Cosmetic Facial Surgery

Elliott H. Rose, MD -  - Plastic Surgeon

The Aesthetic Surgery Center

Elliott H. Rose, MD

Plastic Surgeon & Reconstructive Surgeon located in Upper East Side, New York, NY

Cosmetic Facial Surgery Specialist
Facial cosmetic surgery is used to restore more than physical attributes, it can also bring about renewed self-confidence. Dr. Rose offers “naturally appearing” facial cosmetic surgery for his patients. The upscale, spa like surroundings offers patients the ultimate in luxury, comfort and safety.

Cosmetic Facial Surgery Q & A

by Elliott H. Rose, MD

Is Cosmetic Surgery of the Face for Me?

As we age, the deeper tissues of the face gradually lose their tone and elasticity and respond to the downward pull of gravity in a very predictable fashion. No one is immune from these anatomical alterations of aging, although the process may be accelerated by smoking, sun exposure, and the stresses of ordinary life. A face/neck lift can “set back the clock” by trimming away loose skin, tightening the underlying muscles, and restoring a more youthful structure of the face.

Why Should I See Dr. Rose for Facial Cosmetic Surgery?

Dr. Rose offers the latest in technological advances in less invasive plastic surgery. These incremental approaches rejuvenate the skin to achieve a more natural look rather than a plastic appearance. Most patients start at an early age and continue periodically with “maintenance” procedures so they can keep a fresh, youthful appearance well into their 70s. Some of the facial cosmetic surgery procedures that Dr. Rose offers include:

  • Face/neck lift
  • Mini brow lift
  • Eyelid surgery
  • Nasal surgery
  • Microliposuction
  • Laser resurfacing
  • Chin or cheek augmentation
  • Lip enhancement with dermal strip graft
  • Buccal fat extraction
  • Fat injections for smile lines, lips, frown line
  • Botox injections for frown lines, Crow’s feet and forehead creases
  • Fillers for lip lines and deep laugh lines

What’s a multi-vector face lift?

In the multivector face/neck lift, the negative vectors of aging are scientifically approached by pulling each portion of the face (brows, temples, cheeks, jawline and neck) in a reverse direction of the gravitational pull to correct that tired look. Higher cheekbone are restored, the cheek jowls flattened, and the neck/jawline area sculpted into a fresh, natural look. The face/neck lift is performed as an outpatient under intravenous sedation anesthesia (you are totally unconscious) administered by a Board Certified anesthesiologist at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center, After your facelift, the skin will continue to age at its normal rate but the clock is “reset”. Periodic “maintenance” procedures requiring much less surgical intervention are recommended usually at two to three-year intervals to keep the face fresh and youthful well into your seventies or eighties.

 

Eyelid Surgery

Eyelid surgery (blepharoplasty) is the technique of trimming away droopy skin from the upper or lower eyelids, removing fat from “puffy” eyes, and restoring the more natural “almond shape” of the eye. Eyelid surgery is often done in conjunction with mini-brow lift to raise the arch of the eyebrows and/or resurfacing procedures to smooth the crepiness of eyelid skin or crow’s feet. Dark circles under the eyelids are not eliminated by blepharoplasty but fall more naturally into the groove below the eyelid.

Procedure and recovery

Eyelid surgery is performed under “twilight” sedation (you are totally unconscious) by a Board certified anesthesiologist at our state of the art AAAASF certified facility, The Aesthetic Surgery Center. The length of the procedure is usually one to one and a half hours. Incisions follow natural lines of the eyelid – the crease above the upper eyelid; along the lash line of the lower eyelid. Fat and skin are trimmed and the deep muscle (important for internal support) are strengthened. In special circumstances, when fat pockets protrude into the lower eyelids but there is little or no extra skin, the incision is made inside the lower eyelid (transconjunctival blepharoplasty), leaving no external visible scar.

Ice compresses are applied for two to three days to each eye. Bruising and swelling tend to fade after seven to ten days but may last as long as two to four weeks. Skin care is initiated immediately. A flesh colored concealer custom can be applied during the second week. Most patients are able to return to work or go out in public within a week to ten days (earlier with tinted glasses).

The more alert, youthful shape of your eyes should last for years. With periodic maintenance procedures requiring much less invasive surgery or laser “touch-up”, you should look fresh well into your seventies or eighties.


Nasal Surgery (Rhinoplasty)

Surgery of the nose (rhinoplasty) is performed to enhance cosmetic appearance or correct functional breathing disorders. Nasal abnormalities may be entirely hereditary or may be associated with trauma or congenital birth defects or disorders. With this surgery, the size of the nose can be reduced, the bridge straightened and thinned, the tips better defined, and the nostrils narrowed. Computer imaging greatly assists in projecting the desired nasal profile and shape following surgery.


Procedure and recovery

Most nasal surgery is not performed on teenagers before the age of 14 or 15 (at least one to one and a half years after puberty). The surgery is performed under “twilight” sedation (you are unconscious) by a Board certified anesthesiologist at our state of the art AAAASF outpatient facility, The Aesthetic Surgery Center. The length of the procedure is one and a half to two hours. Incisions are hidden internally within the nose. In complex reshaping of the nasal tip, tiny incisions may be required across the columella or at the base of the nostrils (very inconspicuous after healing).

A custom molded Aquaplast splint that maintains the new nasal architecture is worn for seven to ten days. Bruising and swelling, particularly beneath the eyes, usually lasts ten to fourteen days. Light nasal packing is removed at two to five days. Following removal of the nasal splint, the new shape of the nose is apparent, although subtle swelling, particularly at the base of the nose and at the tip, will gradually fade over the next several months. A flesh colored concealer can be applied to hide bruising and swelling. Most patient return to work or school within a week to ten days.

