Redefining Facial Features
Our Goal
Achieving harmony of your facial features is one of the most important goals of cosmetic plastic surgery. Plastic surgery of the face can reshape, reduce, or increase facial structures to create facial balance using the most sophisticated techniques to alter and enhance your overall appearance.
Nose Reshaping
The goal of rhinoplasty is to reshape your nose so that it complements your other facial features. The earliest recommended age for this procedure is mid-teens when the nose is near full development. If you are in good health, there is no upper age limit for nose reshaping.
Rhinoplasty generally is done through incisions inside your nose. In some instances, there may also be an incision on the underside of your nose between your nostrils. If the base of your nose is to be narrowed, or the size of your nostrils reduced, this can be done by removing small wedges of skin at the base of your nostrils. The resulting scars fade and ultimately should be barely noticeable.
Your nose can be reduced, or built up, by adjusting its supporting structures. This is done either by removing or adding bone and cartilage. Your skin and soft tissues will assume their new shape over this “scaffolding”.
Following surgery you will experience some discomfort, swelling and bruising. You may be instructed to wear a nasal splint for a week or longer. Your routine will be severely restricted for a day or two, but it will be a few weeks before you can resume bending, lifting, and exercising. As long as your job does not involve activities that raise your blood pressure, you should be able to return to work within 10 days. Minor swelling of your nose may persist for up to a year, but most likely this will not be noticeable to others. The final results of rhinoplasty are permanent and well worth the wait.
Liquid Rhinoplasty
Subtle changes to facial features can make a huge difference in your appearance. Given that the nose is the central part of the face, changing this facial feature with a rhinoplasty is among the top five most popular cosmetic surgeries performed in the United States. For those not willing to undergo general anesthesia and endure the downtime required, a liquid rhinoplasty may be the solution. The demand for this procedure has grown tremendously over recent years.
Liquid rhinoplasty uses a non-surgical approach to alter the shape of the nose by injecting dermal fillers. Patients with isolated deformities of their nose, such as a dorsal hump, minor asymmetries, or those wanting instant results, are great candidates. It is also a great way to test drive results in helping to decide if a rhinoplasty is in your future.
Before undergoing a liquid rhinoplasty, the patient needs to be aware that this procedure adds volume to the nose, so it is not an option for those patients that require a reduction.
Liquid rhinoplasty is a safe procedure if you do the research and choose a Board-Certified Plastic Surgeon who has a thorough understanding of the anatomy of the nose and its complicated blood supply. The blood supply of the nose connects to the eyes and if injected incorrectly, complications of vascular compromise, skin necrosis, infections, and blindness can develop.
Chin Augmentation
The contours of your face may be enhanced by a variety of techniques. Chin augmentation, also referred to as Genioplasty or Mentoplasty, strengthens the appearance of a receding chin by increasing its projection. The implant used to enhance the chin appearance is permanent and has predictable results. Sometimes fat may be injected into specific areas to restore a more youthful fullness to your face. Treatment with fat injections may require repeated treatments to maintain improvement.
The goal of chin augmentation is to improve your profile by creating a better balance between your chin and other facial features. Increasing the projection of your chin will not affect your bite or jaw function.
The technique for a chin augmentation involves insertion of a chin implant through incisions inside your mouth or on the underside of your chin. In the latter case, surgery usually leaves only a faint scar that is barely visible underneath the chin.
To permit proper healing following chin augmentation, you may be placed on a liquid diet for a day or two. Your chin may be taped or bandaged. Typically, you are up and about on the same day, but your activities will be restricted. You should be able to work within one to two weeks.
Brow lift
A brow lift, also called a forehead lift, corrects the skin wrinkling and loss of tone that causes sagging of your eyebrows and hooding of your upper eyelids. A brow lift softens the deep creases across your forehead. It reduces the horizontal frown lines at the top of your nose and the vertical lines between your brows. The result is a more relaxed and refreshed appearance.
Some people have inherited traits that cause them to have a brow lift as early as their 20s or 30s. One technique for performing a brow lift requires an incision across the top of the scalp, beginning above your ears.
The incision may be placed toward the middle of the scalp where it is hidden within your hair or at the front of the hairline.
Through this incision, your plastic surgeon can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing position.
Another technique is the endoscopic brow lift. This technique is minimally invasive and requires very small incisions in the scalp. The endoscope, inserted through these tiny incisions, allows your plastic surgeon to see and work on the various internal structures of the forehead.
After surgery, you will have temporary puffiness and discoloration that may involve your eyelid and cheek areas we well. You may experience numbness and itchiness of your scalp. You can wash your hair in a few days and are back to work within 10 days.
Eyelid Surgery
Cosmetic eyelid surgery (blepharoplasty) removes the excess fat and wrinkles, drooping skin of the upper eyelids that can make you look constantly tired or sad. It also eliminates bags under your eyes and tightens your lower eyelid skin. The result is a more alert and rested appearance.
Some people have inherited traits that cause them to have eyelid surgery as early as their 20s or 30s.
Fat and loose skin is removed from your upper eyelid area through an incision that is hidden within the natural eyelid fold. The incision extends slightly beyond the outside corner of your eye where it easily blends into existing laugh lines or other creases. If your upper eyelid problem is aggravated by sagging of your eyebrows, then Dr. Hamilton may recommend a brow lift.
