Facelift

Many factors cause the skin to wrinkle and sag; i.e., exposure to the sun, genetics as well as the natural aging process. Children and young adults have smooth, round faces due to fatty tissue that is evenly distributed throughout the contours of the face. As you age the skin sags and fits more loosely. These folds become prominent, especially around the chin, the jaw line and along the neck.

Dr. Stone performs rhytidectomies, or facelifts, to enhance your appearance and correct these conditions. A facelift involves tightening of the facial and neck muscles as well as the removal of any excess skin. The procedure is often performed in conjunction with additional cosmetic surgeries such as blepharoplasty (eyelid surgery), forehead lift, chin augmentation, liposuction and/or rhinoplasty (nasal surgery). These procedures can be performed any time after signs of aging appear in order to attain a more youthful appearance.

Before Surgery

We will evaluate your medical history in order to determine your overall health. Dr. Stone will discuss with you how your face can look and what you can expect from surgery. Our objective is to create a natural appearance that is pleasing to you. Photographs and computer imaging are performed to determine the amount of improvement after surgery.

We will provide you with preoperative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection. You may be instructed to shampoo your hair the night before surgery. A small amount of hair may be shaved around your ears and temples.

Surgery

A Rhytidectomy can be performed under IV Sedation or general anesthesia in our state-of-the-art surgical facility. These options will be discussed in detail with you. Premedication is administered for relaxation. Incisions are made inside the hairline at the temple, running in front of the ear then around the earlobe and behind the ear, ending in the hair of the scalp. The loose skin is separated from underlying tissue and is pulled up and back. Excess skin is removed. Sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck. Small sutures are used to close the incisions. The procedure may take up to five hours depending on whether any other procedures are performed at the same time.

Postoperative Care

It is recommended that you stay one night in the recovery care center to receive specialized care from the nursing staff. Bandages are applied to the area of surgery and are removed within a few days. Pain is moderate and controlled with oral medications. Your sutures are removed within the first 5 to 10 days. In order to minimize scarring, the doctor may remove the sutures in stages. Scarring fades quickly. Swelling and discoloration decrease within two weeks. Tightness in your face will be present for several weeks and there may be slight changes in your hair pattern around the incision.

It is recommended that you avoid the sun for several weeks after surgery. Healing is gradual so you will not notice final results for up to 6 months. Improvement varies, depending on the your initial condition. In most cases, a single procedure achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.

Laser Skin Resurfacing

As one of the most exciting and innovative scientific achievements to date, laser technology is being utilized throughout the health care community. Dr. Stone uses one of the newest lasers, the ultrapulse carbon dioxide laser, to treat sun-damaged skin, facial wrinkles and scars in a procedure called laser skin resurfacing.

What is a laser?

The word "laser" is an acronym, which stands for Light Amplification by the Stimulated Emission of Radiation. A surgical laser, such as the CO2 laser, is a beam of light capable of removing unwanted tissue, such as scarred, lined, wrinkled and otherwise imperfect skin. The laser vaporizes skin cells by emitting bursts of radiation that are absorbed by water in these cells. Laser light penetrates to a very precise, controlled depth, making the procedure safe and predictable, while reducing the risk of scarring or pigmentation problems. Laser skin resurfacing is bloodless, and is performed right here in our office under light sedation. As a result of this treatment, you are left with more youthful looking skin.

What areas can be treated through laser resurfacing?

The laser is used to reduce tiny wrinkles, acne scars and other minor skin imperfections, especially around the mouth and eyes. It can improve sun-damaged and acne scarred skin problems that often cause concern to both men and women.

Benefits of Treatment

Laser resurfacing can be used as an alternative to chemical peel and dermabrasion. The benefits of using this technique are less pain and a faster recovery time. In most cases, it is less costly.

Before Surgery

Prior to surgery, Dr. Stone and you will discuss the goals for facial improvement. After determining the most appropriate procedure to use, we will fully describe the procedure, what results to expect and the costs. The skin is usually pretreated prior to surgery to improve the healing time.

The Procedure

A local anesthetic is given to ensure that you are comfortable throughout the procedure. The area is cleansed and draped. Dr. Stone directs the laser beam toward your skin imperfections. The laser quickly and accurately vaporizes the outermost layers of skin just four or five cells in thickness.

What can be expected?

In most cases, only one treatment is needed. The initial redness fades in a few weeks to a light pink, which can be camouflaged with cosmetics. The discoloration usually disappears in one or three months. The goal of laser resurfacing is to enhance facial appearance. Expectations by the patient must be realistic and results should be anticipated as improvements rather than total corrections. Results of the surgery depend on many factors such as the size, shape and location of the imperfection and the patient's heredity, age and general skin condition.

