Whenever a patient flies in to see me for a facelift I highly recommend that they stay at least 1 week.  Most of my patients will stay an entire 7 days so that we can follow them during the healing phase and make sure that all areas are healing as expected before we remove the sutures 6 days after surgery.  If a patient is within a half day’s driving distance from me they can certainly go home and return 6 days later, but if they are flying in for the procedure, again I highly recommend that they stay for the entire week to assure that they will get the result that they expect and achieve the rejuvenation that we desire.  We have relationships with various hotels, bed and breakfast, and resorts in the area so that we can minimize the cost to the patient and yet maximize their privacy and comfort during the immediate postoperative period.  In fact patients that have the sophisticated extended SMAS deep plane facelift and certainly all patients that have comprehensive facial rejuvenation by me stay the night in our center with a private nurse so that the first night they can be observed and relax in our resort-like surgery center setting.  I then see them the following morning, remove a light pressure dressing, as well as a small drain, and assure that all areas are healing as we expect.  If they have had comprehensive facial rejuvenation I would see them 2 days later and remove their eyelid sutures and we would perform a skin treatment if they had a laser resurfacing on that same day as well.  I would then see them back 3 days later, which is 6 days after the procedure for removal of any sutures for the facelift.  At that point in time it is perfectly appropriate for the patient to travel back home and in fact with a small amount of cover makeup most patients look quite acceptable and can easily do this even on commercial airlines.

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Dysport is a new FDA approved neurotoxin by the company Medicis.  It has been available in Europe for many years and is a very safe and reliable product with affects very similar to Botox.  Early studies seem to indicate that Dysport may have an earlier onset of action and it may diffuse into tissue slightly more than Botox, but overall the affect is extremely similar.  I personally really have no significant preference between Botox and Dysport and have used both of them significantly with excellent results.  At this point in time I tend to recommend whichever product is more cost effective for the patient as these companies are now in a small price war and are giving rebates to patients.  I am therefore happy to use either product as I feel that they both give excellent results to patients in a very consistent way and both are overall quite cost effective.

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The short and simple answer to that answer is “no.” I cannot contour someone’s face to make them look like a celebrity. However, if the patient is interested in achieving the overall effects of a certain celebrity, such as a thinner nose, a more prominent cheek structure, elevated brows, or better skin we can certainly make those changes, but they would be alterations of the patient’s current appearance. In essence facial plastic surgeons have to modify what is available. We do not create out of nothing a brand new nose or facial appearance. Therefore, we cannot make someone look like someone else. We can only modify the patient’s current appearance and improve them aesthetically speaking.

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For male patients I recommend that they wait until they are fully grown before having a nose job or rhinoplasty performed. For most men this is at age 17 to 18, for girls this can be as young as 13 to 15 years old. If it is indeed crocked, this would involve making some cuts in the bone so that the deviation could be corrected and allow the patient to then have a restored midline appearance to the nose. This would be performed in the operating room and typically only has a handful of days regarding downtime as I do leave a splint over the nose, which can be removed in less than a week.

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Yes there are many procedures that can address sagging eyebrows.  The most common procedure that I personally perform is an endoscopic browlift.  This can be performed through very small incisions that are up in the hair and are thus completely inconspicuous.  The procedure is performed with specialized instruments and scopes that are inserted through these small incisions and used to release some of the soft tissues so that the brows can be elevated into a more aesthetic position.  The downtime is typically very minimal and most patients are back doing normal activities within the first few days.  There are other techniques of browlifting, but the majority of them have significant drawbacks compared to the endoscopic technique.  A consultation and evaluation to develop a customized treatment plan would be appropriate as I do significantly customize my browlifting techniques depending on the patient’s brows, the level of their hairline and the quality of their hair overall.  A newer and very sophisticated approach to browlifting is Ulthera.  This is a new FDA approved browlifting procedure that involves the use of an ultrasound device that can heat up the deeper layers of the tissue resulting in rather dramatic and significant browlift over the 2 to 3 months after the procedure.  This can be a very long lasting result, but is not as dramatic or as significant as the surgical approach.  The advantage of this technique is that there is literally no downtime and it has a significantly reduced cost.

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