Facial Aesthetics

Your face is the part of your body that you view most often on a daily basis. If you are unhappy with a feature that you have either through birth or from age or environmental factors, it can affect your self-confidence and self-esteem.

The UPMC Aesthetic Plastic Surgery Center physicians will take the time to explain each procedure to you, and help you determine which may be right for you. We offer a variety of services including:

Blepharoplasty (Eyelid Surgery)

Overview

Blepharoplasty, or eyelid surgery, rejuvenates the upper and lower eyelids through the removal or repositioning of excess skin and fat. The procedure can provide a more rested, youthful appearance to the eyes, and frequently is done in conjunction with other facial cosmetic procedures such as a facelift or browlift.
Who is a candidate?
Blepharoplasty is a popular procedure for men and women, and is most commonly performed on patients between the ages of 40 and 70 who have excess skin in the eyelids and have a “tired” appearance. The procedure also treats an extreme excess of eyelid skin which can produce “hooding” that may interfere with vision. Blepharoplasty can be combined with a functional eyelid procedure done to address slight drooping of the eyelid. Blepharoplasty of the lower eyelids can help treat bags or dark circles under the eyes.
Before the procedure
Your plastic surgeon will give you specific guidelines about preparing for surgery including:

Smoking cessation
Medications to avoid
When to take your prescribed medications
Proper washing techniques
Restrictions regarding eating and drinking the night before surgery

Your plastic surgeon may request that you have an ophthalmology evaluation prior to surgery in order to evaluate your vision and tear producing function.
Procedure details
A blepharoplasty can be done in a variety of ways with different types of incisions. Your plastic surgeon will perform a careful evaluation of your entire face, including the area of the eyebrow and orbit, and suggest which procedure will work best for you.

Depending on the degree of excess skin and other factors, the incision may be made on the skin of your eyelids, usually in the natural creases which makes the incisions scars difficult to see after healing, or inside the lower eyelid itself.
Where will the surgery be performed?
A blepharoplasty usually is done in a hospital as outpatient surgery. You must be driven to and from the hospital by a friend or family member.
Type of anesthesia
Your doctor will recommend the best type of anesthesia for you, but local anesthesia along with intravenous sedation or a general anesthesia can be used.
Immediate postoperative recovery
In most cases, patients usually experience minimal discomfort around the incisions, which can be easily controlled with prescription pain medication. Swelling and bruising in the eyelid and the cheek area is common, and you should keep your head elevated for a couple of days after surgery to minimize the swelling. You also may notice signs of bruising — a black and blue discoloration. Both the swelling and bruising will begin to disappear within a week.
Short-term recovery
Most patients will be able to return to work in seven to 10 days. Showering is permitted within the first several days, and vigorous physical activity is limited for several weeks following surgery. Signs of surgery should completely fade within three weeks following the procedure.
Risks
A blepharoplasty often will enhance the appearance of a patient’s eye area, producing a more youthful and rested appearance but is considered major surgery. Before surgery you should think carefully about your specific expectations and communicate your goals to your plastic surgeon. Complications are rare. In addition to the risks associated with anesthesia, you might notice a slight asymmetry of your eyelids.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.
Anticipated results
A blepharoplasty usually produces a more rested, rejuvenated, and “refreshed” look to the upper and lower eyelid area.

Brow and Forehead Lift

Overview

A browlift or forehead lift is a procedure that restores a more youthful look to the upper eye and eyebrow. During this procedure, drooping eyebrows or brow tissues are elevated toward the upper eyelid. This procedure also can treat horizontal lines in the forehead and frown lines that can make a person appear tired or sad.

Elevating the brow tissue can produce the effect of opening and “brightening” the entire look of the eyes. It is frequently done at the same time as an eyelid rejuvenation (blepharoplasty), and/or a facelift.

