Facial Procedures
Facelift (Rhytidectomy)
Facelift surgery, or a rhytidectomy, is designed to restore a more youthful appearance by removing major wrinkles and sagging skin in the lower face and neck. It involves tightening of the facial and neck muscles as well as the removal of any excess skin.
Skin can begin to wrinkle and sag as a result of age, sun exposure, smoking and genetics. Children and young adults have smooth, round faces due to evenly distributed fatty tissues with good skin elasticity in facial contours. Over time, the skin sags, and facial volume is lost and folds/wrinkles around the chin, jawline and neck begin to form.
Combining face lift with blepharoplasty, chin surgery, or brow lift
A facelift is frequently performed in conjunction with blepharoplasty, or eyelid surgery, forehead lift, chin/cheek augmentation, and/or conservative liposuction, to create an overall rejuvenation of the face. It is often very rejuvenating to combine facelift procedures with fat grafting to the face to restore the facial volume that is lost with aging.
Dr. McLain will typically perform facelift surgery under general anesthesia, however, it can sometimes be performed under local anesthesia with IV sedation. He will make incisions inside the hairline at the temple, in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. Excess skin is removed and sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck. Incisions are closed with small sutures. The procedure may take up to 3-4 hours depending on whether any other procedures are performed at the same time.
Eyelid Surgery (Blepharoplasty)
Blepharoplasty, or eyelid surgery, is a cosmetic surgery that corrects sagging or drooping eyelids as well as bags and bulges around the eyes. These conditions develop as a result of laxity of the eyelid skin and protrusion of fat around the eyes. It is not limited to older patients, as many individuals inherit a predisposition toward development of fat pouches at an early age. Excess skin is treated by excision or occasionally by laser resurfacing. If excess fat is present, it can be removed simultaneously. Care must be taken to not remove excessive amounts of fat to avoid a hollowing appearance with increasing age of the patient.Most patients seeking eyelid surgery want a rejuvenated appearance that requires reestablishing the normal architecture around the eyes that was present when they were younger. Surgical correction is appropriate for all age groups. In some cases, the condition will be caused by other medical problems such as allergy or thyroid disorders. In these patients, the proper treatment may be medical rather than surgical.
Endoscopic Forehead and Brow Lift
Brow and forehead lifts are common cosmetic surgery procedures that raise eyebrows and reduce ridges and furrows on the forehead, thus creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries. A forehead and brow lift may be required to rejuvenate the eyes rather than or in combination with eyelid surgery. Newer techniques now allow us to perform forehead lifting through small incisions in the scalp by using an endoscope and specialized instruments. This accelerates the healing process. Antibiotics may be prescribed for several days following surgery. Sutures or skin staples are generally removed within one week. Swelling and some bruising may occur, they should subside within a few weeks. Typically, You can proceed with your normal daily activities within 1 week.
Cheek Augmentation
The skin over the face is analogous to a drape. The underlying skeletal structure determines the shape of the face. In some individuals, this framework is not as pronounced as in other individuals and they may appear to have a flattened face or small, recessed chin. Studies also show that as we age, we not only lose volume in the soft tissues of the face but also in the facial skeleton itself. This is very common in the midface which can easily be enhanced with facial implants.
Dr. McLain is able to add facial implants to the facial skeleton to accentuate the areas of the cheekbone, chin, nose, and angle of the lower jaw. By performing these skeletal augmentations, they are able to re-drape and tighten the skin of the face. This provides a more healthy and youthful appearance without the need for a more extensive skeletal reconstructive surgery. This cosmetic surgery is performed from incisions within the mouth with no visible scars. Immediate results are evident. Solid silicone implants are typically used. They are secured to the bone with a one or two small titanium screws to prevent the implants from moving. Different types and sizes of cheek implants are available to provide the most appealing look.
