Facial Plastic Surgery

Ear Surgery

Nasal surgery

Throat Surgery

What is Laser Skin Resurfacing?

Laser skin resurfacing, commonly called a laser peel, removes the outer, often damaged layer of skin for a smoother, younger look. The procedure reduces the appearance of sun damage, wrinkles, fine lines, uneven pigmentation and superficial scarring, usually on the face. It can take anywhere from a few minutes to two hours depending on the size and severity of the area being treated and whether it is combined with other procedures such as a browlift or eyelid surgery for even more dramatic results.

How does it work?

A carbon dioxide (CO 2 ) laser beam of intense, precisely-focused light vaporizes the surface skin and reveals the undamaged layer beneath. The most common complication of the procedure is the regrowth of some hair, though it is usually finer and lighter than what was originally removed. Other, rare side effects include redness, swelling, burns and scarring.

What do chemical peels treat? 

Chemical peels remove damaged outer layers of skin on the face to smooth texture, reduce scarring, and remove blemishes and pre-cancerous growths to produce healthy, glowing skin.

What can rhinoplasty do for me?

Rhinoplasty can reshape, reduce or augment the nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or correct injury, birth defects, or other problems that affect breathing.

How long does the procedure take?

Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.

Can I wear glasses after surgery?

Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.

What can a browlift do for me?

Browlifts can revitalize drooping or lined foreheads by tightening skin and muscles above the eyes, smoothing wrinkles and raising the eyebrows, helping you to look less angry, sad or tired.

What age are patients usually?

While browlifts are typically performed on patients aged 40-60 to counteract the effects of aging, anyone with lined or inelastic skin on the forehead — whether it’s caused by muscle activity or inherited conditions — are eligible.

What’s the difference between traditional and endoscopic methods?

The main difference lies in the type of incision made. In a traditional browlift the surgeon makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. In a minimally invasive endoscopic browlift the surgeon makes three to five short incisions (less than an inch long) behind the hairline. The endoscope — a slim instrument with a camera on the end — is placed in one incision so the surgeon can see beneath the skin, while he or she lifts the skin and adjusts muscles through the other incisions.

What are the advantages of blepharoplasty (eyelid surgery)?

By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient’s field of vision.

Because blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes, the procedure is often combined with others such as a facelift and BOTOX® treatments.

Will I have visible scars?

Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids) to minimize scar visibility. If no skin needs to be removed during surgery, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

How soon after surgery can I wear my contact lenses?

Contact lenses may not be worn for two weeks. Glasses may be worn immediately.

Is sinus surgery safe?

Elective surgery to facilitate drainage of the sinuses by widening the openings and removing excess mucus or diseased tissue is easier, faster and safer today than ever before. Modern advances in medical technology, specifically the endoscope (a thin fiberoptic tube inserted through the nostrils) and surgical lasers, allow for a minimally invasive procedure with less post-operative pain and shorter recovery time.

Who is a good candidate for sinus surgery?

The decision to undergo surgery may be made when sinus infections recur or do not respond to medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) or to non-surgical procedures such as flushing. Pre-surgical testing includes nasal endoscopy, CT scan and allergy testing to determine the effect of allergies on the problems experienced.

What is sleep-disordered breathing?

Sleep-disordered breathing describes a group of abnormal breathing patterns experienced during sleep, which may manifest as light or heavy snoring, pauses in breathing (sleep apnea) or complete airway collapse. People with obstructive sleep apnea syndrome stop breathing while they sleep, sometimes hundreds of times per night and sometimes for a minute or longer each time. The soft tissue at the back of the throat closes, blocking (obstructing) the person’s airway.

Is sleep-disordered breathing dangerous? What are the warning signs?

Because the brain and major organs are deprived of essential oxygen when breathing is disrupted, if left untreated sleep apnea can result in high blood pressure, cardiovascular disease, stroke, memory problems, weight gain, impotency, headaches, and daytime fatigue leading to job impairment and motor vehicle crashes.

A common warning sign of obstructive sleep apnea is snoring (especially snoring interspersed with gasps or lack of breathing), although the two are not always related.

What are the treatment options for sleep apnea ?

