Head and Neck

Synonyms: S lift

Mini facelift is a surgical procedure with the purpose of rejuvenating the face and the upper half of the neck. The region of the face from the lower eyelids downward to the upper third of the neck is the region of interest for this procedure, because that’s the part that firstly and most notably exhibits signs of aging, in the form of lax, non-elastic skin, wrinkles, loose muscles and loss of fat.

Differing from this procedure, a full facelift includes the forehead, wrinkles around the eyes (crow’s feet) and most of the neck.

Candidates for this procedure are people, both sexes from 45 to 60 years of age, whose face in the lower half clearly and obviously shows loose skin full of wrinkles, which gives them an older look.

Before deciding on this procedure, You should consider different skin and facial improving treatments, like: botox, fillers, mesotherapy, fat grafting, laser rejuvenation. Some of those would be procedures of choice if you are younger and have vital skin, and the most of your problems are wrinkles and loss of fat. If You are over 60, then You may might consider a full facelift.

The idea behind this technique is to make as small a scar as possible, and to lift as little skin and subcutaneous tissue as possible, because that will give the most natural appearance. A small incision is made above, immediately in front and behind the ear, this incision is minimally visible. Skin is lifted and the muscles that have slid down are pulled up towards the ear and tightened, together with them, a part of the fatty tissue gets placed back in it’s own original position. Excess skin is then removed. And finally, microsurgical sutures are placed along the previously made incision. Upper neck skin can be tightened if necessary.

Local with sedation or in rare cases, general anesthesia.

There is some swelling and bruising after the procedure, which go away during the first week.

Sutures are removed successively, starting with day 5 through day 14.

There are no special requests, no bandages, cold pads are applied after the intervention, hair can be washed 12 hours after the procedure.

Make up can be used after 3 days, and regular skin care routine can be used.

Very rare. Haematoma, bleeding, skin infection, facial palsy..

The results are visible immediately after the procedure. After 7 days when the swelling and bruising completely subside, You can see the success of the procedure.

Full, permanent results are developed after 1 to 3 months.

We never had any post op complications.

This is our recommended procedure for people of middle age who wish to have the most natural look of their face.

The procedure takes 2 to 2 and a half hours.

7 to 10 days is usually ample enough, because the swelling/bruisung subsides in the first week, and You can resume with Your regular life activities with a little make up.

12 to 24 hours usually.

Any time of the year is fine, flu season should be avoided, if possible.

No.

Synonyms: Full facelift

Facelift is a surgical procedure which deals with removing any signs of aging of the face and neck. It entails tightening (essentially lifting) muscles and fascias, removing excess loose skin and other signs of aging skin.

Any person over 60 who are suffering from obvious consequences of face and neck skin aging.

Before deciding on this procedure, You should study and consider other treatments which improve the appearance and state of the face and neck skin, such as laser rejuvenation, mesotherapy, fat grafting , fillers, botox. Those would be considered procedures of choice if You are younger and have vital skin, and the major problem are wrinkles and loss of fat. Also, a Mini Facelift, should be considered, because it gives great effects on persons in which the aging process is more pronounced on the lower half of the face.

All of these procedures can be successfully combined!

The skin of the face and neck get lifted from subcutaneous tissue. The excess fat is then removed. Muscles that have become loose under the influence of gravity are tightened. Eventually, the excess skin made by the lift is removed. Ultra fine, microsurgical sutures are placed along the edges of the primary incision, mostly hidden in the hairline.

Local with sedation or general.

There is always some swelling and bruising immediately after the intervention, which last for about a week and significantly reduce in the week after. Complete disappearing can be expected after 3 weeks. Sutures are removed successively, staring with day 5 through day 14.

There are no special care and treatment requests. No bandages are required. Cold pads are used after the procedure to reduce swelling. Hair can be washed 12 hours after surgery.

Make up can be used after 3 days, and normal skin care routines can be applied.

Very rare. Haematoma, bleeding, skin infection, facial palsy, delayed healing.

The results are masked by swelling and bruising immediately after surgery and for the first 7 days. After the first seven days, when they resolve, the results are clearlynoted, and they keep improving on a daily basis for the next 3 months.

Final result can be expected after 3 months and it is permanent.

There were no cases of post-op bleeding, infection, and palsy complications in our practice.

In 3 cases of extremely extensive facelifts there was delayed healing observed in the region of the hair line behind the ear.

The procedure lasts from 3 to 5 hours.

Downtime is mostly 2 weeks..

You usually stay at the hospital for 1 to 2 days.

Any period of the year is suitable, preferably the flu season should be avoided.

No.

Synonyms: Blepharoplasty

Surgical procedure which is used to correct ‘droopy’and ‘puffy’eyelids, as well as ‘bags’on the upper and lower eyelid.

