Face Lifts ( Rhytidoplasty) Eyelid Rejuvenative surgery (Blepharoplasty) Lip Augmentation ( Fat transfer/ Fillers) Facial Liposculpture
Facial Laser Rejuvenation (Using Erbium / PIXEL Laser)

Something about Face lift (Rhytidoplasty)

The face is the social parameter of a person. We often judge a person by his or her initial appearance, and it is the face which tells the observer a lot about us, and unfortunately about our age also. The visible effects of ageing appear first on the face, and make the person look older than he or she feels.

Brief physiology of ageing

The face betrays the effects of gravity and the effect that the beating of the sun has on it. There is an effect both on the skin as well as on the underlying structures such as the SMAS ( the underlying soft tissue below the skin lying over the muscles of the face). The ultraviolet radiation has the ill effect of skin damage and gravity adds the effect of descent of tissues. It is therefore essential that any surgical treatment protocol involves tackling both the skin as well as the underlying SMAS layer. It is possible now to surgically peel off a few years off somebody’s face without giving her/ him too many visible scars

The Face Lift - what is it and how is it done

Surgical face lift is a procedure that can be done under local (under injections + sedation) or general anesthesia. It involves an incision at the junction of skin of the face and the ear. (Nowadays short scar face lifts are done, where the scar is very small and over a period of time are rarely visible enough to draw attention). After the incision, the skin and the underlying SMAS is tightened and pulled in an antigravity fashion to oppose the effects of gravity. Once the symmetry is achieved on both the sides, the incisions are closed taking care not to disturb the hair line or disturb the appearance of the ear. In men the side burns can get effected and gets closer to the ear, therefore they are forewarned about the possible requirement of laser to allow hair removal. However it is not required in the vast majority of the population.

Results

Following a face lift, you can expect a role back of almost a decade in your physical appearance. Combined with a PIXEL laser, it gives also a fresh and rejuvenated, soft skin to complement the effect of surgery. A good facelift, is symmetric, maintains the hair line, both in the region of the temple and in the back of head, as well as maintaining the symmetry of the ear. We can expect the effects of a surgical face lift to last for over a decade to almost 15 years if the procedure has tackled both the skin and the underlying SMAS. A number of surgeons do not tackle the SMAS for fear of injuring the underlying nerves, but no face lift is complete, without this, and at best skin only procedure, gives benefit for a few months. Revision of a face lift is also possible, and it is also possible to correct a prior poor face lift. Most common effect of a poor prior procedureis a disturbed hair line in the region of the temple, but such cases can be tackled with hair transplant in this area.
The face lift can be combined with eyelid surgery (blepharoplasty) to give a young look to the eyelids also.

Complications of Face lift

The most common complication is bleeding and haematoma formation in the post operative period. Therefore it is essential that no patient should be on aspirin therapy prior to procedure and blood pressure should be well under control before surgery.

Hospital stay

The patient need only stay in the hospital for about 24-36 hours, after which he or she can go home, but under watchful supervision. There is a definite downtime, and time has to be taken off from work/ social responsibilities to allow the incisions to heal and all the post operative swelling to settle down.

MACS LIFT - Now in India at a Fraction of the Cost of that in Europe

MACS lift (Minimal Access Cranial Suspension) is a new technique in Face Lift Surgery, that is now a rage in Europe. Dr Amit Gupta is the only Plastic Surgeon in India to have trained under Dr Patrick Tonnard (Ghent, Belgium), in MACS Lift Surgery. He has worked with him for a month. These procedures are now being performed in India. Dr Patrick Tonnard and Dr Alexis Verpaele, in Ghent,Belgium, devised the technique of MACS Lift together. This is now almost the most commonly performed procedure for face lift now in Europe, and.

The procedure is done as an out patient procedure, under local anesthesia and sedation. The patient can go home after 6 hours of the procedure. Briefly the procedure involves skin parking, a preauricular incision, in natural skin lines, a zig zag type of incision in the scalp and no incision on the neck and posterior scalp. The deeper layers of the skin are then tightened using a series of 2-3 purse string sutures, meanwhile lifting the SMAS layer and the skin along with it. An additional procedure is the neck liposuction that is done to take care of the bulge in the neck, and all the neck skin is redraped conveniently to provide a rejuvenated look.

The authors of the procedure perform a trichophytic closure, which means that they close the incision in such a way, that hair grows through the scar, thus virtually eliminating the visibility of the scar, adding to the cosmetic value of the procedure.This excellent procedure of face lift is now being done in India at very low costs. The entire procedure may be done at about 3500 $ or 2500 Euro or so. Think about it!!!!!!!!!!!!!

Blepharoplasty

Introduction

Eyes are the mirror to the world. Indeed and eyes speak so much about the face of a person. They give out the inner emotions of the person, even when the person is trying to be someone else. And unfortunately they convey the age of a person, even if that person does not feel that old. Very early age related changes are easily visible in both the upper as well as the lower eyelid. An ageing lower eyelid with its hanging fat bags gives the feeling that the person is actually older than he is. in addition the tear trough deformity that is often present (the hollow crease present below the eyes), further aggravates the situation.It is possible surgically to correct this to a large extent, in a process known as blepharoplasty or eyelid rejuvenation surgery.

