Southwest Plastic Surgery Center

BROWLIFT (Forehead Lift)
Procedure:	Minimize forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the forehead skin. May be done using the traditional technique, with an incision across the top of the head just behind the hairline; or with the use of an endoscope , which requires 3 to 5 short incisions. Most often done on people over 40.
Length:	1 to 2 hours.
Anesthesia:	Local with sedation, or general.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary swelling, numbness, headaches, bruising. Traditional method: Possible itching and hair loss.
Risks:	Injury to facial nerve, causing loss of motion, muscle weakness, or asymmetrical look. Infection. Broad or excessive scarring.
Recovery:	Back to work : 7 to 10 days, usually sooner for endoscopic forehead lift. More strenuous activity: several weeks.
Full Recovery from Bruising :	2 to 3 weeks. Limit sun exposure for several months.
Duration of Results:	Usually 5 to 10 years.

BOTOX ®
How did BOTOX® Cosmetic become America’s most popular cosmetic treatment?	Friends told friends. Wives told husbands. More than half a million people were wowed by BOTOX® Cosmetic in the last year alone. One 10-minute treatment—a few tiny injections—and within days, the stubborn, angry-looking frown lines between your brows dramatically relax for up to 4 months. No surgery. No recovery. And BOTOX® Cosmetic is safe, widely tested, and approved by the FDA.
What exactly is BOTOX® Cosmetic?	A BOTOX® Cosmetic treatment is natural, purified protein, which in very low doses relaxes the overactive muscles that cause frown lines to form. Treatment is simple and nonsurgical and smoothes the deep, persistent lines between your brows that developed over time.
Is it safe?	BOTOX® which has been safely used to treat a variety of conditions for more than 10 years, is now FDA-approved as BOTOX® Cosmetic for the temporary treatment of frown lines in people aged 18 to 65.
Where does the BOTOX® Cosmetic go?	It generally remains only in the treated muscle and gradually disappears without breaking down or traveling throughout the body.
How long does it last?	Results last about 4 months, after which lines gradually disappears without breaking down or traveling through the body.
Will it radically change my appearance?	No. Expect a dramatic improvement in the appearance of your frown lines. In clinical trials, nearly 90% of the men and women surveyed rated the improvement in their brow lines as moderate to better. Overall, you'll look more relaxed and refreshed but not like "you've had work done."
Will it make me lose expression?	No. The only expression you'll lose is the unintentional frown caused by the overactive muscles between your brows. So you can frown, smile, or look surprised-without the creases and wrinkles between your brows.
What can I expect from BOTOX® Cosmetic treatment?	Your doctor will determine exactly where to administer several tiny injections to achieve the best results. No anesthesia is required, although he or she may choose to numb the area with a cold pack or anesthetic cream prior to injecting. The entire treatment takes approximately 10 minutes. Discomfort is minimal and brief-most patients compare the sensation to a bug bite. Most people return to work or normal activity immediately. Within days, you'll see a marked improvement, which may continue to improve for as long as a week and should last up to 4 months. In clinical trials with BOTOX® Cosmetic, 89% of patients rated improvement in frown lines as moderate or better. Individual results may vary. The most common side effects, if they occur, are headache, respiratory infection, flu syndrome, temporary eyelid droop, and nausea. BOTOX® Cosmetic should not be used if there is an infection at the injection site.
Is BOTOX® Cosmetic right for you?	If you're between the ages of 18 and 65 and doing all you can to look your best is important to you, BOTOX® Cosmetic may be for you. If reducing those tough lines between your brows would make you feel more approachable, BOTOX® Cosmetic may be for you. Thousands of appearance-conscious women and men have already discovered the benefits of BOTOX® Cosmetic. Not just models and movie stars, but ordinary people-teachers, mothers, and business people from all walks of life. Your doctor can help you decide if BOTOX® Cosmetic is right for you.
Who should administer BOTOX® Cosmetic?	Any authorized healthcare professional can administer BOTOX® Cosmetic, but dermatologists, plastic surgeons, ophthalmologists, otolaryngologists, or other aesthetic specialty physicians are generally more experienced.
Are BOTOX® Cosmetic treatments painful?	Discomfort is minimal and brief. Your physician may choose to use a local anesthetic cream or ice to minimize this. Once the injection is complete, there is usually no discomfort.
Is BOTOX® Cosmetic expensive?	When considering your facial aesthetic options, you'll find that BOTOX® Cosmetic is quite affordable. According to the American Society for Aesthetic Plastic Surgery’s 2000 survey, BOTOX® Cosmetic is one of the least expensive facial aesthetic procedures, ranking seventh of the 9 most widely used procedures in the United States. Like other appearance-related investments, such as hair coloring and cuts, teeth whitening, and chemical peels, the cost must be weighed relative to your expectations. Consult your doctor for more information.