The new shape of the nose is usually permanent and has been artistically designed to blend with your unique facial features.


Micro-Liposuction (Neck and Jaw Line)

The use of micro-liposuction for facial contouring in the jaw line, submental fat pockets, and prominent cheek folds (nasolabial folds) has eliminated the need for extensive surgery to gain exposure to these areas, thereby preserving circulation and minimizing the necessary incisions.


Procedure and recovery

In the lower face tiny stab incisions (1/16 inch in length) are made in the crease beneath the chin. A tiny 1/8 inch Mercedes tipped cannula is introduced into the subcutaneous fatty layer 1/4 inch below the surface. A “cross hatched” pattern is used to aspirate the subcutaneous fat from the submental pocket. If a “bulge” persists, deep penetration is made beneath the anterior neck muscle to reach the underlying fat. The head is turned to each side respectively and fat is aspirated from along the jaw line, lower face, and mid-mandibular jowls. Separate incisions are made at the base of each earlobe and the cannula is swept in a radial direction across the lower face and in front of the neck. The tip of the cannula may be extended as far as the corners of the lip to soften the lip folds (labiomental or “marionette” folds).

The nasolabial folds may be approached through stab incisions at the nostril base. Dr. Rose, however, is reluctant to remove excess fat from the nasolabial fold because he prefers to use this fat for resuspension over the cheek prominences (mid-face lift). Over time, an extensive removal of fat from the nasolabial folds may also lead to a “gaunt” look in the mid-face as the subcutaneous fatty layer naturally thins with the aging process. In “round” faces, the technique of “buccal fat excision” through an internal oral incision can flatten the submalar area of the cheek and the mid-face.

The micro-liposuction is performed as an outpatient under “twilight” sedation (you are totally unconscious) administered by a Board certified anesthesiologist at our state of the art AAAASF outpatient facility: The Aesthetic Surgery Center. Surgery usually lasts forty minutes to an hour and may be as an independent procedure or may be done in conjunction with other facial rejuvenation surgery (i.e. neck lift, mid-face lift, perioral laser resurfacing, fat injections, etc.).

Micro-liposuction incisions are tiny and heal very imperceptibly. Because of the use of a small caliber cannula, rippling is extremely rare. Over a period of time some degree of collagen reorientation will occur and naturally improve the “acuteness” of the cheek/neck angle. Skin retraction depends on a number of factors including age, texture of the skin, thickness of the muscle, inherent chin/neck angle, etc. Bulky, fat necks may be substantially improved with Micro-liposuction. However, a full neck lift may be necessary to minimize the extra skin laxity.

Recovery is quick. Bruising and swelling will generally last seven to ten days but may be well camouflaged with a turtle neck or high collar. A custom blended makeup can be applied to further disguise postoperative bruising. An elastic neck support is worn intermittently for the first two to three weeks post surgery (may be removed during the day, during work or at social occasions).


Face/Neck Lift - Multivector Approach (More information)

As we age, the deeper tissues of the face gradually lose their tone and elasticity and respond to the downward pull of gravity in a very predictable fashion. No one is immune from these anatomical alterations of aging, although the process may be accelerated by smoking, sun exposure, and the stresses of ordinary life. A face/neck lift can “set back the clock” by trimming away loose skin, tightening the underlying muscles, and restoring a more youthful structure of the face.

In the multivector face/neck lift, the negative vectors of aging are scientifically approached by pulling each portion of the face (brows, temples, cheeks, jawline and neck) in a reverse direction of the gravitational pull to correct that tired look. Higher cheekbones are restored, the cheek jowls flattened, and the neck/jawline area sculpted.This customized approach gives the face a fresh, more natural look while retaining the unique individuality of your facial features – a more youthful “you” without the “plasticized” look.


Procedure and recovery

The face/neck lift is performed as an outpatient under intravenous sedation anesthesia (you are totally unconscious) administered by a Board Certified anesthesiologist at our state of the art AAAASF outpatient facility: The Aesthetic Surgery Center. Surgery usually lasts three to four hours and is often done in conjunction with eyelid and nasal surgeries, mini-brow lift, laser/dermabrasion, or other cosmetic procedures. Incisions are well concealed inside the cartilage at the front of the ear, beneath the earlobe, and in the crease behind the ear. A turban-like dressing is wrapped around the head for comfort and compression for a couple of days.

The facial skin is pre-treated with Vitamin K cream for 2 to 3 weeks before your operation. Bruising and swelling on the face will last for ten to fourteen days after surgery. Oral arnica and anti-swelling medications are given to accelerate healing. An elastic neck strap is worn post-operatively for support. Skin care is instituted after removal of the dressing at the first office visit (usually one to two days). A flesh colored concealer can be applied during the second week to hide residual bruising. Most patients return to work or their regular routine by the third week.

After your facelift, the skin will continue to age at its normal rate but the clock is “reset”. Periodic “maintenance” procedures requiring much less surgical intervention are recommended usually at two to three year intervals to keep the face fresh and youthful well into your seventies or eighties.


Post Traumatic Facial Scars

Facial disfigurement from injury can occur in a fraction of a second and cause life-long emotional, as well as physical, scarring. While early cleansing and meticulous closure in the emergency room is important, permanent scarring may be unsightl

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Elliott Rose, MD
895 Park Avenue
New York, NY 10075