Facial plastic surgery is concerned with improving the appearance and function of facial structures. Dr. Alan J. Burke, who is Board Certified by the American Board of Otolaryngology and Board Certified by the American Academy of Facial and Plastic Reconstructive Surgery, is eminently qualified to perform facial plastic and reconstructive procedures such as:
Rhinoplasty
Facelift
Mentoplasty
Malar Augmentation
Protruding Ears
Facial Sculpturing
Browlift
Eyelift
Botox & Collagen
Dermabrasion & Scar Revision
Lesions
Facial & Skin Cancer Reconstruction
RHINOPLASTY
Creating the Nose You Always Wanted
Rhinoplasty is the surgical procedure for correcting structural deformities of the nose. It involves redesigning the nose either by removing excess tissues or correcting insufficiencies to improve overall nasal contour and function. Your surgeon can shorten a long nose, narrow a wide one, reduce a wide tip, lower a high nose, and straighten a crooked one. The incision is placed in relatively hidden positions, such as inside the nostril or underneath the nose, to avoid visible scarring.
Rhinoplasty is usually performed on an outpatient basis. You may be required to wear an external splint for a few days. During this time you can resume non-stressful activities like bathing, shampooing and walking. After the splint is removed, your nose may appear slightly swollen. Within two weeks after surgery, most patients can return to full activities. Although most of the swelling will be resolved within the first two weeks following surgery, the final results may not be evident for several months due to the normal healing process.
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FACELIFT
A Younger-Looking You
Facelift surgery has become one of the most popular and well-known forms of cosmetic surgery. More and more aging people want to look as youthful as they feel physically and mentally.
The surgery is designed to remove or reduce wrinkling caused by loose skin, and to lift and tighten sagging tissues of the lower face and neck. The incisions are placed in front of and behind the ear in the natural creases of the skin and in areas which help hide the scars. The skin is separated from the underlying tissues and gently smoothed back to relieve the redundant folds. We will often perform tightening of the underlying muscles of the face in order to provide this smoother skin a solid foundation to rest upon. The excess skin then is removed and the remaining skin is brought back into position.
The degree of improvement depends upon the amount of wrinkling and sagging of tissues present. The results can be dramatic if wrinkling is marked, but may be more subtle if the patient is younger and has only early sagging. No operation, of course, can permanently prevent aging, but with surgery you can be restored to a more youthful appearance. As the years go by you may wish to have additional rejuvenation procedures to lessen other signs of aging. The facelift does not speed the aging process and actually serves to help slow the sagging.
The surgery is performed on an out-patient basis. You can resume non-stressful activities during the first week. In about 10 days you can wear makeup and resume most normal activities. Final healing can take several weeks. It is important to understand what a facelift can and cannot do. It can smooth the skin on the face, cheek, and neck areas. However, it does not improve the eyelids, eyebrows, horizontal forehead creases, or the small vertical creases about the lips. Other procedures discussed here may be combined with a facelift to give a rejuvenated appearance to the entire face.
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MENTOPLASTY
Creating Facial Balance through Chin Augmentation
Ideal facial balance starts with an ideal bony structure. This can be achieved through sculpturing and contouring your existing facial framework. One of the most commonly performed procedures to accomplish this is mentoplasty, or chin augmentation. A mentoplasty can bring a receding or weak chin into better harmony with other facial features and create a more pleasing balance. Because mentoplasty can improve the results of a rhinoplasty or facelift, it often is done in conjunction with these procedures.
After numbing with a local anesthetic, an incision is placed usually underneath the chin in a preexisting skin crease. An implant is placed underneath the soft tissue at the point of the chin to enhance the chin's projection. Improvements are noticeable immediately after surgery, although some swelling is to be expected. An external dressing is usually applied and left in place for a few days to aid in stabilization during the healing process.
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MALAR AUGMENTATION
Highlighting the Cheeks
Another common way of contouring the facial framework to achieve greater beauty is through malar (cheek) augmentation. Traditionally, strong cheekbones have been considered signs of beauty because they add to the definition of the face and help improve facial harmony. In addition, some malar implants may give a more youthful appearance to the face and can enhance the results of a facelift.
The surgery is done with a local anesthetic and mild sedation or twilight anesthesia. The implant is placed through an incision in the mouth hidden under the upper lip above the gum line. Dissolvable stitches are used and there is no visible scar. There is minimal discomfort associated with this surgery and swelling resolves rapidly. You can return to work and other activities within two to four days.
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PROTRUDING EARS
Making them Inconspicuous
Ears are ideally positioned close to the side of the head. Anyone with protruding ears knows the hurtful teasing their ears may provoke. This harassment is even more intense in primary school-age children. Classroom teasing can be avoided by having corrective surgery before the age of six, but it can be done at any age, even adulthood. Other outer ear deformities can be corrected by surgery as well.
In young children a general anesthetic is used. In adults, a local anesthetic with IV sedation usually is preferred. The surgery is performed through incisions behind the ears so no scarring is visible. A sweat-band bandage is worn for several days after surgery, and often longer to protect the healing ears at night. You can return to your normal routine in one week.
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FACIAL SCULPTURING
Facial sculpturing/liposhaving is a method of removing fat from the neck to redefine the jawline. Sculpturing is performed either by direct fat removal, with liposuction, or the newer form of liposhaving. It is most often done in conjunction with facelift surgery. However, liposhaving may be done by itself without a facelift.
