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3-D Animations of Face Procedures

Transcripts

Introduction

Eyelid Surgery Lower

Are your eyes still one of the most striking features on your face? Do they convey your actual emotions and inner vitality, or do they make you appear fatigued, sad, or older than you feel? Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. This animation describes lower eyelid blepharoplasty, which reduces the appearance of puffiness and bags underneath the eyes.

What Causes Eyelids to Change?

The skin on your lower eyelid is very thin, especially toward the center of your eye. A layer of muscle is located just beneath the eyelid skin and is separated from the fat by a thin tissue membrane, called the orbital septum. Muscle layers and the orbital septum weaken and sag with age and fat deposits shift in response to weakened tissues, causing puffiness and bags under the eyes. In addition, changes occur in the skin itself. The collagen and elastin that provide support to the skin break down over time, causing the skin to lose elasticity and become lax.

Procedure Variations

There are two variations of the procedure for removing or repositioning fat deposits from beneath the eyes: outside and inside lower eyelid surgery. For those who have excess skin beneath the eyes, the outside lower eyelift, also called transcutaneous lower blepharoplasty, is appropriate. This variation is performed with incisions on the outside of the lower eyelid and removes excess skin and sometimes muscle tissue in addition to fat deposits beneath the eyes. An inside lower eyelid lift, also called transconjunctival blepharoplasty, involves a single incision inside the eyelid in the thin membrane that lines the inside of the eyelid, called the conjunctiva. This procedure is appropriate for patients with fatty deposits and little or no excess skin in the lower eyelids.

Preparation

Lower eyelid surgery is most commonly performed under general anesthesia, which causes you to sleep during the procedure. Alternatively, you may be given local anesthesia with sedation, in which the eyelids and surrounding areas are numb and you are relaxed but may not be asleep. Protective, plastic shields, similar to contact lenses, may be applied to your eyes.

Outside Lower Eyelid Procedure

During an outside lower eyelid procedure, incision guidelines may be drawn just beneath the eyelashes of the lower eyelid to ensure that the resulting scar will be as inconspicuous as possible. Your surgeon will make an incision and expose the underlying muscle. Another small incision will be made in the muscle layer and the skin and muscle will be separated from the underlying orbital septum. Your surgeon will carefully open the orbital septum to expose the three orbital fat deposits of the lower eyelid. These fat deposits will be removed or repositioned to reduce puffiness under the eyes. Finally, excess skin and, if needed, small portions of muscle are removed from the outer eyelid to eliminate bags under the eyes, and the incisions are closed with either absorbable or non-absorbable sutures.

Inside Lower Eyelid Procedure

The inside lower eyelid procedure consists of an incision inside the lining of the lower eyelid. Your surgeon will gently pull the lower eyelid away from the eye and make a small incision in the conjunctiva, exposing the three orbital fat deposits. Each fat deposit will be removed to reduce puffiness under the eyes. Your surgeon may choose to close the incision with sutures, but sutures may not always be necessary.

Recovery and Results

You can expect to experience some pain, bruising, and swelling after the procedure, and your physician will likely recommend cold compresses or pain medication to help make you as comfortable as possible. You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. If absorbable sutures were used, they do not need to be removed and will dissolve on their own. Any non-absorbable sutures are typically removed in five to seven days, and you will begin to notice an improvement in the bruising around your eyes in seven to ten days. Lower eyelid surgery will not stop your eyes from aging, but will reduce puffiness and bags from beneath your eyes. The results are usually very long-lasting and will brighten your eyes to the rested, youthful appearance you desire.

Eyelid Surgery Upper

Your eyes are one of your most expressive facial features, but are they expressing sadness or fatigue rather than your inner vitality? Are your eyes making you look older than you feel? The aging process, heredity, skin type and environmental factors, such as sun damage, can cause the eyelids to sag and droop or become puffy and heavy, making you appear sad, tired or older than you feel. Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. Depending on your specific needs, your surgeon may also suggest a brow lift to improve your upper eyelids. This animation describes upper eyelid blepharoplasty, which can reduce the appearance of heavy and sagging upper eyelids.

What Causes Eyelids to Change?

