Surgical Treatments

Enhance Aesthetics Facelift
Enhance Aesthetics Neck Liposuction
Enhance Aesthetics
Eyelid Surgery (Blepharoplasty)
Enhance Aesthetics Nose Reshaping (Rhinoplasty)
Enhance Aesthetics Ear Reshaping (Otoplasty)
Enhance Aesthetics
Browlift (Forehead Lift)
Enhance Aesthetics Orthognathic (Facial or Jaw Surgery)
Enhance Aesthetics Chin Correction (Genioplasty)
Enhance Aesthetics Scar Revision
Enhance Aesthetics Removal of Facial Skin Lesions
Enhance Aesthetics
Facial Cosmetic Surgery

Facelift

Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow's feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.

If you ever wondered how a rhytidectomy, or facelift, as it is commonly called, could improve your looks or self-confidence, you need to know how a facelift is performed and what you can expect from this procedure. This advice sheet can address many of your concerns and provide you the information you need to begin considering facelift surgery.

Is A Facelift For You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of rhytidectomy is crucial and psychological stability is vital. There is no ideal in a facelift. Rather, the goal is to improve the overall facial appearance. Skin type, ethnic background, degree of skin elasticity, individual healing, basic bone structure, as well as a realistic attitude are factors that should be discussed prior to surgery. This procedure is sometimes performed on patients in their thirties, and successful surgery has been performed on patients in their eighties. A facelift cannot stop aging, nor can it turn back the clock. What it can do is help your face look its best and give you a look of health and a more youthful appearance. A side benefit is that many patients experience increased self-confidence.

Before deciding on a facelift, you should discuss with Mr Majumdar whether the overall effect will be more successful if additional changes are made in the chin and neck areas through other facial surgery. Many patients decide to have facial liposuction to remove excess fatty deposits in conjunction with a facelift. If several flaws need correction, more than one procedure may be necessary for the best overall result.

Making The Decision For A Facelift

Your choice of a qualified facial surgeon is of paramount importance. During the preliminary consultation, the surgeon will examine the structure of your face, skin texture, color, and elasticity. Photographs will be taken so we can study your face. Individual risks will also be examined, especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, and any deficiency in blood clotting. Mr Majumdar will take a thorough medical history, as well as assess the patient's mental and emotional attitudes toward the surgery. Because a realistic attitude is crucial to the success of the surgery, the surgical procedure and realistic expectations will be discussed.

After the decision to proceed with a rhytidectomy is made jointly by you and Mr Majumdar, he will describe the technique indicated, the type of anaesthesia, the surgical facility, any additional surgery, the pros and cons to include possible complications, and costs of the procedure.

Understanding The Surgery

The incision begins in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.

After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips, which permit surgery without shaving hair from the incision site. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anaesthesia, and a mild intravenous anaesthesia, the patient will experience little discomfort. Some surgeons prefer to use general anaesthesia for facelifts. Following the surgery, Mr Majumdar will apply a dressing to protect the entire area where the incisions have been made.

What To Expect After The Surgery

Even though most patients experience very little pain after surgery, Mr Majumdar will still prescribe medication. Some degree of swelling and bruising is unavoidable, and we advise you to use cold compresses to keep swelling to a minimum. If a dressing has been applied, it will be removed within one to two days. We will advise you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery.

In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first day after surgery. All sutures and staples are usually removed within five to 10 days following surgery. We advise that patients avoid vigorous activity. Patients should prearrange for post-surgery support from family and friends.

Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature. In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred. Bear in mind that the aging process continues after surgery and that some relaxation of tissues will occur over the first few weeks.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

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Neck Liposuction

The face and neck are usually the first features we notice when we meet someone new, so improvements in this area can create a dramatic change. A firm, trim neck gives the face a more youthful look. Patients who have been self-conscious about their bulging necklines often feel more comfortable wearing a range of clothing and jewellery styles after liposuction

Neck liposuction removes excess fat and skin, and can help tighten sagging skin around the chin and ear area. Neck liposuction reduces fullness in the neck and can lessen sagging skin which can be caused due to a heredity feature or aging.

Liposuction of the neck is intended to give the patient a more youthful neck with a better contour.
The procedure requires an incision under the chin. Fat is suctioned or directly excised depending on individual findings. The patient goes home with chin and neck in an elastic neck sling. Initial discomfort is easily controlled with oral medication. Swelling and bruising disappear over approximately 2 weeks.

Even though the neck size has been reduced, there may be extra skin once the fat has been removed. Although wearing the compression band will help to firm the area, this extra skin may sag, especially if the skin elasticity is poor. It may be necessary to perform a neck lift or face lift, either concurrently or after this procedure. The final result is evident in 1-3 months Neck liposuction can also be carried out at the same time as other cosmetic procedures such as chin implants and face lifts

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Eyelid Surgery (Blepharoplasty)

This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions.  If you have any other questions that the leaflet does not answer or would like further explanation please ask.

Surgery of the Eyelids

Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Blepharoplasty removes the excess fat, muscle, and skin from both upper and lower lids. The results can be a refreshed appearance, with a younger, firmer eye area. Though blepharoplasty is often performed as a single procedure, if appropriate we may also recommend a browlift, facelift, or skin resurfacing to achieve the best results.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Please ask Mr Majumdar specific questions about your needs.

Making The Decision For Blepharoplasty

During the pre-surgical consultation, you will be examined or asked to answer queries concerning vision, tear production, use of lenses, and your desires for surgery. Good health and realistic expectations are essential . Mr Majumdar will explain what you can expect from blepharoplasty and take a complete medical history. Factors to be weighed include age, skin type, ethnic background, and degree of vision obstruction.

After a mutual decision is made by both you and Mr Majumdar, the technique indicated for your individual surgery will be discussed. The type of anaesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be discussed in detail.

Understanding The Surgery

In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.

In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take approximately two hours.

What To Expect After The Surgery

Immediately after the surgery has been completed, we may apply tiny sterile bandages to support the incision. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. You will be prescribed the necessary medications.

For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eyedrops may be recommended. We will give you a postoperative advice sheet. Permanent stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.

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Nose Reshaping (Rhinoplasty)

Understanding the surgery

The definition of rhinoplasty is, literally, shaping the nose. First, incisions are made to get to the bone and cartilages of the nose . The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, some of the bone and cartilage are removed, added to, or rearranged to provide a new shape. For example, when the tip of the nose is too large, we can shape the cartilage in this area to reduce it in size. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The tissues are then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed.

What To Expect After The Surgery

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structure stable for at least five to ten days. If packing is placed inside the nose during surgery, it is removed the morning following the surgery. Your face will feel puffy, especially the first day after surgery. Pain killers may be required. You are to avoid blowing your nose for seven days after surgery.

In the immediate days following surgery, you may experience bruising and minor swelling around the eyes. Ice packs are used to reduce the bruising and discomfort. Absorbable stitches are usually used that do not have to be removed. Nasal dressing and splints are usually removed six or seven days after surgery. It is crucial that you follow the postoperative advice, especially to keep your head elevated for a certain period after surgery. Some activities will be prohibited in the weeks after the procedure. Sun exposure, exertion, and risk of injury must be avoided. If you wear glasses, special arrangements must be made to ensure that the glasses do not rest on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without putting pressure on the area where surgery was performed.

Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should contact us immediately. It is essential that you keep your follow-up appointments with Mr Majumdar.

Complications

1 General complications of any operation

  • Pain
  • Bleeding
  • Infection in the surgical wound
  • Blood clots

2 Specific complications of this operation

  • Bruising and swelling
  • Bleeding caused by infection
  • Redness
  • Unsightly scarring
  • Injury to nerves
  • Cosmetic problems
  • Nasal obstruction
  • Graft rejection

Summary

A rhinoplasty is a cosmetic operation to improve the appearance of your nose. You should have realistic expectations about the results. It is essential that you understand you must be patient. The nose takes up to a year for the final shape to be fully achieved.

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Ear Reshaping (Otoplasty)

Probably no other physical characteristic cries out for facial plastic surgery more than protruding ears. Children, long the victims of cruel nicknames like "Dumbo" or "Mickey Mouse," are the most likely candidates for otoplasty, but this surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Even if the ears are only mildly distorted, the condition can lead to self-consciousness and poor adaptation to school. When it comes to otoplasty, conventional wisdom is the earlier the better.

