Cosmetic Facial Surgery

Facelift
About facelift
A facelift is one of the most commonly performed procedures at our practice and provides a remarkable improvement in your appearance. This procedure is the ideal treatment for correcting a sagging jawline, fallen cheeks, and an unpleasing neckline. The techniques of facelifts have significantly evolved in the last 10 years. Patients now experience newer and better techniques to relocate the deeper tissues of the face and neck, without the telltale signs of facelift surgery. These advanced techniques give both a more natural and also longer lasting result.

What part of the face is affected by a facelift?
The term “facelift” does not nearly describe all that this surgery can accomplish. A better descriptor for the surgery is a “lower face and full neck lift”. A facelift surgically addresses the lower portion of the face targeting primarily the lower cheek, nasal folds, jowls and jawline. The neck is also improved by removing the fat and excess tissue beneath the chin and rejuvenating sagging neck tissues.

Who is an ideal candidate for a facelift?
The ideal candidate for a facelift is a patient that is seeing facial signs of aging. The typical patient is 45 years old and above and wishes to improve his or her appearance.

How long is recovery from a facelift?
Facelift patients can expect to recover within 1 to 2 weeks. Patients are seen post-operatively many time in stages for suture removal and incision evaluation. Bruising and swelling is to be expected, most of which subside within 2 weeks.

Is there discomfort from a facelift?
Most patients do not find facial surgery to be very painful. The vast majority of patients only need to take prescription strength pain medication for 48 hours before transitioning to acetaminophen for pain control.

Will a facelift leave a scar?
A facelift incision is strategically placed in the hidden areas in front of and behind the ear, in order to be barely perceptible after healing. Although there is time for healing of the scars, our providers pride themselves on closure techniques for facelifts so that even your hairdresser may be left guessing.

Eyelid Rejuvenation
About Eyelid Lifts
A philosopher once wrote, “The eyes are the window to the soul.” No truer words have been written. The eyes convey emotion and intention, they are the center point for human interaction, and most importantly – they provide us our arguably most important sense: sight.

Blepharoplasty, or eyelid lifts, are surgical procedures to correct drooping, baggy or sagging eyelids. Surgery can treat the upper lid, the lower lid, or both at one time. Because the eyelid skin is thinner, it is one of the first facial structures to show age. Sagging upper eyelids can give the appearance of sadness, worry, or anger. Lower eyelid bags can make one appear tired or sad. For our patients, they report stories of colleagues asking them if they are angry or upset, simply because of the appearance of their eyelids rather than their actual emotion.

Additionally, upper eyelid sagging can also impact vision. Surgery to the upper or lower eyelids can have a disproportionately positive impact on your appearance when performed well.

Who is a candidate for eyelid surgery?
The best candidate for eyelid surgery is a physically healthy man or woman who has realistic expectations and is looking to improve the appearance of drooping upper eyelids and/or puffy bags beneath the eyes. Eyelid surgery typically takes between one and three hours to complete and can be performed in the office or at the outpatient surgery center.

What is recovery like from eyelid surgery?
Recovery from eyelid surgery is usually 1-2 weeks, with social downtime of 7-10 days. Results can be seen quickly, as there can be a dramatic improvement in appearance even early on in recovery. Patients generally report mild bruising and swelling, but do not typically complain of pain.

Brow Lift/Forehead Lift
Whether it be gravity, sun damage, or facial deflation, the eyebrows can descend to a position that is displeasing. Because we are driven to see clearly, patients with low brows often raise their brows during conversation and times of concentration, causing deep horizontal furrows to develop over the forehead and the bridge of the nose.

A brow lift or forehead lift is a surgical procedure which aims to place the eyebrow in a more alert, more youthful position. Types of brow lifts may also reduce the wrinkles that develop within the forehead and area at the bridge of the nose, while also treating the frown lines between the eyebrows.