The skin on your upper eyelid is among the thinnest anywhere on the body. A layer of muscle is located just beneath the eyelid skin and is separated from fatty tissue by a thin tissue membrane, called the orbital septum. Muscle layers and the orbital septum weaken and sag with age, and fat deposits shift in response to weakened muscles, causing puffiness and drooping. In addition, changes occur in the skin itself. The collagen and elastin that provide support to the skin, break down over time, causing the skin to lose elasticity and become lax. Additionally, eyebrows may droop with age, causing the upper eyelids to sag.

How Upper Eyelid Surgery Works

Upper eyelid blepharoplasty typically involves removing or redistributing fat deposits, as well as removing excess skin and muscle to improve the contour of the upper eyes.

Preparation

The blepharoplasty procedure will most likely be performed under local anesthesia with sedation, in which the eyelids and surrounding areas are numb and you are relaxed but may not be asleep. Alternatively, you may be given general anesthesia, which causes you to sleep during the procedure. Incision guidelines may be drawn to ensure that the incisions follow the natural contours of the upper eyelid and the resulting scars will be as inconspicuous as possible.

Procedure

Your surgeon will make an incision in the fold of the upper eyelid and carefully remove a predetermined amount of excess skin. In some instances, a small strip of muscle will be removed as well. In order to gain access to the fat deposits, a small incision will be made in the orbital septum and your surgeon will reposition or remove a portion of the fat, which reduces the puffy appearance. To conclude the procedure, the incisions will be closed with absorbable or non-absorbable sutures and a lubricating ointment and small bandages may be applied to your eyelids.

Recovery and Results

You may experience some pain, bruising, and swelling after the procedure, and your physician will likely recommend cold compresses or pain medication to help make you as comfortable as possible. You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. If absorbable sutures were used, they do not need to be removed and will dissolve on their own. Any non-absorbable sutures are typically removed in about a week, and you will begin to notice an improvement in the bruising around your eyes. Upper eyelid surgery will not stop your eyes from aging, but the results are usually very long-lasting and will brighten your eyes to the rested, youthful appearance you desire.

Facelift Full

Signs of aging in the face and neck occur for many reasons, such as heredity, skin type, sun exposure, and lifestyle choices. If you are bothered by a combination of deep facial wrinkles, sagging jowls, drooping eyelids, or loose skin and excess fatty deposits under your chin or on your neck, a facelift may be right for you. A full facelift is best described as a combination of separate procedures that affect different areas of the face. Not all people need the same procedures, so what may be full facial rejuvenation for one person may involve a slightly different set of procedures for another. Typically a full facelift involves a lower or mid facelift, a forehead lift and sometimes eyelid surgery. Your plastic surgeon can help decide the best options to give you the results you desire. A general overview is presented here, and surgical details for individual procedures commonly performed during a full facelift can be viewed separately.

The Forehead

A forehead lift, also known as a brow lift, reduces forehead lines and creases and can improve frown lines that may appear between your eyebrows. Sagging eyebrows may also be lifted with this procedure, restoring a firmer, more youthful appearance to the upper portion of your face.

Upper Eyelids and Lower Eyelids

Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. During eyelid surgery, fatty deposits are removed or repositioned and excess skin and muscle tissues are often removed to brighten the appearance of the eyes.

The Mid Face

The mid facelift, sometimes referred to as a cheek lift, rejuvenates the center of the face in an area approximately from the corners of the eyes to the sides of the mouth. Underlying muscles and fat that have sagged over time are lifted back up onto the cheekbones.

The Lower Face and Neck

A lower facelift can help to reduce the appearance of deep facial wrinkles, sagging jowls, and sagging in the neck, restoring a firmer, more youthful appearance. During a lower facelift, underlying tissues and muscles are repositioned, fat deposits are removed, facial skin is tightened, and excess skin is removed.

For More Information

Consult with your physician to discuss the best options for you. You may learn more details about specific procedures in individual animations or by researching the particular procedures.

Facelift Lower

Introduction

Signs of aging in the face and neck occur for many reasons, such as heredity, skin type, sun exposure and lifestyle choices. An aging face can create a tired appearance or falsely express feelings. A lower facelift can help to reduce the appearance of deep facial wrinkles, sagging jowls, and sagging and banding in the neck, restoring a firmer, more youthful appearance.