‘Puffiness’and ‘droopiness’of the eyelids are most often caused by fatty tissue protruding from the muscles around the eye.

The usual candidates for this procedure are adults of both sexes, suffering from significant drop of the eyelids, which disrupt the appearance of the eyes and facial expressions, sometimes leading to difficulties seeing.

It’s important for You to know that eyelid surgery is a very safe procedure, with extremely rare and minimal complications, while being a source of immeasurable pleasure. It’s also important to know that just a few days after this procedure You can return to Your normal life activities, completely reinvigorated, with a new spin on life.

It should be clearly noted that while excess skin and fat of the eyelids can be resolved by this procedure, wrinkles and dark circles around the eyes cannot.

Upper eyelids: A small incision is placed along the middle of the eyelid, through which the muscles and fat are accessed. The fat is removed from all layers of the muscle. Excess skin formed by accumulation of the fat that increased the volume of the eyelid is then removed. Skin is finally sutured in a way that the suture line is placed in a natural fold in the eyelid skin, thus being almost invisible.

Lower eyelids: The incision is placed just under the lower eyelashes or even on the inside of the eyelids. As with upper lids, all the fat that is present is removed. Finally, sutures are placed.

Local when just the eyelids are operated on, general when eyelid surgery is done along with some other procedure on the face (facelifting, fat grafting…)

There may be swelling, bruising, tingling present after the procedure, sometimes accompanied with tears and sensitivity to light.

No bandages are required after the procedure. Immediately after surgery, cold pads are applied in order to prevent the forming of large swelling (which is expected) and to reduce the already formed swelling. It’s recommended to apply cold pads regularly during the first day. It’s also important for the patient to remain in bed, improving the drainage of lymph, thus reducing the swelling. The swelling keeps progressing to day 3, and stars to subside from day 5. Without regard to the swelling, the patient after eyelid surgery in local anesthesia can be discharged from the hospital in just a few hours, with precise instructions on how to behave. First sutures are removed after three days, the rest from post-op days 5 to day 7. Swelling is fairly minimal after 5 days, and can be concealed by make up, so the patient can resume with their everyday activities.

Cold pads should be applied intermittently at home. Wound maintenance is considered to be done by washing the face with luke-warm boiled water 2 times a day for 5 days at least, after the sutures are removed, maintenance is required for the next 3 weeks, with application of hydrating and re-epithelization creams.

After that period You can resume with Your usual life habits.

Ectropion – inability to fully close the eyelids with tearing.

First result is observed after 3 weeks, after 3 months 80 % of the final result is achieved, and it continues to improve for the next 2 years. The results are permanent.

When all 4 eyelids are operated on, local anesthesia is always recommended, so the surgeon and patient are enabled to cooperate in order to yield the best results.

There was a hint of a possible ectropion in only one case of all 4 eyelid surgery, which was successfully resolved by excellent cooperation of the surgeon and the patient in exercising closing of the eyelids. There was no tearing, and the eyelids were able to fully close within 3 weeks.

The procedure takes from one to three hours.

Downtime is usually 7 to 10 days.

You usually stay at the hospital for 24 hours.

Any period is fine.

No.

Synonyms: Rhinoplasty, Nose job

Esthetic surgery of the nose entails a surgical treatment of the nose in order to achieve a better looking nose and overall harmony of the face. It often includes the solution to breathing difficulties which come from a deviated septum.

Esthetically, nose can be corrected in the sense of size, shape, tip and profile.

Any person who is over 18 years of age and is dissatisfied with the size or shape of their nose. Persons who have sustained a nose deforming injury. Persons with breathing difficulties derived from a deviated/deformed septum.

If you have unrealistic expectations, there is a chance that you will be dissatisfied with the appearance of your new nose. You should also know that repeat surgeries are sometimes necessary in order to achieve the desired appearance..

The basis of every nose surgery is separating the skin from the deeper structures (bones and cartilage), then remodeling the deeper solid structures and then reattaching the skin to them.

General anesthesia, only in case of nasal tip surgery it can be local anesthesia.

In the early post op period, there will almost always be swelling, slight bruising, odd sensations in the operated region. These changes will mostly go away within one week of the surgery.

It’s necessary to get accustomed to breathing through your mouth for 3 to 5 days, during the time in which the tampons are inserted in the nose (patients get used to it after 6 to 8 hours). This procedure is also followed by dryness of the mouth, which can be easily resolved by regular intake of fluids.

After surgery, tampons are inserted in the nose which stay there for 3 to 5 days, and the immobilizing cast is worn from day 3 to day 7. In most cases the sutures fall out by themselves, in rare occasions is it necessary to remove the sutures after 7 to 10 days.

Smokers are in need of stopping smoking until complete healing.

