Facial Surgery Procedures

Rhinoplasty, commonly referred to as a nose job, can improve the physical appearance of the nose as well as correct breathing problems caused by structural abnormalities within the nose. Even slight and subtle changes to the shape and proportion of the nose can lead to dramatic changes in overall appearance and nasal breathing. The size, width, symmetry and profile of the nose can be adjusted, as can the nasal tip and nostrils. Many seek rhinoplasty due to genetic traits that can result in a larger nasal tip, humps or depressions along the profile, asymmetry or a wider bridge. Others seek to correct damage caused by injury.

The nose cartilage can be reshaped, sutured, partially removed or resuspended during the surgery. Cartilage grafts can be used to bolster specific parts of the nose. Additional cartilage may be harvested from the ear or rib if a revision rhinoplasty is performed. Often, the bony parts of the nose will need to be corrected by highly targeted fracturing and resetting. Total recovery time can take up to a year. Swelling can last several months, and the cartilage will continue to evolve and assume a more permanent shape over time.

Over time, our faces can develop lines, folds and sagging skin as our skin loses its elasticity due to exposure to the sun, gravity and facial expressions. A facelift (rhytidectomy) can improve sagging skin, jowls and deep creases in the face and neck by tightening and removing excess skin and tightening the tissues of the face. There are various approaches to facelifts, including minimally invasive techniques. Our Montefiore Einstein aesthetic surgeons will tailor an individualized approach to meet your aesthetic needs and goals.

Traditionally, facelifts are performed by making incisions in the hairline, behind the ear, in the natural creases of the ear and underneath the chin to hide the incisions and any scarring. Your surgeon will lift and reposition the skin and trim the excess. Recovery time can range from one to two weeks before you resume your usual social interactions. Patients can apply makeup during recovery as long as the incisions are not disturbed. Rigorous activity can typically resume within 30 days.

A neck lift, also called a lower rhytidectomy, improves the appearance of the neck and reduces the signs of aging in the jawline and neck. The procedure targets excessively wrinkled neck skin (the “turkey wattle”) and double chin. The surgery can be performed with a traditional neck lift incision or a limited incisional approach.

Fullness under the chin is a problem for many and may not be fully corrected with liposuction or noninvasive procedures. For those who have recently lost weight or may have loose and sagging skin in the neck area resulting from aging, a neck lift may be an ideal solution to remove any extra fat, tighten sagging skin and smooth lines and wrinkles to reveal a slimmer profile.

During a neck lift, an incision is made under the chin and near each ear. Often, liposuction will be used to remove fat under the skin. Excess skin will then be trimmed away, and the remaining tissue and muscles will be tightened. Bruising and swelling will appear immediately after the surgery but will usually subside within a week. During the initial recovery, you may notice tightness and numbness in the area treated. However, once your neck adjusts to its new position, the skin and muscles will relax, and the results will become noticeable.

When the upper eyelid becomes saggy and creates a fold on top of itself, eyelid surgery (blepharoplasty) can improve the look of the upper and/or lower lid. As we age, it is normal to lose volume in this area, giving the appearance of fatigue. For others, the fat pads under the eyes bulge forward, leading to a puffy appearance. Others may have a droopy upper eyelid in which excess tissue and skin collect on the eyelid, causing a sagging look. Eyelid surgery targets the extra skin and fat while tightening the underlying muscles to create a refreshed appearance.

Upper or lower blepharoplasty procedures are often performed together with a brow lift to improve the appearance of tired, drooping eyelids and to help restore a youthful appearance to the eyelid and the area where the lower eyelid meets the cheek. During eyelid surgery, an incision is made in the crease of the upper eyelid, inside the lower eyelid or along the lower eyelid lash line (depending on the specific type of blepharoplasty). The excess skin is removed, along with loose muscle tissue and excess fat. The incision is closed with very fine stitches.

Depending on whether you had any additional procedures, you may return to regular activity within one to two weeks. Over the following four to six weeks, bruising and swelling will resolve, and you will notice an improvement in facial appearance. Appropriate skin care and sun protection, including sunglasses, are required throughout recovery.

A brow lift, also called a forehead lift, lifts low-positioned or sagging eyebrows to restore them to their original, youthful position. It also helps reduce wrinkles that develop across the forehead, rejuvenating the forehead area of the face, where deep lines and drooping brows can give the appearance of premature aging. The procedure helps restore the brow’s position to a higher, more youthful appearance while correcting hanging upper eyelid skin.

Many candidates will often undergo eyelid surgery, facelift and brow lift. Injectable treatments, such as Botox® Cosmetic, can also be used to complement the results. Brow lifts can be performed through various surgical techniques, depending on the position of your hairline, and most commonly involve using an endoscope to help adjust the tissue and muscle beneath the skin. An incision may be made from ear to ear at the hairline or within the hair-bearing skin to hide any resulting scars. The forehead skin is then lifted, and corresponding muscle adjustments are made.

Initial healing may take up to two weeks, during which time your forehead may be bandaged to minimize swelling and bruising. Even though you may begin to notice results and return to normal activities within a few weeks, a full recovery may take several months.

Facial implants are designed to augment the structure of your face in a way that is unachievable with injectables. While they may accentuate any area, implants are most commonly used in the cheeks to increase the projection of the cheekbones and midface; in the jaw to increase the width of the lower third of your face; and in the chin to increase its size and projection so that it is in proper proportion with the forehead and nose.

The placement of the incisions for implants will depend on their location, but most implants for the jaw, chin or cheek are placed through the mouth with the incisions made inside your mouth. There are some exceptions: where the incision for a chin implant can be made just beneath the chin, and incisions for cheek implants can be made inside the lower eyelid or within the hairline.

Recovery can vary depending on the implant, but you can generally expect to experience some initial swelling, numbness and/or discoloration. Although the results are immediate, they will become more visible once the swelling subsides. You may need to wear bandages during the initial phases of healing to keep the implants in their proper position. The timing of returning to normal activities will also vary depending on the implant.

Otoplasty, or ear repositioning surgery, improves the shape, size or position of the ear in adults and children who want to correct the appearance of large or protruding ears. More often referred to as cosmetic ear surgery, this procedure changes the size, shape and overall proportion of the ears by removing tissue and cartilage to mold them into a more refined shape. It is often used to correct congenital disabilities or problems caused by direct physical trauma to the ears.

During cosmetic ear surgery, incisions are made behind the ear, and the cartilage is reformed, often supported by splints. Skin tightening or tissue grafting may be used depending on the repositioning of the ears to address either protruding or hidden ears. After surgery, you must wear bandages and limit physical activity for a few weeks. The surgical scars will remain but will be hidden behind the ears. Results are immediately visible after surgery, although bandages must be worn for several days afterward.