Facial Plastic Surgery
Skin Cancer Removal and Reconstruction on the Face and Neck
Skin cancer is the most common form of cancer in the United States. It involves abnormal growths of skin cells that can form anywhere on the body, but most frequently appear in areas that are regularly exposed to the sun such as the skin of the face, head and neck. In addition to excessive sun exposure, certain factors, such as fair skin, moles and aging, can also increase the risk of skin cancer.
Basal cell carcinoma is the type of skin cancer most frequently found on the face, head and neck. While these lesions can often be removed with a minimally invasive procedure when caught early, all forms of cancer carry a risk of metastasizing to other sites. Therefore, skin exams should always include a thorough check of the entire head and neck to ensure that any abnormal changes are discovered quickly.
Mohs micrographic surgery is a safe and effective treatment for skin cancer that thoroughly excises the tumor while only mildly disturbing surrounding tissue. It is the only skin cancer treatment available that targets just cancerous tissue through comprehensive microscopic examination of the affected area.
Mohs surgery excises not only the visible tumor but also any roots that may have extended beneath the surface of the skin. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurring cancers.
This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, although it can also be used to treat melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancer because its results are so thorough. It is also ideal for treating cancer in cosmetically and functionally prominent areas such as the face, head and neck.
Cosmetic Surgery of the Face, Nose and Eyelids
View VideoFacial cosmetic surgery is a great way to not only change your appearance, but also boost your self-confidence and help you look as young as you feel. Whether you want to sculpt a facial feature, smooth wrinkles and tighten loose skin or correct a problem, a wide array of procedures exist that can help you achieve the appearance you desire. Every surgery performed is based on a customized plan of treatment designed to meet all of the patient's goals. Below are some of the most popular cosmetic procedures we perform.
- Over time, gravity and sun exposure take their toll on the face and neck. Deep creases begin to appear from the sides of the nose and the corners of the mouth; the jawline slackens, jowls begin to appear; and the neck develops loose folds. A rhytidectomy (facelift) counteracts the signs of aging by tightening muscle, removing fat and trimming excess skin, giving your face a refreshed more youthful appearance.
- Rhytidectomy improves the look of the lower and middle areas of the face, and the neck. There is no ideal facelift and the goal is to improve the overall facial appearance. It is most effective at correcting the following:
- mid-face sagging
- nasolabial folds
- sagging fat
- loose skin and fat under chin and jaw
- Although rhytidectomy may improve signs of aging, it cannot stop the aging process. Rhytidectomy does not improve the look of the brow, eyelids and nose, and some areas of the mid face. A patient who wishes to improve these areas may need to consider combining rhytidectomy with a brow lift, or eyelid surgery. The adjunctive use of injectable soft tissue fillers, implants, and or skin resurfacing may need to be considered.
- Droopy eyelids can contribute to the aged appearance and can impair vision. In the lower eyelids, puffiness and bags under the eyes can also make one look worn and tired.
- Eyelid surgery, is a procedure that improves the appearance of the eyelids by tightening muscles and tissue or removing excess fat and skin. This procedure does not alter the dark circles of the skin, the fine lines or wrinkles around the eyes, nor does it change the sagging position of the eyebrow.
- The blepharoplasty procedure is performed under local anesthesia with sedation as an isolated procedure or in conjunction with other procedures including brow lift or facelift. Patients may choose to have this procedure on their upper or lower eyelids, or both.
- With aging the upper third of the face develops frown lines, wrinkling across the forehead and an increased heaviness of the brow. This lead to appearing tired, angry or sad. Correction of this is achieved through a forehead lift, which can be performed through a variety of different methods.
- Placement of the incision varies depending on the location of the hairline and whether or not skin and tissue will be removed as well. The procedure can be performed through incisions made at the mid forehead or hairline or through smaller incisions and the use of an endoscope. Muscles contributing to frown lines are addressed and sagging eyebrows are lifted.
