On viewing some recent emails, I find myself answering questions similar to previously published articles. After nearly five years now, this is normal as we have covered most subjects but I thought it would be good to revisit some of these as they are still subjects of interest.
Under this chapter we include those operations carried out in combination, or not, with the classical rhytidectomy (face lift) most of which are also performed under local anaesthesia.
1. Eye-brow elevation: this simple operation can give spectacular results and is carried out under local anaesthesia. A tiny incision of less than half an inch is made over the tail of each brow. Tissues are separated to gain access to the periosteum of the frontal bone where one ore two stitches are made to anchor the skin to a higher position. The skin is then closed by invisible intradermal stitches thus leaving practically no scar. Another approach is to prolong the face lift incision above the ear in order to lift both brows to a more suitable location.
2. Chin augmentation: This is another classical operation which gives superb results. It creates an equilibrium between the 3 thirds of the face (upper, medial and lower) in cases where the lower is small. Traditionally it used to be performed by an incision made inside of the mouth just below the front lower teeth. An implant of jelly-like medical degree silicone implant is then placed between the muscle and the bone and sutured in place before closing the surgical wound. Nowadays it can be performed with fillers, either permanent or semi permanent, without even the need of surgery. Chin reduction is also possible following a similar approach but in this case general anaesthesia is preferable, as the bone scrapping or cutting is needed to achieve the desired result.
3. Cheek implants: Although now they are usually performed with adequate fillers, they used to be made of polysiloxane, a silicone derivative. The incision can either be made inside the mouth or from the lower lid after a blepharoplasty (eyelid lift). The reason in this case, as in the chin augmentation, would be to resolve an imbalance and according to the degree of imbalance, results range from a slight difference to very dramatic changes.
It is important to mention that fillers of the cheeks may “drop” when the material used is not adequate or the technique is not carried out correctly.
4. Nostril reduction: this operation is typically for those people who either by race, accident or personal circumstances have a deformity of the nose consisting in large and dilated nostrils on a nose which is otherwise normal.
It is carried out both with local or general anaesthesia and basically consists of the removal of a “slice of melon” from the base of both nose wings. The wound is then sutured from inside leaving no trace of the operation.