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COMMONLY ASKED QUESTIONS ABOUT FACIAL PLASTIC SURGERY
(and answers!)
- I have a saggy jawline and my upper eyelids are baggy, is there one surgery that will fix all the droopy areas?
The “old” facelift used to attempt to fix all droopiness at once. The result was a very pulled, “operated-on” look. Newer procedures are geared to addressing individual areas of the face. Each area and problem should be addressed independently to achieve the most natural and refreshed look;
UPPER FACE (usually treated with an endoscopic browlift and/or upper eyelid lift)
MID-FACE/LOWER EYELID (endoscopic or standard midface/lower eyelift)
LOWER FACE/JAWLINE/NECK (facelift, “tuck-up” or neck lift)
WRINKLES AROUND MOUTH/LIPS (injectables and implants)
Individuals “tweaks” can be discussed, such as facial resurfacing, Threadlifting and other minimally invasive procedures that help in achieving the desired look.
- Is it better to have everything done at once or have several procedures spaced out?
That depends on your goals and desires. In general, the cost is less to combine the procedures and you only undergo one recovery period, instead of several. On the downside, it may take a bit longer to heal (longer anesthetic, multiple procedures).
- What is the expected recovery time? When can I go back to work?
Depending on the type of procedure, recovery is generally 7-10 days. Most patients can resume work after 1 to 2 weeks. Regular physical exercise may be slowly resumed after 7-10 days. Makeup can be used to help camouflage the areas that are bruised after one week. Social activities can be resumed after 3 to 4 weeks.
- How much pain can I expect?
Again, it depends on the procedure. Most patients have a headache after an endoscopic browlift. Some discomfort and dryness after eyelid surgery is expected, and the swelling of the eyelids may impair visual fields for a day or two. A facelift is uncomfortable for the first 24 to 48 hours, after which most patients are surprised by the lack of pain. Pain will be controlled with narcotics until it is manageable with Tylenol. Pain is a unique sensation, and no two people will perceive it the same.
- Will scars result?
A scar is always a sequela of having surgery. However, scars can be placed so they are well camouflaged and very difficult to see. Any scar will be red during the healing period (generally 6-12 months) and after that are generally imperceptible.
- How long will surgery last?
Changes made to the tissues are permanent. However, your face will continue to age. Many patients will need a touch up after about 10 years, depending on genetics and the care they provide to their skin and body.
- What is the best age to get a facelift?
There is no perfect age. The younger the patient, the better the results last and the less dissection is needed. In general, younger patients heal faster, better and have better results.
- Can a facelift be done on a man?
Absolutely. The incision is often contoured differently for a man, but the ability to tighten the jaw line and the skin under the chin are no different. In fact, this is one of the fastest growing populations seeking cosmetic refinements!
- What is the best procedure to tighten the jaw line?
Best- the tried and true facelift for the most dramatic tightening of the jaw line and elimination of jowling and sagging skin. Chin implants may add even further improvements.
Good- other procedures, such as a midface lift or threadlift may improve the jowl somewhat. An injectable filler or implant in the depression just in front of the jowl may give added benefit to straightening the jaw line.
- Will insurance cover the cost of surgery?
Usually not. Insurance will cover reconstructive procedures but usually not elective cosmetic procedures. If vision is affected from extra skin hanging over the eye, insurance may cover an eyelift. Nose and sinus surgery is usually covered if problems with breathing or infections are documented.
- What about the no-downtime procedures and skin treatments?
In general, the more downtime you are willing to allow, the more dramatic the result that can be achieved. Certain minimal down-time procedures and facial treatments will help alleviate signs of aging, but dramatic and long-lasting results are best achieved through a permanent surgical change in the tissues. Newer procedures like Contour Threadlifting can achieve about 50-60% of what rejuvenative surgery can with a downtime of only several days. Adjunctive procedures like laser rejuvenation, Botox and injectables have minimal or no downtime as well. Here are some options:
- Contour Threadlift BEST FOR patients with thin (not heavy) skin, ages 30-50, results last 1-5 years. COST $1500 per site (three options for sites- brow, midface/jowl or neck). DOWN TIME- minimal. RESULTS- moderate to dramatic.
- Botox BEST FOR anyone with crows feet or wrinkles around the eyes, results last 3-6 months. COST $200-500, depending on number of areas injected. DOWN TIME- none. RESULTS- moderate to dramatic.
- Chemical peels BEST FOR sun damaged skin, fine wrinkling, enlarged pores, results are permanent. COST $1000 full face, $400 around eyes only. DOWN TIME-5-7 days of redness. RESULTS- moderate to dramatic.
- Photo rejuvenation, photo dynamic therapy (Light therapy with Levulenic Acid) BEST FOR active acne or acne scarring, photo aging, hair removal, fine lines. COST $2000 for full treatment (usually 2-3 treatments). DOWN TIME-3-5 days of redness. RESULTS- moderate to dramatic.
- Thermage BEST FOR fine lines, skin tightening (NOT a facelift!), results are permanent. COST $2000-3000 per treatment, may need to be repeated. DOWN TIME-minimal. RESULTS- minimal(I do not offer this technique at current time- I do not feel it is worth the expense- too many disappointed patients).
- Fraxel BEST FOR sun damage, dark spots, results are permanent. COST $2000-3000 per treatment, may need to be repeated. DOWN TIME 2-5 days. RESULTS- minimal to moderate, patients with best results approach appearance of chemical peel (I do not currently offer this technique, chemical peels are producing more dramatic results for less money in my hands).
