Facial Procedures
1. Forehead Lift
Due to age or excessive facial expressions such as frowning, the forehead shows signs of ageing such as wrinkles, creases and drooping eyebrows. The brows are often the first indicators of ageing as the skin of the forehead begins to lose its elasticity. This can make you appear angry, depressed, sad, or tired-looking.
The brow lift is a procedure designed to reverse the signs of ageing in the forehead and brows by elevating the brows and weakening the muscles that cause the deep creases. The commonest age group for brow lifts is men and women between 40 and 60 years.
Brow lifts are commonly done in addition to other facial surgery, such as a facelift, eyelid surgery, or cheek or chin implants.
Post-operatively, you will look younger, feel more confident, and your eyes will appear fresh.
Types of brow lifts
Mini Brow Lift
A mini brow lift is a minimally invasive procedure that tightens the skin and muscles in the forehead. It involves making multiple small incisions behind the hairline.
Lateral Brow Lift
This procedure targets only the outer brow, and corrects drooping of the eyebrows, by removing excess skin and lifting the outer 1/3 rd of the eyebrows.
Endoscopic Brow Lift
This involves creating 3-6 tiny incisions through which an endoscope is placed. The entire brow area can be lifted by this procedure, and the muscles that cause the grooves can be appropriately weakened.
Classic Brow Lift
This procedure is the oldest and most reliable method in brow lift surgery, and is also known as the Coronal Brow Lift. However, this procedure is not commonly performed any more because of the large incision required. It is especially indicated for raising the hair line.
Incisions are always positioned for least visibility and can be placed within or at the hairline, or even inside a deep forehead crease, or just above the eyebrows.
2. Face Lift (Rhytidectomy)
As people age, the contours of their faces begin to soften and develop wrinkles and furrows, and the skin of the cheeks and jaw begins to sag. This gives you a tired look, and makes you look older than you feel.
A Face Lift is a procedure that is done in people who want to rejuvenate their face. It is also known as Rhytidectomy. The goal of a facelift is to reduce the obvious signs of aging by removing excess fat and tightening the skin and underlying tissue causing wrinkles, creases and lines to disappear.
A facelift is normally required after the age of 40. The type of procedure that would suit you depends on the area of the face that concerns you, the amount of excess skin, fat and the quality of your tissues.
Face Lift Procedures
The face is usually divided into thirds for examination as well as treatment, and there are a number of procedures are available to treat the relevant areas. Surgical face lift procedures are done under General Anaesthesia.
Techniques available:
Traditional Facelift
A traditional facelift involves a large incision along the margin of the ears through which the entire facial skin and muscles are raised, tightened and redraped, giving your face a more youthful appearance, with better-defined contours and the disappearance of most of your wrinkles.
Mini – Facelift
A mini facelift is a surgical procedure that involves smaller and fewer incisions than a traditional facelift. The correction achieved is not as dramatic as a full facelift, but it is very useful in younger patients. People who have done a mini facelift may never need a full traditional facelift in the future.
Laser Facelift
In younger patients who want to delay the early signs of ageing, a laser facelift may be of certain benefit, as there are no incisions or sutures, and the recovery time is short. However this procedure is not for all patients.
Endoscopic Facelift
An endoscopic facelift is done using multiple tiny incisions to gain access to the tissues under the skin. It is quite effective if you do not have too much loose skin. The effect, however is not as pronounced as a surgical facelift.
Threadlift
A threadlift is a minimally invasive procedure that uses specially designed surgical sutures to suspend sagging facial tissues. It is effective in select cases, and the effects last for a shorter period. However the procedure is short, most patients going home the same day, and it can be repeated if necessary.
Non- Surgical Facelift
This is a term used for a number of procedures, used alone or in combination, to reduce the effects of ageing of the face. These procedures involve Botox, Fillers and Dermabrasion.
3. Non-Surgical Facial
Fillers
Temporary Fillers
Injectable fillers are one of the most popular facial rejuvenation techniques. As a person ages, our tissues begin to sag due to the effects of gravity, sun exposure, diet, genetics, and years of facial movement and expression. All these factors contribute to the development of lines, wrinkles and folds in the face.
Modern day fillers give shape with the body’s own natural material called collagen or hyaluronic acid. They bind water in your skin, to lift and give new firmness. After injection, the gel binds water and generally remains for many months. One of the great advantages of temporary fillers is that they are long-lasting but not permanent.