Who is the best candidate for a brow lift?
Appropriate patients for brow lifts are a physically healthy man or woman who has realistic expectations about the forehead lift procedure and is interested in minimizing the appearance of drooping brows, horizontal lines, and furrows of the forehead. Although most patients receiving forehead lifts are between the ages of 35 and 65, the procedure can be performed at any age if necessary. Often, the procedure is combined with eyelid lifts for improvement of the eyelid/brow area as a unit.

Where are brow lifts performed?
Most procedures are done in an outpatient surgery center. The forehead lift procedure itself typically takes between one and two hours to complete and is most commonly performed with a general anesthetic.

Septoplasty
Septoplasty is surgery on the internal structure (midline divider) of the nose to improve breathing if the septum is deviated or causing nasal obstruction.

During a septoplasty, our experts straighten and reposition the nasal septum in the middle of your nose. This may require the surgeon to cut and remove parts of the septum before repositioning them. A septoplasty can be performed alone or in combination with a rhinoplasty.

Our surgeon will discuss your symptoms and examine the physical structure of your nose during your personal consultation. From there they will determine the best plan for you.

Chin Augmentation
About chin implants
A well-defined chin and jawline are key components to an attractive, balanced face. As such, we often find that deficiencies in the chin keep the face from being in harmony. Chin augmentation, or mentoplasty, is a surgical procedure that involves the placement of an implant over a patient’s existing chin bone to change the shape/size of the existing chin. A chin implant can do so much more the enlarge that single site: it can help achieve a more natural, attractive balance between facial features, it can improve the appearance of the neck, and it can make the nose appear smaller.

How is a chin implant performed?
Chin implants are small, solid cup-shaped structures made of biocompatible material (silicone). The shape allows for the implant to sit in a molded fashion around the chin. Implants vary considerably in shape and size, so we will look at your options and graft an implant choice that is right for your face.

How long does surgery take?
Chin implant surgery alone typically takes less than 1 hour. If you are combining a chin implant with other procedures (rhinoplasty, facelift), operative time will increase accordingly.

What is recovery like from chin augmentation?
Most chin augmentation patients return to work and activities 7-10 days following surgery. Discomfort is usually described as minimal, with pain easily controlled with prescribed medications and the use of cold compresses.

How long do results last from chin augmentation?
Chin implants are durable, permanent devices. While the aging process will continue, your enhanced chin contour will persist and will slow down the aging process of your lower face and neck.

Ear Pinning (Otoplasty)
About Otoplasty
Otoplasty is a cosmetic ear surgery aimed at changing the shape, position, or size of the ears. Often, a patient seeking otoplasty for themselves or their children have been bothered by the shape and protrusion (sticking out) of their ears for much of their lives. Otoplasty can be performed after ears have reached maturity/full size, usually after age 5 and all the way through to adulthood. Otoplasty can also be done to one ear, in an effort to gain symmetry to the more desirably shaped ear.

How are Otoplasties performed?
Otoplasties typically require anesthesia for patient comfort. A small incision is made behind the ear, and from this incision, the cartilage and soft tissue of the ear are shaped through non-removable stitches and cartilage excisions. Techniques for otoplasty widely vary based on the individual ear, so a plan will be made with your surgery during your consultation.

Recovery from ear pinning
Recovery from Otoplasty typically takes 1-2 weeks. After surgery, a soft bandage is applied to the ears that will be in place for 2-5 days. After removal, incisions can be cleaned and healing gradually occurs over a 2-4 week period. We ask that patients wear a headband temporarily during the healing process to keep their ears pinned in the desired position.

Earlobe Repair/Reduction
Whether due to the frequent wearing of heavy earrings, gauged ear piercings or a specific accidental tearing event, earlobes are at risk. Frequently, the earlobes demonstrate stretching, tearing or keloid scarring formation(scar tissue). Tears of the earlobe are often very visible and concerning to patients, due to the earlobe’s location. Earlobe repair can fix the split of the earlobe, enabling you to wear earrings once more.