- Nose surgery, can reshape, reduce or augment a person's nose to achieve facial harmony and improve breathing through the nose. While there is no perfect nose, the end result aims to soften a distraction, bring balance with other facial features and often boost self-confidence.
- Multiple factors may influence the outcome of the surgery - including the skin type, ethnic background, prior history of trauma, age, severity of the deformity. Incisions are made primarily inside the nose resulting in minimal to no visible scarring. Cartilage and bone are structurally sculpted while maintaining and or improving structural support to the airway. It is usually an outpatient procedure that is performed under IV sedation or general anesthesia.
Using a chin implant the chin and jaw line can be strengthened to improve facial proportion. When combined with rhinoplasty, this is referred to as a profileplasty as each procedure is used the complement the overall facial profile and improve facial harmony. The procedure may also be considered to improve the jawline and chin-neck angle with or without cervical liposuction or facelift.
Otoplasty is a procedure to correct protruding ears. Children have frequently been victims of name calling on the playground due to this visible distraction which can lead to poor self esteem and adaptation in school. The procedure can be performed at any age and in children as young as five to six years of age. The procedure does not affect hearing. The ears can be reshaped, "pinned back", reduced in size and or addressed to improve symmetry. This procedure can be performed in the office with a local anesthetic combined with a mild sedative or under general anesthesia in an outpatient surgical setting.
Scars are by definition permanent, but certain treatments can narrow, fade and otherwise make them less noticeable, which is especially helpful when they form on conspicuous areas such as the face and hands. Although there are many surgical scar-revision methods, including surgical excision, skin grafts and flap surgery, not all are appropriate for treating all types of scars. The best procedure for scar revision varies depending on the location and severity of the scar, the age and overall health of the patient, and the extent of revision the patient wants.
Minimally Invasive and Non-Surgical Procedures of the Face
Kybella™ is a revolutionary nonsurgical way to address the cosmetic condition known as double chin. With this injectable medication, with the active ingredient deoxycholic acid, Florida E.N.T. & Allergy can eliminate moderate to severe levels of bulging skin and fat deposits below the chin, helping produce a better contoured, more lifted and noticeably more attractive appearance.
Kybella™ is given in a 15 to 20 minutes in-office treatment. The area will first be cleansed, marked out, and then topically anesthetized. Kybella™ will then be injected into the area in 10 to 30 sites. The benefit takes between four and eight weeks to appear. Slowly but surely, after a series of between 2 to 4 treatments, the striking benefit becomes very noticeable, but once completed, destroyed cells will no longer be able to accumulate fat. The number of injections and the number of treatments is determined by how much submental fullness you have.
BOTOX® Cosmetic is a prescription drug that, when injected, temporarily relaxes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat persistent furrows and deep wrinkles in the skin that have formed by the continual contraction of facial muscles. It is most frequently used to address frown lines between the brow, the lines of the forehead and the crows feet.
Hyaluronic Acid Fillers
Hyaluronic acid is a sugar that naturally occurs in the skin that helps hydrate and add volume. Hyaluronic acid in the skin may diminish with age, contributing to the formation of wrinkles and folds. Available injectable hyaluronic acid fillers include Belotero®, JUVÉDERM® Injectable Gel, Restylane® and Voluma®. These fillers are smooth consistency gels that help hydrate, correct mild, medium and deep wrinkles and folds, and can restore volume to deficient areas of the face that develop with aging. Areas that can be frequently improved include the folds that run from the nose to the corners of the mouth (nasolabial folds). The results may last as long as 6-12 months and up to 24 months with Voluma.
Radiesse® is a safe long-lasting alternative to collagen and other dermal fillers for the correction of facial lines and wrinkles and restoration of volume and facial contour. Composed of calcium hydroxyapatite microspheres in a water based gel, this filler is believed to stimulate the production of collagen to help smooth lines and wrinkles and add volume to the skin. Results may last a year or more.