How long a treatment holds its effect is very individual. This depends on many factors, such as your age, skin type, lifestyle and muscle activity, as well as the injection technique. Once fully absorbed the gel disappears unnoticed from the body.
Most patients choose to have a follow-up treatment six to twelve months after an initial treatment of wrinkles or facial contouring. After lip treatments, a follow-up is normally needed after about six to nine months.
Permanent Fillers
Permanent fillers are also available to correct contour defects of the face and body, especially for plumping up the lips. These materials do not get absorbed by the body and therefore have a long lasting effect.
Botox
Repeated facial movements such as frowning, squinting, laughing etc. form lines known as dynamic wrinkles. These are commonly seen around the eyes, forehead, and mouth, and may give the appearance of advancing age. Botox works by relaxing the muscles that cause dynamic wrinkles giving the face a rejuvenated appearance. The procedure is so simple and quick that patients can have it done in their lunch hour, and go back to work immediately after.
When injected by a trained doctor, the procedure takes just a few minutes. The wrinkle-smoothing result can be seen within days, and can last for 3 – 6 months. It is a simple, noninvasive treatment that gives more relaxed, refreshed, and younger-looking faces.
Specific areas can be targeted for Botox treatment, such as ‘Crow’s Feet’ around the eyes, drooping eyebrows or the deep lines around the mouth.
Botox can also be used to reduce excessive sweating of the hands and armpits.
Threadlifts
As we begin to age our tissues become weak, we lose subcutaneous fat and the underlying support structure becomes lax and begins to sag. Sagging is seen earliest around the cheeks, eyes, brows, the jowls, and neck creating a longer and older-looking face, with blurred or softened jaw lines.
The Threadlift procedure is a minimally invasive procedure that utilizes sutures to mechanically lift the skin. It is most commonly used in the face and neck to correct signs of early ageing, although it can be used to lift sagging breasts and buttocks. It is usually done under Local anaesthesia and IV sedation, or entirely by local anaesthesia as a day care surgery.
Threadlifts are done using absorbable or permanent threads, and can make you look upto ten years younger. The effect of a threadlift usually lasts for 2 – 3 years, after which gravity and age begin to catch up with you again. Threadlifts with absorbable threads can be repeated if necessary.
Fat injections
Fat injections are also very useful to fill out aged sunken areas of the face and body, and restore the volume of youth. The fat is first removed from an area of your own body, processed and reinjected into areas that are depressed.
Fat injections are mostly used to augment the breasts, lips, and cheeks. Fat injection can give a much longer lasting effect than temporary fillers.
Growth Factors
Growth factors are chemicals which enable our tissues to grow and heal. The Platelets in blood can be made to release these growth factors under certain conditions in the lab. These growth factors are then injected into the skin of the face, giving you a healthy glow and a new younger, fresher look without any surgical scars. Growth factors can even be used to restore volume to the face.
4. Eye Surgery (Blepharoplasty)
As people age, their lower eyelids begin to develop ‘bags’, while their upper eyelids start sagging, initially at the outer edges, then all over. This gives them a tired, sad look. Women can disguise this problem more easily than men using cosmetics.
One can also develop cholesterol deposits beneath the skin of the upper and lower eyelids, causing irregular, pigmented skin.
Cosmetic Eye Surgery, or Blepharoplasty, involves a number of procedures to correct sagging or bulging eyelids, as well as other problems, such as cholesterol deposits or skin lesions.
Eye Surgery Procedure
A blepharoplasty can take anywhere from 1 to 3 hours depending on the type of procedure being done.
It can be done as a day care procedure under local anesthesia in most cases, but may also be done under sedation or general anaesthesia.
You will be able to go home within a few hours, and may have a dressing for a day or two. Full recovery may take upto a week.
You should avoid any strenuous activity that for the first few days, and sleep with your head raised. You will usually be able to wash your hair after 48 hours.
Complications
The commonest problem during recovery is swelling and bruising, which tends to disappear within a week or two.
Scars may stretch and become prominent.
Infections do occur, although rarely. This is usually treated with medication.
Ectropion, or pulling down of the lower lid may occur, causing tears to spill over. This may necessitate further surgery.
Blindness, though, extremely rare can occur, usually secondary to a large blood clot in the operated area.
5. Nose Surgery (Rhinoplasty)
Your nose is the most prominent feature of your face. Regardless of which direction you view your face your nose is always the center of attention. Many people are unhappy with the appearance of their nose, thinking it too large, wide, crooked or curved.