How a Lower Facelift Works

Much like a rubber band that has been over-stretched, the tissues in your face weaken over time, losing their resiliency and ability to maintain a firm, youthful position. Additionally, fat deposits, which normally give the face a soft, rounded appearance, migrate downward or are depleted, creating hollow areas. These changes create deep wrinkles, jowls, and loose skin in the lower portion of the face and neck.

Preparation

Prior to the start of your procedure, you will be given one of two types of anesthesia to make you as comfortable as possible. General anesthesia causes you to sleep through the procedure; local anesthesia with IV sedation causes the surrounding tissues to be numb and allows you to relax, but you may not be entirely asleep. Prior to making incisions, the physician may part your hair along the incision area and carefully draw the incision lines so that the resulting scars will be as inconspicuous as possible.

Procedure

Typically, a single incision is made within the hairline that extends downward around the perimeter of the ear and into the hairline on the backside of the head. Surgical instruments are used to carefully elevate the skin away from the underlying tissues of the lower portion of the face, jawline, and neck. The SMAS, which is a layer of tissue composed of muscle and fibrous connective tissue, is exposed and may be repositioned to lift and tighten the underlying structures of the face. Proceeding with the neck area, an incision will be made on the underside of the chin. Your surgeon may choose to reposition the neck muscles or remove a portion of them in order to reduce the appearance of skin laxity and banding in the neck. Additionally, fatty tissue may be removed to further sculpt the area. Once the necessary adjustments to the underlying structures are finished, your surgeon will stretch and remove the excess skin around the natural contours of the face. In some cases, a surgical drain may be placed beneath the skin to prevent fluid buildup as you heal. To conclude the procedure, all incisions will be closed with sutures.

Recovery and Results

Bandages around your face and drainage tubes are typically removed within a few days. Any non-absorbable sutures that were used will be removed in seven to ten days. As with any surgical procedure, you can expect to experience some pain, bruising, and swelling, but you will likely feel well enough to return to work in one to two weeks. You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. Results from your procedure will become increasingly more evident as the weeks pass, and your scars will continue to fade. Although a facelift will not stop the aging process, it can rejuvenate your appearance, giving you the youthful look that reflects the way you feel.

Facelift Mid

Introduction

Have you noticed sagging and wrinkles below your eyes that may have created a tired or sad appearance? A mid facelift tightens the center of the face, reducing wrinkles and age signs. Ideal candidates for a mid facelift desire a happier, softer, and younger appearance in the mid face; have not experienced significant sagging in the lower face and neck; and are often younger than those desiring a full facelift.

How a Mid Facelift Works

The mid facelift, sometimes referred to as a cheek lift, rejuvenates the center of the face in an area from the corners of the eyes to the sides of the mouth. Underlying muscles and fat that have sagged are lifted back up onto the cheekbones. Pulling your skin slightly up and to the sides of the cheekbones often gives a rough indication of the results a mid facelift can achieve.

Preparation

Prior to your procedure, you will be given one of three types of anesthesia to make you as comfortable as possible. General anesthesia involves breathing in a gas that causes you to sleep through the procedure. Intravenous (IV) conscious sedation is an option where an IV delivers medication that causes you to relax, but you may not be entirely asleep. The procedure may also be done with local anesthesia, in which tiny injections numb the area surrounding the surgical site. The procedure takes approximately an hour, but it may also be combined with other procedures done at the same time. Your physician will help you determine the preferred treatment options and the desired outcome.

Procedure

A small incision is typically made above each ear in the temple area, well hidden behind the hairline. Alternatively, a pair of incisions may be concealed beneath the eyelashes in the lower eyelids. Another set of incisions are made at the gum line inside the upper lip. Instruments are inserted through the lower and upper incisions to lift the skin, underlying fat, and muscle from the cheekbone. Next, the surgeon will place sutures through the fat deposits and muscle, lift them upwards, and secure them to tissue in the temple area near the upper incisions. All incisions are closed to complete the procedure.

Recovery and Results

Enhancements to the soft, round contours of the mid-face are evident immediately after the procedure and continue to improve over the next few weeks. The swelling or bruising will fade, and you may be directed to use ice packs to minimize swelling. Pain from the procedure is usually minor and can be managed with pain medications. You can often shower and wear makeup, except near the incision areas, the day after surgery, and can generally resume normal activities within a few days. Your mid facelift will reduce signs of aging and restore a firmer, well-rested, happier, and more youthful appearance.