Treatment of the lower eyelids often requires an incision that is hidden just below your lower lashes. Through this incision, excess skin, muscle, and fat are removed or adjusted; sometimes fat may be repositioned to eliminate puffiness or bulges. If your lower eyelid skin is not excessive, a different technique to remove the fat can be done through an incision placed inside the lid.
After surgery, expect some swelling that may persist for a week or longer. Your vision may be somewhat blurry for a few days, and you may want to wear dark glasses to protect your eyes from the wind and sun. Sutures are removed within 3-7 days, and you can typically return to work and daily activities within 10 days.
Ear Surgery
Ear surgery, referred to as Otoplasty, can improve the shape or positioning of your ears. It also can reduce the size of your ears if they are large in proportion to your other features. If your ears protrude more than normal, surgery can reposition them closer to your head.
The supporting tissue of the ears, called cartilage, is reshaped in order to position your ears closer to your head. This usually is accomplished through incisions placed behind your ears. Subsequent scars will be concealed in the natural skin crease.
After surgery, you may be instructed to wear a gauze dressing or bandage for a few days or up to several weeks to ensure that your ears heal in their new, corrected position. You will need to avoid strenuous exercise and contact sports for several weeks. You can resume most non-strenuous activities within a week.
Lip lift
As we age, the lip distance between the nose and lip lengthens which contributes to a “droopy” or “tired” appearance. Using filler once the lip has lengthened creates a heavier and long upper lip as opposed to plumped and balanced. A lip lift modifies the cosmetic appearance of the lips by reshaping them to increase the prominence of the vermilion border; and to enhance the facial area above the lips into a more aesthetically pleasing shape. This procedure can be performed alone or in conjunction with other procedures such as a facelift, browlift, eyelid lift, and fat grafting. If the lip lift is the only procedure you are having then an in-office procedure is an option. The procedure itself is straightforward. It involves marking the upper lip and then removing the necessary skin just beneath the nose to create the lift desired. The area is closed with small sutures and then kept covered with antibiotic cream. Sutures are typically removed within a week. Initial healing is within 2-3 weeks with more aesthetic results within 2-3 months.
Neck Reshaping
There are several options to reshape the neck depending on the type of concerns of the patient as well as the age, skin maturity and genetic factors involved. Here we address the options available.
Submental Liposuction:
For those looking to eliminate submental fullness, the submental liposuction procedure is a good option. Most patients who elect for this procedure typically fall within the 20–30-year range. It is a one-hour procedure in the operating room under general anesthesia with minimal recovery time. A post-surgical chin strap is provided and worn for several weeks to facilitate healing. This procedure targets only the submental fullness of the neck. This procedure does not correct structural issues so if you are seeking a defined or permanent result, then a more invasive procedure would be involved such as a submentoplasty or platysmaplasty.
Submentoplasty/Platysmaplasty:
All but the smallest of facelifts require a procedure called submentoplasty/platysmaplasty. This step is sometimes omitted by many surgeons for its technical difficulty and the extra time involved. Due to Dr. Hamilton’s extensive training, this step is never overlooked and is a critical component in achieving a well-defined jaw and contoured neck. Your platysma enables movement in the lower face and when the platysma weakens as we age or due to genetic factors, the neck’s appearance is affected. You may begin to notice excess fat, sagging skin, and prominence of neck banding. Submentoplasty/Platysmaplasty surgery is an effective way to correct these issues and to rejuvenate the overall appearance of the neck. During the platysmaplasty procedure an incision is placed in the midline just behind the chin crease. The skin is elevated allowing access to the platysma muscle which is then reconnected in the midline and retightened. Sometimes, trimming excessive fat beneath the platysma is required to achieve a flatter and firmer contoured neck. A submentoplasty involves the tightening of the deeper tissues of the floor of the mouth.
When the submentoplasty/platysmaplasty creates excess redundant skin, then removal of the skin may be required which is often referred to as a cervicoplasty.
Cervicoplasty (Neck Lift or Lower Facelift/Neck Lift):
In addition to performing the submentoplasty/platysmaplasty, this procedure requires additional incisions behind the earlobes and the hairline. These incisions allow Dr. Hamilton to work on the deeper structures of the neck and lower face to create a more streamlined profile. To summarize, the cervicoplasty procedure involves removing excess skin, altering neck muscles, tightening of the deeper tissues of the floor of the mouth and possibly liposuction to remove excess fat.
Facelift
Your face is where aging leaves its most noticeable imprint. Many factors contribute to facial wrinkling and skin laxity including sun exposure, smoking, poor diet and nutrition, alcohol consumption, stress, and heredity. A facelift (Rhytidectomy) surgery involves reducing signs of aging in your mid-face, lower face, and neck. It smoothes loose skin on your face and neck, tightens underlying tissues and removes excess fat. Your bone structure, heredity and skin texture all play a role in how many “years” a facelift can “remove” and, to some extent, influence how long it will last.
There are many variations to the facelift procedure and the placement of incisions. The goal of every facelift technique is to keep the incisions hidden as much as possible. The incisions/scars are concealed by your hair or with makeup.
Dr. Hamilton will free your facial skin from its underlying tissues and trim off the excess. In some instances, the deeper tissues may also need to be repositioned to restore a more youthful contour to your face. If necessary, a small incision beneath your chin permits the removal of fat and smoothing of the cord-like structures in your neck.
After facelift surgery, you will experience temporary skin discoloration and some tightness or numbness in your face and neck. Your skin will remain somewhat sensitive for a few months. Protection from the sun including daily use of a sun block is essential.