- Restylane, Radiesse (fillers or injectables) BEST FOR filling around the mouth, smile lines, lips, crease from corner of mouth, cheekbones, etc, results last 3-6 months (Restylane) to 1-3 years (Radiesse). COST $450 for 1 cc (Restylane) or $1000 for 1.3 cc (Radiesse). DOWN TIME- none. RESULTS- moderate to dramatic.
- Fat augmentation BEST FOR aging faces depleted of natural fat and contouring depressions (smile lines, cheekbone depressions, jawline), results are permanent. COST $2000, may need touch up (included in cost). DOWN TIME 2-7 days, depending on degree of correction. RESULTS- moderate to dramatic.
- If a procedure like an eyelift does not cause much discomfort, why is the down-time a week?
All surgeries will cause bruising and swelling and result in an incision that needs care. Facial resurfacing (deeper chemical peel, dermabrasion or deeper laser treatments like CO2) will cause damage to the outer layer of skin, making the underlying skin raw. Wound care is essential for the first week, and lifting after any surgery or procedure is restricted to 5 pounds for the first week. Vision can be blurred from ointment, pain may require narcotics, fatigue and nausea may result from medicines…and the body heals faster if it is taken care of. Certain things can help promote faster healing- protein loading before surgery, eating fresh pineapple after surgery, taking Arnica Montana (supplied to each patient) before and after surgery, stopping smoking, staying well hydrated and enjoying a healthy lifestyle will all speed healing.
- What does Board Certification mean?
Board Certification is a several day process of written and oral examinations that ensures your physician is qualified to be performing procedures. Many physicians performing cosmetic procedures and even surgeries are trained and board certified in Internal Medicine, Dermatology or other non-surgical specialties. Be sure to ask WHICH board has certified them! Board certification in plastic surgery (ABPS) means a surgeon has completed an approved plastic surgery training (although the experience in each training program will vary) and has passed examinations. These are the ONLY surgeons who should be performing body liposuction, tummy tucks, breast augmentation, and body procedures.
Plastic surgery is becoming more subspecialized, and facial cosmetic surgery is increasingly being referred to FACIAL plastic surgeons who have more experience in this area. Someone who specializes in everything specializes in nothing- if a surgeon advertises subspecialty focus in facial plastics, breast and body plastics and hand plastics there is no true subspecialty focus. For FACIAL plastic surgery, look for surgeons board certified through the American Board of Facial Plastic and Reconstructive Surgery. The ABFPRS is the only plastic surgery sub-specialty board that is ABMS equivalent and recognized in every US state. Board certification in FACIAL plastic surgery usually comes through completion of a fellowship that specializes in ONLY facial plastic and reconstructive surgery. Applicants can only be surgeons- head and neck (ENT) or plastic surgeons. Additionally, applicants MUST have a minimum number of facial plastic surgeries to become certified, as well as pass the oral and written examination. It is an arduous process that ensures that the surgeons operating on such a delicate area have the most experience possible. Again, the biggest difference with the ABFPRS is that facial plastics EXPERIENCE is a REQUIREMENT for certification, meaning your face will not be in the hands of the “occasional” facial cosmetic surgeon who largely focuses on breasts and tummy tucks.
Dr. Winslow scored the highest in the nation on this subspecialty exam, and currently serves as an examiner.
- What makes Dr. Winslow different from other plastic surgeons?
- Experience- Dr. Winslow has chosen to focus her practice exclusively to plastic surgery of the head and neck, and can do everything in this area. She has fellowship training in cosmetic and reconstructive surgery of the face. She has been practicing for over six years and has built a reputation for caring, dedication and attention to detail.
- Background- Dr. Winslow was asked to be the first ENT consultant to The White House, and served as Chief of Facial Plastic and Reconstructive Surgery at Walter Reed Army Medical Center. Her experience with teaching, the military and the most distinguished VIPs in the nation have prepared her well for a cosmetic practice in Indiana!
- Service- In addition to her military service, Dr. Winslow has a keen interest in women’s causes. She hosts a fundraiser for the Susan G. Komen Breast Cancer Research Foundation, and has contributed to ovarian cancer, melanoma and other breast cancer groups. She also volunteers time at IU School of Medicine to teach residents and serve the indigent population.
- Education- Dr. Winslow is currently an Assistant Clinical Professor at IU School of Medicine. She taught residents at Walter Reed and now teaches at IU, serves as a board examiner, has published and presented extensively, and stays at the forefront of her field with regards to research and new developments.
- Caring- A surgeon’s hand… a woman’s touch. While many plastic surgeons can tell patients what surgical procedures would benefit them, it takes more attention and effort to LISTEN to patients. This is an emphasis in Dr. Winslow’s practice. Dr. Winslow believes that active listening is a requirement to patient satisfaction.
- What can esthetics do for me?
Facials, peel, microdermabrasion, massage, lymphatic drainage, makeup, skin care…. How much do you spend every year on skin care products, only to be frustrated that they don’t deliver? How many products sit unused in your drawer? Esthetics and good skin care can turn back the clock on the skin and maintain what you have. Our esthetics director can direct you to physician-grade products that you won’t waste money on, as well as help you with mineral based cosmetics, eyelash extensions, relaxing facials and massage, or just pampering! You can call for a free consultation at 814-1104.
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