Facial Refinement

Patronella MD offers surgical and non-surgical facial refinement procedures including facelift, botox and collagen treatments and browlift and necklift.

Facial refinement does just what it implies: Restores a youthful appearance to the face after the effects of sun and genetic factors associated with age. Facial refinement procedures can be both surgical and non-surgical.

A rhytidectomy, or facelift, is a surgical procedure that improves the forehead, eyes, cheeks, and the sagging skin around the neck and chin. A facelift is considered to be the most effective procedure for total facial restoration.

Non-surgical techniques for facial refinement include:

• Botox® injections to smooth out facial wrinkles
• Blepharoplasty, or an eyelid tuck, can improve puffy and wrinkled eyelids
• Endoscopic browlifts improve the brow position and appearance
• Neck lifts and platysmaplasties can tighten the skin and muscle of the neck
• Microdermabrasion treatments gently smooth out fine lines and cleanse the skin

Botox®

Botox® is one of the most effective treatments for wrinkles that appear on the forehead and in-between the eyebrows. It also is used to treat “crow’s feet,” fine lines that appear around the mouth and for those with excessive sweating in the palms and armpits.

Botox® is injected directly into the muscle through a small needle. Botox® injections are given in Dr. Patronella’s office and most patients return to work the same day. Botox® binds with motor nerve terminals in the body to stop the release of Acetylcholine. When injected into a muscle, Botox® produces a reversible paralysis of that muscle, and thus, wrinkling associated with that area.

The effects of Botox® for wrinkle reduction are temporary, and muscle function and its associated wrinkling usually return in four to six months. For the areas around the mouth, the time frame is two to three months.

The Federal Drug Administration has approved Botox® to treat conditions known as strabismus and blepharospasm, or disorders of the facial nerve in patients aged 12 and above. There are risks associated with the use of Botox®; however, complications are usually temporary because Botox® is a temporary treatment.

Restylane

Restylane is used to smooth out wrinkles in the face. It is a clear gel formed from hyaluronic acid. Restylane is injected into the skin to smooth out and produce a wrinkle free appearance that gives you a much younger appearance. The treatment is safe and scar free.

Chemical Peel

Chemical peels also rejuvenate skin that is wrinkled, blemished or damaged from the sun. Two types of chemical solutions (Phenol and TCA) are used in a peel. These chemicals cause the top layers of skin to peel away, allowing new skin cells to form and produce smoother, younger-looking skin.

TCA peels are mostly used to treat fine surface wrinkles and superficial blemishes, with a recovery time of one week. Phenol peels treat fine or coarse wrinkles, blotchy skin coloring, and sun-damaged skin. Patients tend to take close to tow weeks to recover and will experience a few days of swelling. Following treatment, patients must avoid the sun and wind for at least four weeks.

Chemical peels are usually performed as outpatient procedures using local anesthesia. Treatments last from 15 minutes to two hours.

Collagen

Collagen occurs naturally in the second layer of skin and functions as a support structure for the skin. With age, stress from smiling and even squinting causes collagen to break down. Creams that contain collagen serve only as moisturizers for the skin and do not replace lost collagen.

In most cases, collagen can be replaced through a series of injections (less than one hour as an outpatient) under the skin using Purified Bovine Collagen. The amount of injections needed depends on a patient’s age and condition of the skin. Minimal redness and swelling at the injection sites are common, but will only last a few hours after the procedure. Collagen injections effects last approximately three months.

Ear Procedures

A split earlobe may occur as the result of the weight of heavy earrings on pierced ears or by trauma, such as an earring being pulled from the ear. Dr. Patronella usually can repair split earlobes with special sutures that minimize scarring as on outpatient procedure in about one hour with the use of local anesthesia. Your stitches will be removed after four to five days and your ear may be pierced again after three weeks.

Otoplasty is used to correct ears that protrude outward. Children especially are affected by this genetic condition, both physically and emotionally. Otoplasty is an outpatient procedure that can be performed on children who are at least five years old, as that is when the ears are almost at full growth.

