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How much improvement can
one expect?
This is a crucially important question.
We want to see this answer as clearly as possible in advance of making any
decisions.
In general, this can be seen in the
pictures of the faces that are shown here on this web site and the many
others that we can show in the office that are not on this web site.
But for onesspecific face, the
best answerto see the improvement in advance is with drawings.
Looking in the mirror with the doctor
and holding the tissues of the face in more attractive positions is the
standard traditional way of seeing how much improvement can be obtained in
the face. All this is simply done by holding the cheek/neck/eye tissues up
and back or in whatever position looks best.
This technique works well and is always
done for each person, and may in fact be most accurate. But it lacks the
objectivity, precision and reproducibility of the drawings.
We answer this question for each person
with drawings. The drawings should be of good enough quality that the
answer to how good the face can look can be clearly seen. Doing this is
much like trying on clothes. You can see how they look on you before
buying them.
And with the drawings,the person
can take them home, hang them up on he wall and look at them when in
different moods. One can get the opinion of others as to which looks best
or how much improvement there is.This makes them, in a way, more
objective. We are accustomed to seeing ourselves in photographs. And
sometimes it is that appearance in a picture that leads a person to want
to look better.
Then there is the question of how close
to the drawings the after surgery appearance is. You can see that for
yourself by looking at any of the thousands of photographs of before and
after we can show you, then comparing them to the chosen drawings.
We also have the opinions of hundreds of
our patients who have had work done. A majority of patients say that the
results equal or exceed the drawings. Youmay see hundreds of these
questionnaires
and the summaries of the answers to these questions.
Anything that can be done with the
fingers on the face such as lifting up and back or lifting eyebrows or the
corners of the eyes up and back can be done with surgery. So this is a
preview of the results. And even without drawings, most doctors look in
the mirror with the person and discuss the changes and improvements in the
mirror. Often, it is good to see that you and the doctor agree more or
less on what is possible and most advantageous.
The drawings have an advantage over
looking in the mirror in that they can take more details into
consideration, show more at one time, and are more objective in that they
can be studied and critiqued by anyone, anytime, anywhere, even without
the subject being present. And, they are much more permanent. In king
Tut's tomb, the drawings would have lasted thousands of years.
There is permanent improvement and
temporary improvement. It is a good thing to emphasize and plan for the
permanent things of shape and form over the temporary. The face-lift is
mostly temporary compared to the many changes that can be made and chosen
in drawings that are permanent. We can make many persons appear
permanently younger and more attractive without a face-lift. And those
things can be explained to each person and shown to him/her in the
drawings.
The amount of improvement is quite
different for each person. The best estimate is with drawings. Looking at
a lot of the results of a surgeon's works in before and after photographs
is a very good way to get a general idea of what can be done. Beware of
photo retouching, especially those that are digitally rendered. Seeing
actual hard copy film prints, slides and negatives in a doctors office
is much more veritable.
How long will the
improvement last?
Those aspects of the face that are
changed in
shape
, such as the nose, cheeks, chin, eyelids and
removal of bags of the eyes are very long lasting or even permanent.
Those things that are accomplished by
tightening
and repositioning
the skin are much more temporary. Therefore,
tightening the skin of the face with a standard face-lift by itself may
take 5 to 20 years off the persons appearance in age. One way to
express how long it will last is to say if it takes 10 years off, the
person will always look 10 years younger than if they had not had it done.
And so it will take 10 years for their appearance to catch up to what it
was in the beginning before anything was done.
And so, by that formula, however much
younger a person looks in years is how long it will last. But on the other
hand, even the tightening up or face lift is permanent in the sense that
the person who looks 5 or 10 years younger will always look that much
younger no matter how many years go by.
No operation can permanently prevent
aging, but the individual never appears as old as she/he might have if the
operation had not been done. The exact duration of improvement canbe
most accurately predicted with drawings that show the expected result.
In summary
- The improvement is permanent in change of shape and structure, such as
of the chin, under the chin, nose, etc. Some looseness of the skin always
returns. If a person is made to appear five or ten years younger, they
should always appear that much younger than if they had not had the
surgery. This effect is cumulative, in that if a person has two or three
procedures, each causing them to look five years younger over a period of
time, they may look a total of fifteen years younger as a result.
How is the surgery done
?
Gentleness is the key to rapid recovery.
The surgery is performed with the
patient in a twilight sleep. The patient is given sedatives, tranquilizers
and medicines to prevent any feeling of discomfort. Our anesthesia
questionnaire shows that more than 94% say they had a pleasant experience.
With the person comfortable and mostly
sleeping soundly, the work is done as planned with small sterile
instruments made for this purpose. All of the instruments and equipment
used are sterilized.
While surgery is in progress the person
is connected to a pulse oximeter, an automatic vital signs monitor, and an
electrocardiograph. But most importantly, the person is always under
direct observation of the surgeon and his nurses and assistants.
Where is the operation
performed?
It may be done in the federally
approved, medicare certified, outpatient surgery center of our office, or
in the hospital. Most persons choose the office for more ease, greater
privacy and safety and reduced chance of infection, as well as to avoid
the added cost of the hospital bill.
We have had an occasional patient have
consultation and laboratory work at the hospital both before or sometimes
after a surgical procedure.
