Facial Plastic And Reconstructive Surgery

Our Facial Plastic Surgical facility combines serene office setting, designed to offer patients private, comfortable location to see the doctor, have surgery, recover and be attended to by a caring staff.

With Dr. Randal Swenson's 20 years of surgical experience in facial plastic and reconstructive surgery, you can be rest assured Dr. Swenson will give you a valid honest medical opinion of possible results as well as know that he has the skill and artistry to achieve realistic surgical improvement.

Skin Care Products

We offer a range of skin care products for the face and for normal and sensitive skin. Whether battling acne, rosacea, skin damage or age, hyperkeratosis and hyperpigmentation, we offer the appropriate therapy to match to any skin type or conditions.

Please ask our skin care specialists to recommend the right skin care treatment beneficial in improving and enhancing your skin appearance. She will customize a program to help you achieve your personal skin care goals.

Clinical Care Products And Facial Treatment Options

To place an order on any of the skin products we offer please contact our skin care specialist at (801) 303-3873

Gift Certificates Need a last minute gift? Can't think of a gift and running out of time? Dr. Swenson offers gift certificates for birthdays, holidays or any occasion. Buy that special someone the gift they've always wanted.

Procedures in Depth:

• Blepharoplasty (Surgery of the Eyelids)
• Facial Scar Revision
• Forehead and Brow Lifts
• Mentoplasty (Surgery of the Chin)
• Facial Liposuction
• Hair Replacement
• Laser Surgery
• Otoplasty (Surgery of the Ears)
• Rhinoplasty (Surgery of the Nose)
• Rhytidectomy (Surgery of the Face)
• Skin Resurfacing
• Wrinkle Treatment

Understanding Blepharoplasty

Surgery Of The Eyelids

Every year, one hundred thousand men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, Dr. Swenson may also recommend a browlift, facelift, or skin resurfacing to achieve the best results.

If you are wondering how blepharoplasty can change the way you look, you need to know how eyelid surgery is performed and what you can expect from this procedure. This website can address many common questions and provide you the information to begin considering blepharoplasty.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs.

Is Blephharoplasty For You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Blepharoplasty removes the excess fat, muscle, and skin from both upper and lower lids. The results can be a refreshed appearance, with a younger, firmer eye area.

People with circulatory, ophthalmological, or serious medical conditions must rely on the diagnostic skills of their own personal specialists to determine whether blepharoplasty is an option to consider. Consultation with Dr. Swenson can help you decide whether any additional, complementary surgery would increase the success of the surgery. He might recommend planning a simultaneous forehead lift to correct a drooping brow and smooth the forehead, or skin resurfacing to remove the fine line wrinkling in the eye area.

Making The Decision For Blephharoplasty

Whether the surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. The patient must also make the commitment to follow the pre-surgical and post-operative instructions of the surgeon.

During the pre-surgical consultation, you will be examined or asked to answer queries concerning vision, tear production, use of lenses, and your desires for surgery. Dr. Swenson will explain what you can expect from blepharoplasty and take a complete medical history. Factors to be weighed include age, skin type, ethnic background, and degree of vision obstruction. Furthermore, you can expect an open and honest exchange between you and Dr. Swenson, which will establish the basis for a successful outcome.

After a mutual decision is made by both you and Dr. Swenson, the technique indicated for your individual surgery will be discussed. The type of anesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be outlined.

Understanding The Surgery

In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.

In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.

What To Expect After The Surgery

Immediately after the surgery has been completed, your surgeon may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. Your surgeon will prescribe medication for discomfort.

For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eyedrops may be recommended. Your surgeon will also list activities and environments to avoid in the weeks immediately following surgery. Permanent stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, facial plastic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve vision or surgery for eye deformity or injury may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Facial Scar Treatment

Surgery Of Facial Scars

When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Once a scar forms, it is permanent but may be made less visible or relocated surgically.

With very few exceptions most people are self-conscious about facial scars. Some people may also experience diminished functioning of the eyes, mouth, or nose due to scarring. If you've wondered how facial scar revision could improve your appearance, your self-confidence, or your level of facial functioning, you need to know how scar revision works and what you can expect from this procedure. This website can address many of your questions and provide you the information to begin considering facial scar revision surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery is performed. Dr. Swenson can answer specific questions about your specific needs.

Is Facial Scar Treatment For You

The most basic requirement for all surgery is good health. Other requirements are more subtle and should be carefully considered in discussion with your surgeon. Expectations of the surgery and of the surgeon must be realistic. A person considering facial scar revision must understand that there is no way to remove scars completely. The goal is to improve the appearance of the scar either by disguising it, relocating it, or minimizing its prominence. Skin color and type, age, and the type of scarring, are all important factors that must be part of the discussion prior to surgery.

Different types of scars respond to different plastic surgery techniques. Timing of surgery is another important choice. Some surgeons advise against any scar revision in cases of injury for a period that might extend up to a year after the injury. This interval allows the body enough time to heal fully.

Making The Decision For Scar Treatment

Whether the surgery is desired for functional or cosmetic reasons, your choice of a facial plastic surgeon is of paramount importance. Dr. Swenson will examine the scar in order to decide upon the proper treatment and inform you of outcomes that can be expected from facial scar revision surgery.

Different scars require different treatments. For example, severe burns that destroy large sections of skin cause the skin to heal in a puckered way. As the skin heals, muscles and tendons may be affected in this "contracting" movement. Keloid scars are a result of the skin's overproduction of collagen after a wound has healed. These scars generally appear as growths in the scar site. Hypertrophic scars, unlike keloids, do not grow out of the boundaries of the scar area, but because of their thick, raised texture, can be unsightly and may also restrict the natural movement of muscles and tendons.

Some facial scars are unattractive simply because of where they appear on the face, while others affect facial expressions. All surgical possibilities will be discussed in the initial consultation along with risks involved for each type of scarring. The agreement between you and Dr. Swenson on how to proceed is a prerequisite for successful surgery. After you both decide to proceed with scar revision, he will inform you about the anesthesia, the surgical facility, any supportive surgery options, and costs.

Because scars are highly individualistic and the patient's attitude toward scars is so personal, maximum improvement in facial scars may require more than one procedure, and more than one technique may be employed.

Understanding The Surgery

When a scar is of the contracture type, surgery generally involves removing the scar tissue entirely. Skin flaps, composed of adjacent healthy, unscarred skin, are then lifted and moved to form a new incision line. Where a flap is not possible, a skin graft may be used. A graft involves taking a section of skin tissue from one area and attaching it to another, and time must be allowed following surgery for new blood vessels and soft tissue to form. Z-plasty is a method to move a scar from one area to another, usually into a natural fold or crease in the skin to minimize its visibility. While Z-plasty does not remove all signs of a scar, it does make it less noticeable.

Dermabrasion and laser resurfacing are methods a surgeon uses to make "rough or elevated" scars less prominent, by removing part of the upper layers of skin with an abrading tool or laser light. Clearly, the scar will remain, but it will be smoother and less visible.

