We are a tertiary referral center and often see patients from far and wide for second, third and seventh opinions! Complications of cosmetic surgical procedures of the face can be concerning to the surgeon as well as the patient. Most surgeons are skilled enough to correct any undesireable results. However, patients will often want second or third opinions. We also see many patients who want complications and undesireable results corrected.
IMPORTANT NOT ALL UNACCEPTABLE RESULTS ARE COMPLETELY CORRECTABLE. CERTAINLY, WHEN IT COMES TO LOSS OF TISSUE AFTER REPEATED SURGERIES, AN IMPROVEMENT CAN BE SOUGHT, BUT A COMPLETE CORRECTION MAY NOT BE POSSIBLE
WHAT COMPLICATIONS OF FACIAL COSMETIC SURGERY DO YOU SEE?
The list of the types of patients we see is long. Some of the conditions we see are:
OVER-TIGHT FACE AFTER A FACELIFT
We have all heard about the joker’s smile look and the over-tight face. Many of us have seen these results on the television screens and on the big screen. These are not easy problems to treat once the overly tight facelift or necklift has been performed. However with a careful review of the operation reports and examination of the patient, we can often improve the “pulled look” appearance.
Surgical correction of the wind-swept look and correction of the earlobe that is pulled downwards and forwards with loss of the earlobe is complex and much more difficult than doing the facelift and necklift properly in the first place. However, with a combination of revision surgery, scar replacement, fat grafts and lasers, a reasonably nice result can be obtained as seen here.
EARLOBES PULLED DOWN AND STUCK TO THE FACE WITH LOSS OF EARLOBES AND WITH A WIND-SWEPT LOOK
The earlobes pulled down and stuck to the face after a facelift and necklift.
This is a common problem that we see. It is possible to revise the scars and improve the position of the ear lobe and, in some cases, to even make a new “hanging” earlobe so that the face looks natural.
PULL LINES ON THE FACE AFTER A FACELIFT
Pull lines on the face after a facelift: many patients succumb to the temptation of “weekend facelifts”, quick facelifts, etc. These are done through small incisions which can result in abnormal tension on the facial skin, resulting in “pull lines” which we also call kite lines. In such cases, it is necessary to redo the facelift and neck lift and change the vectors of the tissue repositioning, often with the use of other modalities like fat grafts, lasers, etc. We can improve these pulled faces.
INADEQUATE IMPROVEMENT OF THE JOWLS, JAWLINE AND NECK AFTER A FACELIFT
Facelift and necklift surgery are precise surgical techniques that depend upon experience, a detailed knowledge of anatomy and a careful study of aging of men and women. A careful preoperative analysis and planning are vital. If and when
quick and template-type facelifts and necklifts are performed, the improvement can be moderate and unsatisfactory. About 30% of our facelifts are revision facelifts performed for patients who are either dissatisfied with their results from surgery elsewhere or where the results have not lasted sufficiently long enough after surgery.
BEFORE & AFTER
TREATMENT OF SKIN CHANGES: PORES, VESSELS, PIGMENT SPOTS, WRINKLES, LINES, SCARS, ETC
Some surgeons will perform very nice facelifts and necklifts but ignore the canvas of the face: the skin. A beautiful face demands beautiful skin as well as excellent underlying anatomical structures. We often see patients where the skin has been neglected: here we can achieve a lot of improvement using a combination of lasers, peels, pulsed light lasers, radiofrequency lasers, injection radiofrequency and other non-surgical techniques.
BEFORE & AFTER
BADLY PLACED SCARS AFTER A FACELIFT AND NECKLIFT
The designing of the incisions is a very precise technique and is not the same in men and in women and, indeed, is not same from one face to another. We often see scars that are obvious and very anterior to the ear or hairline. In others, the scars are too wide and distort the ear or the face. In such cases, we carry out scar revisions of various kinds to improve and hide as much as possible the old scars and reduce the size and improve the location.
ASYMMETRY AFTER FACELIFTS AND NECKLIFTS
surgical reduction of the depressor angularis oris muscle may be used, but botox can achieve the same result, albeit on a more temporary basis.
improvement in the melolabial folds and the angle of the mouth using the lifting surgical technique together with surgical weakening of the depressor angulari soris and fat augmentation of the mesolabial folds.
Surgical markings for angular lift and weakening of the depressor angularis oris muscle.
ASYMMETRIC EYELIDS AND BROWS
of all plastic surgery procedures.
UNABLE TO CLOSE EYELIDS AFTER UPPER AND/OR LOWER EYELID SURGERY
be possible to completely correct the problems.
LOWER EYELIDS PULLED DOWN AND AWAY FROM THE EYEBALL AFTER LOWER BLEPHAROPLASTY
ABNORMAL INCISIONS AND SCARS AFTER BLEPHAROPLASTY AND ASYMMETRIC RESULTS
MISPLACED IMPLANTS IN THE FACE
Facial plastic surgery gone bad
BEFORE & AFTER
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With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days.
Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.
Everyone will experience some numbness in the face: this resolves over weeks to months. This occurs because of the dissection of the face. This is not a complication.
Because of the dissection and repositioning of the tissues, it is common for there to be small differences in the smile between the right and left sides: this is usually only noticeable to the patient and to Dr. Patel! It recovers over a few weeks.
All faces have asymmetry and there will be some degree of asymmetry. This is to be expected.
Permanent weakness of nerves and muscles is rare.
The scars are usually very well hidden. However, some patients may have a tendency to cause hypertrophic scarring: in such cases, certain lasers and treatments will help. By-and-large, scars are rarely a problem. With Caucasian skin, pinkness of scars is to be expected for several weeks. With darker skin, some hyperpigmentation may occur.
In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision.
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CONTACT DR. PATEL
Do you have questions or need more answers?
Dr. BCK Patel MD, FRCS
Salt Lake City, Utah 84106, USA
(801) 413-3599 (phone/text)
Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA