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Surgical Procedures

Scottsdale Plastic Surgery by a Certified Plastic Surgeon

 

    FACIAL SPECIALIST
    Natural, Proven, Time-Tested Results.
   - Our approach to Surgical Cosmetic Procedures of the face and neck

Facial surgery procedures have been relied on for years as the answer to fixing deformities associated with diseases, injuries or genetic defects. Today, facial cosmetic surgery has become a mainstream option for both men and women who want to both look younger and improve their appearance. Many of the common surgical procedures that patients undergo, today such as rhinoplasty (nose job), blepharoplasty (eye lift) and chin augmentation, can be performed in an office or hospital setting with local or intravenous anesthesia and very little down time. Click Here for More Detailed Information.

Safety is paramount. We are proud to practice the most innovative medicine with honesty and integrity. Schedule a consultation and experience the difference.

Our practice philosophy is simple- treat patients like family members.

 

• What is a Rhinoplasty?

• Rhinoplasty is a surgical procedure designed to change the structure and appearance of the nose. Every year over 500,000 people seek consultation with a surgeon for this type of procedure. Rhinoplasty is performed for both cosmetic and functional reasons- sometimes for both. There are a variety of different “types” of rhinoplasty procedures and your surgeon will recommend the best one for you.

• How is a Rhinoplasty performed?

• Most patients are placed under a brief general anesthetic to complete the rhinoplasty procedure. To begin the surgery, incisions are placed inside the nose to lift the skin over the nasal tip. In some cases a very small incision is required externally between the nostrils to complete the soft tissue elevation. Next, components of the nasal skeleton that are comprised of bone and cartilage are rearranged, reduced, or added to in order to achieve the desired result. The soft tissue is re-draped over the nose, and sutures are used to close the tissues. Tape and a soft cast are often placed over the surface of the nose to protect the area during the healing for about a week.

• What should I expect after surgery?

• All patients should expect some swelling, bruising, and nasal obstruction after surgery. The nasal cast and tape will remain in place for up to one week depending on the type of surgery you have performed. Sutures inside the nose dissolve, while those that may have been placed in the undersurface of the nose will be removed one week after your surgery. Patients are placed on an intense protocol both before and after surgery to reduce bruising. Bruising is usually present after a rhinoplasty under the eyes and will resolve within 7 to 10 days. Nasal obstruction usually dissipates over two to four weeks post-operatively. Pain is generally mild after a rhinoplasty.

• How should I choose my surgeon?

• Choosing the right surgical team is critical. Make sure your surgeon is board certified in Facial Plastic and Reconstructive Surgery and that the facility is fully accredited. The experience of seeking consultation for cosmetic facial surgery and undergoing surgery is a very intense and personal experience. The skill, compassion and a caring attitude of both your surgeon and the staff will make all the difference in the world. Take the time to become comfortable with the entire team that will help you along with your experience.

• What is blepharoplasty?

• Blepharoplasty refers to an “eyelift” or reshaping of the eyelid area. It is a surgical procedure performed to improve appearance or to improve vision loss due to excess skin of the upper lid. It is an extremely common procedure with over 100,000 men and women undergoing blepharoplasty every year.

• What changes occur in the eyelids with aging?

• Over time, repeated blinking, facial expressions, and age-related changes in the soft tissues around the eye lead to excess skin and fat around the upper and lower eyelid. This can make the patient appear fatigued or angry, and may even cause actual mechanical impairment of the upper eyelid elevation causing vision loss. Blepharoplasty is a surgical procedure to remove this extra skin and fat improving the cosmetic appearance of the eyes and possibly improving vision.

• How is blepharoplasty performed?

• Blepharoplasty may be completed under a variety of surgical conditions ranging from a simple local anesthesia (injections for numbing) to a full general anesthesia. Your doctor will help you decide what is best for you.
  There are also a number of different eyelid procedures designed to address the individual needs of each patient. Usually small incisions are made in the skin of the upper or lower eyelids and excess skin and fat is removed. Your doctor will guide you to the least invasive option for your needs.

• Who is a candidate for blepharoplasty?

• Patients interested in improving the appearance of the eyes or those with excess skin reducing the visual field are candidates for blepharoplasty. Occasionally insurance will cover the cost of the procedure if an eye exam reveals a mechanical reduction of the movement of the upper lid due to excess skin. This simple test is referred to as a “visual field study” and can be performed by most eye doctors. Dr. Hobgood may refer you to an appropriate physician for testing.
  Blepharoplasty does not improve the position of the brows or the texture and fine lines around the eyes. Your doctor may recommend completing a brow lift or skin resurfacing at the same time as blepharoplasty if you have concerns about these areas as well.

• What should I expect after my surgery?

• Patients will see an immediate improvement after surgery. However, the healing process takes place over a few weeks and bruising and swelling is certainly expected to last about a week. Sutures are commonly required and will be removed within the first week and cosmetic eye products or make-up can be applied at that time. Contact lenses can usually be inserted one week after surgery. Many patients return to light activity after a few days and may return to work one to two weeks after surgery. Patients generally have very little pain after blepharoplasty.

• How should I choose my surgeon?

• Choosing the right surgical team is critical. Make sure your surgeon is board certified in Facial Plastic and Reconstructive Surgery and the facility is fully accredited. The experience of seeking consultation for cosmetic facial surgery and undergoing surgerycan be a very intense and personal experience. The skill, compassion and a caring attitude of both your surgeon and the staff will make all the difference in the world. Take the time to become comfortable with the entire team that will help you along with your experience from beginning to end.

• What is the “Midface”?

• The “midface” is the area of our face that most of us think of as our cheeks. Anatomically it extends from the cheek bone prominence down to the area of the upper lip. The shape of the cheek is formed by the facial skeleton and the soft tissues draped over its surface.

• What anatomic changes occur in the Midface with aging?

• Age-related changes under both genetic as well as environmental influences occur in the three major components of the Midface: skeletal structure, subcutaneous fat and muscle, and skin. As we age, the midfacial skeleton tends to shrink leaving weaker cheek bones. This occurs in combination with a gradual decrease in volume of fatty tissues and weakening of support structures in the face. The end result is a tendency toward dropping of the facial soft tissues and skin and loss of prominence of the cheeks.

• What are the signs of Midfacial Aging?

• The sign that patients first notice is an increase in the definition in the Nasolabial Fold. This is the crease that tends to develop between the nose and the corner of the mouth as the cheek tissues drop. In addition, the cheek tissues fall down causing an increase in the “tear trough” leading to bags under the eyes. The end result is a change from the youthful “heart-shaped” face to a more “pear-shaped” profile.

• What are the goals of a Midface Lift?

• The midface lift is a surgical procedure designed to re-establish the heart-shaped contour of the younger face. It involves repositioning soft tissues back into their original anatomic location creating a fuller cheek in a more youthful position. Patients will notice a significantly less prominent Nasolabial Fold, a smoother contour under the eyes, and a higher cheek bone. In certain cases, the surgeon may also recommend using a filler material or an implant to replace the bone or soft tissues.

• How is the procedure performed?

• There are a number of surgical techniques that are used to achieve a more youthful midface. Your surgeon may recommend something as simple as a soft tissue filler placed in an office visit. Most surgical interventions aimed at repositioning the soft tissues do require a brief anesthetic. Incisions are carefully placed to allow for a nearly invisible scar after the healing process has completed. Soft tissues are elevated to the proper position and fixed in place.

• What is expected during recovery?

• Patients who undergo a surgical midface lift can expect immediate results. There is, however, a period of swelling that lasts for a few weeks in the operated area. Most patients do not find the surgery to be painful and few require any medicines to treat pain after 2-3 days. A small amount of bruising may also occur which should also clear by one week. Most women are able to use their normal make-up routine around one week following surgery. For most patients we recommend re-starting most forms of light to medium exercise after about 3 weeks.

• How should I choose my surgeon?

• Choosing the right surgical team is critical. Make sure your surgeon is board certified in Facial Plastic and Reconstructive Surgery and that the facility is fully accredited. The experience of seeking consultation for cosmetic facial surgery and undergoing surgery is a very intense and personal experience. The skill, compassion and a caring attitude of both your surgeon and the staff will make all the difference in the world. Take the time to become comfortable with the entire team that will help you along with your experience from beginning to end and make sure your specific goals and needs are understood.

• What are cheek implants?

• Cheek implants are permanent, soft materials naturally shaped to rejuvenate the cheeks or midfacial area. As we age, the bone structure of our face actually shrinks somewhat leading to less prominent cheek bones. Gravity and repetitive facial movements cause the cheek tissues to drop down sometimes causing deep smile lines to develop. In addition, the soft tissues under the eyes can descend creating dark circles. The end result is a loss of the “youthful” heart-shaped face.
  There are a number of different shapes and sizes of implants to fit every type of patient. In general they are categorized according to the location that needs volume. Malar (high cheek bones), submalar (low cheek bone) and tear trough (dark circles under eyes) are available.

• How are cheek implants placed? Are they permanent?

• Cheek implants are semi-solid materials that are added to the face to create a fuller appearance. They are usually placed through a hidden incision inside the under surface of the upper lip or the inside surface of the lower eyelid. No visible incisions are necessary. They are permanent and are difficult to feel through the face after the healing process has occurred. Most patients choose to undergo a brief general anesthetic for comfort during placement.