Keloid or hypertropic scars are often treated first with injections of steroids to reduce size. If this is not satisfactory, the scars can be removed surgically, and the incisions closed with fine stitches, often resulting in less prominent scars.

What To Expect After The Surgery

You can expect to feel some discomfort after facial scar revision surgery. Some swelling, bruising and redness are generally unavoidable. It is important for you to follow Dr. Swenson's after care recommendations to the letter. Though the sutures will be removed within days after the surgery, your skin needs time to heal. Surgeons generally insist on decreased activity after surgery and instruct the patient to keep the head elevated when lying down, to use cold compresses to reduce swelling, and to avoid any activity that places undue stress on the area of the incision. Depending on the surgery performed and the site of the scar, Dr. Swenson will explain the types of activities to avoid. No medication should be taken without first consulting the surgeon. It is important to remember that scar tissues require a year or more to fully heal and achieve maximum improved appearance.

Facial plastic surgery makes it possible to correct facial flaws that can undermine self-confidence. Changing how your scar looks can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve scars caused by injury may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Forehead & Brow Lift Surgery

Forehead Lift Surgery

The effects of aging are inevitable, and, often, the brow and forehead area show the first signs. The skin begins to lose its elasticity. Sun, wind, and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows. Even people in their thirties may have faces that look older than their years. Your tired, angry, or sad expression may not reflect how you actually feel. As a result, many people have opted for a procedure known as the forehead lift. Based on variations in how men and women age and on new advances in medical technology, different methods are used to perform this procedure.

If you are wondering how a forehead lift could improve your appearance, you need to know how these procedures are performed and what you can expect. This website can address many of your concerns and provide you the information you need to begin considering forehead surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Swenson can answer specific questions about your specific needs.

Is Forehead Lift Surgery For You?

As with all elective surgery, good health and realistic expectations are prerequisites. When a surgeon tightens loose skin and removes the excess, forehead wrinkling and drooping brows are modified. The procedure is called a forehead lift or brow lift. If necessary, the surgeon removes part of the muscle that causes vertical frown lines between the brows. The result can be a smoother brow and a more youthful expression. To see what a forehead lift can do for your face, put your hands above your brows and outside the edges of your eyes and gently raise the skin upwards. Forehead lifts are an option if you have a sagging brow or deep furrows between the eyes. This procedure is usually done between age forty and sixty-five, although it may be necessary at an earlier age.

Incisions can be placed at the hairline, behind the hairline, or in some cases, above the brow or in the mid-forehead. Dr. Swenson can help you select the best technique suited to your particular situation.

Making The Decision For A Forehead Lift

Whether you are having surgery for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. During the consultation, Dr. Swenson will examine your facial structure, the condition of your skin, and your hairline in order to decide where incisions should be made. A thorough medical history will be obtained so that he can consider any medical conditions that may heighten surgical risks. A detailed description of the procedure will also include a discussion of risk involved.

After the decision to proceed with surgery is made, he will describe the technique indicated, the type of anesthesia, the surgical facility, any additional surgery, and the risks and costs.

Understanding The Surgery

The main difference among the various options for forehead lifting consists of the placement of the incision.

The original technique is the coronal incision, which is made slightly behind the natural hairline. An alternative is the pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline. This incision generally heals favorably and has the advantage of lowering the hairline. The disadvantage could be noticeable scarring. An option is to place the incision within the midforehead creases. This is primarily used in men with deep pre-existing forehead lines.

The newest apporach is endoscopic surgery. Several small one-half-inch to one-inch incisions are placed just behind the hairline. Although this technique may require more surgery time, it is less invasive and results in a smaller chance of temporary scalp numbness.

This procedure takes between one to two hours to perform. It is most commonly performed under IV sedation or twilight anesthesia.

What To Expect After The Surgery

You will experience a certain amount of swelling and bruising in the 10-day period following surgery. In some patients, this condition may include the cheek and eye area as well as the forehead. You will be advised to keep your head elevated in order to reduce swelling. Cold compresses may further reduce swelling. As the incisions heal, you may experience some numbness as well as itching, both of which will diminish with time. The sutures are usually removed within seven to 10 days following surgery. If bandages have been used, they are removed in one to three days. It is important to follow the advice of your surgeon on resuming normal activities. For most patients, the recovery time will not exceed two weeks, but patients may still be advised to avoid strenuous activities for longer periods. Any prolonged bruising can be camouflaged with standard make-up techniques.

Not infrequently, a brow lift is combined with Blepharoplasty (an eyelid tuck) or face lift to provide a harmonious rejuvenation.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve sagging foreheads and brows which interfere with vision may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Mentoplasty Surgery

Surgery Of The Chin

A well defined chin helps give balance to the face and creates a major part of one's profile. When people look in the mirror, most focus on the size and shape of their noses, their ears, sagging jowls, or fine wrinkling of the skin. But even though few examine their chins with the same discerning eye, having a "weak chin" is certainly not an asset. Surgeons who specialize in rhinoplasty, or surgery of the nose, are often the first to suggest that changes in chin size or shape may enhance a profile as much as rhinoplasty. It is common for the facial plastic surgeon to recommend chin surgery in addition to nose surgery when the surgeon sees that chin augmentation is necessary to achieve facial balance and harmony. Fortunately, this is a relatively straightforward procedure that can make a major difference.

If you are wondering how chin surgery could improve your appearance, you need to know how the surgery is performed and what you can expect from this procedure. This website can address many of your concerns and provide you the information to begin considering chin surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Swenson can answer specific questions about your specific needs.

Is Chin Surgery For You?

As with all elective surgery, good health and realistic expectations are prerequisites. It is also key to understand all aspects of the surgery. A pleasing, balanced profile can be achieved by inserting an implant or moving the bone forward to build up a receding chin, or by reducing a jutting or too prominent chin. The result can be greater facial harmony and an increase in self-confidence.

Another possibility for improvement through chin surgery is submental liposuction in which excess fatty tissue is removed to redefine the chin or neckline. When there is a contributing problem of dental malocclusions or birth defects in the structure of the jaw itself, surgery of the jaw can improve the form and function of the lower face and greatly enhance appearance.

Your consultation can help you decide on the type of surgery that addresses your concerns. Dr. Swenson can also provide information on new medical techniques for chin surgery and offer recommendations for supplementary surgery that can ensure the greatest improvement.

Making The Decision For Chin Surgery

Whether you are interested in chin surgery for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is extremely important. During the consultation, Dr. Swenson will thoroughly examine your chin and jaw to pinpoint problems. In some instances, he will suggest chin surgery as a supplement to rhinoplasty because a small chin can make the nose appear larger. Dr. Swenson will weigh other factors that could influence the outcome of surgery such as age, skin type, and attitudes toward surgery. The surgical procedure will be described in detail along with reasonable projections. If you opt for surgery, he will describe the technique indicated, the type of anesthesia to be used, the surgical facility, any additional surgery, and risks and costs.

