FACIAL SURGERY

Nose Surgery: Rinhoplasty
Chin Surgery: Mentoplasty
Ear Surgery: Otoplasty
Cheek Surgery: Meloplasty
Bichat Bags

NOSE SURGERY

RHINOPLASTY

The nose has a very specific role in breathing that should be improved after a procedure and its shape should be sufficiently normal so that the surgery is imperceptible. 

The nose does not play prominently in the expressiveness of the face as does the look and shape of the mouth (smile, displeasure, etc.)  A well-proportioned or beautiful nose is considered a general facial feature like facial shape, cheekbone definition or the chin.
Cosmetic surgery should leave your nose working perfectly but also well-proportioned and sculpted through taking into account the totality of you as a person, especially your face.  Furthermore, the result achieved should be natural and not in any way appear to be the result of a cosmetic procedure.  Many times the patient is able to actually improve his facial profile with a rhinoplasty and accomplishing at the same time a chin augmentation to in order to make his or her appearance more harmonious with all of his face.
The preoperative study study is very important in these type of procedures, as much for identifying unique anatomical issues that causes the underlying problem (a deviated septum, misaligned alar folds, etc.) as for evaluating pre-existing assymetries and the type of change that is desired.
We are able to classify a nose as “primary” that has never been operated on and “secondary” when it has suffered some kind of trama or condition that required surgery. 

Secondary noses tend to have fiberous tissues that are more difficult to treat and that tend to  have post-operative swelling a longer period of time.
There are a variety of rhinoplasty techniques which into one of two categories:
The closed rhinoplasty in which the incisions lie within the nostrils and where some phases of the procedure take place without directly sight of the structures involved.
The open rhinoplasty that uses an incision on the bridge of the nose permitting a direct of the underlying tissues.
A rhinoplasy (nose surgery) can be performed using either local or general anesthesia and may require anywhere from a few hours or a whole day in the clinic.  It is a procedure that is by no means painful, although there is often bruising an dswelling in the area around the eyes for a few days afterward.  Often a bandage in the nose area is required for a few hours or few days as well that can cause some discomfort for the patient and require temporary breathing through the mouth. 

Normally, a splint or dressing of moldable plastic or plaster is applied and then removed after about a week in order to make sure that any swelling cannot alter the result.  One should also take into account that once the bandages are removed, the nose may still be slightly swollen and, therefore, it may be necessary to wait for a time as this can vary from patient to patient in forder to achieve what is desired.

CHIN SURGERY

Mentoplasty

The search for aesthetic improvement and proportionality of ones facial features is often advised through augmentation or reduction of the cheek or jawline in order to match most closely the rest of the face.  A jaw implant can be solid silicon which allows us to place the implant using an incision located in the inside of the mouth between the gumline and interior lip or with a small incision under the jawline.

In order to reduce a jaw that is too prominent, it is necessary to perform the “sanding” or removal of a section of bone (osteotomy) through an incision inside the mouth.  An osteotomy allows you to lengthen, shorten and stretch the jaw.
It is important to identify possible asymmetries and differences in form and shape from one side of the face to the other.
These procedures can be accomplished with either local or general anesthetic and the time of your stay in the center a matter of only a few hours if it is accomplished on an outpatient basis.

EAR SURGERY

Otoplasty

Any differences from what is “normal” in the form or size of one’s ears is able to create distress for the patient so that even sometimes they will even hide them under their hair.  It is even common that young children will petition their parents for an operation because their classmates are making fun of them.

The otoplasty or ear surgery can be performed at an early age without waiting for the final development of the child.  Furthermore, when the ears are overly large, it is possible to reduce the size of all of the ear and, in addition, ears that stick out too far from the head can be situated correctly.
Ear lobes that have been pierced for earrings and the holes stretched overly wide or even torn (through continual use or trauma from removing the earrings) can be repaired through means of closing the hole and then reopening it after several weeks have passed.  In ears where the ear lobe is too large in proportion to the rest of the ear (frequently in persons of advanced age), it is possible to diminish the size of the ear lobe while rejuvenating the face during a face lift.  In adults an otoplasty is generally performed with localanasthesia and children with general anesthesia.

Moving the ears closer to the head is accomplished through an imperceptible incision behind the ear along the line where the ear joins the head.  There are different otoplasty techniques, some of which are based in the weakening of the ear cartilage allowing the modification of its shape and yet still are based on the applications of suture points to bring things closer together.  The objective of both techniques is to produce an ear more anatomically proportional and natural, as well as restoring and maintaining the normal contours and angles.

CHEEK SURGERY

MELOPLASTY

The cheekbones, of course, are the bones that provide support to the prominent features we know as cheeks.  These structures bring elegance and beauty to the face.  When the cheekbones have not developed sufficiently, they appear flattened or diminished (malar hypoplasia) giving the patient the appearance of fatigue or lack of personality.
Repositioning the cheekbone can be accomplished through a unique outpatient procedure or instead at the same time that we are doing other cosmetic work such as nose surgery or an eye lift.  This procedure can correct both lack of cheekbone prominence or assymetries is achieved by placing an implant of the appropriate configuration, size and shape through a minimal incision at the back of the mouth.

In some cases the incisions used for eyelid surgery can be utilitzed.  In aactuality, it is possible to proceed with a cheek augmentation using fat extracted from the same patient or also through solid implants or even through an injection of synthetic material.  This also can be done by itself or combined with other facial rejuvenation procedures such an endoscopic eyebrow life or an eye life of the uppoer and lower eyelids, jaw surgery or skin treatments on the neck for improved results.

BICHAT BAGS

Bichat Bags are fatty “bags” found in the cheek area.  The purpose in an extraction is in this case to refine the cheeks, accentuate the cheekbones and achieve an effect similar to that expected when applying blush to the sides of the face.

A Bichat Bag fat extraction is usually indicated for persons with a very round face that desire a more angular appearance. This usually requires only a local anesthetic.  This procedure is simple and should last between 30 and 45 minutes with a result that is very similar orthodontic procedures.
 
Inflammation is usually minimal and dimishes steadily.