Earlobe reduction is a surgical procedure that removes drooping or enlarged portion of the earlobe, giving the ear a more youthful, sleeker appearance. Patients typically notice their enlarged earlobes are both bothersome and aging are looking for a minimal downtime procedure with high success.

What is involved with earlobe repair/reduction?
Earlobe repair is a ½ to 1-hour procedure, done in the office with local anesthesia (patient awake during the procedure). Earlobe reduction typically requires a 1-hour stay at the office. During the procedure, portions of the scarred or redundant/enlarged earlobe are removed and stitches are placed to make the earlobe whole once more. Downtime after earlobe repair is minimal, and recovery is typically pain-free. A follow-up appointment is required for stitch removal 5-7 days after the procedure.

Facial Fat Transfer
About fat grafting
One of the telltale signs of facial aging is the loss of youthful facial volume. This typically begins in and around menopause for women or when body fat drops and can be seen in all areas of the face and body. All areas of the face can be affected, but most patients identify the cheeks, lips, temples, nasal folds and chin as the most common areas for fat loss.

Fat grafting, or “autologous fat transfer” involves liposuctioning excess body fat from preferably the tummy, love handle, or thigh area for purposes of adding volume to these sunken areas of the face. Fat grafting has several key advantages: first, it is your own body’s tissue so this eliminates the risks of allergic reaction or rejection. Secondly, fat grafting in expert hands demonstrates excellent longevity of results. For patients who tire of the endless need for injections to keep their cheeks full or their jawline smooth, fat grafting offers a more durable solution.

How long does this surgical procedure take?
Typically, depending on the volume of fat that needs to be harvest, facial fat grafting takes 1-2 hours in the operating room.

How long is recovery from fat grafting?
Facial swelling and bruising are common after fat grafting procedures. Recovery can take 2-3 weeks from the procedure due to surgical swelling.

Who is the ideal candidate for fat grafting?
Patients for fat grafting are typically 30 and older, and who have begun to see age-related facial deflation. It is necessary that patients have adequate sites for fat harvest (not too thin). Often, fat grafting patients are women in their 30s and 40s who have developed “filler fatigue”. They enjoy the look of their facial dermal fillers but are tired of returning frequently for injections and desire a more durable or cost-effective solution.

Mole/Lesion Removal
For some people, the presence of a mole or lesion can be very distressing. Excision can be performed with cosmetic skin closure to remove these moles with care. When performed by our skilled plastic surgeons, scarring can be minimized.
Your surgeon will work with you during your personal consultation to discuss the best procedure for removal, whether surgical, chemical or laser procedures. If a mole or lesion shows signs of being cancerous, they will be recommended for additional testing.

Skin Cancer Reconstruction after Mohs Surgery
Mohs Surgery
Mohs micrographic surgery is a procedure for the removal of certain skin cancer types. Mohs surgery is performed by local, board-certified dermatologists, also known as “Mohs Surgeons” who will layer-by-layer, remove skin cancers from the face and body. After the skin cancer has been removed, holes are left behind in the face and neck that typically require repair by plastic surgery.

Reconstruction of the Treated Areas
Once skin cancers have been removed by the Mohs technique, holes on the face, neck, and body are left behind – sometimes in areas critical for form and function. Reconstruction involves borrowing tissue from immediate or adjacent areas of the face to fill the hole left behind by skin cancer removal. Skin grafts can also be used for reconstruction.

Lip Lift
An upper lip lift can drastically improve the aesthetic of one’s smile and facial proportions. Dr. Showalter is committed to tailoring the procedure for each patient to create youthful, natural-looking results. The procedure can create a more proportional smile and reduce the signs of aging around the mouth.

What is a lip lift?
The upper lip lift is a same-day, 40-minute procedure in which the patient is awake but numbed. The solution to improving an elongated upper lip is to reduce the length of the upper lip area. By surgically removing the tissue beneath the nose, the lips can be made to look lifted and the smile more attractive. Luckily, the incision is placed directly at the base of the nose, with little to no visibility of the scar over time.