Chemical Peels

Chemical peel is helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots. Pre-cancerous conditions such as keratoses (thick, rough, reddish growths) also respond well to this procedure.

There are several types of chemical peels:

• Light peels remove superficial wrinkles
  
• Medium peels and
  
• Deep peels are for more severe conditions.

After thoroughly cleansing the skin, a small applicator is used to apply the chemical solution to an area of the face. Excess solution is removed and the procedure is repeated on other areas.

The amount of improvement varies and depends upon the initial condition of the patient's skin. Significant improvement of damaged skin has been achieved, which can produce dramatic results.

Skin Rejuvenation

A skin rejuvenation program is often used in conjunction with either chemical peels or laser wrinkle removal to reduce the fine wrinkles of the face, lighten areas of hyperpigmentation and produce a softer texture to the skin. The program can be accomplished separately or in conjunction with the other procedures listed here. It is followed at home by the patient after a consultation and a treatment plan is established for the patient's cosmetic needs. Our skin care department is dedicated to providing you with the latest and most effective skin treatments available.

We invite you to inquire about laser skin resurfacing and hope it can help you achieve smoother, fresher, younger-looking skin.

Rhinoplasty

Dr. Stone performs rhinoplasty in order to reshape the nose. Appearance can be improved for those people who are dissatisfied with the shape and size of their nose. Nasal reconstruction was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone or cartilage.

Reasons for Surgery

Reasons include reducing the size of the nose, removal of bumps as well as improving the angle of a nose. Conditions may be natural or due to external trauma to the face. This operation will also help patients who have difficulty breathing. The operation can be performed on all age groups, including teens and the elderly.

Before Surgery

A medical history along with a careful examination is conducted in order to evaluate your general health. We will discuss with you the way your nose can look in relation to your other facial features. Digital Photographs and computer imaging allow Dr. Stone to evaluate the appropriate procedure to achieve the desired results. Pre-operative instructions may include eliminating certain drugs that contain aspirin to minimize the possibility of excess bleeding. Antibiotics may be prescribed before surgery to prevent infection.

Method of Surgery

Surgery is usually performed under IV sedation, which is both extremely comfortable and results in less swelling and bruising than general anesthesia. In most cases involving a reduction in shape or size of the nose, angle or removal of a hump, the skin of the nose is separated from the underlying skeleton of bone and cartilage. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum may benefit by correction of this problem. The incisions are placed inside the nose, unless the surgeon uses an open approach, in which case the incisions are made across the columella (the tissue between the nostrils). In cases where the nostrils flare, the surgeon may make an incision at the junction between the nose and the skin of the upper lip to narrow the flared appearance. It is not unusual to combine rhinoplasty with chin augmentation to improve the profile.

Post-Operative Information

The recovery takes one to two weeks. Most people resume their normal activities within a week or two. Following surgery, a lightweight splint is applied to maintain the new shape of the nose. The splint is removed within a week. Nasal splints may be inserted at the time of surgery to protect the septum. These are removed within a week. There is always some stuffiness of the nose, especially when work has been done on the nasal septum.

Pain is minimal and is controlled with medications. Bruising occurs around the eyes and begins to fade within a few days. Discoloration usually disappears in two weeks.

Insurance

Your insurance company may pay for all or part of the costs associated with your surgery if it is performed as a result of nasal obstruction. It is recommended that you check with your carrier to determine if there is coverage.

Brow Lifts

Endoscopic Brow Lifts

Dr. Stone performs brow and forehead lifts to raise eyebrows and reduce ridges and furrows on the forehead, creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries.

An incision is generally made across the top of the head from the front of one ear to the front of the other ear. The forehead and brows are elevated and excess skin is removed. The flap is then sutured. Newer techniques now allow us to perform forehead lifting through small incisions in the scalp by using an endoscope and specialized instruments. This accelerates the healing process.

Post-Operative Information

Antibiotics may be prescribed for several days following surgery. Sutures are generally removed within one week. Swelling and some bruising may occur which should subside within a few weeks. Our doctors will prescribe ice compresses and eye exercises to reduce swelling and regain mobility. Women will be allowed to use eye cosmetics up to two weeks after surgery. You can proceed with your normal daily activities within 1 to 2 weeks. A final evaluation may occur within several months from the initial surgical procedure.

Insurance

Your insurance company may pay for part or all of the cost of surgery if the procedure is performed as a result of visual impairment. Because every insurance carrier is different, it is recommended that you check with your own insurance company to determine the level of coverage.