Who is a Candidate?
Patients typically range in age from 40 to 70 and have sagging brows. The sagging can create the appearance of additional upper eyelid skin and make patients look tired. Patients with furrowed brows and “frown” lines can benefit from this procedure.

Before the Procedure

Your surgeon will give you specific guidelines about preparing for surgery, including:

Smoking cessation
Medications to avoid
When to take your prescribed medications
Proper washing techniques
Restrictions regarding eating and drinking the night before surgery

Procedure Details
Browlifts can be done in a variety of ways with different types of incisions and it often depends on the height of the forehead or hairline. Prior to the procedure, your plastic surgeon will perform a careful evaluation of your entire face. He or she will suggest the type of procedure that will work best in your particular case, and show you the location of the incisions. The incisions may be short or long depending on the degree of brow sagging, heaviness of the tissues, and whether or not you are having another procedure performed at the same time.

Where Will the Surgery Be Performed?

A browlift usually is done in a hospital as outpatient surgery, and you will have to be driven to and from the hospital by a friend or family member.
Type of Anesthesia
Your doctor will recommend the best type of anesthesia for you but local anesthesia along with intravenous sedation or general anesthesia can be used.
Immediate Postoperative Recovery
In most cases, patients report discomfort around the incision site, as well as a headache that can be controlled with prescription medication. Swelling of the forehead and eyes, and sometimes the cheeks, is common. In order to minimize the swelling, you should keep your head elevated. You may notice signs of bruising (black and blue discoloration). Both the swelling and bruising will begin to disappear in a week.
Short-term Recovery
In most cases, patients will be able to return to work in approximately 10-14 days. Vigorous physical activity will be limited for several weeks.
Risks
A browlift often will enhance the appearance of your brow and eye region. Before surgery, however, you should discuss your specific goals and expectations with your plastic surgeon. While complications of browlift are uncommon, there could be a slight asymmetry of brow appearance. In addition to risks associated with anesthesia, loss of skin sensation and temporary hair loss also may occur.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.
Anticipated Results
A browlift can produce a refreshed and rejuvenated look to the brow and upper eyelid area.

Eyelid Surgery

Overview

EYELID SURGERY

Also, known as blepharoplasty, eyelid surgery improved the appearance of the upper eyelids, the lower eyelids, or both. It gives a rejuvenated appearance to the surrounding area of your eyes, and the mid-face. Typically, after this operation you look more rested and alert. The signs of eyelid aging can occur at any age. Generally, if young people have bags or festoons under the eyelids, it is often hereditary and has nothing to do that there aging poorly. As people socialize, the appearance of the eyes is the first thing that is noticed during interaction. For someone with a “tired” appearance in the eye region, that statement of aging is often quite noticeable. Eyelid surgery can be very powerful and reversing that effect.

Why eyelid surgery?

Eyelid surgery can rejuvenate the effects of aging on the upper and lower eyelids. Sun exposure, gravity, and as well as a patient’s genetics or heredity can contribute to excess wrinkling and sagging skin of the upper and lower eyelids. Puffy bags under the eyes are common findings along with droopy upper eyelids, a product of excessive skin. All these eyelid aging stigmata can convey a tired appearance and can sometimes even interfere with full vision.

Eyelid surgery can treat:

– Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision

– Excess fatty deposits that appear as puffiness in the upper eyelids

– Bags under the eyes

Droopiness of the lower eyelids, showing white below the colored portion of the eye
Excess skin and fine wrinkles of the lower eyelid

Is eyelid surgery right for me?

The best results of eyelid surgery, are seen in patients with healthy facial tissues, and have realistic goals for improvement of the upper and or lower eyelids and surrounding areas.

These are patients without serious medical conditions that could affect healing, as well as individuals without serious eye conditions such as glaucoma, dry eye, or detached retina. A careful preoperative examination is done to rule out thyroid disorders that can cause eyelid changes.

