Facial Rejuvenation Procedures

Facial rejuvenation procedures are those that restore the face to a more youthful appearance. Genetic factors and also damage by the sun are two reasons why patients consider facial rejuvenation procedures. Both surgical and non-surgical options are available, and they may not be suitable for all patients. Please contact Dr. Fortes for a consultation to determine if you are a candidate for facial rejuvenation.

Non-surgical techniques for facial rejuvenation include: BOTOX® injections, microdermabrasion treatments, collagen injections and fat grafting.

Surgical techniques for facial rejuvenation include: blepharoplasty (eyelid surgery), endoscopic brow lifts, face lifts, facial implants and ear procedures.

BOTOX® Injections

BOTOX® ( Allergan Irvine , CA ) is purified Botulinum Toxin Type A, which is produced by the bacteria Clostridium botulinum. BOTOX ® is used to treat wrinkles that appear on the forehead and mouth, as well as the "crow's feet" that appear in the corners of the eyes. In April 2002, BOTOX® Cosmetic was approved by the FDA. BOTOX® injections have become the fastest growing cosmetic procedure performed by plastic surgeons, with more than 1.6 million people undergoing treatment in 2002 alone.

Dr. Fortes administers BOTOX® injections on an outpatient basis. The procedure usually lasts about ten minutes. There are ten groups of muscles in the face and scalp that contract to express emotions, but only a few of these muscles are targeted for BOTOX® treatment to reduce or eliminate wrinkles. Natural facial expressions are preserved during treatment.

First, Dr. Fortes will identify the areas for planned injections using a unique marking pattern, and he then will cleanse the skin with alcohol and cool it with an ice pack. He will use a tiny needle to make the injections - the pain should feel less than that of a bug bite in most cases. The ice pack is kept on the treated areas to prevent bruising.

The effects of BOTOX® can be noticed about three days after the treatment, and the results can last for about three months in most cases. Side effects of the treatment are usually minimal and may include bruising at the injection site and/or headaches. Very rarely, a BOTOX® injection may cause a temporary weakness of the muscle that opens the upper eyelid when a treatment is performed between the eyebrows. This will correct itself when the effects of BOTOX® wear off.

Contact Dr. Fortes today to determine if you are a candidate for BOTOX® treatment.

Microdermabrasion

Microdermabrasion is a non-surgical, non-invasive method of skin rejuvenation that offers a safe and controlled skin abrasion process to correct fine lines, wrinkles and hyperpigmentation, as well as improve aging and sun damaged skin. During microdermabrasion, medical-grade microcrystals are propelled at a high rate of speed across the skin's surface to restore a more youthful appearance.

The massaging action of the microdermabrasion treatment cleanses below the skin's surface, resulting in a vibrant and healthy appearance and complexion. Microdermabrasion works well on all skin types and is perfect for removing dead skin cells from dry skin and unclogging pores on oily skin types.

After the treatment, a cooling facial mask is applied to sooth and refresh the skin. A microdermabrasion session can be performed in less than an hour and results are seen immediately. This procedure requires no recovery time.

Collagen Replacement

Collagen is a substance that occurs naturally in the second layer of skin. It supports the skin and also the growth of cells and blood vessels. With time and the constant stress of smiling and squinting, collagen breaks down and causes wrinkles and lines to form. In most cases, collagen lost to wrinkles and lines can be replaced with a series of injections under the skin using Purified Bovine Collagen (creams that have collagen in them only serve as moisturizers and can do nothing to replace lost collagen under the skin).

A series of collagen injections takes less than one hour and can be performed on an outpatient basis. The number of injections is determined by your age and skin condition.

Side effects include minimal redness at the injection sites and swelling, but these symptoms usually last for a few hours after treatment. The results of collagen injections last about three months.

Dr. Fortes will determine if you are a candidate for collagen replacement and what regimen will work best for you.

Fat Grafting

"Fat grafting" is a procedure that uses a patient's own fat tissue to fill-in creases, lines and depressions that appear in certain areas of the body, such as the buttocks.

Fat grafts are used to plump the lips, reduce the appearance of "laugh lines" and improve a person's profile by lifting the cheeks and strengthening the chin. Most fat is taken from a patient's abdomen or inner thigh and then carefully grafted and injected into the designated areas.

Depending upon the patient and the area grafted, fat grafts can last anywhere from several months to several years. Most of these procedures are performed under general anesthesia, and require minimum recovery time. Dr. Fortes will discuss with you all associated risks and benefits of this procedure.