Eyelid Surgery

As we all know, the eyes are a prominent facial feature. Although the eyes are expressionless structures, the surrounding skin conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Unfortunately, wrinkles and deep lines as well as puffiness under the lids develop as you age. In addition, exposure to the sun as well as hereditary factors contribute to the aging process, all resulting in changes of expression. In many cases, people may look fatigued, worn out and older than their true age. Beyond possible visual impairment, these changes in your appearance can cause stress and anxiety.

Dr. Stone is trained in several surgical procedures, such as blepharoplasty, forehead lift and brow lift in order to eliminate the majority of these problems.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes and face are made in order to take the most effective surgical approach. The amount, distribution and type of excess skin to be removed are carefully reviewed.

Dr. Stone will provide you with pre-operative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection.

The areas that will be excised are marked and digital photographs and computer imaging is performed in order to determine the amount of improvement after surgery.

Blepharoplasty

We can perform blepharoplasty to correct sagging eyelids, bags or pouches beneath the eyes, as well as excess folds around the eyes. This surgical procedure involves the removal of excess skin and fat on upper and lower eyelids and is often performed in conjunction with other surgical procedures including facelifts, eyebrow and forehead lifts. Blepharoplasty can be done under general anesthesia (with you asleep) or under IV Sedation. Both are very comfortable options. Pre-medication is utilized prior to surgery to decrease swelling after the operation.

Dr. Stone will trace the natural lines and creases of your face and make incredibly fine incisions from the inner to the outer edge of the eyelid. Surgery on the upper eyelid is performed first with the incision made in the fold of the lid. The incision is made below the eyelash on the lower eyelid. Any excess fat and skin are removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is applied to the area. Small sutures are used to close the incision and special ointments and dressings may be applied. The surgery can take up to 2 hours. In certain cases, lower eyelid incisions are made inside the lid. Laser may be used at the same time to reduce wrinkles.

Post-Operative Information

Initially, drying of the eyes can occur after blepharoplasty. This condition can be alleviated with medication. In addition, you may be sensitive to bright light and wind for a period of time. Numbness and itching may also occur during the healing process. A final evaluation may occur within several months from the initial surgical procedure.

Insurance

Your insurance company may pay for part of the cost of surgery if the procedure is performed as a result of visual impairment. Because every insurance carrier is different, it is recommended that you check with your own insurance company to determine the level of coverage.

Botox

Botox treatment is a revolutionary approach to reversing the affects facial wrinkles. Crows feet, worry lines and laugh lines can all be a thing of the past. These are referred to as dynamic wrinkle lines and all are treatable with this procedure. Cosmetic denervation is the process of injecting botox into the tiny facial muscles that create the wrinkles.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes is made in order to decide the most effective injection sites. All issues and concerns will be discussed.

The areas that will be treated are marked and digital photographs are taken in order to determine the amount of improvement after surgery.

The Botox Procedure

Botox injections are performed without anesthesia because they are virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long term use of the injections leads to a longer duration of each treatments effect. Patients over the age of 65 may not experience such dramatic results. Botox is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

Post-Operative Information

After the operation patients may experience slight bruising around the area that quickly fades. Normal activities can be performed immediately. Possible side effects are temporary weakness of nearby muscles or in rare cases an eyelid may droop. Botox is completely reversible so any side effect is only a temporary condition. The doctor will explain all risks associated at the time of your consultation.

Cosmetic Ear Surgery

Otoplasty

In cases of protruding or over-developed ears, the procedure of otoplasty may be an option. Otoplasty is commonly referred to as "pinning back" of the ears. It is available for children once their ears have stopped developing around the age of six. Over-developed ears can be the cause of psychological stress and trauma and should be treated at a young age before it becomes a serious issue. Dr. Stone is trained in several surgical procedures, in order to eliminate the majority of the problems related to protruding ears.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your ears is made in order to take the most effective surgical approach. All issues such as shape and types of anesthesia used will be discussed.

Dr. Stone will provide you with pre-operative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection.

The areas that will be excised are marked and digital photographs are taken in order to document the amount of improvement after surgery.

Ostoplasty

The procedure can be performed under IV sedation or general anesthesia and the doctor will discuss this option with you. Dr. Stone has the option of either folding the cartilage located on the back of the ear or removing excess cartilage. Sutures are placed and bandages applied to speed the healing process. The procedure typically takes only a few hours.

Post-Operative Information

After the operation patients should expect bruising around the area that fades in 2 to 3 weeks. Pain associated with operation is minimal and can be easily treated with oral medication. The bandages are only needed for a few days and should be replaced with a lighter dressing. Refraining from sleeping on the ears is required and patients are advised to use a very soft pillow. Showering and shampooing may begin after a few days. Expect two to three days of recovery before normal activities can be performed. Consult with Dr. Stone before attempting any athletic or precarious activities that may affect the healing process.