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  • Plastic Surgery at Rhode Island Hospital

  • Facial Procedures

  • Face

    MACS Facelift

    Lee Edstrom, MD, is the only plastic surgeon in New England who has extensive experience with the MACS-lift, a type of facelift developed in Europe and recently gaining popularity in the US. Edstrom has been performing this type of facelift since 2004 on many of his patients. The MACS-lift concentrates on the lower part of the face, from the lower eyelids down to and including the neck.

    This is a technique characterized by two features: first, a short scar, which does not go behind the ear, and second, the use of suspension sutures to lift the deep tissues (the "SMAS"). Both of these features contribute to an operation that takes less time to perform (2.5 hours instead of 3.5 hours), and requires less recovery time (2-3 weeks instead of 3-4 weeks). This means less expense and less downtime - a shorter time back to normal activities.

    The deep tissues are elevated and the extra skin removed, so that the operation has the usual overall effect. However, there is less of a tendency for a "windswept" look - a less severe and dramatic result. The outcome seems to last as long as the traditional facelift, and the patients who have had it are very pleased. With less operative time, less recovery time, less risk of complications, and a comparable result - it is Edstrom's preferred technique.

    Traditional Facelift

    A facelift is one of several procedures that address the aging process. Facial skin stretches over time and is pulled down by gravity, causing sagging skin and wrinkles. This process can be affected by many factors including sun exposure, weight fluctuations, and heredity.

    Facelifts correct the sagging excess skin by pulling the loose skin back and up and removing the excess. It is also possible to remove fat that is has been stored in the face and neck. While no surgery can prevent the natural aging process from occurring, a facelift can improve appearance and self-image for some time.

    The procedure involves an incision being made along parts of the hairline and around the ear. This is done to prevent detection of the scar and to allow the surgeon to tighten muscles and sagging tissue and to remove excess and reposition skin to create a more youthful look. Facelifts are often combined with correction of a "double chin," forehead lifting, and/or eyelid surgery.

    Facelifts generally take three or four hours and are performed in our own operating room under local anesthesia with sedation. Facelifts are usually performed as outpatient procedures, and patients usually experience very little pain.

    Blepharoplasty (Eyelid Surgery)

    Aging, heredity, sun damage, and puffiness of the eyes that can also result from deposits of fatty tissue are some causes of undesireable eyelid appearance. Fat deposits, commonly called "bags", loose skin of the upper and lower eyelids, and other imperfections can be corrected by your cosmetic surgeon in a procedure called blepharoplasty, or "eyelift."

    In the procedure, excess skin and fatty tissue can be reduced in the upper or lower eyelids separately or both at the same time. After a short time, any signs of the procedure are virtually unnoticeable. Blepharoplasty is sometimes combined with a face or forehead lift as part of an overall facial rejuvenation procedure.

    Usually this type of surgery is done as an outpatient with local anesthesia.

    Skin Resurfacing (Dermabrasion)

    The technique of skin resurfacing is designed to reduce the appearance of fine lines and wrinkles, and for the improvement of facial scarring. Resurfacing can be done by three methods: chemical peel, laser, and dermabrasion. Results are improved contour, smoother skin and rejuvenated appearance due to removal of layers of damaged skin. When first developed over 100 years ago, dermabrasion was primarily used to improve scars from acne, chicken pox, accidents and diseases. Now, it is used to correct pigmentation, wrinkles, sunspots, age (liver) spots, certain skin lesions, select areas of deformed skin, and issues relating to tattoos. Dermabrasion is not effective when dealing with congenital skin defects, various types of pigmented birthmarks and moles, and burn scars.

    Dermabrasion is normally performed in a doctor's office or an outpatient surgical facility with local anesthesia and sedation. After surgery, there is some discomfort, but easily controlled with pain medication. Healing normally takes 7 to 10 days. Your skin will also appear pink, gradually fading to your regular coloring. Make-up can be used as soon as the first crust is off. After dermabrasion, patients should be careful with sun exposure for 3 to 6 months and to regularly use sunscreen.

    Lip Augmentation

    Full, lush lips are currently viewed as an aesthetically pleasing feature. Lip augmentation can change your thin, poorly defined lips into vibrant lips. It can also help remove fine lines and wrinkles and drooping corners of the mouth. Lip augmentation is individualized for every patient and can be either semi-permanent or permanent. Sometimes, a collagen injection will be suggested first in order to make sure you are happy with the results.

    For lip augmentation, a doctor implements a small needed to insert a substance into your lips. This substance can be one of many different substances including Artecoll, Restylane, or fat taken from your body. Collagen is often used for lips and lines around the mouth. If you have chosen to have a lip implant, there are many natural substances that can be use as well as materials such as Gore-Tex.

    Lip augmentation is usually a 1 hour operation with full recovery taking 1 to 2 weeks.

    Otoplasty (Ear Surgery)

    There are a multitude of reasons for otoplasty with the most common being to set prominent ears closer to the head and to reduce the size of large ears. Surgery can be used for "cupped ear", "lop ear" and "shell ear". Other conditions that otoplasty can repair are large or stretched earlobes and earlobes with large creases and wrinkles. If a patient is missing ears for any reason, whether accident, injury or other cause, surgeons are able to construct new ones. Otoplasty is performed more frequently on children than it is on adults, which is uncommon for surgery. Children as young as 4 years old are eligible for otoplasty due to the ears being almost fully developed. Otoplasty is performed on many adults, even though ear cartilage becomes less pliable with age, thereby limiting the enhancement capabilities as one ages.

    Otoplasty surgery begins with an incision along the back of the ear. Due to differing desired effects, the ear cartilage will be reshaped, sometimes with small pieces being trimmed or removed, and excess skin will be removed. Permanent sutures will be used to keep the ear in place. In other circumstances, the cartilage will be pinned with permanent sutures. The effect of this surgery is to pull the ear closer to the head and make the ear appear smaller. At the end of all otoplasty surgeries, temporary stitches are utilized to close the incision that was made at the beginning of the surgery. After surgery is completed, a soft dressing will be applied around the ears for a few days. During this time, you will not be able to sleep on your side. Sometimes, headbands are recommended while sleeping to help keep the ears in the proper place. Otoplasty does not affect hearing, but there will be a small scar in back of the ear.

    Otoplasty is most commonly performed as an outpatient procedure at a doctor's surgical facility or at a hospital. General anesthesia is advised for younger patients while local anesthesia combined with a sedative is commonly used for older teens and adults. Surgery takes between 1 to 2 hours per ear and recovery time can take 2 or more weeks.

    Rhinoplasty (Nose Surgery)

    Rhinoplasty is surgery to reshape the nose to reduce or increase its size, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between the nose and upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. Patients seeking rhinoplasty may be striving for improved appearance or have a medical need. Insurance will often cover the costs of rhinoplasty when there is medical need.

    Rhinoplasty can be performed using a variety of techniques, depending upon the unique needs of the patient. Some surgeons perform rhinoplasty from within the nose and others start with the columella, the vertical strip of tissue separating the nostrils. The cartilage and bone causing the external deformity are altered and reshaped and in some cases, internal problems, such as breathing obstructions, can be improved by removing the obstruction.

    Rhinoplasty generally can be performed in one to two hours. The surgery is commonly done under local or general anesthesia, depending upon the extent of the procedure and is usually performed in a surgeon's office with return home for recovery on the same day. Occasionally, for more complex procedures a hospital stay is beneficial. A small splint is usually applied to the exterior of the nose to maintain its improved form. Risks associated with rhinoplasty are few.

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