Blepharoplasty (Eyelid Surgery)

Eyelid surgery, or blepharoplasty, is recommended for healthy adults of any age who suffer from droopy eyelids or heavy bags under their eyes. Dr. Fortes will evaluate your medical history to determine if you are a candidate for this type of facial surgery.

Blepharoplasty involves incisions being made in the creases of your upper eyelids and just below the lashes in your lower eyelids, so that underlying fat and excess skin are removed, eliminating the dropping appearance.

Eyelid surgery usually takes between one to three hours as an outpatient procedure under general anesthesia. The incisions are closed with fine sutures designed to leave nearly invisible scars. The sutures are removed in about one week, and scarring is usually minimal after three weeks and undetectable in six months. Most patients can return to work in five to seven days and can begin strenuous activities in about three weeks.

Contact Dr. Fortes to learn more about eyelid surgery, including transconjunctival blepharoplasty, during which skin is not removed and the incision is made inside the lower eyelid. If droopy eyelids impair your vision, check with your health care provider to determine if this procedure is covered by insurance.

Endoscopic Browlift

For patients who suffer from drooping eyebrows, frown lines and wrinkles across the forehead, Dr. Fortes may recommend an endoscopic browlift, during which he uses an endoscope (a device with a small camera attached) to reposition the forehead muscles. With the endoscope, three or more small incisions are made just at the hairline or in the upper forehead wrinkle. Patients are left with no visible scars, and stitches can be removed in seven to 10 days.

Dr. Fortes will determine where the incisions are placed depending upon the position of your hairline. The brow lift also elevates the eyebrows and helps to minimize the "crow's feet" that appear in the corners of the eyes.

Endoscopic brow lift is a two-hour procedure that is performed under local or general anesthesia. Bruising and swelling is minimal, and patients normally return to work in seven to 10 days.

Facelift

A facelift (or rhytidectomy) provides total facial restoration by rejuvenating the forehead, eyes, cheeks, and sagging skin around the neck and chin.

Dr. Fortes will need to evaluate your skin and facial structure to determine if you are a candidate for a face lift, as well as for other procedures, such as endoscopic brow lift, eyelid surgery, fat grafts, laser resurfacing and rhinoplasty, which may be recommended in conjunction with a facelift. Facelift surgery usually takes several hours to perform. 

Facelifts begin with an incision being made at the temples just above the hairline. This incision is extended downwards in front of the ear, below the earlobe and behind the ear. Next, the skin of the face and the muscle is separated from deeper tissues. Dr. Fortes will tighten the underlying muscle and membrane and remove any excess skin. Sutures are used to close the incisions, and they should be ready for removal after about five days. Each patient's case will vary.

Most facelift patients usually experience some discomfort after surgery, but none that should be severe. You will want to minimize your movements in the first few days following surgery, and you also may be advised to keep your head elevated for a few days after surgery to help keep the amount of swelling down. Drainage tubes may be placed beneath the neck or behind the ears to minimize swelling during your initial recovery period.

Dr. Fortes will answer all your questions and address any concerns you may have before you undergo facelift surgery.

Facial Implants

Cheek and chin implants can enhance your facial appearance and also may help improve your self esteem. Young patients often wish to increase the prominence of their cheeks so these traits are better proportioned, while older patients may choose to have an implant placed in conjunction with another cosmetic procedure. Implants may also be selected to fill out a face that appears "sunken" or tired.

Ear Procedures

Dr. Fortes is skilled in the best techniques for repairing split ear lobes, reducing the signs of aging on the ears and correcting the shape of the ear.

Split earlobes usually occur as the result of the weight of heavy earrings on pierced ears or may be caused by trauma, such as an earring being pulled from the ear. Dr. Fortes can usually repair the earlobe in the office in about one hour using local anesthetic to reduce any discomfort. The split is stitched together with special sutures to minimize scarring. The stitches are removed in about four to five days, and ears may be pierced again in about three weeks.

A procedure called otoplasty is used to correct the shape of the ear, during which the shell shape of the ear and the fold can be sculpted or reshaped to create a more natural appearance.

Otoplasty is an outpatient procedure performed on both children and adults (a child's ears are almost fully grown by the time he or she is five years old). Local or general anesthesia is administered during the one to three hour surgery and stitches can be removed in one week. Postoperative bandages are applied to the head following surgery. Children recover in about one week, and adults usually return to work in about five days.

Ask Dr. Fortes about other ear surgery procedures, including those that are more advanced such as the formation of new ears.