Face aesthetic surgery represents a separate chapter of plastic surgery. There are many surgeries performed on the face on daily basis in order to make it younger, more beautiful, more symmetrical, or to correct irregularities or deformities.

There are minimally invasive methods which are simple, do not last long and achieve effective results (dermabrasion, fillers, eyelid surgery, lipofilling), as well as more demanding ones which fully lift the facial skin (face-lifting, neck lifting and forehead lifting) or change the nose shape (corrective rhinoplasty).

(Corrective rhinoplasty)

Objective

Changes in size and shape of the nose (marked nose bridge-aquiline nose, too long, too wide nose, widened or asymmetric top, bent nose top, saddle nose), as well as correction of possible respiratory disorders, or septum deviation.

Operative technique

The correction is performed through the incisions inside the nostrils, so there is no external visible scar. The procedure consists of changing the shape and position of the nose cartilage and bones. Upon the intervention performed, tampons are placed in the nasal corridors, and a compressive mask on the nose from the outside, which are all removed after seven days.

Duration of procedure and anaesthesia

The surgery usually lasts from 45 min to 2 hours and is performed in total anaesthesia, or in local an aesthesia with intravenous sedation.

Recovery

The patient breaths through the mouth until the removal of the tampons and the mask, while in the meantime the swelling withdraws up to the greatest extent.

Rare complications

Swellings around the eyes and the surrounding tissue.

Septoplasty

Septoplasty is a surgery by which the nose septum is corrected with a view to improving the nose function. It can be performed independently, as well as within the aesthetic nose correction. The nose septum is an osteocartilaginous barrier that divides the nose cavity into two equal parts. The cause of septum deviation is not fully clarified. These can be nose traumas that happen even during the childbirth or n the childhood or due to the pressure on the nose septum due to the erect walk. The intervention is not performed in children, as the nose growth is not completed, except in extreme deviation symptoms.

The most common symptoms of the nose septum deviation are: difficult breathing through nose, nose congestion, frequent nose bleedings, repeated sinusitis, headaches, vertigo.

The surgery includes a removal of the deformed parts of the nose septum and placing the septum in the right position. After the surgery, the patients have tampons in their nose for 2 days. Unlike the septorhinoplasty, the patient does not have any swellings or suffusions. After the removal of the tampons, a care is required for several days more in terms of nose cleaning and use of vasoconstrictive nasal drops.

(Blepharoplasty)

Objective

Removal of the excess of the loose skin and fat tissue of the upper and lower eyelids, or correction of eye bags; correction of the upper and lower eyelids can be performed together or as separate procedures.

Operative technique

By the previously marked drawing, the excess skin and fat tissue of the upper eyelid gets elliptically removed with the scar in the eyelid fold. The incision on the lower eyelid goes immediately under the eyelashes, and if there is no excess skin, the fat tissue is removed via conjunctive on the inner side of the eyelid, i.e. without the external scar.

Duration of procedure and anaesthesia

The surgery is performed in local anaesthesia in duration of 30 minutes for the upper eyelids and 45 minutes in general anesthesia for the lower eyelids.

Recovery

24 hours after the surgery it is necessary to put cold compresses onto the eyelids. The suture is removed in 6-7 days.

Rare complications

Swellings of the eyelids and suffusions that last 5-7 days; impossibility of full closing and eye leaking are temporary phenomena.

(Otapostasis)

Objective

Reduction of the angle between the earlobe and the head and correction of the earlobe shape.

Operative technique

The procedure consists of removal of the excess skin behind the ear and re-shaping of the earlobe cartilage until the achievement of the normal contour and angle between the earlobe and the head.

Duration of procedure and anaesthesia

The surgery is performed in local anaesthesia and lasts around one hour (both sides). If needed, in smaller children that are not mentally prepared, it can be performed in total anaesthesia as well.

Recovery

The bandage is removed after seven days and the suture after two weeks.