Traditionally, surgical treatment of the soft palate involved a procedure called uvulopalatopharyngoplasty, which removes the tonsils, uvula and part of the soft palate to open the airway. Now, more advanced procedures such as Laser Assisted Uvula Palatoplasty (LAUP) and somnoplasty (radiofrequency ablation) are performed to stiffen the soft palate without the need for general anesthesia.

Before surgery is attempted, patients suffering from sleep apnea are given a breathing mask to wear at night that uses Continuous Positive Airway Pressure (CPAP), wherein air is forced past the obstruction for clear breathing. If this fails to correct the problem or if the patient is too uncomfortable to continue, surgical options may be considered, such as uvulopalatopharyngoplasty or a procedure using radiofrequency energy that shrinks the base of the tongue and the soft palate.

What causes nasal obstruction?

Nasal obstruction (stuffiness, congestion) affects millions of Americans. It arises from a number of causes, including a deviated septum (misalignment of the normally centered sheet of cartilage and bone which divides the nose into a right and left passageway); swelling of the mucosal covering of the turbinates (bony structures lining the inside of the nose) due to illness, allergy, infection or other irritation; sinus blockage; enlarged adenoids (masses of lymph tissue in the back of the throat); and aging.

What are the surgical options for nasal obstruction?

Surgical treatments range from adhesive strips for minor blockages associated with aging, to in-office injection, freezing, radiofrequency, laser or cautery procedures for turbinate reduction, to an outpatient procedure called septoplasty. Septoplasty (called septorhinoplasty when it is combined with cosmetic improvements) involves the re-shaping of the cartilage and bone for improved air flow. Full enjoyment of results from septoplasty are usually experienced within a week or two when swelling is reduced and splints or packing are removed.

What is myringotomy?

Also called tympanostomy, myringotomy involves the removal of fluid from the eardrum. Myringotomy with or without tube implantation is the most frequently performed ear operation and the second-most common surgical procedure in children younger than two years of age, after circumcision. Surgery is recommended for patients with hearing loss and the presence of fluid for four months or longer.

What’s involved in a myringotomy?

Myringotomy consists of making an incision in the eardrum and vacuuming out fluid under general anesthesia. Even the youngest patients typically recover within a few hours, with pain relief medications taking the form of acetaminophen, codeine or topical anesthetic ear drops.

Are results usually satisfactory?

After surgery, most patients experience a full return of hearing ability as well as less pain, fewer infections and increased speech capacity. Complications are rare and usually minor but may include infection (usually resolved with antibiotics) and additional surgery to correct perforation of the tympanic membrane or replace the tympanostomy tubes.

What is the mastoid? When is a mastoidectomy required?

Located behind the ear, the mastoid bone connects to the middle ear and, when healthy, is filled with air. Infection or disease in the ear or elsewhere can cause the mastoid to fill with fluid, mucus or excess tissue (such as a cholesteatoma, a benign tumor that may grow out of a healing perforated ear drum and cause hearing damage). When medications and other non-surgical treatments such as antibiotics or professional cleaning fail to resolve the problem, mastoidectomy may be performed.

Are there complications?

Complications from surgery are rare but may include drainage from the ear, infection, temporary dizziness or loss of taste on one side of the tongue, hearing loss and, rarely, nerve injury to the side of the face operated upon.

What is tympanoplasty?

Tympanoplasty is an elective, ambulatory microsurgical procedure performed to close a perforation (hole) in the tympanic membrane (ear drum) when non-surgical methods are ineffective.

How do perforations form in the ear drum?

Perforations may be caused by infections, injuries, flying with a cold and use of cotton swabs; symptoms include drainage or bloody discharge from the ear, hearing loss, dizziness when water enters the ear and frequent ear infections.

Is surgery always necessary?

Antibiotics, decongestants, ear drops and abrasion with a small hook are often tried before surgery is recommended. Surgery may not be recommended for very young children or patients with chronic sinus or nasal problems such as severe allergies, acute infection in the sinuses or nose, or poorly controlled diabetes or heart disease.

What’s involved in a tympanoplasty?