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BROWLIFT
An Upper Facelift
One of the earliest signs of aging is the drooping of the eyebrows. This causes the eyes to appear smaller or deeper set and accentuates crowsfeet (the wrinkles often found at the outer corners of the eyes). In addition, furrows may appear horizontally and vertically as the brow descends. These conditions can be dramatically improved with a forehead lift. We often will recommend this in conjunction with, or in place of, a facelift to help in facial rejuvenation.
In appropriate patient candidates, this procedure can be performed using an endoscopic approach. The incisions are made in such a way so that they are hidden. The skin is separated and tightened. Some of the smaller muscles in the forehead which cause the deep furrowing may be weakened to reduce the severity of the frown lines. The procedure is frequently combined with a blepharoplasty [insert hyperlink] in opening up and rejuvenating the eyes. For the first week after outpatient surgery you may engage in relaxed activities, and then begin to resume normal activities the following week. Final healing may take several weeks.
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EYELIFT
Creating Less Tired Eyes
One of the earliest signs of aging is the drooping of the eyebrows. This causes the eyes to appear smaller or deeper set and accentuates crowsfeet (the wrinkles often found at the outer corners of the eyes). In addition, furrows may appear horizontally and vertically as the brow descends. These conditions can be dramatically improved with a forehead lift. We often will recommend this in conjunction with, or in place of, a facelift to help in facial rejuvenation.
In appropriate patient candidates, this procedure can be performed using an endoscopic approach. The incisions are made in such a way so that they are hidden. The skin is separated and tightened. Some of the smaller muscles in the forehead which cause the deep furrowing may be weakened to reduce the severity of the frown lines. The procedure is frequently combined with a blepharoplasty [insert hyperlink] in opening up and rejuvenating the eyes. For the first week after outpatient surgery you may engage in relaxed activities, and then begin to resume normal activities the following week. Final healing may take several weeks.
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BOTOX & COLLAGEN
Removing Fine Wrinkles
Collagen and botox injections are useful means of improving specific wrinkles and scars. Both can be used to refine the improvements from other cosmetic procedures. Botox is most helpful in improving vertical furrows between eyebrows. Collagen is used to fill out small skin surface defects, as well as the creases about the lips.
A test injection of collagen is done before the first treatment to detect any allergic reaction to the collagen. If there is no allergic reaction, the treatment can begin one month later. The collagen is injected into the wrinkles and scars. Additional treatment may be necessary over time since the collagen gradually absorbs into the tissue and its effect disappears. This treatment provides improvement in about eighty percent of patients and is done in the office with local anesthesia. You can resume full activities immediately after the injection.
Botox is a medication which is injected directly into the muscles to weaken the activity of the muscle. This in turn will result in a smoother appearance on the skin surface. The duration of the effect from botox varies from individual to individual but is usually in the range of three to six months. The treatment can be repeated as often as desired. Like collagen injections, there is no restriction on activities following botox treatments.
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DERMABRASION & SCAR REVISION
There are a variety of techniques which may be used to improve the appearance of scars. The overall goal of improvement is to minimize the appearance of the scars. You must realize that it is not ever possible to completely remove all traces of a scar since the body can only heal by forming a new scar. Thus the goal of scar revision and dermabrasion is to render a scar less conspicuous.
Scar revision is done either in the office setting or in an outpatient surgery setting. Healing generally takes several days and there usually is minimal restriction on activities. On occasion a scar revision surgery is combined with dermabrasion in a staged fashion to achieve the best results possible.
Dermabrasion is an excellent means of providing overall improvement in acne scarring. The scarring cannot be completely removed, but when combined with other minor procedures and, rarely, a complete facelift, dermabrasion can provide excellent smoothing of noticeable acne defects. The acne itself must be quiescent or inactive prior to dermabrasion.
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Lumps, Bumps, Skin Cancers, Pigmented Lesions, Moles and Tattoos
If you have skin cancer, blemishes, moles or tattoos, surgical excision may be an option. Even though most moles are not dangerous, a certain type of flat, deeply colored variety may precede a highly malignant skin tumor.
Excision of lesions may be done in an outpatient surgery setting or in the office. There usually is a small scar which results from this type of surgery, but these generally blend well with the surrounding skin.
Vascular Lesions & Laser Surgery
Congenital birthmarks, hemangiomas and prominent facial blood vessels maybe treated by laser applications. The laser is a special focused beam of light used to seal off the tiny vessels without injuring the surrounding normal skin. The results of this treatment usually are a nearly normal appearing skin area but vary with the particular patient and the particular process.
Typically laser surgery is done in an outpatient surgery setting. There usually is no restriction on activities following the procedure. Some patients may require more than one treatment for satisfactory improvement
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FACIAL & SKIN CANCER RECONSTRUCTION
Reconstruction of the skin and deeper tissues of the face may be necessary because of injury or following removal of skin tumors, or even with congenital facial deformities.
The reconstruction usually is performed in an outpatient surgery facility. Tissue from an adjacent region is used to repair the defect so that the tissue matches the surrounding areas as closely as possible. More than one operation may be necessary to achieve the best result. Since these reconstructions can vary depending upon the defect, we will discuss with you all of the steps planned for your reconstruction at the time of your pre-operative visit to our office.
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