For children and adult patients, local anesthesia is used during this procedure, which may last one to three hours. Stitches can be removed after one week, and post-op bandages are applied to the head following surgery. Children recover after about one week, and most adults return to work after five days.

Eye Procedures

If others perceive you to be tired or angry even when you are not, drooping eyelids and bags under your eyes may need attention. Eyelid surgery or blepharoplasty is recommended for adults who are in good health. Additionally, if your droopy eyelids impair your vision, your insurance company may cover this procedure.

During blepharoplasty, incisions are normally made in the creases of your upper eyelids and just below the lashes of your lower eyelids. After underlying fat and excess skin are removed from the area, sutures are used to close the incisions and leave behind “invisible” scars. A transconjuctival blepharoplasty involves incisions to the lower eyelid, with no skin being removed.

Eyelid surgery is performed as outpatient surgery under general anesthesia and lasts from one to three hours. Stitches are removed after one week and you can return to work within five to seven days. You may resume strenuous activities after about three weeks.

Scarring from eyelid surgery is usually minimal after three weeks and undetectable in six months. In addition to eyelid surgery, fine lines and light wrinkles can be erased from around your eyes with the CO2 (outpatient) laser procedure, which also requires general anesthesia and lasts one to two hours.

Rhytidectomy, or Facelift

A facelift is designed to make your face appear more youthful and fresh. The procedure smoothes the loose skin on both the face and neck, while tightening the underlying tissues and removing excess fat in these areas. Other options to improve the appearance of the face include laser resurfacing, fat injections, nose reshaping and facial implants.

Browlift

A lateral brow lift provides eyes with an invigorating and fresh new look. During this procedure, the eyebrows are elevated, which also helps to minimize “crow’s feet” that develop in the corners of the eyes. Incisions made during a browlift are hidden inside the hairline and are virtually invisible. This procedure is usually performed as an outpatient procedure under local or general anesthesia.

Endoscopic brow lift procedures take two hours, and also are performed under local or general anesthesia. Stitches are removed after seven to ten days and bruising and swelling is minimal. After seven to ten days, patients also may return to work.

Laugh lines

Creases or "laugh lines" can be caused by exposure to the elements, such as the sun, or they also can be hereditary. One way in which these lines are treated is through fat injections, meaning fat is taken from one part of the body (usually the stomach or thighs) and then injected along the facial crease.

The injection procedure takes less than one hour and involves a series of injections. The procedure can be performed as an outpatient. Minimal redness and swelling are common, but these usually subside a few hours after the procedure. Collagen injections also are used to treat laugh lines.

When lines develop around the mouth, the lip tissue breaks down, causing the lips to sag and retreat into two thin lines (lips lengthen as a result of gravity). The gradual shrinking of the jaw bone and teeth causes an inversion of the vermilion, or the pink portion of the lip. Lip enlargement and improvements are made in a variety of ways. Lip improvement using a CO2 laser can remove fine lines and wrinkles around the mouth, while dermabrasion, chemical peels, collagen injections and micro-fat injections allow for significant improvements to be made. These procedures also are generally performed as an outpatient.

Microdermabrasion

Microdermabrasion is a revolutionary skin refinement method that is non-surgical and non-invasive. The process involves medical grade microcrystals being propelled at a high rate of speed across the skin's surface. This process removes dead skin cells from dry skin and unclogs pores for those who have oily skin.

The massaging action of the treatment cleanses below the skin’s surface, resulting in a vibrant complexion. After the treatment, a cooling facial mask is applied to soothe and refresh the skin. One session can be completed in less than an hour, and the results are immediate.

Necklift

Sagging skin in the neck area occurs as the skin ages and loses its tone. Even younger patients can have premature aging in the neck area due to the laxity of the neck muscle and fat accumulation in this area.

Fortunately, skin has the ability to retract into more youthful positions. Liposuction is used to remove unwanted fat from the neck area, but a combination of liposuction and the tightening of the neck muscle may be more effective. This procedure is referred to as platysmaplasty. General anesthesia is generally used, and stitches are removed after one week. Bruising or swelling will usually subside within a month after the procedure.

Contact Dr. Patronella for all your facial refinement
needs, questions and concerns.