A ‘Nose Job’ or Rhinoplasty can dramatically improve the appearance of a nose, and correct imperfections, and is performed for cosmetic reasons or for reconstructive purposes to correct birth defects, chronic breathing problems or after injury.
The aim of rhinoplasty is to reshape the nose and correct any disproportion. A nose can be made smaller and shapelier, the width of the nostrils can be reduced, the tip can be raised, a curved hump can be removed, the angle of the nose with the lip can be changed, depending on your specific complaint and the proportion of the rest of your features. It can be combined with other procedures such as chin augmentation to enhance the aesthetic results.
There are two main sculpting techniques used in rhinoplasty surgery.
Open Rhinoplasty
Open rhinoplasty involves making an incision on the skin outside the nose, in order to peel back the skin and fully visualize the bones and cartilages. It provides the best access for technical precision.
Closed Rhinoplasty
In a closed rhinoplasty, all the incisions are made inside the nostrils, so that there are no scars visible on the outside. However, this procedure is more technically challenging and may not be indicated for all patients.
6. Ear Surgery (Otoplasty)
Most people who dislike their ears think that they are too large or that they stick out. Women can disguise this problem more easily than men, because they can adjust their hairstyle to minimize ear show. Growing up with protruding and odd shaped ears, however, can have a huge psychological impact on a child, who may become the object of jokes.
In today’s fashion-conscious world, ladies also tend to wear heavy earrings, which may cause the hole in the earlobe to enlarge, or even tear if the earrings are caught in clothing or pulled out by accident.
Cosmetic Ear Surgery, or Otoplasty, involves a number of procedures to correct prominent ears, as well as other problems, such as torn ear lobes or enlarged ear-ring holes.
Surgery for Prominent Ears (Bat ears)
This procedure is also known as pinnaplasty, and is a relatively simple and short surgery, with minimal recovery time. It is done under Local Anesthesia in adults, and under General Anesthesia for children, usually as a day care surgery.
Surgery for Torn Earlobes
This involves repairing earring holes which have become enlarged due to wearing heavy jewelry, or have torn completely due to earrings getting caught in clothing, or being pulled by small children.
Reconstruction of a Birth Defect
Congenital deformities of the ears are not very common, but these defects may have a severe impact on the psyche of the child. Depending on the ear structures and tissues present, a number of surgical procedures can be done to correct these deformities.
Ears Too Close To Your Head
This extremely rare condition can be rectified by placing a piece of cartilage (or silicone) underneath your skin and behind your ear to push your ear forward into a normal position.
Other Ear Irregularities
Other irregularities cause problems as well. For example, your ears can be too large, or the upper area of your ears can droop over (Lop Ears) or be pointed. In addition, the lobes of your ears can be too big or torn and disfigured.
7. Cheeks & Chin Surgery
Everyone does not have a perfect face. Many people would like some modification to the contours of their face, to give them a look closer to their ideal.
You may feel that you have a small chin in proportion to your face, or that your cheeks are too flat. The contours of the face, especially the cheeks, the jaw and the chin are areas that can be reshaped and augmented, giving you the features that you have always desired. You may even want a dimple in your chin or thicker, pouty lips to enhance your smile.
Face Implant Procedures
Cheek Implants
High cheekbones are a feature seen on the beautiful faces you see on models and actors. You can now get the high prominent cheekbones that you have always desired. Cheek implants are relatively safe, can be done as an OPD procedure, and have a very short recovery time. The implants are inserted either through an incision in the lower eyelid, or inside the mouth.
Jaw Implants
People with small chins often wish that they could improve their appearance, due to the age old beliefs that a prominent chin and jaw are the signs of strength and prosperity. Both the chin and the sides of the jaw can be reshaped with implants to give you the look you desire.
There are two types of implants, one to augment the chin and make it more prominent, and the other to augment the sides and angle of the jaw to make it more prominent.
Chin and jaw implants are custom shaped to suit your particular needs.
Nose Implants
Augmentation of the dorsum of the nose can also be done using implants. The procedure is shorter than a traditional rhinoplasty, has less downtime and can be done as an OPD procedure. It is done via an incision within the nostril, so there are no visible scars seen.
Dimple Creation
You can get that dimple in your cheeks that you always wanted. Surgical creation of a dimple is a simple, short procedure done under local anesthesia. There is almost no downtime, and you can resume your normal life in a day or so.