Adults may also benefit from this procedure, which improves self-esteem with relative ease. Often, adults choose this surgery in conjunction with other facial plastic surgical procedures. Not only is it possible to "pin back" ears, but ears can also be reshaped, reduced in size, or made more symmetrical.

If you are wondering how otoplasty can improve the way you look, you need to know how otoplasty is performed and what you can expect from this procedure. This advice sheet can address many of your concerns.

Is Otoplasty For You?

General good health and realistic expectations are prerequisites. It is also important to understand the surgery. Otoplasty will not alter hearing ability. What is important for successful otoplasty is that the ears be in proportion to the size and shape of the face and head.

When considering otoplasty, parents must be confident that they have their child's best interests at heart. A positive attitude toward the surgery is an important factor in all facial plastic surgery, but it is especially critical when the patient is a child or adolescent.

Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears does not provide the same molding capacity as in children. A consultation with a facial plastic surgeon can help parents decide what is best for their child, not only aesthetically, but also psychologically and physically. Timing is always an important consideration. Having the procedure at a young age is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping; and secondly, the child will experience psychological benefits from the cosmetic improvement.

Making The Decision For Otoplasty

Your choice of a qualified facial surgeon is of paramount importance. During the consultation, Mr Majumdar will examine the structure of the ears and discuss possibilities for correcting the problems. Even if only one ear needs "pinning back," surgery will probably be recommended on both ears to achieve the most natural, symmetrical appearance.

After the surgeon and patient decide that otoplasty is indicated, Mr Majumdar will discuss the procedure. Following a thorough medical history, he will explain the kind of anaesthesia required, surgical facility, and costs. Typically, a general anaesthesia for young patients and a local anaesthetic combined with a mild sedative for older children and adults. Under normal conditions, otoplasty requires approximately two hours.

Understanding The Surgery

Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The necessary amounts of cartilage and skin required to achieve the right effect will be removed. In some cases, Mr Majumdar will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage.

In other instances, no cartilage will be removed at all, using stitches to hold the cartilage permanently in place. After shaping the cartilage to the desired shape, stitches will be applied to anchor the ear until healing occurs to hold the ear in the desired position.

What To Expect After The Surgery

Soft dressings applied to the ears will remain for a few days. Most patients experience some mild discomfort. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands are sometimes recommended to hold the ears in the desired position for two weeks after the surgery.

The risks are minimal. There will be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential. Anything unusual should be reported to the surgeon immediately.

Please also refer to Correction of Prominent Ears (Otoplasty) in surgical procedure section for additional information.

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Browlift (Forehead Lift)

Forehead Lift Surgery

The effects of aging are inevitable, and, often, the brow and forehead area show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Your tired, angry, or sad expression may not reflect how you actually feel. As a result, many people have opted for a procedure known as the forehead lift. Based on variations in how men and women age and on new advances in medical technology, different methods are used to perform this procedure.

Is A Forehead Lift For You?

As with all elective surgery, good health and realistic expectations are prerequisites. When a surgeon tightens loose skin and removes the excess, forehead wrinkling and drooping brows are modified. The procedure is called a forehead lift or brow lift. If necessary, the surgeon removes part of the muscle that causes vertical frown lines between the brows. The result can be a smoother brow and a more youthful expression. To see what a forehead lift can do for your face, put your hands above your brows and outside the edges of your eyes and gently raise the skin upwards. Forehead lifts are an option if you have a sagging brow or deep furrows between the eyes. This procedure is usually done between age forty and sixty-five, although it may be necessary at an earlier age.

Incisions can be placed at the hairline, behind the hairline, or in some cases, above the brow or in the mid-forehead. Your surgeon can help you select the best technique suited to your particular situation.

Making The Decision For A Forehead Lift

Whether you are having surgery for functional or cosmetic reasons, your choice of a qualified facial surgeon is of paramount importance. During the consultation, Mr Majumdar will examine your facial structure, the condition of your skin, and your hairline in order to decide where incisions should be made. A detailed description of the procedure will also include a discussion of risk involved.