Collagen is a key structural ingredient which allows the skin to appear youthful and smooth. Collagen production decreases with age. Sculptra® uniquely works in the deep dermis (below the skin surface) to replace lost collagen. Sculptra® gradually restores fullness in shallow to deep wrinkles and folds that are the result of volume loss. Replacement of lost collagen results in a refined more youthful appearance with results lasting as long as two years.
Non-Ablative Fractional Resurfacing
The Palomar ICON™ System is a 1540nm non-ablative laser which delivers an array of microbeams below the skin surface into the dermis to improve a variety of skin imperfections. This laser promotes the generation of collagen and elastin by the delivery of columns of energy into the dermis. Zones of treated columns amongst untreated skin stimulates faster wound healing resulting in smoother, firmer, more elastic skin with more even tone and color. Because the top layer of skin remains intact, healing is rapid with little or now downtime. It is an excellent treatment option for the management of rough sun damaged skin, fine lines/wrinkles, surgical and traumatic scars, acne scarring and for the improvement of pore size. It also has demonstrated FDA approval in the improvement of stretch marks by up to 75%. Optimal results are frequently achieved with a series of 3-4 treatments depending on the area of concern.
Intense Pulse Light
A photofacial incorporates pulsed light to target pigmented blemishes and facial veins to improve the surface appearance of the skin. The depth of the wavelength provides limited dermal modulation to stimulate collagen and may also provide improvement in fine lines and wrinkles as well. With as few as 1-3 treatments, a photo facial or series of IPL treatments can reverse the visibly damaging effects of the sun and provide rejuvenation of the face with limited downtime. A series of treatment may also be an effective treatment option to improve the facial flushing and ruddy complexion associated with Rosacea. Typically following treatment, pigmented lesions will turn a darker color and over the course of 5-10 days will disappear.
Skin Care Services
Elizabeth Vargas is our licensed medical esthetician. With advanced training in providing the latest medically proven skin care treatments, Ellie provides personalized treatments based on your individual skin type and skin care needs. We are proud to provide customized chemical peels and facials tailored to your specific needs.
Skin Care Products
At a time where there are endless choices with baseless claims, choosing which skin care products are most appropriate for you can be a daunting task. The products made available through our office have been carefully hand-selected to provide scientifically proven results - helping your skin look and feel great while providing long term benefits and reversing the signs of aging. Our products available include:
- Obagi Nu-Derm® System is an anti-aging therapy that penetrates below the skin's surface to transform the skin cell function at the cellular level and correct the damage within to reveal healthy, younger-looking skin. Combined with the prescription tretinoin, Obagi Nu-Derm® helps restore healthy cells and is an ideal option for correction of age spots, fine lines, wrinkles, rough skin, skin laxity, sallowness (dull or yellow complexion), and hyper pigmentation (discoloration) of the skin
- IS Clinicals® by Innovative Skincare incorporates botanically sourced pharmaceutically purified ingredients designed to provide a healthy glowing complexion. Using antioxidant technology, the formulations are targeted for anti-aging, pigmentation, acne, and uneven skin tone.
- SkinMedica® using scientifically proven ingredients including growth factors, antioxidants and retinoids, this advanced formulation of skin care products is designed to rejuvenate the skin, improve collagen production and elasticity to diminish the effects of aging including fine lines and wrinkles.
- Glo Minerals® is an award winning mineral makeup foundation which delivers unsurpassed coverage that nourishes, corrects and protects the skin. The products are talc free, non-comedogenic and fortified with a blend of vitamins and antioxidants and is ideal for all skin types
- LATISSE® eyelash enhancer is the first and only U.S. Food and Drug Administration-approved cosmetic treatment for increasing the length, thickness and darkness of eyelashes. Available only through prescription, it is applied once a day to the base of the upper eyelashes. Results may be apparent within four weeks; full results take sixteen weeks.