Understanding The Surgery

To augment the chin, the surgeon begins by making an incision either in the natural crease line just under the chin or inside the mouth, where gum and lower lip meet. By gently stretching this tissue, the surgeon creates a space where an implant can be inserted. This implant, made of synthetic material that feels much like natural tissue normally found in the chin, is available in a wide variety of sizes and shapes. This allows custom fitting of the implant to the configurations of the patient's face. After implantation, the surgeon uses fine sutures to close the incision. When the incision is inside the mouth, no scarring is visible. If the incision is under the chin, the scar is usually imperceptible.

In chin reduction surgery, incisions are made either in the mouth or under the chin. The surgeon sculpts the bone to a more pleasing size. For orthognathic surgery, the surgeon will make an incision inside the mouth and reposition the facial bones. The procedure, depending on the extent of the work, takes from less than an hour to approximately three hours.

What To Expect After The Surgery

Immediately after surgery, the surgeon usually applies a dressing that will remain in place for two to three days. You will experience some tenderness. Post-operative discomfort can be controlled with prescribed medications. Chewing will probably be limited immediately after chin surgery, and a liquid and soft food diet may be required for a few days after surgery. Most patients feel a stretched, tight sensation after the surgery, but this usually subsides in a week.

After approximately six weeks, most swelling will be gone, and you can enjoy the results of your procedure. Rigorous activity may be prohibited for the first few weeks after surgery. Normal activity can be resumed after approximately ten days.

Facial plastic surgery makes it possible to enhance your appearance and eliminate signs of premature aging that undermine self-confidence. By changing how you look, facial plastic surgery can improve your self-image.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve genetic deformity or traumatic injury may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Hair Replacement Surgery

Surgery Of The Scalp

Because of significant surgical advances with improved results, interest in hair replacement surgery has increased significantly during the past decade. Hair loss affects two out of every three men, and one in five women. Some people begin to lose hair in their twenties. Frequent shampooing, poor circulation, wearing hats or any other personal habits are not factors that cause hair loss. For men, heredity is the major factor in hair loss. For women, hormonal changes, including those that occur in menopause, are mainly responsible for female "pattern changes," which include thinning and loss. Accidents, burns, and disease can also trigger hair loss. The key factor in hair replacement is the presence of donor hair on the side or the back scalp, which is then used to replace hair where loss has occurred. Total baldness makes replacement surgery impossible. Hair quality is another factor. Light-colored hair, as well as coarse-textured hair, produce a look of greater density than fine or dark hair.

If you've wondered how hair replacement surgery could improve your appearance and your self-confidence, you need to know how this surgery is performed and what you, as an individual, can expect from this procedure. This website can address many of your concerns and provide you the information to begin considering hair replacement surgery.

Is Hair Replacement Surgery For You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of the surgery is crucial. No ideal in hair replacement surgery exists. The goal is to improve your appearance as much as possible. Before deciding on hair replacement surgery, ask your facial plastic surgeon to explain the options available for your particular type of hair loss.

Male pattern baldness often begins with a receding hairline or thinning at the crown, and is the easiest condition to correct. It is progressive over a lifetime and is a major consideration for your surgeon. Hair replacement surgery frequently requires multiple grafts of hair being implanted during multiple sessions, generally spacing each session at least four months apart to allow for adequate healing.

Dr. Swenson will explain which type of anesthesia is indicated. Facial plastic surgeons usually decide on a local or twilight anesthesia for grafting, but many surgeons choose general anesthesia for the more involved surgical procedures for replacing hair. The surgical facility to be used will also be determined by the extent of the procedure.

Making The Decision For Hair Replacement

It is not essential to be bald or nearly bald before undertaking hair transplantation. Age also is no contraindication for hair transplantation. The younger the person, though, the more conservative the approach must be for transplantation, because the permanent donor site may not yet be established. Ideally, the patient should have dense growing hair in the donor sites to sufficiently fill any present or future areas of baldness.

The color of the hair in contrast to the skin color will be discussed with you by your surgeon. The texture of your hair, coarse or fine, will also determine the final result in hair transplantation.

However, the patients most satisfied with hair transplantation are those who will accept the estimate of improvement as given by the surgeon.

If you opt for surgery, Dr. Swenson will describe the technique indicated, the type of anesthesia to be used, the surgical facility, any additional surgery, and risks and costs.

Understanding The Surgery

The most commonly known hair replacement surgery requires taking a strip of hair-bearing scalp from the back of the head. The strip is then divided into several hundred smaller grafts. These grafts are then inserted into tiny slits in the scalp, and must be placed in such a way that hair all grows in the same, natural direction. While some of the grafts may contain up to five or six hairs, it is sometimes necessary to use a number of grafts containing only one or two hairs to create a natural appearance. This is known as mini- and micrografting.

Skin flap surgery is another efficient technique used to cover balding areas. After a piece of bald scalp is removed, a section of hair-covered scalp is moved and sutured into place. Scars are generally covered by new hair growth. Bald spots at the crown of the head can be covered by removing the hairless area of skin and then stretching the hair-covered scalp adjacent to the bald spot over the opening. This is known as scalp reduction surgery.

A newer technique involves the use of tissue expanders. This allows stretching of the skin which aids in the reduction of the size of the bald scalp.

What To Expect After The Surgery

After surgery, your surgeon may choose to apply a dressing for a day or two. If stitches are used, they are usually removed within 10 days. The second or third day after surgery, you will probably be allowed to shampoo. Your head and scalp may feel tight with some aching, but this can be controlled by medication. It is crucial that you follow the instructions for post-operative visits and care. Swelling or bruising in the area treated is likely. Cold compresses may be recommended by the surgeon.

The newly transplanted hair often falls out in the six weeks following the procedure. This, however, is absolutely normal. New hair growth will take about six to 12 weeks to develop. To attain a look of natural hair growth, it is often necessary to fill in patchy areas, adjust the hairline, or remove excess tissue from areas that have been treated with flap surgery. These touch-up procedures are to be expected and are an essential part of the whole picture of hair replacement surgery.

Your facial plastic surgeon is the best source of information on what may be required for you as an individual and for your specific surgery. Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct hair loss from accidents, burns, disease, or trauma may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Facial Liposuction

Facial Suction Lipectomy or Liposuction - Common Problems

Before Facial Liposuction	After Facial Liposuction

Sometimes, an abnormal number of fat cells will accumulate in isolated areas of the face and neck. This excess fatty tissue may originate for various reasons. It is not just a problem of the overweight, although a history of a general weight gain is common among patients who seek liposuction . That's because one of the hardest places to lose weight is in the neck and jowl areas.

Another common reason for excess fatty tissue is heredity. Even younger people may find that, although not overweight, they have the same round, plump face or neck as their parents.

A third reason is the natural aging process. As we age, our skin loses its elasticity and gravity causes it to sag. In the neck and jowl areas, more fat can be accommodated than before.

Whatever the reason, this excess fatty tissue is unsightly to many people. Its removal by a facial plastic surgeon often can improve the appearance.