After the decision to proceed with surgery is made, Mr Majumdar will describe the technique indicated, the type of anaesthesia, the surgical facility, any additional surgery, and the risks and costs.

Understanding The Surgery

The main difference among the various options for forehead lifting consists of the placement of the incision.

The original technique is the coronal incision, which is made slightly behind the natural hairline. An alternative is the pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline. This incision generally heals favorably and has the advantage of lowering the hairline. The disadvantage could be noticeable scarring. An option is to place the incision within the midforehead creases. This is primarily used in men with deep pre-existing forehead lines.

The newest apporach is endoscopic surgery. Several small one-half-inch to one-inch incisions are placed just behind the hairline. Althought this technique may require more surgery time, it is less invasive and results in a smaller chance of temporary scalp numbness.

This procedure takes approximately two hours to perform. It is most commonly performed under IV sedation.

What To Expect After The Surgery

You will experience a certain amount of swelling and bruising in the 10-day period following surgery. In some patients, this condition may include the cheek and eye area as well as the forehead. You will be advised to keep your head elevated in order to reduce swelling. Ice packs may further reduce swelling. As the incisions heal, you may experience some numbness as well as itching, both of which will diminish with time. The stitches are usually removed within seven to 10 days following surgery. If bandages have been used, they are removed in one to three days. It is important to follow the postoperative advice on resuming normal activities. For most patients, the recovery time will not exceed two weeks, but patients may still be advised to avoid strenuous activities for longer periods. Any prolonged bruising can be camouflaged with standard make-up techniques.

Not infrequently, a brow lift is combined with Blepharoplasty (an eyelid tuck) or face lift to provide a harmonious rejuvenation.

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Orthognathic (Facial or Jaw Surgery)

Orthognathic surgery is also known as corrective jaw surgery. It is used to treat a variety of facial and jaw abnormalities in which the facial bones and teeth are not correctly aligned. This results in difficulty with chewing, speech, and jaw function. In many cases, the facial appearance is affected by this problem. Teeth are straightened with orthodontics and corrective jaw surgery repositions the misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

In addition, some patients may decide to have other cosmetic procedures done in conjunction with orthognathic surgery to further enhance their facial appearance. These include procedures to the chin, cheeks, eyes, nose, neck and facial skin.

Orthognathic treatment is a team effort and is carried out in close cooperation with your Orthodontist, general dental practitioner and the dental technician and laboratory staff.
Orthognathic surgery is performed in one of the hospitals where Mr Majumdar has admission privileges. Patients generally stay in the hospital 1-2 nights, depending on the extent of surgery done. Most patients state that the post-operative discomfort is much less than they were expecting. Almost all patients agree that they are happy with the results and would go through the surgery again, without hesitation. The improvement in jaw function and facial appearance is remarkable. Most patients experience a great improvement in their self-confidence and quality of life after orthognathic surgery

Please download a patient information leaflet from the British Orthodontic Society  from the link below

Click Here >>

www.bos.org.uk/sales/patientinformationleaflets/orthognathicsurgery.htm

Please also see sections on Maxillary osteotomy and  Mandibular osteotomy  under Surgical Procedures

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Chin Correction (Genioplasty)

A well defined chin helps give balance to the face and creates a major part of one's profile. When people look in the mirror, most focus on the size and shape of their noses, their ears, sagging jowls, or fine wrinkling of the skin. But even though few examine their chins with the same discerning eye, having a "weak chin" is certainly not an asset. Surgeons who specialize in rhinoplasty, or surgery of the nose, are often the first to suggest that changes in chin size or shape may enhance a profile as much as rhinoplasty. It is common for the facial surgeon to recommend chin surgery in addition to nose surgery when the surgeon sees that chin augmentation is necessary to achieve facial balance and harmony. Fortunately, this is a relatively straightforward procedure that can make a major difference.

If you are wondering how chin surgery could improve your appearance, you need to know how the surgery is performed and what you can expect from this procedure. This advice sheet can address many of your concerns and provide you the information to begin considering chin surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Mr Majumdar can answer specific questions about your specific needs.

Is Chin Surgery For You?

As with all elective surgery, good health and realistic expectations are prerequisites. It is also key to understand all aspects of the surgery. A pleasing, balanced profile can be achieved by inserting an implant or moving the bone forward to build up a receding chin, or by reducing a jutting or too prominent chin. The result can be greater facial harmony.