Eyelid surgery comes with several options for anesthesia that can sometimes include office procedures under local anesthesia itself. The incisions are generally nicely concealed and heal with an almost imperceptible scar in most patients. These incisions will be discussed with you preoperatively by your surgeon.

Eyelid surgery recovery is very well tolerated, and is not described as painful. Patients can often get back to their normal routine within a week, and typically there is a 3-4-week recovery time to look un-operated.

Eyelid surgical procedures can create some of the most powerful changes in the face. It can take away a tired look, they can rejuvenate a face, and bring back a brightness to the eyes that are highlight of a patient’s face! It is very exciting for the patient and the surgeon to know a brighter more youthful face and eyelid appearance can be restored making you look and feel better about yourself!

The University of Pittsburgh cosmetic plastic surgeons are some of the best strained surgeons in the world. They bring the expertise, the experience to provide the surgical services in a safe and effective way.

We look forward to see you in consultation.

Please call us at 412-648-9670.

Facelift/Necklift

Overview

A facelift is a surgical procedure that addresses issues common to the aging face: sagging of the soft tissues of the cheek, lower face, and neck region. The procedure elevates falling cheek tissues, redefines the jaw line by lifting sagging jowls, and repositions and tightens the skin of the neck. Facelifts often are combined with other procedures, such as a browlift and/or an eyelid rejuvenation procedure (blepharoplasty).
Who is a Candidate?
Patients may range in age from 45 to 80 and should be in reasonably good health. Potential patients typically have sagging facial and neck tissues. The goal is to enhance each patient’s features, and leave the patient looking refreshed and energetic. If a patient has loose skin of the neck but minimal jowling, they may be a candidate for an isolated neck lift, which may utilize short-scar approaches around the ear.
Before the Procedure
Your surgeon will give you specific guidelines about preparing for surgery, including:

Smoking cessation
Medications to avoid
When to take your prescribed medications
Proper washing techniques
Restrictions regarding eating and drinking the night before surgery

To optimize the facelift’s results, a skin care program by a licensed aesthetician usually is recommended.
Procedure Details
Facelifts can be done in a variety of ways with different types of incisions but typically, the incisions are located in front and behind the ear, and also in under the chin. The procedure is instrongidualized based upon your goals and anatomic issues.

Your plastic surgeon will perform a detailed aesthetic analysis and a careful evaluation of the face including:

Following the initial evaluation, the surgeon also will make suggestions about other areas of the face that can benefit from surgical enhancement such as sagging or drooping eyebrows, or extra skin or fat around the eyelids.

With aging or weight loss, there is often a loss of volume in the face. Fat injections, taken by liposuction from other areas of the body, can be injected into the face to restore lost volume and refill the face to a more youthful appearance.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

your blood pressure
bleeding tendencies
history of adverse scar formation after previous surgeries

Where Will the Surgery Be Performed?

A facelift is done in a hospital as outpatient surgery but an overnight stay typically is recommended. You will have to be driven to and from the hospital by a friend or family member.
Type of Anesthesia
Your doctor will recommend the best type of anesthesia for you but a facelift can be performed under local anesthesia with the addition of intravenous sedation, or it can be done under general anesthesia.
Immediate Postoperative Recovery
In most cases, patients may experience moderate pain in the facial area for the first 24-48 hours but then it rapidly subsides. Swelling of the cheek and neck tissues usually is mild, and there may be bruising (black and blue discoloration). Both the swelling and bruising will begin to disappear in a week. To minimize swelling and discomfort, you should keep your head in an elevated position the first few days after surgery.
Short-term Recovery
In most cases, patients should be able to go out in public after 10-14 days. Showering is permitted within the first several days. Vigorous physical activity is limited for several weeks following surgery. Signs of surgery should completely fade after three weeks.

Risks

A facelift often will enhance the appearance of your cheek, jaw line and neck region but is considered major surgery. You should think carefully about your specific expectations and communicate your goals to your plastic surgeon. Complications from a facelift procedure are uncommon but slight facial asymmetries, which often exist prior to surgery, are possible. There is a slight chance of nerve damage which usually resolves itself but, in some cases, additional treatments or unplanned surgery is required.