An incision is made either in the ear canal or behind the ear, depending on the size and depth of the perforation. The damaged ear drum is lifted and the perforation located; skin from behind the ear or from the ear lobe (tragus) is removed, thinned, dried and applied to the ear drum.

The bones of the middle ear are examined for damage. In a supplemental procedure known as ossicular reconstruction, the damaged or eroded bones may be bridged with a bone or cartilage graft, re-shaped using an operating microscope, or strengthened by the implantation of an artificial bone strut made of hydroxy apatite to reduce risk of rejection. Another, rarer ossicular reconstruction procedure called malleus fixation involves the reshaping of the malleus bone (“hammer”).

Is the operation usually successful?

The perforation heals properly in over 90% of cases. Failure may result from immediate infection, water getting into the ear or displacement of the graft after surgery. Complications are uncommon but may include temporary dizziness, tinnitus, loss of taste on one side of the tongue, facial nerve injury and further hearing loss.

What is a stapedectomy?

Stapedectomy is an elective microsurgical procedure that replaces the stapes bone with a prosthesis (artificial bone) to counteract calcium deposits in the ear associated with otosclerosis. The ear drum is raised and the middle ear opened, revealing the calcium deposit, which is then broken up with a laser. The remains of the vaporized stapes bone are removed and the bone is replaced. A tiny sample of tissue from behind the ear lobe is grafted to promote healing, and the incisions are closed.

Are there often complications?

Complications are rare and depend on the patient’s anatomy. These may include temporary loss of taste on one side of the tongue, dizziness, tinnitus (ringing in the ears) and, rarely, facial nerve paralysis or partial or total hearing loss requiring the use of additional surgery or a hearing aid.

What are cochlear implants?

Cochlear implants are tiny electronic devices surgically implanted behind the ear. They are not hearing aids, which amplify sounds the ear already hears; rather, while the implants do not restore a deaf person’s hearing, they help a person to understand the sounds in their environment, such as speech.

The implant consists of a microphone to pick up sound, a speech processor to process that sound, a transmitter/receiver which converts the sound information to electrical impulses, and electrodes that send those impulses to the brain.

Who is eligible for cochlear implants?

Implants can be useful for adults who associate sounds made through the implant with sounds they heard earlier in life when their hearing was better; early implantation and therapy can help children as young as two years old to learn speech and other auditory comprehension skills.

What are the tonsils? Is infection dangerous?

The tonsils are masses of lymph tissue in the back of the throat that work with the adenoids and immune system early in life to defend the body against invading bacteria and viruses. Occasionally the tonsils become infected or abscessed, and, if these conditions continue, enlarged, causing breathing and swallowing problems such as snoring, disturbed sleep, chronic mouth breathing (possibly resulting in deformations of the face and mouth), ear infections and hearing loss.

Are my / my child’s tonsils infected?

Signs that you or your child may have tonsillitis (infected tonsils) include:

  • Tonsils that are enlarged, redder than usual, or have a white or yellow coating
  • Swelling that causes a slight voice change
  • Sore throat
  • Difficult or painful swallowing
  • Swollen lymph nodes (glands) in the neck
  • Fever
  • Bad breath

When is removal recommended?

Removal is usually recommended for patients with three or more infections of the tonsils each year and patients with sleep-disordered breathing, and may also be recommended for patients with tumors or difficulty breathing.

What are the adenoids?

The adenoids are masses of lymph tissue in the back of the throat that work with the tonsils and immune system early in life to defend the body against invading bacteria and viruses.

What happens when the adenoids become infected?

Occasionally the adenoids become infected and, after repeated infections, enlarged, causing breathing and swallowing problems such as snoring, disturbed sleep, chronic mouth breathing (possibly resulting in deformations of the face and mouth), ear infections and hearing loss. Signs that you or your child may have enlarged adenoids include:

  • Breathing through the mouth rather than the nose
  • Blocked-sounding nose when speaking
  • Frequent ear infection
  • Noisy breathing
  • Snoring
  • Sleep apnea (frequent pauses in breathing at night)

When is removal recommended?

Removal may also be recommended for patients with chronic ear infections, tumors or difficulty breathing.