For over thirty years of conducting
surgery from our outpatient surgery center, we have had a perfect safety
record, and there have been no emergencies.
What type of anesthesia is
used?
The surgery is performed with the
patient in a twilight sleep. The patient is given sedatives, tranquilizers
and medicines to prevent any feeling of discomfort. Our anesthesia
questionnaire shows that more than 94% say they had a pleasant experience.
The type of anesthesia administered is
local anesthesia with sedation. It is administered by the surgeon who has
been an American Heart Association approved instructor of Advanced Cardiac
Life Support continuously for more than 20 years, along with the help of
his assistants. The safety record ofsurgery with this anesthesia is
perfect for more than 30,000 procedures performed over more than thirty
years. This record of safety is unsurpassed.
This type of local anesthesia has a much
higher safety record than does general anesthesia. It is widely agreed
upon in surgical and medical practice that any surgery which can be done
under local anesthesia should, for safety, be done that way. The normal
apprehension a patient might feel is allayed by the use of tranquilizers
and sedatives.
With the person comfortable and mostly
sleeping soundly, the work is done as planned with small sterile
instruments made for this purpose. All of the instruments and equipment
used are sterilized.
While surgery is in progress, the person
is connected to a pulse oximeter, an automatic vital signs monitor, and an
electrocardiograph. But most importantly, the person is always under
direct observation of the surgeon and his nurses and assistants.
It may be done in the federally
approved, medicare certified, outpatient surgery center of our office, or
in the hospital. Most persons choose the office for more ease, greater
privacy and safety and reduced chance of infection, as well as to avoid
the added cost of the hospital bill.
We have had an occasional patient have
consultation and laboratory work at the hospital both before or sometimes
after a surgical procedure.
For over thirty years of conducting
surgery from our outpatient surgery center, we have had a perfect safety
record, and there have been no emergencies.
Is
there much swelling or bruising?
There is some bruised appearance in
nearly every case. There can be a bruise from just a flu shot or a blood
test. Usually on the face a bruise can be hidden by make-up within a
few days or in one or two weeks. It is mostly gone in three weeks. Many
procedurescan be done without bruising.
Is there much pain?
No pain should be felt during surgery.
After surgery there is a feeling of tightness and tenderness of the area
for a few days. Our anesthesia questionnaire that is filled out by all
patients after surgery over many years is available for your information.
It shows that well over 90% were pleased with the experience.
Will insurance pay for
this kind of surgery?
Strictly cosmetic surgery is rarely
covered by insurance.
How long does the
operation take?
Careful surgery may require several
hours. Additionally, one hour of preparation and two hours of observation
after surgery are usually required.
Are bandages worn on the
face?
In most cases no bandages are needed. If
they are used, they will be removed the second day following surgery. We
find that little plastic drains that cannot be felt by the person are much
more comfortable than bandages when needed.
When are the sutures
removed, and is this painful?
Some sutures are removed within the
first week. Some sutures are removed each time you are seen over a period
of one to several weeks. There is no real pain with suture removal. Each
suture removed may feel like one hair being plucked from the head and
should not even be felt that much. Usually there is no sensation, or just
a tickle with suture removal.
Are
there any scars?
Cosmetic surgery should produce no scars
and no signs that it was done. The location of the incisions can be
drawn on the patient to show where they will be. Most patients heal well
and do not have any visible scars.
We can almost always eliminate any
visibility of all scars.
Must some of the hair be
shaved? Is any hair lost?
No hair is shaved and no hair is lost.
Very rarely, there is a low forehead hairline that is wished to be set
back.
However, some surgeons still make
incisions behind the hairline and routinely remove precious hair. This
eventually leads to what is referred to as a bald face, which is a
hairline that is pulled too far back, leaving hair loss and a long
distance from the hairline to the eyebrows and eyes. Many celebrities who
are over forty and up have this condition - and some who have it even deny
ever having had surgery.
How long is the recovery
period?
The average recovery is as follows: On
the first or second day after surgery any drains inserted post-surgically
are usually removed. If any bandage was applied, this is removed on the
next day. On the first through fifth day some sutures are loosened orremoved
and make-up may be applied. Post-op visits to our office are quite
frequent in the first two weeks to make you as comfortable as possible
during your recovery.
How long before I will be
presentable in appearance after face surgery?
After only nose, eyes or cheek surgery
the person may look normal in one or two days. The nose and eyelid
pictures typically show recovery in only one to three days. A normal
appearance may be evident in only three to five days if face, chin, or
cheek implants are done.
Sometimes a bruise develops, and this
can last one to three weeks. But if it is only a bruise without swelling,
it can usually be covered with makeup and still look good during recovery.
When combining the peel, nose,face-lift,
chin and/or eyelid surgery, usually one to three weeks are required. The
patient should expect noticeable signs of surgery in the first week. With
proper make-up after the second week, most strangers you meet will not be
able to tell any surgery was done. In two to three weeks patients often
wish to return to work. Complete healing may require four to six weeks or
more.
We
have several sets of very informative pictures donated by our patients
that show how they progressed through having the face and eyes and other
procedures done. You may wish to see them here on the web site under each
category of nose, face, eyes, etc. And, we have thousands more in the
office. Everyone is welcome to see them.
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