Nose bleeding and infections of the nose are a possibility. These occurrences are rare and they are easily resolved, without consequences to the effects of the surgery itself.

First result that you will be able to see is after the immobilizing cast is removed, then you can see if the position and profile of the nose have been corrected. After 3 to 4 weeks the results will significantly improve, because that’s when most of the swelling will go down, and the nose looks much thinner and more subtle. The appearance of your nose will improve more and more for the next 6 months.

The final result can be expected after 6 months, and it will be permanent.

On patients that have the surgery done early, before 18 years of age, there is almost always a need for small corrections because the nose continues to grow after the first surgery.

On patients who had the surgery before 25, there is a certain number of cases that needed to have corrective procedures on the tip region of the nose after a few years.

On other patients corrective procedures were very rarely needed.

Of all the surgeries done, there was one occurrence of bleeding 3 days after surgery, which was easily resolved by correcting the placement of the tampon. Other complication was an infection of the nose from inflamed sebaceal glands, it spontaneously subsided immediately after removing the immobilizing cast. There were no serious complications.

The procedure takes from one to one and a half hours.

Time off work usually is between 7 and 14 days.

You stay at the hospital for a day or two.

It can be done anytime of the year, but it’s best not to do it in flu season.

There is no pain after the procedure.

Synonyms: Otoplasty , Protruding ear, Prominent ear

Esthetic surgery of the ears, in most cases, deals with solving the issue of prominent or protruding ears, by bringing the ears closer to your head.

Estheticaly speaking, ears can be corrected size and position-wise, or they can be completely remodeled in cases of congenital deformities or severe trauma.

Since there are two possible solutions for solving prominence of the ears, with or without remodeling of the cartilage of the ear, You should know that if the procedure is done without remodeling, the ears get much closer to your head, and may seem larger than they did and even more unnatural.

The skin gets separated from the cartilage on the back of the ear, then the cartilage gets remodeled so it mimics the correct anatomy of the ear. Afterwards, the cartilage gets fixated nearer to the head. Finally, excess skin is removed and sutures are placed.

General anesthesia is always applied on children.

Local anesthesia can be used on any grown up.

After the procedure, ears get fixated to the head with bandages which are removed 3 to 5 days after.

Sutures are removed between days 7 and 14.

There may be swelling and bruising present in the operated region immediately after the procedure.

A sensation of numbness is reported by patients after 3 weeks of the surgery, when the swelling subsides, it may last for a couple months.

There are no special care and treatment requests after this procedure. Until the sutures are removed, all the care is performed by our staff.

Bleeding, haematoma, infection are possible after this procedure. All of them are easily fixable without endangering the outcome of the procedure.

Fixing prominent ears (with cartilage remodeling) is a once-in-a-lifetime procedure, it doesn’t have to be repeated, it’s permanent.

In cases without cartilage remodeling, prominence may come back to some extent.

Results are visible immediately after removing the bandages.

This procedure is not as simple as it seems, the position of the ear needs to be adjusted (bringing the ear closer to the head), but there are a lot of smaller, esthetic and functional matters to not overlook. Glasses need to be considered, earrings, shape of the ear, bumps, dents, curves. Thus, this is one of the most demanding, but also one of the most inventive procedures for an esthetic surgeon.

The period of immobilization is shortened to 3 to 5 days, thanks to our improved technique of remodeling and fixating the cartilage.

The procedure takes about an hour.

Downtime is usually from 7 to 10 days.

How long is the hospital stay?

Summer break is most suitable for children, any time of the year is fine otherwise.

No.

Synonyms: Lip augmentation, Lip fat injection

Lips can be remodeled by injecting different fillers or Your own fat (fat grafting). Anyone of these methods can increase the volume of Your lips, and/or change the shape of it.

Fat grafting is a procedure that entails a transfer of Your own fatty tissue from one location (abdomen) to another (lips)..

Any person who seems dissatisfied with the size and shape of their lips, or deems that their lips do not match the overall appearance of their face.

This procedure is often done by people who have uneven lips, i.e. when the lower lip is significantly more voluminous than the upper lip.

Before deciding on lip remodeling, You should consider which is the procedure of choice for You.

Fillers or Fat grafting?

The procedure includes harvesting of fatty tissue by liposuction (usually from the abdomen), filtering and preparing of the adipose cells and finally, injecting the fat into the lips. About 40% more fat than necessary is injected in this procedure, because not all of the fat ‘takes’, some of it always gets reabsorbed, essentially disappears.

Local, or general (very rarely).

There is some swelling and bruising present after the procedure. They go away fast, and can be easily concealed by make up from day 3. Cold pads need to be applied in 30 minute intervals for the first 6 hours after the intervention, they can also be intermittently applied for 10 minutes at home.