Common Solutions

The operation used to remove excess pockets of fat is called facial suction lipectomy, or liposuction. The procedure is not a substitute for weight loss and exercise if excessive facial fat is part of an overall weight problem.

Fig. A	Fig. B

Liposuction is performed by inserting a special instrument ( a cannula) beneath the skin through a tiny incision placed either below the chin or just behind the earlobe in a natural crease or fold. A suction apparatus connected to the cannula removes the unwanted fat cells. These cells will not be replaced, since fat cells do not multiply (fat cells increase and decrease in size, not number). After the fat is removed, the overlying skin collapses and shrinks to create a smooth appearance. The more elastic the skin, the better the result.

Liposuction can be done alone or in combination with other facial plastic surgery procedures. For example, combining liposuction with a facelift may help create a better overall result if skin elasticity is poor, since excess fat is removed at the same time as excess sagging skin.

Combining liposuction with a chin implant can help correct a receding or a double chin.

Deciding on an Operation

Anyone interested in facial liposuction should consult a facial plastic surgeon. During the initial visit, Dr. Swenson makes a thorough evaluation of the face and neck to determine whether surgery is indicated and whether it might be combined with another procedure for best results. He then will discuss any questions and concerns related to the surgery.

Important considerations for surgery, in addition to the skill of the surgeon, are the patient's realistic expectations about the results of the surgery and his or her general emotional state. Mental attitude is as important as the ability to heal in evaluating candidates for facial plastic surgery.

Once surgery is agreed upon, preoperative photographs are taken to help Dr. Swenson plan the operation. These photographs usually are compared with similar ones taken sometime after surgery and serve as a permanent before and-after record of the results.

Where Surgery Is Performed

Facial liposuction can be performed in a hospital, an ambulatory surgical care center, or an office surgical suite, depending on the patient's and the physician's preference. It usually is performed safely as an outpatient procedure; however, the surgeon may recommend a short stay in the hospital.

Keeping the Patient Comfortable

Pre-operative medications to relieve tension and local anesthetics to numb the areas to be liposuctioned commonly are used for surgery. These should keep the patient comfortable and free of pain. If desired, general anesthesia can be used. Dr. Swenson will discuss which anesthetic technique is suitable for each individual case.

The Immediate After-Effects

After the operation, a snug dressing is placed around the face and neck. It is removed the next day and you may be advised to wear a "chin strap" (an elastic bandage placed under the chin and tied on top of the head) for a few days and several weeks at night. Some swelling and bruising can be expected. The bruising usually subsides within two or three weeks, while the swelling takes a bit longer to go away. Mild discomfort, which may be present for a short time after surgery, usually is easily controlled with medication. Significant pain is quite rare.

The Results to Expect

Depending on the inherent elasticity of the skin and the amount of postoperative swelling, there may be no noticeable results until one or two months after surgery. On the other hand, if the patient's skin is relatively healthy with good elasticity (allowing the skin to contract rapidly), and if there is minimal swelling, the results may be immediately recognizable, and often dramatic improvement can be easily seen early in the postoperative course. Whatever the case, the final result should be evident six months after the surgery. At that point, all of the swelling is gone, and any irregularities or firmness noted immediately after surgery will have softened and smoothed out. Just how much improvement will be made depends on the individual's physical characteristics and the extent of the surgery.

The Risks

The risks are minimal when facial liposuction is performed on a patient. There are inherent risks in any surgery, however, and these should be discussed thoroughly with your facial plastic surgeon. Many thousands of facial liposuction operations are performed successfully and safely each year.

The Costs

Fees for facial plastic surgery and operative facilities vary widely and depend on the extent and complexity of the surgery. Dr. Swenson and his staff will discuss costs before the operation.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. The best way to find out if an insurance company will consider a claim is to consult an insurance company representative in advance of the surgery.

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Understanding Laser Surgery

Surgery Using Lasers

What is a laser? A laser is a high-energy beam of light that can selectively transfer its energy into tissue to treat the skin. Lasers contain a material that produces and amplifies light. Two mirrors cause the light to reflect back and forth through this material. The result is a light beam that is collimated and intense. This light is either one pure color or several different pure colors. These properties which separate the laser from a light bulb, are important to the medical application of lasers.

Many procedures cannot be done without the laser. Likewise, many procedures are better performed without the laser. Even with the sparkle, pure color, and high-energy beam, the laser is not always the best tool for surgery. The choice of using a laser or other surgical methods is carefully made by the facial plastic surgeon. Your surgeon has the preference to consider the results, the possible complications, and the alternatives.

In this website, you will find some of the procedures that can be performed with the laser. You are also given a brief explanation of the laser. Always remember that there are very few "right" and "wrong" answers with laser surgery. Many procedures can be performed with different lasers. The choice of the laser depends upon many factors, including the surgeon's experience, the size of the area to be treated, and the expectations of the patient.

What Can Laser Surgery Do For You?

What is a laser? A laser is a high-energy beam of light that can selectively transfer its energy into tissue to treat the skin. Lasers contain a material that produces and amplifies light. Two mirrors cause the light to reflect back and forth through this material. The result is a light beam that is collimated and intense. This light is either one pure color or several different pure colors. These properties which separate the laser from a light bulb, are important to the medical application of lasers.

Many procedures cannot be done without the laser. Likewise, many procedures are better performed without the laser. Even with the sparkle, pure color, and high-energy beam, the laser is not always the best tool for surgery. The choice of using a laser or other surgical methods is carefully made by the facial plastic surgeon. Your surgeon has the preference to consider the results, the possible complications, and the alternatives.

In this pamphlet, you will find some of the procedures that can be performed with the laser. You are also given a brief explanation of the laser. Always remember that there are very few "right" and "wrong" answers with laser surgery. Many procedures can be performed with different lasers. The choice of the laser depends upon many factors, including the surgeon's experience, the size of the area to be treated, and the expectations of the patient.

Types Of Laser Surgery

Laser Skin Peeling

Lasers can be used to reduce wrinkles around the lips or eyes, even the entire face, softening fine wrinkles and removing certain blemishes on the face.

Laser Removal of Birthmarks and Skin Lesions

Port-wine stain birthmarks respond remarkably well to laser treatment. The abnormal blood vessels that cause these marks are reduced in size by the laser. This results in a lightening of the treated area. Skin growths, facial "spider veins," warts, and some tattoos respond to laser surgery. Most situations take more than one laser treatment, but some respond to a single treatment.

The facial plastic surgeon often uses the minimum laser intensity possible. The low intensity requires many treatments. However, the low intensity also preserves as much of the healthy tissue as possible. This produces an aesthetically pleasing result. Many of these laser surgeries are performed as outpatient treatments in hospitals or offices.

Laser Hair Transplants

In this procedure, lasers are used to prepare the area where the hair transplants will be placed.

New Lasers

There are constant technologic advances which lead to even new applications of future generations of lasers. Please ask your doctor to discuss the latest advances with you.