Fat Grafting
Fat Grafting can be done using your own fat, in order to increase your cheekbones, or enhance your jawline.
8. Threadlifts
As we begin to age our tissues become weak, we lose subcutaneous fat and the underlying support structure becomes lax and begins to sag. Sagging is seen earliest around the cheeks, eyes, brows, the jowls, and neck creating a longer and older-looking face, with blurred or softened jaw lines.
The threadlift procedure is a minimally invasive procedure that utilizes sutures to mechanically lift the skin. The suture material (polypropylene) is FDA approved and has been used in surgery for decades. It has been modified by creating “cogs” or “barbs” on one side of the suture. These barbs engage the soft tissue and create a lifting effect. Newer absorbable threads have also been designed.
It is also known as the Featherlift, Contour Lift, Aptos Lift, Happy Lift, and Suture Suspension Face Lift, depending on the type of thread used.
Each thread may have unidirectional or bidirectional barbs, cogs or cones, and each type of thread has a specific indication and location that it can be used.
Areas that can be treated:
Face and Neck
The face is the most common area of the body to be treated by threadlift among both men and women. Not all patients are good candidates for threadlifts. The individual areas that can be treated are the forehead, the eyebrows, the cheeks, the jowls, and the midface. Threadlift can also be done for sagging neck folds.
Buttocks
The shape of the buttocks is formed by subcutaneous fat. The goal of threadlifts of the buttocks is to correct a minimal sagging of the fat pads.
Breasts
In Females: Threadlift of the female breast is done to correct early sagging of the breasts with minimal pain, rapid recovery, quick return to normal activities, and virtually no scarring. It is done in women who feel that their breasts have begun to sag, usually after breastfeeding stops, or as age advances, but who do not need or want to undergo a full breast lift surgery. Threadlift of the breasts can even be done to reposition the nipples.
9. Hair Restoration
The hair on your head is often described as your crowning glory, and it is therefore a cause of concern to you when you see it thinning or falling out. This is a problem common to both men and women, although the patterns of the hair loss are different in both cases.
There are a number of options, from medical to surgical that can help you slow or stop hair loss, or even restore your lost hair.
Medical hair restoration involves using a number of medicines to slow down hair loss, and even restore some hair. It is the first line of management in hair loss.
Surgical hair restoration is for more advanced cases of hair loss, and can be done in both men and women. It involves transplanting hair from one site to the area of hair loss.
About Hair Loss
A hair follicle is composed of a structural protein called keratin which is present in our nails and the outer layer of our skin.
Each strand of hair consists of three layers:
- The innermost core known as medulla found only in mature thick hair
- The middle layer or the cortex , the main body of the hair which provides color, texture and strength to hair
- The outermost colorless layer or cuticle , the main function of which is to protects the cortex
A hair follicle is composed of a structural protein called keratin which is present in our nails and the outer layer of our skin. Each strand of hair consists of three layers:
- Anagen – Growth Phase (2-6 years, 85% of scalp).
- Catagen – Transitional phase (30 to 60 days)
- Telogen – Resting Phase (2 to 3 weeks, 10-15%)
Hair loss in men
Male–Pattern Baldness (Androgenic alopecia) is the commonest cause of balding in men.
Male hormones or androgens (DHT) are present in both men and women, though the concentrations vary greatly. The production of DHT, and also the density and the location of androgen-sensitive hair follicles on the scalp is genetically determined. It is the metabolism of these androgens which is the main cause of Androgenic Alopecia.
Proper nutrition is also critical for the maintenance of the hair. DHT prevents the necessary proteins, vitamins and minerals from providing nourishment to the hair follicles.
Male pattern baldness is classified according to the Norwood scale.
Hair loss in women
The typical pattern of female baldness is different from that of male pattern baldness. Although thinning of hair is seen all over, the frontal hairline is usually preserved. Widening of the parting is also often seen. Female pattern balding is permanent, although it rarely progresses to total baldness, but it can cause severe distress.
Female pattern baldness is classified according to the Ludwig Scale.
Hair loss can also occur for other reasons such as:
- Temporary shedding of hair (Telogen effluvium) usually after a stressful period such as pregnancy, severe illness, etc.
- Breaking of hair (from styling or straightening of hair)
- Patchy areas of total hair loss (alopecia areata) due to disease or allergy
- Thyroid Diseases
- Certain skin diseases
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