It is common for the brows to slowly descend with age. This can obstruct vision, create forehead wrinkling and lead to a tired or angry appearance.
Many patients who seek eyelid surgery – either to freshen their appearance or clear their vision – would in fact benefit greatly from a brow lift. Eyebrow beauty ideals vary greatly between different cultures, ages, genders and styles. However in men the height of the brow should typically be at the upper bony margin of the eye socket and in women a few millimeters higher. When the brow descends below this level it can contribute to sagging of the upper eyelids and contribute to visual obstruction. Subconscious efforts to raise the brow deepen forehead wrinkles. The overall effect is an angry, tired or aged appearance in both the forehead and eyes.
Brow lift surgery can be done either endoscopically, using a small camera and keyhole incisions, or through longer incisions hidden in the hairline if extra lifting is required. Is it a procedure that may be offered alone, but is often combined with either eyelid surgery or a facelift for more complete facial rejuvenation. I perform brow lift surgery under general anaesthetic in fully accredited operating theatres, either as a day only or overnight stay, depending on whether other procedures are being done at the same time.
Skin incisions are hidden within the hair or natural creases. These will heal and the majority of swelling resolve within two weeks. Strenuous exercise or heavy work should be avoided during this time. The result may continue to improve for three months.
The effects of ageing can be problematic around the eyes, creating a constantly tired look and interfering with your vision.
Over time both upper and lower eyelids may develop sagging skin, weakening of the supporting structures and bulging of muscle or fat pads. In the upper eyelids weakening of the muscles and excess skin can bring the lid down and obstruct vision. Many people with this problem compensate by wrinkling their forehead and trying to elevate their brows. Both men and women are commonly affected.
Blepharoplasty is surgery to correct the position and function of the eyelids. The goal is to restore clear vision and create a refreshed appearance. Procedures vary considerably between the upper and lower eyelids. Requirements in the upper lid may be only to recreate normal folds, or may include the removal of excess skin, muscle and fat and the repair of stretched or weakened muscles. In the lower lid the focus is on ensuring correct positioning of the eyelid relative to the eye, eliminating any heavy bags or creases at the eyelid-cheek junction and restoration of youthful cheek volume and projection.
Upper eyelid blepharoplasty may be deemed medically necessary when visual obstruction is present and confirmed by an optometrist or ophthalmologist. This procedure therefore attracts some rebates from Medicare and private health funds. If you wish to check your fund’s coverage the MBS item number is 45617. Lower eyelid blepharoplasty unfortunately does not qualify for any rebates. Both procedures may provide you with a natural and refreshed appearance when done well.
Minor blepharoplasty is offered under local anaesthetic in the office. More extensive procedures require sedation and are performed in fully accredited private hospitals. Only a day stay is necessary.
I recommend two weeks off work and exercise, to allow bruising and swelling to settle. Sutures are removed in the first week, by which time the scars are already difficult to see. After several months the scars fade into natural skin creases and become almost imperceptible.
Rhinoplasty is surgery to reshape the external nose. It may be combined with procedures to open the airway and improve breathing. Every nose is different and everyone’s goals of surgery are unique. Every rhinoplasty must therefore be personalised and precise.
Changes that can be made include reductions in the size or width of the nose, removal of unwanted humps, reshaping of the tip, or rebuilding collapsed noses.Whether you have been injured, have had your nose damaged by disease, or simply do not like it’s shape, I can assist you. As a plastic surgeon specialising in cosmetic and reconstructive procedures I am ideally placed to deliver a result that is both attractive and functional.
I perform all rhinoplasty procedures under general anaesthetic in fully accredited private hospitals. Incisions may be entirely inside the nose, or hidden at the base. Depending on the extent of the procedure you may be able to go home the same day, or may benefit from an overnight stay.
I recommend two weeks off work, to allow bruising and swelling to settle. Strenuous exercise should be avoided for four to six weeks. Sutures, if present, are removed in the first week, by which time the scars are already difficult to see. The result may continue to improve for up to three months.
Natural ageing results in weakening of the soft tissues, loss of volume and wrinkling of the skin. In the face and neck these changes can be particularly apparent. In some people these changes are slow and subtle. In others they can be more extreme, occur early, and result in an outward appearance that doesn’t reflect the way they feel, think or live their lives.
Face and neck lift surgery can reverse many of these changes. Descending cheeks and jowls can be smoothed and lifted, neck bands can be removed and the angle between the chin and neck can be restored. The trade-off is fine scars placed in the hairline and the crease in front of the ears. When a lift has been performed well these are subtle and should be barely perceptible.