Facelift Mini

Introduction

A mini facelift corrects signs of aging in the lower face and may also be known by a variety of other names such as weekend facelift, S-lift, or limited incision facelift. Although specific details of these procedures may vary, they are variations of a mini facelift, which is so-named because of the decreased length of surgery and recovery time compared to conventional facelifts and the short s-shaped incision placed in front of the ear. Signs of aging in the face occur for many reasons, such as heredity, skin type, sun exposure and lifestyle choices. An aging face can give you a tired appearance or falsely express feelings. A mini facelift restores the youthful appearance of the lower face by correcting sagging skin and eliminating areas of excess fatty deposits along the jawline. The best candidates for a mini facelift are typically between the ages of 40 and 55, with mild to moderate amounts of loose skin in the lower face. Individuals with significant amounts of loose skin may be better candidates for a conventional facelift.

How a Mini Lift Works

Much like a rubber band that has been over-stretched, the tissues in your face weaken over time, losing their resiliency and ability to maintain a firm, youthful position. Additionally, fat deposits, which normally give the face a soft, rounded appearance, migrate downward and are depleted, creating hollow areas. These changes create deep wrinkles, jowls, and loose skin in the lower portion of the face. During a mini facelift, a layer of tissue under the skin is repositioned and facial muscles are tightened.

Preparation

Prior to the start of your procedure, you will be given one of three types of anesthesia to make you as comfortable as possible. General anesthesia causes you to sleep through the procedure; IV sedation causes you to relax, but you may not be entirely asleep; or the procedure may be done with local anesthesia, in which tiny injections numb the area surrounding the surgical site. A special type of fluid, called tumescent fluid, may be injected into the area in front of the ear. Tumescent fluid is a sterile saline solution that helps lift the skin from underlying tissues, and contains agents that prevent the sensation of pain and minimize bleeding.

Procedure

Your surgeon will carefully draw a guideline starting from the hairline above the ear, descending in front of the ear and ending behind the earlobe. The narrow S-shaped section is cut away and then the skin is elevated. Sutures are used to pull the underlying fat and muscle toward the cheekbone, lifting the sagging jowls. The skin is gently pulled toward the ear and the incision is closed with fine sutures to conceal scars. The procedure is repeated on the opposite side of the face and the entire mini facelift procedure typically takes less than 2 hours.

Recovery and Results

You may be advised to wear a small bandage for two to three days and external sutures are removed in about one week. You can expect minor bruising and swelling following the procedure, and can usually resume normal activities within four to five days, or sooner. With this relatively quick procedure, and minimal recovery time, your appearance can be rejuvenated, giving you the youthful look that you desire.

Facial Implants Cheek

Introduction

Facial contours are among your most noticeable features. Some individuals may be unhappy with how they look as a result of congenital defects or injury to the face, while others are simply dissatisfied with their appearance. Cheek implants, also known as malar implants, can restore smooth, round contours to the cheeks to create a proportional and balanced appearance.

Cheek (Malar) Implants

Malar implants are made of soft, solid silicone or porous substances that may allow integration with surrounding tissues. These implants are frequently chosen to enhance areas of the face for the following reasons:

  • areas of the face are asymmetrical
  • an area of the face is not well developed
  • an area of the face is malformed due to a health condition
  • an area of the face has lost volume as part of the normal aging process

Appropriate for young patients who would like to improve the balance of facial features, or older patients seeking to restore volume to sunken regions, cheek implants improve or accentuate the appearance by restoring balance and enhancing your natural contours.

Incision and Pocket Creation

The cheek, or malar, implant procedure is usually performed through an incision inside the upper lip or in the natural crease of the lower eyelids below the lower eyelash. You should discuss the benefits of each type of incision with your physician. This animation demonstrates the procedure in which the incision is made inside the upper lip. To begin, your physician makes an incision near the top of the gums. Then the soft tissue is elevated, and a pocket is created. The pocket is usually positioned directly over the cheekbone, but your physician may adjust the position slightly to produce optimal results for the shape of your face.