Understanding The Surgery

After Dr. Swenson has indicated that a laser can be helpful in the surgery, he will explain the laser of choice and what can be accomplished. As with all surgery, the laser has its limitations. Often the results are spectacular. Dr. Swenson will give you the best judgment for the particular procedure.

Some surgeons may use local anesthetics to numb the treated area before the surgery. Surgery can sometimes be done in the surgeon's office; other times the surgeries are performed in outpatient facilities at a clinic or hospital. Dr. Swenson will decide on the appropriate method, dictated by the nature of the surgery.

Because safety is a major component of laser use, Dr. Swenson will describe safety precautions before the surgery. If you are treated with a local anesthetic, you will be required to wear protective glasses or goggles during laser use.

What To Expect After Laser Surgery

After the surgery, you will probably experience some swelling and skin redness for several days. Antibiotic ointments may be used during the healing process. It is important for the patient to follow all the post-operative directions of the surgeon, particularly in using sunblock and avoiding sun exposure.

The full impact of the laser may not be apparent for a month or two, especially with vascular deformities. Additional treatment sessions will not be scheduled until the healing process for a particular treatment is complete.

It is important for the patient to realize that lasers have specific applications. The facial plastic surgeon is experienced in the use of the laser and is the best source of information as to whether laser surgery is appropriate for your condition.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve congenital deformities or accidental skin injuries may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Otoplasty Surgery

Ear Surgery

Probably no other physical characteristic cries out for facial plastic surgery more than protruding ears. Children, long the victims of cruel nicknames like "Dumbo" or "Mickey Mouse," are the most likely candidates for otoplasty, but this surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Even if the ears are only mildly distorted, the condition can lead to self-consciousness and poor adaptation to school. When it comes to otoplasty, conventional wisdom is the earlier the better.

Adults may also benefit from this procedure, which improves self-esteem with relative ease. Often, adults choose this surgery in conjunction with other facial plastic surgical procedures. Not only is it possible to "pin back" ears, but ears can also be reshaped, reduced in size, or made more symmetrical.

If you are wondering how otoplasty can improve the way you look, you need to know how otoplasty is performed and what you can expect from this procedure. This website can address many of your concerns.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Swenson can answer specific questions about your specific needs.

Is Otoplasty For You?

General good health and realistic expectations are prerequisites. It is also important to understand the surgery. Otoplasty will not alter hearing ability. What is important for successful otoplasty is that the ears be in proportion to the size and shape of the face and head.

When considering otoplasty, parents must be confident that they have their child's best interests at heart. A positive attitude toward the surgery is an important factor in all facial plastic surgery, but it is especially critical when the patient is a child or adolescent.

Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears does not provide the same molding capacity as in children. A consultation with Dr. Swenson can help parents decide what is best for their child, not only aesthetically, but also psychologically and physically. Timing is always an important consideration. Having the procedure at a young age is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping; and secondly, the child will experience psychological benefits from the cosmetic improvement.

Making The Decision For Otoplasty

Your choice of a qualified facial plastic surgeon is of paramount importance. During the consultation, Dr. Swenson will examine the structure of the ears and discuss possibilities for correcting the problems. Even if only one ear needs "pinning back," surgery will probably be recommended on both ears to achieve the most natural, symmetrical appearance.

After Dr. Swenson and patient decide that otoplasty is indicated, he will discuss the procedure. Following a thorough medical history, Dr. Swenson will explain the kind of anesthesia required, surgical facility, and costs. Typically, he will suggest a general anesthesia for young patients and a local anesthetic combined with a mild sedative for older children and adults. Under normal conditions, otoplasty requires approximately two hours.

Understanding The Surgery

Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The surgeon will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage.

In other instances, the surgeon will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, the surgeon will apply sutures to anchor the ear until healing occurs to hold the ear in the desired position.

What To Expect After The Surgery

Soft dressings applied to the ears will remain for a few days. Most patients experience some mild discomfort. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands are sometimes recommended to hold the ears in the desired position for two weeks after the surgery.

The risks are minimal. There will be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential. Anything unusual should be reported to the surgeon immediately.

Facial plastic surgery makes it possible to correct many facial flaws that can often undermine one's self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve birth defects or traumatic injuries may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Rhinoplasty Surgery

Surgery Of The Nose

Every year, half a million people who are interested in improving the appearance of their noses seek consultation with facial plastic surgeons. Some are unhappy with the noses they were born with, and some with the way aging has changed their nose. For others, an injury may have distorted the nose, or the goal may be improved breathing. But one thing is clear: nothing has a greater impact on how a person looks than the size and shape of the nose. Because the nose is the most defining characteristic of the face, a slight alteration can greatly improve one's appearance.

If you have wondered how nose surgery, or rhinoplasty, could improve your looks, self-confidence, or health, you need to know how rhinoplasty is performed and what you can expect. No pamphlet can answer all your concerns, but this site can provide answers to many of the questions you may have.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Swenson can answer specific questions about your specific needs.

Is Rhinoplasty For You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding nasal surgery is also critical. Since there is no ideal in rhinoplasty, the goal is to improve the nose aesthetically, making it harmonize better with other facial features.

Skin type, ethnic background, and age are important factors to be considered in discussions with your surgeon prior to surgery. Before the nose is altered, a young patient must reach full growth, usually around age fifteen or sixteen. Exceptions are cases in which breathing is severely impaired.

Before deciding on rhinoplasty, ask Dr. Swenson if any additional surgery might be recommended to enhance the appearance of your face. Many patients have chin augmentation in conjunction with rhinoplasty to create a better balance of features.

Making The Decision For Rhinoplasty

Whether the surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. Many facial plastic surgeons are trained in both ear, nose, throat, and facial cosmetic surgery, which provides you, the patient, with the highest level of training and expertise. Dr. Swenson will examine the structure of your nose, both externally and internally, to evaluate what you can expect from rhinoplasty. You are most likely to be pleased with the results of your surgery if you have a realistic idea of what nasal surgery can and cannot do.

You can expect a thorough explanation of the surgeon's expectations and the risks involved in surgery. Following a joint decision by you and Dr. Swenson to proceed with rhinoplasty, he will take photographs of you and discuss the options available. Dr. Swenson will explain how the nasal structures, including bone and cartilage, can be sculpted to reshape the nose and indicate how reshaping the chin, for example, could enhance the desired results.

After conducting a thorough medical history, Dr. Swenson will offer information regarding anesthesia, the surgical facility to be used, and the costs for the procedure.

Understanding The Surgery

The definition of rhinoplasty is, literally, shaping the nose. First, incisions are made and the bone and cartilage support system of the nose is accessed. The majority of incisions are made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, certain amounts of underlying bone and cartilage are removed, added to, or rearranged to provide a newly shaped structure. For example, when the tip of the nose is too large, the surgeon can sculpt the cartilage in this area to reduce it in size. The angle of the nose in relation to the upper lip can be altered for a more youthful look or to correct a distortion.

The tissues are then redraped over the new frame and the incisions are closed. A splint is applied to the outside of the nose to help retain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed.