Another possibility for improvement through chin surgery is submental liposuction in which excess fatty tissue is removed to redefine the chin or neckline. When there is a contributing problem of dental malocclusions or birth defects in the structure of the jaw itself, surgery of the jaw can improve the form and function of the lower face and greatly enhance appearance.

Your consultation can help you decide on the type of surgery that addresses your concerns. Mr Majumdar can also provide information on new medical techniques for chin surgery and offer recommendations for supplementary surgery that can ensure the greatest improvement.

Making The Decision For Chin Surgery

Whether you are interested in chin surgery for functional or cosmetic reasons, your choice of a qualified facial surgeon is extremely important. During the consultation, Mr Majumdar will thoroughly examine your chin and jaw to pinpoint problems. In some instances, the he will suggest chin surgery as a supplement to rhinoplasty because a small chin can make the nose appear larger. Your surgeon will weigh other factors that could influence the outcome of surgery such as age, skin type, and attitudes toward surgery. The surgical procedure will be described in detail along with reasonable projections. If you opt for surgery, Mr Majumdar will describe the technique indicated, the type of anaesthesia to be used, the surgical facility, any additional surgery, and risks and costs.

Understanding the Surgery

To augment the chin, the surgeon begins by making an incision either in the natural crease line just under the chin or inside the mouth, where gum and lower lip meet. By gently stretching this tissue, the surgeon creates a space where an implant can be inserted. This implant, made of synthetic material that feels much like natural tissue normally found in the chin, is available in a wide variety of sizes and shapes. This allows custom fitting of the implant to the configurations of the patient's face. After implantation, the surgeon uses fine sutures to close the incision. When the incision is inside the mouth, no scarring is visible. If the incision is under the chin, the scar is usually imperceptible. Other surgical options of repositioning the chin point are also available.

In chin reduction surgery, incisions are made either in the mouth or under the chin. The bone is shaped to a more pleasing size. For orthognathic surgery, the surgeon will make an incision inside the mouth and reposition the facial bones. The procedure, depending on the extent of the work, takes from less than an hour to approximately three hours.

What To Expect After The Surgery

Immediately after surgery, the surgeon usually applies a dressing that will remain in place for 24 hours. You will experience some tenderness. Post-operative discomfort can be controlled with prescribed medications. Chewing will probably be limited immediately after chin surgery, and a liquid and soft food diet may be required for a few days after surgery. Most patients feel a stretched, tight sensation after the surgery, but this usually subsides in a week.

After approximately six weeks, most swelling will be gone, and you can enjoy the results of your procedure. Rigorous activity may be prohibited for the first few weeks after surgery. Normal activity can be resumed after approximately ten days.

Please also look at Genioplasty section in Surgical Procedures for additional information

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Scar Revision

This leaflet is designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions.  If you have any other questions that the leaflet does not answer or would like a further explanation please ask.

The problem

Facial scars can arise from trauma or surgery.  Scar revision is designed to improve or disguise the appearance of an existing scar.  Scars tend to improve on their own with time and therefore surgery to revise a scar is not usually carried out for at least six months after the original injury or operation.  Scar revisions can be carried out under either general anaesthesia (i.e. you are put to sleep completely) or local anaesthesia (an injection to make the area numb).

What does the operation involve?

There are many different types of facial scar and treatments vary according to the type and size of the scar.  Some scars are cut out and restitched carefully.  Other scars are removed by abrasion or laser surgery and require no stitching. 

What can I expect after the operation?

Scar revision is not a particularly painful operation although it might be necessary for you to take simple painkillers (e.g. Ibuprofen) afterwards.  The discomfort is usually worse for the first few days although it may take a week or so to completely disappear.  If your surgeon feels that infection may be a problem you will be given a course of antibiotics.

Swelling and bruising is variable and is generally worse for the first few days after the operation.  The swelling can be reduced by using cold compresses and sleeping propped upright. 

How long will I be in hospital?

If the surgery is carried out under local anaesthesia you will not stay in hospital.  If a general anaesthetic is necessary you might need to stay in hospital overnight. 