Other potential risks include:
temporary loss of skin sensation
unfavorable scars
anesthesia-related risks
hair loss

Not every person is a candidate for this procedure, and your risk may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.
Anticipated Results
A facelift usually produces a refreshed and rejuvenated look. You will have some scars from the procedure but these usually are hidden in the creases of your face and ears, and become unnoticeable with time. Facelifts won’t stop the aging process.

Facial Implants

Overview

Facial implants for cosmetic purposes are typically done to enhance the face’s underlying structure in order to give it proportion and balance. While implants may be used in any part of the face, the cheeks, chin and jaw are the most common sites for facial implants.

Facial implants are made from solid, bio-compatible materials and are often combined with other facial contouring procedures such as rhinoplasty (nose reshaping) or ear surgery.
Type of Anesthesia
Your doctor will recommend the best type of anesthesia for you but facial implants can be performed under local anesthesia or under general anesthesia.
During the Procedure
During the procedure, your surgeon will make an incision near the part of the face where the facial implant is to be placed and will create a pocket in the facial tissue. After inserting the implant, the muscles and tissues surrounding the pocket hold the implant in place.
Short-term Recovery
Following the procedure, it is common to have swelling, numbness and discomfort at the surgical site. Your facial movements also may be limited. If your implants were placed through incisions made inside your mouth, you may be restricted to a soft or liquid diet for several days as you continue to heal.

In most cases, your sutures will stay in for seven to 10 days, and the healing will take several weeks. In addition, you may have some swelling for a few months after surgery.
Risks
In addition to the risks associated with anesthesia, you may experience infection, minor nerve damage, or shifting or misalignment of the implant.

Lip Augmentation

Overview

Lip augmentation is done through fillers, fat, or implants. The procedure is most commonly performed to give patients fuller, plumper lips, and to reduce fine wrinkles around the mouth.
During the Procedure
In most instances, a local anesthetic will be administered. During the procedure, a natural or synthetic biocompatible material is injected or implanted in the patient’s lips. Sometimes the patient’s own fat, taken from another part of the body, will be injected into the lips with the same desired results.
Short-term Recovery
Patients who receive injections can usually return to their normal activities immediately but patients who receive implants may require a day or two to recover. The results from the injections are temporary and the procedure must be periodically repeated in order to keep the desired results.
Risks
Risks can include:

Non-surgical Facial Rejuvenation

Overview

Did you know that more cosmetic surgical procedures are done with the needle rather than the knife? About 10 times more. This is happening every day across the entire country and right here in Pittsburgh.

Patients of all ages are seeking a refreshed look, with decreased facial wrinkles and increased fullness in areas of the face. This can be achieved in our office with no down time in approximately 20- or week and fluid in just before the minutes. We utilize either Botox or Dysport as a means of softening the dynamic lines that result from muscle contraction, for example those that appear as “crow’s feet” along the lateral aspect of the eyelid – or in the area in the lower central brow known as the “11’s” or frown lines. A simple injection of these medications softens these areas and has a very significant overall effect on a patient’s appearance producing a more refreshed and rested look in virtually all patients. This is done with no down time.

Other lines or folds in the face can also be softened with a all dermal filler or substance injected just beneath the skin, in some cases completely eradicating these lines. It has a particular advantage in the nasal labial fold region which is located on the inner aspect of the cheek next to the nose and upper lip. It is also effective for softening the so called “marionette lines” along the sides of the mouth. And these medicines are also used to increase the volume to the face in the cheek area and in front of the jowl to help create a smoother, crisper, more youthful jawline.

Plastic surgeons in the Department of Plastic Surgery at the University of Pittsburgh (UPMC) do these procedures on a daily basis. Patient’s satisfaction is high, adverse effects are very rare, and there is no down time. Come in and see us for a consultation.