What To Expect After The Surgery

Immediately after surgery, a small splint will be placed on your nose to protect it and to keep the structure stable for at least five to eight days. If packing is placed inside the nose during surgery, it is removed the morning following the surgery. Your face will feel puffy,especially the first day after surgery. Pain medication may be required. Dr. Swenson will advise you to avoid blowing your nose for seven days after surgery. In the immediate days following surgery, you may experience bruising and minor swelling in the eye area. Cold compresses often reduce the bruising and discomfort. Absorbable sutures are usually used that do not have to be removed. Nasal dressing and splints are usually removed six or seven days after surgery.

It is crucial that you follow your surgeon's directions, especially instructions to keep your head elevated for a certain period after surgery. Some activities will be prohibited in the weeks after the procedure. Sun exposure, exertion, and risk of injury must be avoided. If you wear glasses, special arrangements must be made to ensure that the glasses do not rest on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area where surgery was performed.

Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should be reported to your surgeon immediately. It is essential that you keep your follow-up appointments with Dr. Swenson.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve nasal function or surgery for major deformity or injury may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understading Rhytidectomy

Facelift Surgery

Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow's feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.

If you ever wondered how a rhytidectomy, or facelift, as it is commonly called, could improve your looks or self-confidence, you need to know how a facelift is performed and what you can expect from this procedure. This website can address many of your concerns and provide you the information you need to begin considering facelift surgery.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery is performed. Dr. Swenson can answer specific questions about your specific needs.

Is A Facelift For You?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of rhytidectomy is crucial and psychological stability is vital. There is no ideal in a facelift. Rather, the goal is to improve the overall facial appearance. Skin type, ethnic background, degree of skin elasticity, individual healing, basic bone structure, as well as a realistic attitude are factors that should be discussed prior to surgery. This procedure is sometimes performed on patients in their thirties, and successful surgery has been performed on patients in their eighties. A facelift cannot stop aging, nor can it turn back the clock. What it can do is help your face look its best and give you a look of health and a more youthful appearance. A side benefit is that many patients experience increased self-confidence.

Before deciding on a facelift, you should discuss with Dr. Swenson whether the overall effect will be more successful if additional changes are made in the chin and neck areas through other facial surgery. Many patients decide to have facial liposuction to remove excess fatty deposits in conjunction with a facelift. If several flaws need correction, more than one procedure may be necessary for the best overall result.

Making The Decision For A Facelift

Your choice of a qualified facial plastic surgeon is of paramount importance. During the preliminary consultation, Dr. Swenson will examine the structure of your face, skin texture, color, and elasticity. Photographs will be taken so he can study your face. Individual risks will also be examined, especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, and any deficiency in blood clotting. Dr. Swenson will take a thorough medical history, as well as assess the patient's mental and emotional attitudes toward the surgery. Because a realistic attitude is crucial to the success of the surgery, the surgical procedure and realistic expectations will be discussed.

After the decision to proceed with a rhytidectomy is made jointly by you and Dr. Swenson, he will describe the technique indicated, the type of anesthesia, the surgical facility, any additional surgery, the pros and cons to include possible complications, and costs of the procedure.

Understanding The Surgery

The surgeon begins the incision in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.

After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips, which permit surgery without shaving hair from the incision site. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia, the patient will experience little discomfort. Some surgeons prefer to use general anesthesia for facelifts. Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.

What To Expect After The Surgery

Even though most patients experience very little pain after surgery, the surgeon will still prescribe medication. Some degree of swelling and bruising is unavoidable, and Dr. Swenson may instruct you to use cold compresses to keep swelling to a minimum. If a dressing has been applied, it will be removed within one to two days. The surgeon will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery.

In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery. All sutures and staples are usually removed within five to 10 days following surgery. Surgeons generally recommend that patients avoid vigorous activity. Patients should prearrange for post-surgery support from family and friends.

Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature. In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred. Bear in mind that the aging process continues after surgery and that some relaxation of tissues will occur over the first few weeks.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve genetic deformity or traumatic injury may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Skin Resurfacing

Facial Peels and Laser Surgery

In the last half of this century, men and women have had more leisure time to spend outdoors than in previous generations. Many hours spent on outside recreations and the prevalence of both summer and winter vacations, have all taken their toll on people's skin. Premature wrinkling is more common now than ever before. Both men and women seek facial plastic surgery to reverse the effects of sun damaged skin. Surgery may also improve the pitted look of acne scars and remove pre-cancerous skin growths called keratoses.

If you've wondered how skin resurfacing with chemical peeling or dermabrasion could improve the look of your skin, your self-confidence, or your health, you need to know how chemical peeling and dermabrasion are performed and what you can expect from these procedures. No pamphlet can answer all of your concerns, but this site can provide answers to many common questions about chemical peeling and dermabrasion.

Successful facial plastic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Dr. Swenson can answer specific questions about your specific skin problems.

Is Skin Resurfacing For You?

The most basic requirement for any surgery is good health. Other requirements are more subtle and should be carefully considered in discussions with your surgeon. Expectations of surgery and of the surgeon must be realistic. Skin resurfacing procedures cannot produce perfect skin; rather the goal is to improve the appearance of the skin as much as possible.

Skin type and color, ethnic background, and age are important factors that should be discussed prior to surgery. If you have dark skin or problems such as allergies, previous burns, a history of poor scars, or radiation exposure, you may need special evaluation to determine if you are a candidate for these procedures. If you have had episodes of cold sores and blisters around the mouth, inform Dr. Swenson of this condition.

Before deciding on a skin resurfacing procedure, Dr. Swenson may recommend a skin care regimen prior to the procedure. If you have extensive damage from aging or injury, more than one procedure may be necessary.

Making The Decision For Skin Resurfacing

Whether you seek a chemical peel or dermabrasion for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. Dr. Swenson will examine your skin to assess factors that could affect the outcome of the surgery and to determine the proper procedure for your condition. You and your surgeon will explore your attitudes toward surgery, and discuss realistic expectations and risks. Trust is built through these discussions, and the agreement between surgeon and patient is a prerequisite for a successful outcome to the surgery.

After you and Dr. Swenson decide to proceed with a chemical peel or dermabrasion, all options for the procedure will be discussed along with the risks. You will also receive information relating to each procedure. Bear in mind that neither chemical peel nor dermabrasion can correct sagging skin or halt the aging process. Furthermore, as some chemical peels lighten skin color, you must make a commitment to use sunblock. Following a thorough medical history, Dr. Swenson will advise you as to anesthesia options, the surgical facility being used, any additional surgery options, and the costs for the procedure. He may also suggest other surgery, either before or after your resurfacing procedure in order to enhance your overall appearance.

Understanding The Surgery

The skin is composed of the epidermis and the dermis. Within the dermis are two layers, both of which are constructed of collagen, long fibers that loosen and stretch with age and sun damage. If the deepest layer, the reticular layer, is damaged, scars result, while the upper layer of the dermis, the papillary layer, heals from injuries without scarring. In a chemical peel, the surgeon applies one of several chemicals to the skin. Glycolic acid is the mildest. TCA, trichloroacetic acid, can be used in varying strengths for longer-lasting smoothness. The deepest peel is done with phenol.

