift. Recovery time is also reduced with a mini facelift, allowing patients with busy schedules to heal in less time compared to other types of cosmetic surgery.

I have developed a nasty scar from a previous injury, can I get rid of it somehow?

Absolutely! Scar revision is a specialty of many highly trained plastic surgeons. Treatment options to lessen the appearance of scars vary widely and are determined by severity as well as scar location. Scar revision treatment may include minimally invasive procedures, specialized surgical revision techniques, or basic topical treatments. The specific step taken to decrease the appearance of scars will largely depend on the nature of the scar itself.

My child has a deformed ear, can plastic surgery help?

Yes, and more often than not, these types of anatomical irregularities are a source of stress for adults, teens, and even children. Otoplasty, also known as ear reshaping is designed to correct these problems with the ears in both children and adults. This particular procedure aims to sculpt, position or proportion of the ear’s tissues and soft cartilage.

What are my non-surgical options to make me look younger?

These days, injectable fillers such as Juvederm have been approved as medical devices by the Food and Drug Administration (FDA). Most of these types of treatments are temporary as they are absorbed by the body. Some patients may require multiple injections to achieve a wrinkle-smoothing effect and lasts for up to six months without surgery.

Is there anything I can do to stop my spouse’s constant snoring?

Snoring can be cause by chronic nasal obstructions as a result of allergies, narrow nasal passages, and misaligned septal structures. The septum is the structure that partitions the nasal passages into the right and left sides and can cause breathing problems if it becomes misaligned, or deviated. A septoplasty is the procedure that can correct a deviated septum and result in a better night’s sleep for you and your spouse!