Implant Placement

Malar implants are pliable, which allows them to be inserted through a small opening. Your physician will insert and carefully position sterile, triangular shaped implants, ensuring the proper fit inside each pocket. In some cases, small surgical screws are used to attach the implants to bone. Once an implant is in place, your physician will verify that it looks natural and balanced, making any necessary adjustments. When satisfied, your physician will close the incisions with dissolvable sutures. Tape may be applied to secure the implants during healing

Recovery

You will likely experience some tightness and swelling for a few days, and some people experience numbness in the implant area for several weeks. The sutures inside your mouth will dissolve, and the stabilizing tape will be removed after about seven days. While you may feel well enough to resume work and light activities in less than a week, you should avoid strenuous physical activity or activities that may jar or bump the implant areas for several weeks.

Results

You will notice results from facial implant procedures immediately. As the swelling subsides, the area that received the implant will soften and begin to look more natural. Your muscle movement should not be affected. The implants are placed so that they are unlikely to shift, and the tissue surrounding the implants will stretch to comfortably accommodate them over the following months. With malar implants, you can achieve the shape, definition, and cheek contours that you have always wanted.

Facial Implants Chin

Introduction

Facial contours are among your most noticeable features. Some individuals may be unhappy with how they look as a result of congenital defects or injury to the face, while others are simply dissatisfied with their appearance. Chin implants can achieve a proportional size or balanced shape to the face.

Chin Implants

Chin implants are made of soft, solid silicone or porous substances that are designed to integrate with surrounding tissues. These implants are frequently chosen to enhance areas of the face for the following reasons:

  • areas of the face are asymmetrical
  • an area of the face is not well developed
  • an area of the face is malformed due to a health condition
  • to achieve better facial proportion for nose surgery patients

Chin implants improve or accentuate the appearance by providing balance or enhancing your natural contours.

Chin Implant Incision and Pocket Formation

The procedure is usually performed through a small incision on the inside of the mouth or along the underside of the chin. You should discuss the benefits of each type of incision with your physician. This animation demonstrates the incision beneath the chin, which is also known as a submental incision. To begin the procedure, your physician will make an incision along a pre-marked line. Then, with the aid of an electrocautery device or other surgical instruments, your physician carefully creates a pocket below the muscle layer, just above your jawbone.

Chin Implant Placement and Closure

Chin implants are pliable, which allows them to be inserted through a small opening. Your physician will insert and carefully position a sterile implant, ensuring a tension-free fit inside the pocket. With the implant in place, your physician will verify that it looks natural and balanced, making any necessary adjustments. Once satisfied, your physician will close the pocket and skin incision with sutures. Small bandages in combination with a compression bandage may be applied to provide comfort and support.

Chin Implant Recovery

As with any surgical procedure, you will likely experience some pain, swelling, and bruising after surgery, which will decrease over the course of several days. If the incision was made inside your mouth, the sutures will most likely dissolve. If non-dissolving sutures were used for an incision beneath your chin, they will usually be removed within seven to ten days. While you may feel well enough to return to work and normal activities in approximately a week, you should avoid any strenuous physical activity for approximately three to four weeks.

Chin Implant Results

You will notice results from facial implant procedures immediately. Swelling after the procedure may cause the skin to appear shiny at first, but it will subside within a couple of weeks, and the skin will regain its normal appearance. As the swelling subsides, the area that received the implant will soften and will look even more natural. Scars are hidden in creases or in areas where they are difficult to detect, and they will fade considerably over time, making them almost imperceptible. With chin implants, you can achieve the shape, definition, and contours that you have always wanted.

Facial Implants Nasal

Introduction

Facial contours are among your most noticeable features. Some individuals are unhappy with how they look as a result of birth defects or injury to the face, while others are dissatisfied with the general appearance of their nose. Nasal implants can achieve a proportional size and shape to the nose or balance the face.

Nasal Implants

Three broad categories of materials have been used for nasal implants. Autologous materials are harvested from your own body and can include cartilage from the nose, ear, or rib; bone from the pelvis; or other soft tissues. Homologous materials are the same types of human tissues that are harvested from cadavers. Homologous tissues are sterilized for safety and treated to be accepted by the body. Alloplast materials are synthetics such as soft, solid silicone or porous substances designed to integrate with surrounding tissues. Surgical procedures for each type of implant are similar; silicone implants that come in predesigned, adjustable shapes will be shown in this animation. Nasal implants are frequently chosen for the following reasons:

  • to clear breathing obstructions caused by nasal collapse or injury
  • to enhance the shape of a nose that is flat or has a low spot along the ridge
  • to correct an area that is malformed due to a health condition, surgical complications, or injury
  • to improve facial symmetry for a proportional and balanced appearance

Nasal Implant Incision and Pocket Formation

The nasal implant procedure involves creating a small pocket in which the implant will be placed. Your physician will make an incision inside one or both nostrils and carefully sculpt a pocket underneath the skin along the bridge or base of the nose, or both. In some instances, cartilage and bone may be altered and reshaped in order to change the profile of the nose. However, adjusting the size of the implant itself will often provide the desired result.

