Facial Cosmetic Surgery: Nose Job (Rhinoplasty), Brow (Forehead) Lift, Eye Lift (Blepharoplasty)

Facial Plastic Surgery

There are a number of different procedures that plastic surgeons do to make an older face look younger. The face lift (technically known as a rhytidectomy) is probably the most well-known. Surgeons can also do brow or forehead lifts, as well as eye lifts (also called blepharoplasty).

Forehead lift / brow lift

A forehead lift, which is also known as a brow lift, can be done alone or in combination with other procedures such as a facelift. A brow lift is designed to help improve the appearance of deep forehead furrows, frown lines, and/or sagging droopy eyebrows. While a face lift targets the lower third of the face, a browlift targets the upper third.

A forehead lift is generally performed under sedation with local anesthesia. An incision is made behind the hairline. Then excess skin is removed, and the skin is then repositioned. The operation may take several hours. Following the procedure, the area by the sutures is bandaged. There can be swelling and bruising afterwards. You may need to use pain medication or cold compresses for swelling. During this week after the surgery, you may want to avoid strenuous activity. The suturing will be removed about a week after surgery, and it can take several weeks for positive results to be seen.

In an endoscopic brow lift, the surgeon uses small incisions, through which he or she inserts a small, thin camera device connected to a television monitor. The endoscope and camera provide guidance while the doctor repositions the eyebrows at a higher level. The surgeon may also remove the muscles that produce frown lines. An endoscopic brow lift does not alter the hairline.

Nose surgery, nose job (rhinoplasty)

A rhinoplasty or "nose job" is nose surgery to change the shape of the nose or improve its function. Cosmetic rhinoplasty is done strictly for appearances or cosmetic reasons. You can have surgery to increase or decrease the size of your nose, to change the bridge of the nose or the nose tip, or to change the shape of the nostrils.

Cosmetic nose surgery can be done as an outpatient procedure under either general or local anesthesia. Incisions are made inside the nostrils, although sometimes they can be made at the base of the nose. The inner bone and cartilage of the nose are reshaped to produce the shape you're looking for. In a structure rhinoplasty, only small amounts of cartilage are removed. Generally, you wear a nasal splint for about a week after the plastic surgery. There will be swelling and you may notice bruising around the eyes. This can last several days or up to two weeks. The final shape of the nose will be permanent after about six months healing time.

If you are considering a nose job, make sure your expectations are realistic. There is no such thing as a perfect nose. Your nose should fit the rest of your facial features. Your rhinoplasty surgeon should show you before-and-after photos of nose surgeries. You will also need to discuss cost. The cost of a rhinoplasty can range from $3000 to $9000, depending on the extent of your surgery and where you live. If this is being done for cosmetic reasons, it will not be covered by insurance. You may also need more than one surgery. Secondary rhinoplasty can be done to correct things not corrected in the primary rhinoplasty. Secondary rhinoplasty may also be needed if you are not happy with the results of your primary rhinoplasty.

Cosmetic eye surgery, eye lift, eyelid surgery (blepharoplasty)

Cosmetic eyelid surgery, technically known as blepharoplasty, is designed to improve drooping eyelids, which can give a hanging appearance. This procedure can be done along with a facelift or brow lift, as well as other procedures such as Botox or laser resurfacing.

An eyelift is usually done on an outpatient basis, with local anesthetic. During eyelid plastic surgery, excess skin, fat, and muscle are removed through precise incisions. The incisions are placed in the natural folds of your eyelids to reduce scarring. After cosmetic eye surgery, there can be discomfort, swelling and bruising.

As with any cosmetic surgery procedure, make sure you see only a qualified plastic surgeon with years of experience in this area. Make sure the surgeon is certified by the American Board of Plastic Surgeons. Make sure that the cosmetic surgeon has also been in practice a number of years, and does the type of procedure that you're considering often. Also remember that these types of procedures are generally not covered by insurance.

It is also important that afterwards, you treat your skin correctly. That means using moisturizers regularly. It also means you should use good sun protection, such as sun protective clothing and/or sunscreens and sunblocks.

Face lift (rhytidectomy)

Face lift or rhytidectomy is one of the most common facial cosmetic surgical procedures. As we get older, there are many changes that happen to our face. Fine lines may get deeper, face and neck tissue may start to sag and we may develop a haggard look. Changes that occur as we age include wrinkles and sagging skin, folds on the neck, jowls, loose skin, double chin. Gravity and too many sunburns can take their toll. Facelifts are one procedure designed to remedy some of that.

If you are thinking about a face lift, you will need to consider many things. These include your age, your overall physical health, your bone structure, the texture of your skin, your coloring, and your attitude about what you want to accomplish. You may need procedures in addition to the face lift, for example liposuction to remove excess fat. A brow lift or eye lift may also be done at the same time. A facelift will not correct age spots or discoloration; for that you would consider laser or other aging skin treatments. A face lift will also not eliminate wrinkles or acne scars. Other treatments such as cosmetic fillers might help those conditions.

It is essential that you choose a qualified plastic surgeon with years of experience in doing facelifts. The American Board of Plastic Surgery certifies plastic surgeons. The surgeon should take photos of your face and talk about realistic expectations. You should also be told about potential risks and complications. Your doctor will also need information on any health problems you may have, such as whether or not you smoke or tend to develop scars. Other issues such as hypertension or blood clotting problems must also be considered.

During a face lift, the surgeon will make an incision by the temple and down to the ear. In a mini-facelift, the incision is just by the ears. The skin will then be raised, repositioned and underlying structures are tightened. The incision should be placed where it can be hidden by natural skin folds or hair. The operation may take several hours, and can be done with sedatives, local and/or general anesthesia. Following the procedure, the incision area, where the sutures are, will be bandaged. There will be swelling and bruising afterwards. You may need to use pain medication or cold compresses for swelling. Sutures will be removed about a week after surgery. During this week, you may want to avoid strenuous activity. It will take several weeks for positive results to be seen.

A face lift won't stop the continued process of aging skin. You may need additional procedures in the future. Keep in mind that a face lift is probably not covered by insurance. There can also be side effects. Patients may feel that their skin is too tight, or there can be scarring. Other risks include bleeding, infection, poor healing, numbness, nerve damage and anesthesia risks. It is important that you not smoke, as smoking can reduce circulation and impact healing. Smoking will also accelerate the aging of your skin.

Facial plastic surgery precautions

Before and after any facial cosmetic surgery, make sure you follow a healthy diet. Ask your doctor about any medications you might be taking, both prescription and over-the-counter. It's also important that you use good sun protection, such as sunblock or sun protective clothing both before and after surgery to prevent problems and further skin aging.

If you are considering facial cosmetic surgery, don't choose your plastic surgeon based on price alone, even though the cost of your surgery won't be covered by insurance. You should also do your research. There are many plastic surgery links and resources such as forums and message boards; however the types of information you get on message boards and forums is not guaranteed, so check things out carefully. Remember too that the success of your plastic surgery depends on your wound-healing ability and the skill of your surgeon. Ask to see before-and-after photos of patients your doctor has treated. And make sure you use only a board-certified plastic surgeon.

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Updated May 2008

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