For an appointment call us at 412-648-9670.

Rhinoplasty

Overview

A rhinoplasty is a procedure to reshape the nose and/or to improve breathing. The most common reasons patients undergo a rhinoplasty include:

To change or improve appearance
To open blocked nasal passages that are caused by a deviated septum
To correct an injury or birth deformity

The surgery is done by making incisions inside the nostrils or outside the nostrils across the columella. The underlying cartilage and bone structures are then exposed and altered to produce the desired result.
Who Is a Candidate?
A rhinoplasty can be done at any age, but the procedure is recommended for those who have finished puberty and nose growth. Any person who wants to improve the appearance of their nose is a good candidate. Patients with a history of nasal trauma and increased difficulty breathing are candidates for evaluation.
Before the Procedure
Some of the specific instructions you’ll receive about preparing for surgery include:

Smoking cessation
Medications to avoid
When to take your prescribed medications
Proper washing techniques
Restrictions regarding eating and drinking the night before surgery

Procedure Details

A rhinoplasty can be done in a variety of ways with different types of incisions. Your plastic surgeon will perform a careful evaluation of your entire face including your chin and mid-face, and suggest which procedure is best for you. The surgeon will show you where the incisions will be made.

A rhinoplasty has three main components:

Lifting the skin of the nose from the bone and cartilage. The nose is injected with xylocaine (a numbing medication), and epinephrine (to minimize bleeding). After the incisions are made, the skin is then lifted off the cartilage of the nose to expose the cartliage and the bone structures that will be altered.
Remodeling bone and cartilage. Depending on the desired outcome, some nasal bone may be removed, precisely cut, and reset to a new shape. Cartilage may be trimmed. Other techniques involve using a tissue graft (most often cartilage or bone) to help remodel the shape of the nose. Occasionally, a synthetic graft may be used.
Redraping the skin over the new base. Once the procedure is finished, the incisions are closed and the skin is redraped over the new bone structure. The skin is taped to keep it in place and a protective splint is applied on the outside of the nose so that it maintains the proper position when healing. Nasal packs generally are not necessary.

Where Will the Surgery Be Performed?

A rhinoplasty is usually done in a hospital as outpatient surgery, or you may be required to stay overnight. You must be driven to and from the hospital by a friend or family member.

Type of Anesthesia

Your doctor will recommend the best type of anesthesia for you but local anesthesia along with intravenous sedation or general anesthesia can be used.

Immediate Postoperative Recovery

In most cases, patients may experience some nasal discomfort and swelling immediately after surgery. You should keep your head elevated for the first few days after surgery. Take prescription or over-the-counter pain medications as directed by your doctor.

You will have to breathe and sneeze through your mouth, and you will be instructed to avoid totally blowing your nose during the first week, and not blowing it forcefully for one month. You may notice signs of bruising (black and blue discoloration) below your eyes. Both the swelling and bruising will begin to disappear in a week, and the external nasal splint and all external sutures will be removed within a week’s time.

Short-term Recovery

Most patients will be able to return to work in approximately 10-14 days.
Showering is permitted within the first several days. Vigorous physical activity is limited for several weeks following surgery. Protect your nose from any injury for six weeks, do not wear glasses, and be careful when washing your face.

Risks

A rhinoplasty will routinely enhance the appearance and function of your nose but is considered major surgery so you should think carefully about your specific expectations and communicate your goals to your plastic surgeon.

Risks from a rhinoplasty are uncommon but possible complications include slight nasal asymmetry, poor healing of the skin, anesthesia-related risks, development of permanent excess scar tissue, perforation of the septum, or collapse of the nasal bridge (relatively rare). Repeat surgery because of infection and dissatisfaction with the result can occur.

Facial Aesthetics

AESTHETIC SURGERY(Cosmetic Surgery)