Nasal Implant Placement and Closure

A nasal implant is carefully inserted into the pocket, and your physician will check for a proper fit and definition. After sizing, the implant is typically removed and sculpted to customize the height and shape. Once satisfied that the implant looks natural and balanced, your physician will close the incision with self-dissolving sutures. After the procedure, stabilizing tape and a nasal splint are usually applied to keep the implant in the correct position as it heals.

Nasal Implant Recovery

As with any surgical procedure, you will likely experience some swelling and bruising, which will subside over the course of several days. Pain is typically controlled with oral medications. The stabilizing tape and nasal splint will be removed after about seven days, and your sutures will dissolve with time. Most patients feel well enough to return to work and light activities after a few days. Your nose will most likely be completely healed and you will be able to return to full physical activity in a few weeks.

Results

You will notice results immediately. As swelling subsides, the area around the implant will soften and begin to look even more natural. Your muscle movement should not be affected. A nasal implant is placed so that it is unlikely to shift, and the tissue surrounding the implant will stretch to comfortably accommodate it over the following months. With nasal implants, you can achieve the shape, definition, and facial contours that you have always wanted.

Fat Transfer

Introduction

For those who would like to decrease unwanted fat in specific body areas while restoring or adding volume to other areas of the body, a fat transfer can improve body contours and revitalize overall appearance. This animation will highlight the fat transfer procedure including how fat is removed from certain areas of the body using liposuction, the process of transferring fat into a targeted location, and what to expect after surgery.

How a Fat Transfer Works

Over time, the contours of the body change due to the effects of aging, gravity, and weight and hormonal fluctuations. Additionally, unwanted fat may accumulate in areas such as the abdomen, back, buttocks, and thighs.

A fat transfer procedure works by removing unwanted, excess fat through liposuction and injecting it into areas of the body where rejuvenation is desired. The face, breasts, and buttocks are three common areas that can be revitalized using fat injections.

Signs of aging in the face and neck occur for many reasons, such as heredity, skin type, sun exposure, and lifestyle choices. Several areas of the face can be treated with a fat transfer including the cheeks, forehead, nose, chin, under-eye area, jawline, temples, and lips. A fat transfer, sometimes performed in combination with a facelift, can reduce the appearance of wrinkles, frown lines, or depressions while revitalizing the contours of the face.

Women who are dissatisfied with the size of their breasts or have experienced changes in breast appearance can achieve fuller, shapelier breasts with a fat transfer breast augmentation. A fat transfer breast augmentation results in only a small increase in breast size, but offers natural-looking results.

Weight loss, aging, and heredity may cause you to be unhappy with the size and shape of your buttocks. A buttock augmentation using fat transfer can help add volume and create a more youthful, shapelier appearance.

This animation will highlight a fat transfer procedure used for buttock augmentation, also known as a Brazilian Butt Lift.

Preparation

A buttock augmentation by fat transfer may last approximately one to four hours, depending on the complexity of the procedure and whether an additional procedure is performed at the same time. Your surgeon will carefully mark the areas where fat will be removed, and the areas where fat will be injected. These markings will be used as guidelines during the procedure. Fat transfer may be performed under local anesthesia where only the surrounding area is numb. Alternatively, for procedures involving large or multiple areas of the body, you may be asleep under general anesthesia. A special medicated fluid called tumescent fluid is injected into the areas that will be treated with liposuction. This fluid expands the tissues, to make it easier to remove fat cells, numbs the treatment area, and minimizes bleeding. Once a large volume of tumescent fluid is injected into the treatment area, you will rest for several minutes while the area becomes completely numb.

Procedure

Your surgeon will begin the procedure by using liposuction to harvest your fat. Excess fat is removed from areas of the body including the jowls, back, abdomen, thighs, and buttocks. Most body fat is located on top of muscle tissue, just beneath the skin. Liposuction works by surgically removing excess fat with a suction device, resulting in improved contours in the desired area.