• What should I expect during my recovery?

• There is some swelling that will occur after cheek implants are placed. This can be minimized following post-operative instructions closely. Swelling will disappear over a few weeks. Pain is rare after this type of surgery and most patients just describe some mild tenderness.

• Are there alternatives to improve the cheek without a permanent implant?

• Some patients may benefit from the injection of a filler substance to the cheek area. Radiesse™, Juvederm™, and Restylan™ are options for “no down-time” injections that are commonly used to achieve this goal as well. These results generally last about one year. Currently there are no permanent injections that Dr. Hobgood feels are safe.

• How should I choose my surgeon?

• The more informed you are about all your options, the better the choice you’ll make for yourself. Choose a surgeon that has experience dealing with both the cosmetic as well as functional aspects of the cheek bones, soft tissues, and muscles. The physicians and staff at Hobgood Facial Plastic Surgery will ensure that you have a truly exceptional experience.

• What are the signs of aging in the lower face and neck?

• Over time, gravity and repetitive facial movements create excess tissues that descend toward the jaw line. This creates some new folds of skin and wrinkles that increase over time. Patients often notice more prominent nasolabial folds, marionette lines, and jowling. The “nasolabial folds” run from the corner of the nose toward the corner of the mouth as the cheek descends. “Marionette lines” appear with excess skin and soft tissue hanging at the corner of the mouth. “Jowling” refers to the extra skin that begins to sag from the jaw line causing a loss of the youthful sharp profile.
  Neck skin also begins to descend as the sheet-like muscle, the platysma, weakens and separates in the midline. This results in vertical folds of skin hanging below the chin most easily seen in the side view. The surgical correction of this banding is referred to as a platysmaplasty, or reshaping of the neck muscle and is commonly performed as a part of the necklift. Excess fatty tissue, if present, is removed from the chin and neck with liposuction contouring techniques.

• What are the goals of the “Facelift (Lower Facelift)” and “Necklift”?

• The facelift and necklift surgical procedures are designed to return the skin and soft tissues to their more youthful and natural position. Excess skin is removed as the muscular tissue is resuspended resulting in a natural and permanent improvement in the lower face, jawline, and neck. Because the lower face and neck commonly age at the same rate, many patients will require both a facelift and a necklift (platysmaplasty). However, this is not always the case, and your doctor will advise you of the most appropriate surgical approach for you. Dr. Hobgood will refer to the facelift procedure as the “Lower Facelift” to accurately convey the surgical goals to our patients and avoid confusion with the Midface Lift addressing the upper cheek.

• How is the Lower Facelift performed?

• The procedure begins with a short surgical incision largely hidden within the hair-bearing areas and natural creases of the face just in front of and behind the ear. The skin is released and the strong fibrous tissue beneath the skin known as the SMAS (Superficial Musculo Apneurotic System) is elevated and permanently fixed into a natural, youthful position. Utilizing this SMAS suspension is critical to achieve natural and permanent results. The excess skin is trimmed and meticulous suture techniques allow nearly invisible scars after healing.
  The necklift or “platysmaplasty” is performed through a short incision just beneath the chin in a natural crease. Liposuction of the neck and lower cheek is performed, and the muscle bands of the platysma are secured permanently in the midline. Excess skin is trimmed creating a sharper neckline.

• What is expected during my recovery?

• Patients usually return to home within a few hours after surgery with simple care instructions. The results of the facelift and necklift are immediate, but swelling and bruising are expected for about one week. Most patients can return to normal light activities including driving about one week after the surgical procedure, and facial cosmetic products may be applied about nine days after the surgery. Fortunately, pain and discomfort are very rare during the recovery process. However, some numbness of the cheek and ear area is expected and resolves over a few weeks. Light exercise routines may be resumed around 2 to 3 weeks after this procedure. The healing process does occur naturally over a few weeks, but many patients are able to return to work 10 to 14 days after surgery.

• Is my facelift permanent?

• The surgery discussed above is the “gold standard” facelift, and the changes are permanent. Most patients find that completing a facelift will remove seven to ten years from their aging process, but this is variable. Aging continues of course, but the facial area will always be improved relative to the preoperative condition.

• How should I choose my surgeon?

• Choosing the right surgical team is critical. Make sure your surgeon is board certified in Facial Plastic and Reconstructive Surgery and that the facility is fully accredited. The experience of seeking consultation for cosmetic facial surgery and undergoing surgery is a very intense and personal experience. The skill, compassion and a caring attitude of both your surgeon and the staff will make all the difference in the world. Take the time to become comfortable with the entire team that will help you along with your experience from beginning to end and make sure your specific goals and needs are understood.