Smart Planning for your first Procedure

You have decided that you want to have facial plastic surgery—what next? Whether it is minimally invasive or major surgery, the following steps will help yo

Step 1: Trust your face to a board certified facial plastic surgeon

A facial plastic surgeon is recognized for his or her extensive training, qualifications, and proficiency in cosmetic and reconstructive surgery of the face, head, and neck. Ask your physician if he or she is board certified in otolaryngology, surgery of the head and neck. This entails passing a series of rigorous oral and written tests about medical procedures and practices. Many surgeons specialize further with an additional fellowship in facial plastic surgery and passing the American Board of Facial Plastic and Reconstructive Surgery exam. Don’t be afraid to inquire and verify your facial plastic surgeon’s credentials.

Step 2: Take your time

Don’t rush into a procedure just because it is featured in the news as the latest and greatest treatment option. Take the time to get educated about your options. Think about any short or long-term goals you have regarding your facial features. The more prepared you are, the more you will assist your facial plastic surgeon in creating a treatment plan that is as unique as you are.

Step 3: Prepare for the consultation appointment

Before meeting with your facial plastic surgeon, write down any questions you have; be prepared to discuss what you do and don’t like about your features and why you are seeking treatment. Additionally, this appointment will allow your facial plastic surgeon to conduct a physical examination, find out more about your medical history, and ensure you are a good candidate.

Step 4: Keep in mind moderation

Just because you have finally decided to proceed with a treatment or procedure, does not mean that you have to go for a drastic, multiplefeature combination surgery. In fact, your facial plastic surgeon may have mentioned several options to enhance your appearance, but that does not mean that you need to schedule any or all of them. You can always do more down the road, but you cannot undo.

Step 5: Prepare your body

Actively try to improve your overall health before surgery. Start with your diet—are you eating foods rich in essential nutrients? Eat a good balance of protein and complex carbohydrates; avoid sugar and alcohol, which may suppress wound healing. Next, aim for seven to eight hours of sleep each night; your body needs time to rejuvenate and revitalize. With plenty of rest, you’ll be able to get moving! If you are not exercising daily, begin with walking. Regular exercise will improve your cardiovascular fitness and assist in weight management. Quit smoking; it reduces the blood supply to tissues, which decreases the rate of healing and increases the risk of infection. By taking charge of your health now, you will be setting yourself up for the most favorable recovery and optimal results. Check with your facial plastic surgeon for other tips he or she may have prior to surgery.

What’s wrong with your chin? There are options for change

Chin surgery has increased significantly over the past year. Patients want to have a strong chin and jawline, which is associated with youth, more selfconfidence, and authority. Thanks to many visual reminders and cues—i.e., video chat and photographs—a new self-awareness has brought people to their facial plastic surgeons asking for a more harmonious appearance to share across cyberspace.

Whether you think your chin is too weak, too prominent, or too fatty, your facial plastic surgeon will guide you through the process in order to create a well-proportioned appearance. Start with a thorough evaluation. In addition to studying the dimensions of each feature, your facial plastic surgeon will take into consideration your facial shape, facial size, size of your nose, height, and gender. In profile, a vertical line drawn down from the edge of your lower lip should just touch your chin. If the tip of your chin is behind the line, chin augmentation may be needed to bring your facial features into balance. If it extends beyond the line, you may benefit from reduction mentoplasty (surgery to reduce your chin size).

After a complete examination, your surgeon will determine which surgical procedure, or combination of procedures, is needed to improve your look. Successful surgery depends on good rapport between patient and surgeon—so don’t hold back any questions. This trust develops in the consulting stages before surgery. It is important that you understand all aspects of the proposed plan and have realistic expectations of the results.

Too weak

If you have a weak chin, you may benefit from chin augmentation. The shape and projection of a small chin are improved with an implant made of special surgical plastic (most commonly silicone plastic) or a similar material that mimics the feel of natural body tissues. Chin implants come in a variety of shapes and sizes, which the surgeon selects depending on the shape of the chin and the degree of correction needed.

The incision is made either inside the mouth, between the lower lip and gum, or in the crease beneath the chin. The surgeon creates a small pocket and slips the implant into place. The incision is closed carefully, and a small dressing may be applied with the skin incision.

Be aware that a prominent nose can make your chin look weaker. Often in these cases, a surgeon may recommend reshaping the nose as well as augmenting your chin.

Too prominent

A chin that is too prominent can be treated with a procedure called reduction mentoplasty. The surgeon makes an incision either inside the mouth or under the chin and sculpts the bone to a more pleasing size using an instrument similar to a dental drill.

If the over projection is due to a structural problem of the jaw or severely misaligned teeth, you may be referred to a dentist, orthodontist, or oralmaxillofacial surgeon for consultation. Regardless, the dental and facial plastic specialists in these areas will often coordinate an overall plan for correcting your chin area in a cooperative fashion.

Too fatty

If you have fatty deposits under your chin, you may be a good candidate for liposuction. Liposuction reduces the number of fat cells in a localized area. It is not recommended for persons whose excess facial fat is part of an overall weight problem; the procedure is ideal for refining the contour of the neck and jaw line and eliminating heavy jowls. Liposuction is often done in conjunction with other procedures, such as chin surgery and facelift. A narrow tube is inserted through a small incision beneath the chin and excess fat cells are vacuumed out. Loose skin under the chin can be removed and muscles tightened with a facelift.