Depending on the location of the procedure, your surgeon will make short incisions along natural creases of your body in order to easily conceal scars. Your surgeon will insert a small tube-like device, called a cannula. Using a forward and backward motion, small tunnels are created in the fat layer, removing the fat with a gentle suction. The tunnels will collapse over the next few weeks, resulting in new contours in the specific treatment areas. For more information on the liposuction procedure, please view our liposuction animation.

Next, the undamaged fat cells that were removed are isolated, cleansed, and prepared to be injected into the buttocks. Some surgeons may prepare the fat with stem cells before injection.

Then, your surgeon will use a cannula to inject the fat cells into your buttocks. Using a forward and backward motion, fat is slowly added in multiple areas until the desired volume is achieved.

The incisions may be closed with sutures or may be left open. Surgical drains may be inserted in order to help prevent fluid buildup. Lastly, absorbent pads are applied to protect the incision sites as you heal.

Recovery

Most fat transfer procedures are completed in outpatient surgery facilities; you should be ready to go home the same day, usually within two to four hours.

You will likely need to wear a compression garment for a few weeks to provide support, minimize swelling, and help the skin conform to the new contours of the body. You may also be prescribed medication to manage your pain for the first few days and as needed as you heal. It is a good idea to allow yourself several days to recover before resuming your daily activities.

Pain and bruising after the procedure are normal, and typically will fade within a couple weeks. Swelling also may occur and should subside within several months. If surgical drains are present, they along with any bandages will likely be removed within the first week following surgery, while any non-dissolvable stitches may stay in place for seven to ten days.

Be sure to follow your surgeon’s recovery plan, including sitting and sleeping position restrictions, in order to avoid complications and allow your body time to heal.

Risks and Results

Consult your surgeon regarding risks such as cysts, infection, small mineral deposits called microcalcifications, and death of fat cells. You also may need to discuss options for future fat transfers as it may take more than one procedure to achieve your desired look.

While you will most likely notice an improvement immediately after the procedure, final results will not be apparent until one year after surgery. You should have initial satisfaction with the size and shape of the buttocks after surgery, however much of this is due to swelling and the results may diminish over time. Although fat cells are removed permanently during the procedure, it is important to realize that fat transfer does not prevent growth of remaining fatty tissue. Additionally, fat cells injected into the buttocks may disperse from the injected area. Your results may also change if you gain or lose weight.

With realistic expectations and proper maintenance, you may enjoy the results of your fat transfer procedure for several years.

Forehead Lift

Introduction

Over time, facial features undergo age-related changes that may make you look tired, angry, sad, or older than you feel. These changes often occur first in the forehead and eyebrow region. A forehead lift, also known as a brow lift, reduces forehead lines and creases, and can improve frown lines that may appear between your eyebrows. Sagging eyebrows may also be lifted with this procedure, restoring a firmer, more youthful appearance to the upper portion of your face. Two alternative procedures for lifting the forehead are a coronal forehead lift, and the endoscopic forehead lift, which is described in this animation.

Why a Forehead Lift?

The aging process and environmental factors, like sun damage, cause the skin’s support network of collagen and elastin to break down. As a result, the skin loses its structure and elasticity and becomes lax. Additionally, layers of muscle weaken, causing lines and wrinkles in the brow region to become increasingly apparent. An endoscopic forehead lift tightens loose skin on the forehead and adjusts underlying muscles which contribute to frown lines.

Preparation

Prior to the start of your procedure, surgical guidelines will be drawn on and around your forehead. You will be given one of two types of anesthesia to make you as comfortable as possible. General anesthesia causes you to sleep through the procedure; local anesthesia with IV sedation causes the surrounding tissues to be numb and allows you to relax, but you may not be entirely asleep.Prior to the start of your procedure, surgical guidelines will be drawn on and around your forehead. You will be given one of two types of anesthesia to make you as comfortable as possible. General anesthesia causes you to sleep through the procedure; local anesthesia with IV sedation causes the surrounding tissues to be numb and allows you to relax, but you may not be entirely asleep.