CHIN AUGMENTATION

Plastic surgeons use facial implants to improve and enhance facial contours. Frequently, these implants will help provide a more harmonious balance to your face and features so that you feel better about the way you look.

There are many implants available, manufactured from a variety of materials. They may help strengthen a jawline or bring the chin or cheekbones into balance with the rest of the face.

This brochure describes some of the facial implants currently available as well as the techniques for their use. It will familiarize you with these procedures but cannot provide all the details which may be relevant to your particular needs.

If you feel that one or more of the procedures described in this brochure may be of benefit, be sure to ask your plastic surgeon for more information.

COLLAGEN / FAT INJECTIONS
Procedure:	Plump up creased, furrowed, or sunken facial skin; add fullness to lips and backs of hands. Works best on thin, dry, light-colored skin.
Length:	15 minutes to 1 hour per session.
Anesthesia:	Collagen: usually none; local may be included with the injection. Fat: local.
In/Outpatient:	Outpatient.
Side Effects:	Temporary stinging, throbbing, or burning sensation. Faint redness, swelling, excess fullness.
Risks:	Collagen: allergic reaction including rash, hives, swelling, or flu-like symptoms; possible triggering of connective-tissue or autoimmune diseases. (A skin test is required before collagen treatment to determine whether an allergy exists.) Both: Contour irregularities, infection.
Duration of Results:	Variable; a few months to 1 year.

EAR SURGERY (Otoplasty)
Procedure:	Set prominent ears back closer to the head, or reduce the size of large ears. Most often done on children between the ages of 4 and 14 years. (Occasionally covered by insurance.)
Length:	2 to 3 hours.
Anesthesia:	Young children: usually general. Older children or adults: general or local, with sedation.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary throbbing, aching, swelling, redness, numbness.
Risks:	Infection of cartilage. Excessive scarring. Blood clot that may need to be drained. Mismatched or artificial- looking ears. Recurrence of the protrusion, requiring repeat surgery.
Recovery:	Back to work or school: 5 to 7 days. Strenuous activity, contact sports: 1 to 2 months.
Duration of Results:	Usually permanent.

EYE LIFT (Blepharoplasty)
Procedure:	Correct drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (Upper-eyelid surgery may be covered by insurance if used to correct visual field defects)
Length:	1 to 3 hours.
Anesthesia:	Usually locally with sedation or general.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
Risks:	Temporary blurred or double vision. Infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare).
Recovery:	Reading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses : two weeks or more. Strenuous activities , alcohol: about 3 weeks.
Bruising and swelling gone :	Several weeks.
Duration of Results:	Several years. Sometimes permanent.

FACELIFT (Rhytidectomy)
Procedure:	Improving sagging facial skin, jowls, and loose neck skin by removing excess fat, tightening muscles, redraping skin. Most often done on men and women over 40.
Length:	Several hours.
Anesthesia:	Local with sedation, or general.
In/Outpatient:	Usually outpatient. Some patients may require short inpatient stay.
Side Effects:	Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.
Risks:	Injury to the nerves that control facial muscles or feeling (usually temporary but may be permanent). Infection, bleeding. Poor healing; excessive scarring. Asymmetry or change in hairline.
Recovery:	Back to work: 10 to 14 days. More strenuous activity : 2 weeks or more.
Bruising :	2 to 3 weeks. Must limit exposure to sun for several months.
Duration of Results:	Usually 5 to 10 years.