Do I need to take any time off work?

This varies enormously from person to person and also depends on what type of job you do.  Most people require a couple of days off work.  You should remember that you cannot drive or operate machinery for 48 hours after a general anaesthetic.

Do I need to do anything when I get home?

Taking care of the wound after scar revision is very important.  A dressing may be put over the wound after the surgery.  You need to keep the wound dry until the stitches have been removed or until you have been advised by your surgeon that it is alright to wash the wound.

Stitches are usually after a week.  Depending on the type of scar it may be necessary to continue dressing the wound after the stitches have been removed.

What are the possible problems?

  • Some oozing from the wound is not uncommon in the first day or so after surgery.  If bleeding is a problem when you get home it can usually be stopped by applying pressure over the area for at least 10 minutes with a clean handkerchief or swab.

  • Infection is uncommon particularly if antibiotics have been prescribed.

  • It is usual for a scar revision to appear red for several weeks after surgery.

  • Even in the best hands unsightly scars can reappear despite scar revision.  If your surgeon thinks this might happen to you additional forms of treatment may be suggested (e.g. silicon dressings or steroid injections into the scar).

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Removal of Facial Skin Lesions

This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions.  If you have any other questions that the leaflet does not answer or would like further explanation please ask.

The problem

You have a lesion on the skin of your face that requires removal.  It will already have been discussed with you that this is the best form of treatment rather than using creams, lotions or freezing the area.  The removal involves a local anaesthetic, i.e.: you are going to be awake but the area will be numb so that you feel no pain.

What does the operation involve?

First the area in and around the skin lesion will be frozen with a local anaesthetic injection.  This takes a few minutes to work.  An antiseptic solution may then be used to clean the area and special ink used to mark out the piece of skin to be removed.  The amount of time that the removal takes obviously varies depending on the size of the area involved but typically it may take between 20 and 30 minutes.

Is anything done after the area is removed?

Removal of the lesion leaves a hole in the skin.  This hole can be repaired in one of three ways: 

  • If the hole is small the surrounding skin can be gently pulled together with stitches.  Some of these stitches may be dissolvable but often stitches on the skin need removal after a week.  Most skin lesions can be removed and repaired in this simple way.

  • If there is not enough loose skin next to the hole to allow the edges to be stitched directly then a neighbouring area of skin can be partly lifted and moved round to fill in the hole.  This “flap” is then stitched into place.  Once again a combination of dissolvable and removable stitches are often used.  If it is necessary to raise a flap this does leave a larger scar but wherever possible the flap will be designed such that the scar lies in natural skin creases.

  • If a large area of skin has been removed it may be necessary to repair the wound with a piece of skin taken from elsewhere.  Such a “graft” is often taken from behind the ear or just above the collarbone.  These sites are chosen because they already have an excess of skin.  The graft is then laid over the area where the facial lesion has been removed and sewn into place.  A dressing is put over the graft for around 10 days. 

Which method of skin closure is best for you will be discussed with you before you sign any consent form for your operation. 

What should I expect afterwards?

There will be some mild pain and discomfort once the numbness of the local anaesthetic injection has worn off.  You may need to take simple painkillers (e.g. paracetamol, Ibuprofen).  There is a variable amount of swelling and bruising which tends to be worse for the first few days after surgery but has usually settled after a fortnight.

Do I need to take any time off work?

If you have a local anaesthetic then you can drive yourself to and from hospital on the day of your operation.  Depending on the type of work you do it may be best to take the rest of the day off.  If the lesion that you are going to have removed is close to your eye it would be best if you could bring somebody with you to drive you home in case your vision is altered by any swelling. 

What are the possible problems?

Bleeding is uncommon.  Should it occur it can usually be stopped by applying pressure over the area for at least 10 minutes with a rolled up handkerchief or swab.  Infection is also uncommon but if the doctor carrying out the surgery thinks it might happen you will be given an antibiotic ointment (Polyfax) or tablets.

Will I need further appointments?

You will obviously need any dressings or stitches removed and an appointment for this will be arranged before you leave the clinic.  It is important to keep any dressings or stitches dry until they are removed.  It is routine for any skin lesions to be sent for examination under a microscope so that we can tell you what the lesion was and whether it has been completely removed.  This test takes time to carry out and the results may not be available for a couple of weeks.