Recovery

Immediately following surgery, you will have a dressing that will remain in place for two to three days. There will be some tenderness and swelling; any discomfort can be controlled with prescribed medications. Avoid bumping the area and foods that require significant chewing for the first few days. Normal activity can be resumed after 10 days. After approximately six weeks, most swelling will be gone and you can enjoy the results of your procedure—including more self-confidence, a balanced profile, and a better self-image.

Teen facial plastic surgery on the rise … is it for your teen?

The media has featured teens having facial plastic surgery at an increasing rate. Some stories highlight the benefits of surgery to quell bullying; other articles assert a procedure as the perfect graduation gift. The most popular procedures or treatments are to improve severe acne breakouts, scars, prominent or enlarged ears, disproportionate or disfigured nose, and weak chin.

As a responsible and caring parent, your job is to ensure that your teenager is not trivializing or rushing into any decision to have a cosmetic or reconstructive procedure. You can help your doctor and teen make the right decision by listening to your teen, seeking expert advice, and being supportive.

Listen

Your teen should feel comfortable discussing his or her insecurities with you. Allow them to vent about feelings of awkwardness and embarrassment. Validate your teen’s concerns. If he or she is actively seeking a treatment or procedure to improve his or her appearance, ask questions regarding why the change is important. Try to discern if his or her motives are regarding self-confidence or external peer pressure. Is it because everyone is getting it? Is it going to make him or her the most popular kid? Parents should also be aware of body dysmorphic syndrome, a disorder characterized by an unhealthy preoccupation of perceived imperfections that can interfere with daily functioning. The more you let the teen talk about the issue, the more you will be able to get a good sense of his or her motives.

Seek advice

Once you understand your teen’s point of view, make a consultation appointment with your facial plastic surgeon. This is your surgeon’s opportunity to screen your teen for maturity, motivations, expectations, in addition to the physical examination. Ask questions and be open to recommendations. There will be several options to discuss regarding what will meet your teen’s needs, produce desired results, and work within your budget. You may also want to request to speak with other patients that have had similar issues and treatments. This will help your teen understand the process and know what to expect from beginning to end.

Support

There should be no rush to schedule the procedure. Be sensitive and realistic; ensure that your teen feels at ease with his or her decision.

As one parent states, “My daughter had expressed displeasure over her ‘imperfection’ for several years. First it was annoyance, but eventually those feelings turned to angst and avoidance of getting her photograph taken. Although it didn’t seem like a major flaw to me, it was a big deal to her. I wish I would have researched our options sooner and been more supportive. In the end, the treatment was not as extensive as I assumed, the cost was reasonable, and the effect on her confidence and self-image was priceless.”

Social media made me do it!

As more people see themselves on video chat technology and tagged in innumerable photographs, they may notice that their appearance is not the way they want it to be. “It is hard not to judge yourself, when you are seeing your face all over the place,” says one young woman in her forties. “If you are self-conscious about any particular feature, these social media sites are only going to make it worse.”

Some images can be improved with a better camera angle, different pose, or slight tilting of the head; however, when a person is still unhappy it may be time to seek expert advice from a facial plastic surgeon.


ASK THE SURGEON

I have heard that facial plastic surgeons donate their time and expertise to provide pro bono surgery to women who have suffered facial injuries due to domestic violence. Where can I find more information about this program?

Domestic violence is the leading cause of injury to women. The American
Academy of Facial Plastic and Reconstructive Surgery partnered with the National Coalition Against Domestic Violence to offer a 24-hour toll-free hotline (800-842-4546) for individuals who have sustained physical scars or injuries to the head, face, or neck as a result of domestic violence. Facial plastic surgeons, nurses, and anesthesiologists are involved in FACE TO FACE: The National Domestic Violence Project; all donate their time and expertise to treat one face at a time, one person at a time. Participants are matched with a surgeon based on need, expertise, and location. For more information, you can call the hotline or visit www.facetofacesurgery.org.

HEALTH TIP

Can consumption of coffee reduce your risk of skin cancer? A new report published in Cancer Research states that drinking more caffeinated coffee could lower your chances of developing basal cell carcinoma, a common, slow-growing skin cancer.

Researchers analyzed data from the Nurses’ Health Study (more than 112,000 people) and found that one-fourth of those studied had developed basal cell carcinoma over a 20-year period. They found the more someone drank caffeinated coffee (more than two cups a day), the lower his or her risk of developing basal cell carcinoma. The caffeine seems to be the crucial fact; since tea, cola, and chocolate—all which contain caffeine—also seemed to reduce a person’s risk. Doctors will not be prescribing caffeine just yet; more research is needed.

WHAT’S NEW?

If you are worried about hiding any evidence of your procedure when you go back to work—don’t worry—there are three techniques to employ: conceal, color correct, and contour shadows.

Concealers work well to disguise bruising and incision lines. They are thicker than foundation makeup; use one that closely matches your skin tone. You can ask your surgeon for product recommendations or continue to use what you have used in the past; just buy new applicators so they will be as clean as possible.

Color correctors neutralize color in reddened or yellowish skin, e.g., from bruising or overall redness that follows chemical peels and dermabrasion. Less opaque than concealers, correctors are tinted and have the same consistency and sheerness as foundation.

Contouring masks swelling and creates the illusion of highlights and shadows. This technique may require a quick lesson or assistance; ask your facial plastic surgeon. The idea is to create dimension using light and shadow. The lighter areas appear to come forward; use two shades lighter than your normal skin color. The darker areas recede; use two shades darker than your foundation.