Endoscopic Lift

An endoscopic forehead lift is performed using a surgical video device, called an endoscope, and other surgical instruments inserted into small incisions within the hairline around the forehead. Your surgeon will loosen and separate the skin and underlying muscle tissues from the frontal bone, which makes up the forehead. Small portions of the corrugator muscles, which form frown lines at the bridge of the nose, are snipped away to remove frown lines and prevent new ones from forming. The brow will be lifted and fixed in a higher position either by placing sutures beneath the skin, or by inserting absorbable fixation devices between the tissues. The incisions will be closed with sutures, and bandages may be placed around your head. The internal sutures or devices will often dissolve in approximately nine months, after the muscles and connective tissue layer, called the fascia, have healed and re-fastened in their new elevated position.

Recovery and Results

Your physician may recommend cold compresses or pain medication, and that you keep your head elevated as you recover, which will help to reduce bruising and swelling. Bruising normally fades quickly and any non-absorbable, external sutures will be removed in approximately seven to ten days. You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. Scars will be well hidden within your hairline and you should be able to notice the results very soon after your procedure. A forehead lift can significantly reduce the appearance of creases, frown lines and a sagging brow line and will rejuvenate your facial expressions to reflect the way you feel.

Nose Reshaping

Introduction

Are you interested in improving the appearance of your nose? If so, you’re not alone. Nose reshaping, or rhinoplasty, is one of the most common plastic surgery procedures performed today. This popular procedure can improve a disproportionate appearance by altering the size or shape of the nose, the span of the nostrils, or the angle between the nose and the upper lip. In addition, nose reshaping may be performed to correct a nasal birth defect, an injury, or to improve breathing problems. Rhinoplasty may be performed using an open or closed method. Closed rhinoplasty, modifies the structure of the nose through internal incisions, and open rhinoplasty includes an additional incision at the base of the nose between the nostrils.

Anatomy

A brief overview of structures inside the nose will help you understand the nose reshaping process. The upper third of the nose, called the bridge, consists of bone, while the mid and lower portions of the nose are supported by cartilage. A dorsal hump is an area of built up cartilage or bone that forms along the dorsum, or ridge of the nose. Cartilage in the lower portion of the nose, called alar cartilage, is what determines the shape and appearance of the nasal tip. A thin layer of cartilage, called the septum, separates the nose in the center. The columella is the tissue that lies between the nostrils at the base of the nose.

Preparation

Rhinoplasty surgery may be performed under general anesthesia, which causes you to sleep during the procedure. Alternatively, you may be given local anesthesia with sedation, in which the nose and surrounding areas are numb and you are relaxed but may not be asleep. Prior to making incisions, the physician may draw small guidelines on or around your nose.

Incisions

To begin an open rhinoplasty procedure, a small incision is made across the columella at the base of your nose, followed by an incision inside each nostril in order to fully expose the nasal framework. In a closed rhinoplasty procedure, which is shown for the remainder of this animation, your surgeon will generally make two small incisions inside each nostril in order to gain access to the cartilage and bone.

Procedure

In patients whose nasal tip is wide or bulbous, the surgeon may choose to remove a portion of the alar cartilage from the tip of the nose. Depending on your particular nasal structure and the extent of treatment necessary, sutures may be used to bend or pull the alar cartilage inward to create a narrower tip or adjust its position. Additionally, the surgeon may choose to remove a dorsal hump by carving away areas of cartilage and bone. Once any bone or cartilage has been removed, your nose may have an open space between the nasal bones, known as an open roof. Nasal bones may be divided or a piece of bone may be removed. This is called an osteotomy and can create a narrower base of the nose as well as helping close an open roof. An open roof will be closed as the surgeon smoothes the ridges and repositions the nasal bones by pushing them together in the center.

Depending on the type of procedure, cartilage grafts may be used to smooth the dorsal ridge, and to support or adjust the shape of the nasal tip. This cartilage is often taken from the septum during the procedure, but if a larger amount of cartilage is necessary, it can be taken from the ear or ribs. Additionally, nasal implants may be used to alter the shape of the nose.

Incision Closure and Dressings

After the surgeon has finished reshaping your nose, the incisions will usually be closed with dissolvable stitches. Nasal airway splints will likely be placed inside your nostrils to provide support and stabilize the nose as it heals. Bandages will be applied to the outside of your nose and if the nasal bones were adjusted during the procedure, a splint will be applied as well. The bandages and splint help the tissues heal and conform to the new cartilage and bone structure.