Before any peel, the face is first thoroughly cleansed with a solution to remove oil and to prepare the skin for deepest penetration. As the chemical is applied, the epidermis is removed, and the chemical penetrates into the first layer of the dermis.

Dermabrasion is a surgical technique where by some deeper scars and wrinkles can be smoothed. The surgeon uses a local anesthetic and/or a freezing agent to render the skin numb. Then, using a high speed rotating brush, the surgeon removes the top layer of skin to the appropriate level for the best results. The size and depth of scars and the degree of wrinkling determine the length of the surgery.

Laser surgery is used to resurface facial skin with wrinkles caused by excess sun exposure, "crow's feet," and acne scarring. The high energy, amplified light waves of carbon dioxide (CO2) laser vaporize the top layer of skin instantly, with no beeding and minimal trauma to the surrounding skin.

What To Expect After The Surgery

Immediately following a chemical peel or dermabrasion, the surgeon may apply a dressing to your skin. Swelling and "crusting" of the skin are normal, and ointments to keep the skin supple will be applied for seven to 10 days following surgery. The redness of skin that persists after the initial healing phase will usually fade in about 4 weeks. The surgeon often recommends a soft diet, avoidance of extremes in temperature and any activity that would cause stress to healing skin. It is imperative that you follow the post-operative instructions of your surgeon to the letter. Should you experience any increase in redness or itching in the days after surgery, notify Dr. Swenson immediately.

In one to two weeks after surgery, new skin will emerge that is pinkish, finer, and free of many wrinkles. But it will take several weeks for all the redness to vanish. Follow-up care involves using sunblock in order to protect the skin while new pigment is created. Patients will notice that the skin remains lighter for a long time after surgery, but that condition will usually subside when the skin's pigment level has been restored.

Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve major deformities or accidental skin injuries may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

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Understanding Wrinkle Treatment

Understanding Various Treatments Of Facial Wrinkles

The gradual development of facial wrinkles, whether fine surface lines or deeper creases and folds, is the classic early sign of accumulated skin damage and inevitable aging. Premature aging and wrinkling of the skin may be accelerated by excessive exposure to the sun and other elements, overactive facial expression muscles, the frequent use of tobacco products, poor nutrition, or skin disorders. Fine surface wrinkles that progress to deeper creases, deepening facial expression due to repeated skin folding, and deep folds which develop with one's maturity are obvious changes which may combine to portray a less desirable appearance. Persistent facial lines, especially those involved in negative emotional expressions, may mistakenly portray to others, the look of worry, anger, anxiety, disgust or sadness, despite one's own positive internal feelings. Regardless of the cause of facial creases or folds, safe and successful treatments for reduction or elimination of these problems are now available with the help of a Facial Plastic Surgeon. Injecting or implanting substances which either temporarily weaken the muscles or act as skin volume fillers serve to soften or eliminate the appearance of wrinkles and produce a more youthful, rejuvenated appearance.

Treatments for facial wrinkles are usually performed in the office setting which is convenient, private, and safe for persons who desire therapy. Your health, in conjunction with the appropriate therapy to achieve your goals, is given full consideration by Dr. Swenson prior to the any decision to undertake specific treatment. However, very few individual health problems would limit the use of these therapies due to their minimally-invasive methods of application. Your concerns and any medical requirements for each facial wrinkle therapy will be part of the consultation with Dr. Swenson.

Understanding Types Of Treatments For Facial Wrinkles

Prominent forehead creases, brow furrows or eye lines (crow's feet) produced by specific facial expression muscles repeatedly creasing the skin may be effectively treated by reducing the function of specific facial muscles. Botulinum toxin (Botox) is a sterile, purified protein produced from the bacteria, Clostridium botulinum, in the laboratory. Botox injected in small amounts into facial muscles binds to the nerve endings supplying the muscle and prevents nerve impulses from traveling to the muscle. When injected into muscle, it weakens or paralyzes the muscle around the area injected for a typical period of several months. The resultant weakening or paralyzing effect on the facial muscle temporarily reduces or eliminates previous skin creasing and new skin creasing is avoided. Botox may take several days to have its effect, and the effect typically lasts 3-6 months, in most individuals, before full muscle movement returns. At that point further treatment may be elected.

Injectable collagen is an animal protein filler material formulated for safe use in nearly all areas of the face, including the lips and crow's feet. Fine wrinkles are filled in by the material to reduce their visibility. Other prominent facial creases and folds around the forehead, cheeks and chin can be treated as well with this material. Initial collagen allergy testing must be performed, and repeated treatments every 2-4 months are typically needed to sustain the desired result. The treatments are easily performed in the office and usually have minimal side effects.

Human collagen matrix, is an implant used for the reconstruction of soft tissue defects. It may be threaded beneath the deep creases of the brow or cheek folds or placed within the upper and lower lips, to flatten and reduce wrinkle visibility. Typically, this material maintains the majority of its volume correction similar to injectable collagen.

Another type of implant is a nonresorbable synthetic polymer material, ePTFE which may likewise be used in the forehead, cheek folds, and lips to produce volume enhancement and effacement of deep facial creases. This material does not incorporate into surrounding tissue, but it does not lose volume either. It provides more lasting change and may be placed during an office procedure using local anesthetic and small incisions with a relatively short recovery period.

Fat grafting creates a natural augmentation for the face, especially for the lips and mouth region. Fat is usually harvested from the abdomen and about one third of the volume remains after the treatment. Fat grafting can be repeated for additional fullness.

Making The Decision For A Specific Therapy

Expectations of any facial wrinkle therapy must be realistic. While an expectation for the complete and permanent removal of facial wrinkles for those persons considering treatment may be attractive, it is unrealistic, due to the ongoing nature of wrinkle formation and the currently available methods for treatment. The patterns and severity of facial wrinkle formation are highly individual. Therefore, after consultation with Dr. Swenson, the appropriate therapy for your specific problems must be tailored to meet your needs. Management of many facial wrinkles may require repeated treatments or the use of combinations of treatments to achieve optimal results. The goal is to improve or reduce the appearance of the wrinkle or crease. This can be accomplished by reducing skin folding caused by underlying facial muscle action, as in botulinum toxin therapy. Alternatively, the skin beneath the wrinkle can be augmented to efface the wrinkle with injected or inserted filler material. The choice of a type of therapy depends on the location and extent of the wrinkles, the desired duration of the effects, and the tolerance for potential side effects. All of these treatments provide additional and complimentary aesthetic benefits when combined with another facial rejuvenation procedure such as facelift, browlift, blepharoplasty or skin resurfacing.