Causation of the ageing eyelids

The skin of the lids tends to sag as a result of ageing. Further the fat bags which are present over the eyeballs tend to come out of their natural position, and get more visible. In some persons, the eyebrow also tends to sag down, and it is important to hitch the eyebrows as well as correct the eyelid problem.

Treatment

The surgery can be done under local anesthesia in most patients. This involves an injection containing local anesthesia in the skin of the eyelids. The skin incision is just under the eyelashes, and the scar is easily hidden in the lines of the lids, and no evidence remains of the surgery. There is also the approach where the incision is done through the conjunctiva, known as trans-conjunctival blepharoplasty. Then the excess skin over the eyelid and protruding fat bags are removed, to leave behind a younger looking eyelid, and the look is not present anymore. The fat bags can also be used to cover the tear trough, and reduce the hollowness that is present under the eyes. This procedure has been popularised by Dr Ruth Graf in Brazil, under whom the author has trained.

Possible problems

The skin over the eyelids is very thin; hence there is easily some swelling that comes there. This can take between 3-6 weeks to disappear. Thus the patient must know, that he/ she will need to wear glasses if they have to go back to work in this period. Some conjunctival inflammation can be there, particularly with the trans-conjunctival approach. If the patient is hypertensive, it is mandatory that this is controlled well before surgery. If there is the use of aspirin or similar drugs, they need to be stopped at least 7 days before surgery; otherwise there is a greater chance of bleeding.

MACS LIFT - Now in India at a Fraction of the Cost of that in Europe

MACS lift (Minimal Access Cranial Suspension) is a new technique in Face Lift Surgery, that is now a rage in Europe. Dr Amit Gupta is the only Plastic Surgeon in India to have trained under Dr Patrick Tonnard (Ghent, Belgium), in MACS Lift Surgery. He has worked with him for a month. These procedures are now being performed in India. Dr Patrick Tonnard and Dr Alexis Verpaele, in Ghent,Belgium, devised the technique of MACS Lift together. This is now almost the most commonly performed procedure for face lift now in Europe, and.

The procedure is done as an out patient procedure, under local anesthesia and sedation. The patient can go home after 6 hours of the procedure. Briefly the procedure involves skin parking, a preauricular incision, in natural skin lines, a zig zag type of incision in the scalp and no incision on the neck and posterior scalp. The deeper layers of the skin are then tightened using a series of 2-3 purse string sutures, meanwhile lifting the SMAS layer and the skin along with it. An additional procedure is the neck liposuction that is done to take care of the bulge in the neck, and all the neck skin is redraped conveniently to provide a rejuvenated look.

The authors of the procedure perform a trichophytic closure, which means that they close the incision in such a way, that hair grows through the scar, thus virtually eliminating the visibility of the scar, adding to the cosmetic value of the procedure.This excellent procedure of face lift is now being done in India at very low costs. The entire procedure may be done at about 3500 $ or 2500 Euro or so. Think about it !!!!!!!!!!!!!

Facial Lipocontouring

Dr Goldmann is famous for his work on fat injections and using fat for facial rejuvenation. The area of the face which is most responsive to fat injection are the nasolabial lines. Use of restylane and other fillers is common in the nasolabial lines, the naso-jugal groove, and other areas showing depression. But the problem with fillers is that they are expensive and are temporary. The latter aspect is also thought to be a beneficial aspect, since any irregularity is at most going to last for 5-6 months.

However here fat scores very highly, in that the procedure is a one time affair, uses self fat (autologous fat transfer) and tends to be permanent. It is specially suitable for the nasolabial lines, which are notorious for their irresponsiveness to treatments. Special instruments are available for releasing the nasolabial lines and then injecting fat there to correct the depression.

The trick in autologous fat transfer is the processing of fat. It is important to not to expose the fat to air, since it degenerates very fast. Also we must be careful to isolate the fat cells, and not the oil. Further there is a distinct stem cell layer in the form of a clot. It is mandatory to preserve this. Failure to follow these precautions is responsible for the oft repeated poor results seen with fat injections. Fat has to be treated gently like babies.

Lip Augmentation.

Many men and women are born with thin lips, and there is a constant desire to achieve more fullness in this region. Thus a number of clients request for filler injections in the lip and along the lip margin. Again we need to remember, that fat is excellent filler for lip augmentation. Fillers are better to highlight the lip margins, because the size of fat cells tends to leave a clumpy appearance at the lip margins.

Possible problems with autologous fat.

Injection of fat necessitates a small liposuction in the region of the abdomen and/ or thighs to harvest fat. Though this can be done under local anesthesia, the patient must know that an additional procedure is required, since fillers come prefilled into syringes. The harvested fat is then carefully processed and transferred to smaller syringes. This is then injected into the desired area. There is a swelling in the injected region. In the region of the lip, this can last for between 3-6 weeks, so social appearance in this time will need to be curtailed.30-50% of the injected fat may be resorbed, and thus whenever we inject fat, we always inject about 30% extra. This is responsible for the over filled look initially but always settles down within 6 weeks.

Bat ear / Prominent Ear Correction

Bat ear is a condition since birth, where the child is born with prominent ears. This is basically a fault with the folding of soft tissues of the ear during formation of the ear.

Treatment

The surgery can be done under local anesthesia in most patients. It involves, an incision on the back of the ear, and allowing folding of the soft tissues so that the ear now is more closely set and looks like normal ears. There is usually no need of admission. The scar is easily hidden in the back of the ear and is not visible