Rare complications

Transitory earlobe swelling and even rarer suffusions

Objective

Improvement of the shape of the lower third of the face and neck (especially the profile), by removing the fat deposits under the lower jaw and the chin.

Operative technique

Through smaller prick incisions on the skin under the lower edge of the chin, an infiltration of the physiological solution with anaesthetics is first performed, and then with special thin cannulas (up to 3 mm in diameter) the fat tissue aspiration is performed.

Duration of procedure and anaesthesia

The surgery is performed in local anaesthesia in duration of 15-20 minutes.

Recovery

After 2-3 days, removal of the elastic compressive bandage, as well as return to normal activities; an early post-operative massage is recommended.

Rare complications

Transitory occurrence of bruises and mild swelling.

Botulin toxin

These are the protected trade marks of the purified forms of the botulinum toxin type A, which is a product of the bacteria Clostridium Botulinum. When injected in certain facial muscles in very small doses, it blocks the nervous impulses of these muscles whose movements bring to the appearance of the wrinkles. This is the most frequent cosmetic procedure in the United States of America.

Objective

Correction of the existing and prevention of appearance of new wrinkles around the eyes, on the forehead and between the eyebrows; this preparation relaxes the muscle and prevents its contraction, leaving the skin smooth and not wrinkled. This does not ’’freeze” your face, because it acts only on specific muscles, leaving the surrounding ones to function normally.

Manner of performing

After the dissolving and precise marking of several spots on the face, the preparation is injected by means of the finest (insulin) needle under the skin, i.e. into the muscle. The sensation of pain at injecting is minimal and is prevented by previous skin cooling. The application of the local anaesthetic is not necessary. The return to regular activities is possible immediately after the intervention. The procedure lasts around 15 minutes, the effect begins after 2-3 days, and full effect is achieved after 7 days.

Transitory side-effects

Redness, skin itching, mild swelling and appearance of haematomas (bruises) and in some cases temporary weakness of the surrounding muscles; in rare cases mild and temporary droop of the upper eyelid or eyebrow, that lasts 1-2 weeks.

The procedure is not recommended during pregnancy or lactation, during the therapy with Aspirin (acetylsalicylic acid) and in some nervous or muscle disorders. The effect lasts for 3-5 months or longer and it can be repeated after 6 months. Clinical studies show that duration of effect is prolonged after subsequent administrations of the preparation, so that in the future the frequency of treatments is reduced, and the effect is still maintained.

Objective

Improvement of contours and enhancing of thin lips, as well as correction of asymmetry.

Operative technique

The lips can be enhanced with the own tissues, such as fat tissue (most frequently), dermis, scalp tissue, part of the muscle or tendon, or by injecting synthetic materials (hyaluronic acid and other).

Duration of procedure and anaesthesia

Lip enhancement with the own fat tissue is performed in local anaesthesia, in duration of some 20-30 minutes, while for injecting of synthetic materials anaesthesia is not needed, as it is performed with very thin, insulin needle.

Recovery

It is required to abstain from stretching the lips, laughter and over-talking one day after the intervention. Considering the unpredictable degree of absorption of the fat tissue and collagen, withdrawal of the part of the synthetic materials into the surrounding tissues, it is possible that the procedure should be repeated after some time in order to obtain a better and more durable result.

Rare complications

Mild lip swelling.

Objective

Removal of bumps and damages of the skin, such as scars from acne and measles, post-traumatic and surgical scars, seborrheic keratosis, shallow tattoos, blotchy pigmentations and fine lines. Thus the skin becomes softer, lighter and tighter, free from bumps, enlarged pores, scars and fine wrinkles around the mouth and the eyes.
Operative technique

Dermabrasion

It is performed manually or by means of a device with the so-called abrasive cylinders which remove the damaged superficial skin layers with rotation.

Chemical peeling

Application of acids of various types and concentrations on the facial skin (phenol, fruit acids, trichloroacetic acid, etc.).