There are no special care and treatment requests after this procedure.

Very rare. Haematoma forming is possible, tingling sensations in the lip, skin infections, forming of subcutaneous lumps.

This procedure has to be repeated sometimes (once or twice, at max), if there is a significant amount of fat lost. But when the desired effect is achieved, the result is permanent.

There were no post op complications in our practice.

We have continually evolved our technique in order to achieve an increase in the volume of fat that gets accepted by the recipient region.

This is the method that gives the lips the most natural appearance in a well selected group of patients.

Fat grafting procedure takes about an hour.

Downtime is usually 2 to 3 days.

You stay at the hospital for 4 to 6 hours.

Completely irrelevant, it can be done anytime of the year.

No.

Synonyms: Adipose tissue transplantation

Wrinkles are grooves on the skin of your face, which occur under the influence of changing structures in the skin itself (loss of collagen, elastin and dehidration), often and pronounced mimicking, aswell as loss of subdermal fatty tissue in certain regions of the face. They give the face an older, more tiresome look, and often are a source of discontent.

There are many ways of reducing and removing wrinkles. Based on the region on which the wrinkle is located, the depth of the wrinkle and the state of the surrounding skin, Your doctor will suggest the most appropriate method.

Wrinkles can be treated by fat grafting, fillers, lasers, botox, surgery and many other ways.

Fat grafting is a procedure in which Your own fatty tissue is grafted and transferred from one place (abdomen) to another (wrinkles).

Any person that considers that wrinkles are disrupting the looks of their face.

Before making a decision about reducing wrinkles by fat grafting, You need to consider if it’s the most suitable procedure for You.

Get acquainted with other methods, then make a decision, we are always on service to You to help You make a right choice!

The procedure entails harvesting fatty tissue by liposuction (usually from the abdomen), filtering and preparing the fat cells and eventually injecting the fatty tissue in the wrinkle. About 40% more fat than appears necessary has to be injected, because at the end, not all of the fat ’takes’, one part is always resorbed, effectively disappearing.

Local or general anesthesia (extremely rare).

Immediately after surgery, there is always swelling and bruising. They resolve quickly, and from day 3 and on, can be easily covered up with make up. Cold pads need to be applied for 30 minutes after the procedure, during the first 6 hours, cold pads can be also applied intermittently at home, in 10-ish minute durations.

There are no special care and treatment requests after this procedure.

Very rare. It’s possible for haematoma, skin infection and subdermal clumps to form.

Fat grafting needs to be repeated in some cases (once or twice, at max) if there is a significant loss of injected fat. But once the desired effect is achieved, the results are long lasting.

There were no post op complications in our practice.

We have constantly improved our technique over time, in the sense of increasing the volume of ’taken’ fat.

This is the method that gives the face the most natural look.

Fat grafting procedure takes about an hour.

Downtime is 2 to 3 days.

The hospital stay is between 4 and 6 hours.

Completely irrelevant, it can be done any time of the year.

No.

Dermabrasion is a procedure that ‘s used to improve the appearance of the skin of the face, when it’s compromised by scars, bumps or sun damage.

Persons suffering from skin damage caused by acne at an early age, scars of any origin, as well as persons with severe skin sun damage.

Other procedures such as microdermabrasion or acid peel treatment should be considered. Dermabrasion gives by far the best results, but we keep it as a last resort, for problems that weren’t solved by other methods, because of it’s somewhat greater aggressiveness.

The surface layer of the skin is removed by using different tools, thus reaching the layer from which the skin will heal better, giving a more even, smoother appearance.

Local or general anesthesia.

Within 2 days, the treated region dries out and forms a superficial crust. After 5 to 7 days, the crust peels off, and new, young, reddish skin appears from under it.

Intense care in the form of hydrating facial products and sun protection is needed. Make up can be applied but needs to be carefully removed at night.

Very rare. Skin infection is possible, it is easily resolved without consequences to the effects of the procedure.

The final result of the procedure is achieved after one month, and it is permanent. It’s important to protect and take care of the skin in order to have a better and faster re-epithelisation.

When indicated, in cases of pronounced scars and hyperpigmentations, classic dermabrasion gives the best results. It is also the procedure of choice on persons that have an inclination towards forming hyperpigmentation after laser and radiofrequency treatments.

Radiofrequency dermabrasion holds it’s place in cases of limited and superficial regions with scars and/or hyperpigmentations.

In all cases of superficial and partially deep scars and hyperpigmentation, ablative laser treatments have an advantage, especially on persons with pronounced signs of skin elasticity and tension loss.

The procedure takes from 20 to 60 minutes.

Usually 7 days with larger procedures, 2 to 3 days with smaller ones.

1 to 2 days only with larger procedures, just a few hours with others.

Fall, winter and early spring.