There are different face and neck lift techniques available. Less invasive procedures require shorter incisions and less downtime, but achieve less dramatic effects.
Short scar (or mini) facelifts use smaller incisions to improve the cheeks and jawline. Some skin tightening is achieved but the neck is not significantly altered. This procedure has a faster recovery, but a more focused effect. It is most suited to younger people without significant signs of ageing or excess skin in the neck region. Lower face and neck lifts require incisions around the lower portion of the ear and sometimes under the chin. Through these, the lower face, jawline and neck may be recontoured. A full facelift addresses significant ageing and skin laxity throughout the cheeks, jowls and neck.
Depending on your needs and goals, face and neck lifts may be combined with a brow lift, blepharoplasty, rhinoplasty, facial fat grafting or other facial contouring procedure to completely refresh your appearance.
I offer short-scar facelifts, lower face and neck lifts, or full facelifts. These may be combined with other procedures as part of a holistic facial rejuvenation strategy. Face and neck lift procedures are performed under general anaesthetic in fully accredited private hospitals. An overnight stay is usually required.
I recommend two weeks off work, to allow bruising and swelling to settle. Strenuous exercise should be avoided for four to six weeks. Sutures are removed in the first week. Scars may be slightly pink in the first few weeks but then fade, becoming barely perceptible. The result may continue to improve for up to three months.
Otoplasty is surgery to reshape or reposition the ears. This is most commonly performed to correct prominent ears, but can also be done to correct abnormally shaped or sized ears, or those disfigured by trauma. Prominent ears can be the result of a combination of slight alterations in the way the ear has formed. The folds may not have formed correctly, there may be too much cartilage, or the angle between the ear and the head may be too wide. Whatever the cause, a correction can be tailored to set your ears – or your child’s ears – back into a more natural position.
The best time to consider correction of prominent ears is after they have reached full size. This usually happens around the age of five or six. At this stage parents may consider offering correction to their children before starting school, to prevent the teasing that unfortunately often occurs. In other instances it may be best to wait for the child to ask about their ears, as they may never cause concern.
After childhood, the next best time to consider ear correction is once you are fully-grown and decide it is something you wish to change. While the procedure is best carried out at a younger age, it is certainly still possible in adulthood. It is important to note however, that in Australia Medicare and private health insurance rebates only apply if prominent ear correction is carried out before the age of 18. If you wish to check your insurance coverage, the applicable MBS item number is 45659.
I perform otoplasty as a day procedure, under general anaesthesia, in fully accredited private hospitals. The incisions required are hidden behind the ears. The two main techniques used to correct prominent ears involve either shaping the existing cartilage, or repositioning the cartilage using permanent sutures. I use a combination of both of these techniques, varied to best correct your exact problem.
After surgery you will be placed in a head bandage that is left in place for seven days. Usually post-operative discomfort is very mild, and most swelling has resolved after two weeks. The skin sutures are dissolvable and hidden. After your bandages are removed some small tapes are placed on the incisions and you are asked to wear an elastic headband to protect your ears while sleeping for up to six weeks.
Facial contouring describes a broad range of procedures. These may be done to enhance one particular feature, to improve symmetry and balance, to reverse the signs of ageing or to bring your outward appearance in line with your inner identity and gender.
There are various techniques that may be used to optimise facial contours. Injectable fillers are a minimally invasive option that can temporarily enhance features or correct contour problems. Alternatively, fat transfer provides natural and long lasting filler. In this process your own fat is harvested by liposuction, purified then placed where required. This creates soft, natural volume that also has the power to rejuvenate the overlying skin.
Stronger structures, such as the brow, cheeks and chin can be altered either by reshaping the underlying bone, or placing customized implants. Such procedures are an effective way to create dramatic change, such as permanently correcting a receding chin.
Facial contouring may be required to target one specific problem, or may be used as part of a broader strategy for effective facial rejuvenation. If there is something about your appearance that you don’t like, or isn’t consistent with how you view yourself, then please come for a consultation to discuss possible solutions.
Small enhancements or corrections may be achieved in office with the use of injectable temporary fillers. More dramatic or permanent transformations may be achieved through a variety of procedures such as facial fat transfer, facial implant placement or facial bone remodeling. Depending on the procedure and your goals this may be offered under local or general anaesthetic, and may be a day only or overnight hospital stay. All invasive procedures are performed in fully accredited operating facilities.
Office injectables may result in a small amount of swelling and bruising that resolves within days. No time off work is usually required. More invasive facial surgery will usually require several weeks of downtime. During your consultation I will provide information specific to your procedure regarding the expected scars, anticipated extent of bruising and swelling and required time off from work and exercise.