What To Expect After Each Treatment

In comparison to typical cosmetic surgical procedures, the office time for these procedures and the subsequent recovery period until one returns to normal function are minimal. Botulinum toxin therapy typically takes a few minutes to perform, and most patients may return immediately to home or work. Minor local irritation, redness, bruising, or swelling at the injection sites are the most commonly observed side effects, all of which typically abate within a few hours. Likewise, collagen or human dermal injection therapy can be accomplished with a 5-15 minute procedure with similar attendant side effects. Some mild irritation at the injection sites is unavoidable but can easily be camouflaged with standard make-up, if necessary.

Filler implant insertions typically take up to an hour to perform in the office, depending upon the number and extent of treatment locations. Several sutures are used to close the insertion site. More swelling, redness, and discomfort may accompany these procedures, which require the use of a local anesthetic. Local application of cold compresses may feel comforting. Most early swelling subsides within a day or two, though minor swelling and irritation may last for several weeks during the implant healing phase. Your activity level and medication for pain after the procedure are dependent upon your doctor's recommendations.

Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. Surgery to correct or improve facial scars or contour deformities resulting from injury may be covered. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.

What Is A Facial Plastic Surgeon

Appearance plays a big role in the lives of most people. We begin the day looking in the mirror-washing our face, brushing teeth, combing hair, shaving, putting on make-up. For some, the reflection can cause displeasure due to accidents, birth defects, or other signs such as premature aging. Many of these conditions can be improved surgically and many people choose to put their faces in the hands of a facial plastic surgeon. A facial plastic surgeon specializes in performing cosmetic and reconstructive surgery on the face, head, and neck region.

A facial plastic surgeon is typically board certified in otolaryngology, the specialty addressing surgery of the head and neck. These surgeons perform the majority of elective facial plastic surgery procedures in the United States. The facial plastic surgeon has spent five to six years in postgraduate surgical training. Training includes one year of postgraduate training in general surgery and at least four additional years of specialty training in head and neck surgery and facial plastic surgery. Concentrating on the complex anatomy, physiology, pathology, biochemistry, and bacteriology of all the organs and structures of the head and neck, provides the facial plastic surgeon a strong focus on the anatomical region being treated.

When Do You Need A Facial Plastic Surgeon?

The reasons for facial plastic surgery are varied. Some patients suffer from birth disfigurements such as birthmarks, cleft palates, and congenital facial deformities. Others are victims of accidents, burns, diseases, and the treatment required for such diseases. Many choose to change some of the signs of premature aging or the shape or size of a facial feature that has bothered them for years.

One aspect of facial plastic surgery that cannot be ignored is the patient's mental and emotional attitudes. Facial surgery can help you increase self-confidence because, for most people, when they look better, then generally feel better.

Facial Plastic Surgeons may perform any or all of the following:

Rhinoplasty

Surgery of the nose where cartilage and bone are reshaped and reconstructed; excess bone or cartilage may be removed. Recovery time is approximately one week. Results: Permanent.

Blepharoplasty

Surgery of the eyelids where fat and excess skin, bags, pouches, wrinkles in the eye area are removed. Recovery time is approximately one week. Results: Lower lids, permanent; upper lids, ten years.

Rhytidectomy

In facelift surgery, excess skin is removed and muscles are tightened. Recovery time is approximately two weeks. Results: From five to 10 years, depending on the patient.

Forehead Lift

Surgery to minimize forehead lines and wrinkles, and elevate brows to reduce lid drooping. Recovery time is about 10 days. Results: 10 years.

Submental Lipectomy

Surgery beneath the chin to eliminate "double" chin; excess fat is removed. Results: Generally permanent.

Genioplasty/Mentoplasty

Surgery of the chin where a receding chin is augmented with bone or an implant or a too prominent chin is reduced. Recovery time is about one week. Results: Permanent.

Otoplasty

Surgery of the ear where ears can be "pinned back" by reshaping the cartilage. Recovery time is about one week. Results: Permanent.

Laser Skin Resurfacing

Removal of the upper layer skin using a laser, resulting in smoother and less wrinkled skin. Recovery time is about 10 days. Results: Generally permanent.

Chemical Peel

Controlled removal of the outer layer of skin with specific chemicals. Recovery time, depending on the nature of the chemical, is from one to three weeks. Results: Generally, permanent.

Dermabrasion

Abrasion of the skin with either a wire brush or diamond fraise to remove the upper layer of the skin resulting in smoother, less wrinkled skin. Recovery time is about 10 days. Results: Generally permanent.

Facial Reconstruction

Surgery to repair or reconstruct facial features. This includes scar revision, fracture repair, laceration repair, vascular birth marks, cleft lip and palate, craniofacial deformitites, orthognathic surgery, free flaps, and other cancer reconstruction.

How To Find A Facial Plastic Surgeon

The American Academy of Facial Plastic and Reconstructive Surgery instituted a toll-free number, 1-800-332-FACE in the United States and Canada, that provides inquirers the names, addresses, and telephone numbers of facial plastic and reconstructive surgeons in the inquirer's area who specialize in the inquirer's desired surgical procedure.

In addition, as with many things, word of mouth is often best. It is helpful to talk with friends, relatives, and coworkers who have had or may know someone who has had facial plastic surgery.

You may want to ask the following questions:

• How did they locate the surgeon?
• Were they happy with the results?
• Would they return to the same surgeon for another procedure?

General practice physicians may also be able to recommend facial plastic surgeons with whom they may have worked. It is still important to validate the training, skills, and experience of the surgeon. The Directory of Medical Specialists, available in public libraries, can be used to check the credentials of any referral you may have been given. Facial plastic surgeons will be listed under the heading "Otolaryngology."

Facial plastic surgeons are certified by The American Board of Otolaryngology, a board recognized by The American Board of Medical Specialties. Facial plastic surgery is included in the otolaryngology certification because it is an integral part of otolaryngology training, which is focused on the face, head, and neck. Other specialists are trained in surgery of the whole body.

Choosing A Facial Plastic Surgeon

One of the most important factors for successful facial plastic surgery is the relationship between the patient and surgeon. An initial consultation provides the patient and surgeon an opportunity to discuss all that is involved in the desired procedure. It is advisable for the patient to write questions down before the consultation.

You may want to ask the following questions:

• Am I a good candidate for this procedure?
• How long will the operation take?
• What is the recovery time?
• What are the risks involved?
• Is post-operative medication necessary?
• What is the charge for the procedure?

It is also a good idea to write down the answers the surgeon provides so that the patient can review these carefully. The consultation also provides the patient a chance to experience the personality style of the surgeon to see if it is compatible with the patient's.

The patient should be prepared to be candid with the surgeon about their medical history, any medications, allergies, habits, and background which could affect the outcome of the surgery. The surgeon will also explain to the patient their experience in the area of facial plastic surgery the patient is considering. Some consultations may include computer imaging to show the patient what the surgery might accomplish. The surgeon can also describe what anesthesia the surgeon uses for each of the surgeries the patient is contemplating. The surgeon might also advise on supportive surgery to enhance the outcome of the specific surgery. It is crucial for the patient to find out about all aspects of the proposed surgery.

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