Coblation® (controlled ablation)

A cutting-edge treatment of the damaged facial skin with the device that removes the superficial skin layers by high-frequency radio-waves, in a very controlled manner; it successfully substitutes the laser treatment which often has unpredictable effects and requires a long recovery.

Upon the finished procedure, an antibiotic Vaseline gauze, followed by the layer of wet and dry gauzes, or some special means, are placed onto the treated area.

Duration of procedure and anaesthesia

Dermabrasion and Coblation are performed in local anaesthesia (5% anaesthetic cream) in duration of some 30-40 minutes, depending on the area of the skin treated, while chemical peeling is performed in mild sedation.

Recovery

Within maximum seven days, gradual removal of all the bandages and gauzes from the face; make-up can be used two weeks after the intervention, and in the following several months the skin should obligatorily be protected from the sun.

Rare complications

Mild swelling and skin redness; hyper-pigmentation of the treated regions can occur in case of overexposure to the UV rays.

Objective

Lifting of the drooped eyebrows in whole length or just their external part.

Operative technique

In case of eyebrow lifting in whole length, three minor pricks on the skin of the upper eyebrow edge are made, where thin threads are drawn under the forehead skin up to the hairy part of the head and fixed there. In lifting just the external part of the eyebrows, one minor prick on the skin per eyebrow is sufficient. The surgery can be performed as independent or within face and eyelid lifting.

Duration of procedure and anaesthesia

The surgery is performed in local anaesthesia and lasts some 30 minutes.

Recovery

Avoiding of forehead mimics for several days, return to the usual activities the day after.

Rare complications

Mild eyebrow asymmetry; in the first days, the eyebrows look a little over-lifted, but very soon come to the desired level.

Objective

Lifting of the loose forehead skin, correction of long horizontal and vertical wrinkles on the forehead and between the eyebrows, as well as eyebrow lifting

Operative technique

The incision is made in the hairy part of the head between the upper poles of the earlobes, the entire skin is liberated up to the eyebrows, and its excess is removed with the previous neutralisation of the muscles which corrugate the forehead. It can be performed as separate procedure or together with face-lifting surgery.

Duration of procedure and anaesthesia

The procedure lasts some 2 hours and is performed in total anaesthesia.

Recovery

Washing the hair and return to normal activities after 2-3 days, while the sutures are removed between the day 10 and 15.

Rare complications

Mild swelling and rare suffusions on the forehead

Objective

Correction of the receding chin by embedding a silicone implant

Operative technique

The incision of 3-4 cm in length is made on the mucosa of the inner side of the lower lip, along the lower edge of the gums, the sin and subcutaneous tissue are separated from the central part of the lower jaw and the semi-arched silicone implant is placed into the formed space. The external approach with the horizontal incision under the chin is also in use.

Duration of procedure and anaesthesia

The operative intervention most frequently lasts around 30 minutes and is performed in local anaesthesia.

Recovery

The sutures are self-absorbing. Mild disinfection of the oral cavity with hydrogen and chamomile for several days.

Rare complications

Chin swelling and mild suffusions; moving of the implant can also occur.

Golden threads are ecologically clean material which stimulate creation of elastic fibres in the organism and thus performs skin lifting. This is a painless and bloodless surgical-cosmetic rejuvenation procedure which substitutes face-lifting.

Objective

Lifting of the not too loose facial skin.

Operative technique

By the previously marked spots in form of net, the 24-karat golden threads of 0,1 mm of thickness are drawn under the skin. Visible results are expected in the period from several weeks to three months, which is the period that the organism needs for creation of elastic and collagen fibres around the threads themselves.

Duration of procedure and anaesthesia

The intervention is performed in local anaesthesia and lasts up to 30 minutes.

Recovery

The patient goes home right after the intervention.

Rare complications

Mild swelling that last for several days and can be concealed by make-up.