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Facial Cosmetic Surgery

Facial cosmetic surgery has long been the solution of choice for the correction of physical malformations resulting from aging, disease, injury and birth defects. In recent years, however, a growing number of men and women of all ages are choosing facial cosmetic surgery to improve their appearance and reduce the signs of aging.

Is Cosmetic Surgery for You?

Thanks to the development of advanced medical devices and biomaterials, many of today's facial cosmetic procedures are minimally invasive and can be performed in an clinic setting using local and/or intravenous anaesthesia. Some procedures may require use of an outpatient or same day surgery centre, or hospital.

Because of their surgical and dental background, oral and maxillofacial surgeons are uniquely qualified to perform cosmetic procedures that involve the functional and aesthetic aspects of the face, mouth, teeth and jaws.

Extensive education and training in surgical procedures involving soft tissue (skin and muscle) and hard tissue (bone and cartilage) finely attune the oral and maxillofacial surgeon to the need for harmony between dental and facial appearance and function.

Following are some of the procedures available to you. Your oral and maxillofacial surgeon may perform other surgeries not listed here. Please telephone us to discuss your requirements.

Cheekbone Implants (Malar Augmentation) create the appearance of higher, more prominent cheekbones and better facial balance.

Chin Surgery (Genioplasty) increases or reduces the length and projection of the chin.

Ear Surgery (Otoplasty) is usually done to set prominent ears back closer to the head, or to change the shape or reduce the size of large ears.

Eyelid Surgery (Blepharoplasty) removes fat and excess skin from the upper and lower eyelids, and can be done alone or in conjunction with other facial surgery procedures such as a facelift or browlift.

Facelift (Rhytidectomy) provides a more youthful appearance by tightening facial skin, muscles and removing excess skin. A mini facelift is a minimally invasive technique involving only small incisions.
Facial and Neck Liposuction can help sculpt the face by removing excess fat.

Neck liposuction is often performed in conjunction with such procedures as genioplasty and corrective jaw surgery.

Forehead/Brow Lift is often done in conjunction with blepharoplasty to improve brow positioning, minimize frown lines and reduce forehead wrinkles.

Lip Enhancement can reshape the upper and lower lip to give a more aesthetic or youthful appearance. Augmentation of the lips is accomplished using various materials that help "plump" the lips, creating fullness and decreasing vertical lines.

Nasal Reconstruction (Rhinoplasty) can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip.

Skin Treatments

Several techniques exist for treating skin that is wrinkled, scarred or otherwise damaged. The amount of improvement varies and depends upon the initial condition of the patient's skin and the procedure.

Antiwrinkle treatments can reduce the signs of aging by reducing the muscle activity and wrinkles of the eyebrow and forehead. It is especially effective in reducing frown lines.

Chemical Peel involves the application of a solution that causes the wrinkled or damaged top layers of skin to peel, revealing new, healthier skin after healing. There are several types of chemical peels: a light peel to remove superficial wrinkles, a medium depth peel, and a deep peel for more severe conditions.

Dermabrasion smoothes surface irregularities to produce a more uniform appearance.

Laser – Through the use of a special laser, the outer layers of the damaged or wrinkled skin are removed.The new skin appears healthier and smoother, giving a rejuvenated, more youthful appearance.

Injectable Fillers (Restylane®, Collagen, etc.) are synthetic or naturally occurring materials that are placed with small needles to plump wrinkles, furrows or grooves in the skin.The results are instantaneous although the duration varies with the material chosen.

Facing the Facts

Facial cosmetic surgery may refine, enhance and/or rejuvenate existing features. It will not give you a new face or a new life. How much or how little change is realized depends on the individual and the extent of the surgical procedure. Your age, health, skin texture, bone structure, healing capacity and personal habits, such as smoking or alcohol consumption, are all factors that may affect the results of your surgery.

Each procedure outlined in this brochure entails a reasonable recovery period during which you may experience some swelling, bruising and discomfort. These are part of the normal healing process.
If you are interested in learning more about these procedures and determining whether you are a candidate for cosmetic surgery, please schedule a consultation with Mr Majumdar.

 

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