Chin Surgery (Genioplasty)
Cosmetic chin surgery is the technique of repositioning your chin to achieve the desired esthetic result. Changing the position or projection of the chin by correcting the underlying bone framework can improve the appearance of the chin. Many people have a chin that is just too small for their face. When one has a lack of chin projection, the face is weakened. It can also make the nose look longer than it really is. A well defined jawline is viewed as youthful and attractive in nearly all societies. For this reason, many patients will seek surgery to improve the appearance of the chin. Moving the position of the chin and securing it in its new position with titanium screws or by inserting a small synthetic implant over the natural bone accomplish this. The operation can also greatly enhance the results of a face-lift, since loss of chin projection may occur with aging. Chin augmentation also is commonly combined with facial liposuction, where fat is removed from under the chin and from the neck. A small incision is made either underneath the chin or inside the mouth. A sterile implant, similar to the consistency of a natural chin, is placed in front of the bone to increase the projection of the chin. The implant is secured and the incision is sutured closed. Alternatively, the chin can be repositioned so that the bone and soft tissues are advanced to create facial balance and a natural, improved appearance. Some swelling and bruising can be expected and usually subsides within the first two weeks. A tape of elastic dressing may be recommended for a period of time. Mild discomfort is usually easily controlled with medications prescribed by your surgeon. After healing, the skin drapes smoothly over the implants. The implants themselves conform to the bone and usually are undetectable. The added projection of the chin results in significant improvement, which is especially apparent in profile.
Ear Surgery (Otoplasty)
In cases of protruding or over-developed ears, the procedure of otoplasty may be a cosmetic surgery option. Otoplasty is commonly referred to as "pinning back" of the ears and is available for children once their ears have stopped developing, around the age of six. Over-developed ears can be the cause of psychological stress and trauma and should be treated at a young age before it becomes a serious issue. Dr. McLain is trained in several surgical procedures, in order to eliminate the majority of the problems related to protruding ears. Commonly a combination of removing overgrown cartilage and shaping existing cartilage is required for optimal results. The procedure typically takes only a few hours. The procedure can be performed under IV sedation or general anesthesia and the doctor will discuss this option with you. Sutures are placed and bandages applied to speed the healing process. After the operation patients should expect bruising around the area that fades in 2-3 weeks. Pain associated with operation is minimal and can be easily treated with oral medication. The bandages are only needed for a few days and should be replaced with a lighter dressing. Refraining from sleeping on the ears is required and patients are advised to use a very soft pillow. Showering with shampoo may begin after a few days. Expect two-to-three days of recovery before normal activities can be performed. Consult with your surgeon before attempting any athletic or precarious activities that may affect the healing process.
Rhinoplasty - Cosmetic Nose Surgery
Appearance of the nose can be improved for those people who are dissatisfied with the shape and size of their nose. Nasal reconstruction was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a cosmetic surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone or cartilage.
Dr. McLain is also experienced in revision rhinoplasty, where patients who have had one or more prior rhinoplasty procedures, yet are still unsatisfied with their cosmetic results and/or have post-surgical breathing problems and are seeking secondary surgery to address these concerns. Dr. McLain commonly performs rhinoplasty simultaneously with orthognathic surgery which can lead to a significant improvement in facial balance and esthetics.
Fat Transfer
Autologous fat grafting is the removal of fat from one area of the body and subsequent injection into another area. Fat grafting can be very useful for filling in facial wrinkles or augmenting certain areas of the body, particularly the buttocks. Because it uses your own tissue, fat grafting can provide natural and long lasting results.
Cosmetic and reconstructive surgeons have used fat grafting to treat a wide variety of conditions for many years. On the body, injections of fat can be used to perform a procedure commonly known as the Brazilian Butt Lift due to its popularity in South America. This surgical procedure is intended to provide increased fullness and enhanced shape in the buttocks. Your cosmetic surgeon performs liposuction on the back and hips and then injects the fat into the buttocks to provide more fullness and shape. This procedure is not indicated for patients who are very thin or have limited body fat.
Fat transfer is also very popular in facial rejuvenation. Using liposuction, Dr. McLain will take a small amount of fat from around the abdomen or thighs and then re-inject it into areas of volume loss in the face.
How Fat Transfer Works
During a fat transfer procedure, your surgeon carefully removes fat cells from your body with liposuction. Using a small cannula and minimal suction, a sufficient amount of fat can be removed from the abdomen, thighs, buttocks or elsewhere. The fat is then prepared (separating fluids from the graft) before it is injected into the treatment area. The injections are done in a series, placing a small amount of fat with each pass.