What is recovery like?
Swelling should subside within 1-2 weeks and tightness should diminish within a few months. Mild discomfort may occur but should not hinder day-to-day tasks.

Neck Lift
About Neck lifts
A neck lift involves treating the sagging skin and muscle of the aging neck. It is usually performed as a portion of a facelift, however, may be performed as a standalone procedure if the patient is satisfied with his or her facial appearance. Fat is generally removed from beneath the chin and the muscle layer (platysma) of the neck is tightened in order to provide a more youthful appearance.

Who is an ideal candidate for a neck lift?
The ideal candidate for a neck lift is a patient that is seeing neck signs of aging. The typical patient is 45 years old and above and wishes to improve his or her appearance.

How long is recovery from a neck lift?
Neck lift patients can expect to recover within 1 to 2 weeks. Patients are seen post-operatively many times in stages for suture removal and incision evaluation. Bruising and swelling is to be expected, most of which subside within 2 weeks.

Is there discomfort from a neck lift?
Most patients do not find neck lift surgery to be very painful. The vast majority of patients only need to take prescription strength pain medication for 48 hours before transitioning to acetaminophen for pain control.

Will a neck lift leave a Scar?
A neck lift incision is strategically placed in the hidden areas behind the ear, in order to be barely perceptible after healing. Although there is time for healing of the scars, our providers pride themselves on closure techniques for neck lifts so that even your hairdresser may be left guessing.

Rhinoplasty (Nose Reshaping)
Second only to the eyes, the nose is the most prominent feature of the face. When the nose does not exist in harmony with the remainder of the face, it can be very distressing to the patient. Rhinoplasty is surgery to reshape the nose is one of the most common facial cosmetic procedures. Rhinoplasty involves surgery to reduce the size of the nose, change the shape of the tip or bridge, or narrow the nose, all with the goal of improving the balance of the nose with the face.

Septoplasty is a surgical procedure to straighten the midline divider (cartilage and bone) between the nasal cavities. It may be required at the time of rhinoplasty, depending on your overall nasal anatomy.

Short Scar (or Mini) Facelift
About short scar facelift
A short scar facelift, or J-lift, uses small incisions to tighten underlying facial muscle tissue and remove sagging skin. Short scar lifts are meant for patients with less significant facial aging and tend to have a shorter recovery than the traditional facelift.

What is recovery like after short scar facelift?
Patients are typically in minimal pain and transition to taking Tylenol within 48 hours. With makeup, most patients are ready for social activity in 7-10 days.

What outcome can you expect from a short scar facelift?
Overall rejuvenation of the lower face is expected after recovery. A refinement of the cheek and jawline tissues can be easily seen. Most patients note that their friends and colleagues often ask if they’ve gotten a good night’s sleep or appear well rested, as the results achieved are both effective and natural.

Submental Liposuction
About chin liposuction
Liposuction under the chin and neck can be used to make the neck and chin slimmer and bring it into proportion with the face. During this procedure, small incisions are made behind the ears and under the chin. Using a small, metal tube called a cannula, fat is gently removed from targeted areas beneath the chin and within the neck tissues.

Who is a good candidate for Submental Liposuction?
Ideal candidates for submental (chin) liposuction are patients who have good tissue elasticity (younger skin), overall good health, stable weight, and who do not smoke. Liposuction can be performed alone or in combination with other surgical procedures (such as a chin implant or neck lift).

What is recovery from Liposuction like?
Bruising and minor swelling are typical after this type of procedure. An elastic “chin up” bandage will be worn around the face and neck to reduce symptoms. Patient can return to work after 5-7 days. Exercise should be avoided for 2 weeks after the procedure.

Results of Liposuction
After resolution of swelling and bruising, patients will see improvement in their chin and neck contours. The results of liposuction are long lasting, except in the case of significant weight gain.