HAIR TRANSPLANTS/RESTORATION
Procedure:	Fill in balding areas with a patient's own hair using a variety of techniques including scalp reduction, tissue expansion, strip grafts, scalp flaps, or clusters of punch grafts (plugs, miniplugs and microplugs). Works best on men with male pattern baldness after hair loss has stopped.
Length:	1 to 3 hours. Some techniques may require multiple procedures over 18 months or more.
Anesthesia:	Usually local with sedation. Flaps and tissue expansion may be done with general anesthesia.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary achy, tight scalp. Unnatural look in early stages.
Risks:	Unnatural look. Infection. Excessive scarring. Failure to "take." Loss of scalp tissue and/or transplanted hair.
Recovery:	Back to work: usually 2 to 5 days. More strenuous activities : 10 days to 3 weeks.
Final Look:	May be 18 months or more, depending on procedure.
Duration of Results:	Permanent

LIPOSUCTION (Suction-Assisted Lipectomy)
Procedure:	Improve body shape by removing exercise-resistant fat deposits with a tube and vacuum device. Can be performed using the tumescent technique , in which targeted fat cells are infused with saline containing solution with a local anesthetic before liposuction to reduce post-operative bruising and swelling. Common locations for liposuction include chin, cheeks, neck, upper arms, above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles. For larger volumes of fat or for fibrous body areas, ultrasound-assisted lipoplasty (UAL) may be used. UAL is a new technique in which a ultrasound probe is inserted beneath the skin to "liquify" the fat before it is suctioned.
Length:	1 to 2 hours or more. UAL : 20-40 percent longer than traditional liposuction.
Anesthesia:	Local, epidural, or general.
In/Outpatient:	Usually outpatient. Extensive procedures may require short inpatient stay.
Side Effects:	Temporary bruising, swelling, numbness, soreness, burning sensation. Tumescent : Temporary fluid drainage from incision sites. UAL : Larger incisions for cannula.
Risks:	Asymmetry. Rippling or bagginess of skin. Pigmentation changes. Skin injury. Fluid retention. Excessive fluid loss leading to shock. Infection. UAL: thermal burn injury caused by the heat from the ultrasound device.
Recovery:	Back to work: 1 to 2 weeks. More strenuous activity: 2 to 4 weeks.
Full Recovery from Swelling and Bruising :	1 to 6 months or more. Use of tumescent technique or UAL may decrease post-operative bruising and swelling.
Duration of Results:	Permanent, with sensible diet and exercise.

MICRODERM ABRASION
Procedure:	Mechanical scraping of the top layers of skin using a high-speed rotary wheel. Softens sharp edges of surface irregularities, including acne and other scars and fine wrinkles, especially around the mouth.
Length:	A few minutes to 1 hour. May require more than 1 session.
Anesthesia:	Local, numbing spray, or general.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary tingling, burning, itching, swelling, redness. Lightening of treated skin. Acute sensitivity to sun; loss of ability to make pigment (tan).
Risks:	Abnormal color changes (permanent). Tiny whiteheads (temporary); infection; scarring; flare-up of skin allergies, fever blisters, cold sores.
Recovery:	Back to work: 2 weeks. More strenuous activities : 4 to 6 weeks.
Fading of redness :	about 3 months. Return of pigmentation/sun exposure: 6 to 12 months.
Duration of Results:	Permanent, although new wrinkles may form as skin ages.

NOSE RESHAPING (Rhinoplasty)
Procedure:	Reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May also relieve some breathing problems. (May be covered by insurance.)
Length:	1 to 2 hours or more.
Anesthesia:	Local with sedation, or general.
In/Outpatient:	Usually outpatient.
Side Effects:	Temporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness.
Risks:	Infection. Small burst blood vessels resulting in tiny, permanent red spots. Incomplete improvement, requiring additional surgery.
Recovery:	Back to work: 1 to 2 weeks. More strenuous activities : 2 to 3 weeks. Avoid hitting nose or sunburn : 8 weeks.
Final Appearance:	1 year or more.
Duration of Results:	Permanent.