| Each surgical procedure we offer
can be applied separately or they can be combined to give
you the best possible cosmetic result.
Remember that the goal of facial cosmetic
surgery is improvement, not perfection. The facelift surgery
diminishes jowls and improves neck contour. It does not
restore your appearance of 20 years ago when the elasticity
of your skin was tighter. The same concept occurs in rhinoplasty
where the goal is improvement not perfection. Each of
my patients heal at a different rate and with different
healing processes, thus all patients heal differently
even if they have had the same operation(s).
Revisional Surgery is more complex
to perform as there has been scarring and changes under
the skin. If you can, bring your preoperative photos or
snapshots as well as the operative notes from the previous
surgeon. This will help in the assessment of your condition
which will lead to an accurate understanding of what type
of surgical changes are possible to get the best improvement.
Some of the Anti-Aging Techniques
can be considered as steps to slow the aging process.
Skin care maintenance is important to keep your facial
skin as health as possible.

Droopy and heavy eyebrows are early
signs of aging where the skin under the brow descends,
making the eyes appear smaller. Frowning may result in
a tense angry look.
This is corrected with a forehead lift, which is performed
endoscopically through tiny incisions in the hairline.
There may be minimal bruising afterwards and patients
are socially acceptable in 2 weeks.


Excessive skin and fat of the upper
eyelids causes the eyes to look puffy, hooded, and small.
Often there is wrinkling and fat bulges in the lower eyelids
that show up as "bags under the eyes". The laser
is used as a precise cutting tool, which removes the fat,
skin and muscle of the upper lids with minimum bruising
afterwards. The fat from the lower lids is removed from
behind the eyelid so that there is no scar. The wrinkling
can be improved with excision of the extra skin, or with
laser resurfacing to shrink and smooth the lower eyelid
skin. 

This is our most popular surgery;
many people do not like their nose.
Daughters often inherit their father's nose and want their
noses reduced in size or their tip raised so the nose
harmoniously and naturally fits the face. Some want their
nasal bridge built up and the nasal tip width narrowed.
Rhinoplasty is choosing the right surgical steps to give
the most satisfactory result to the patient. Recovery
period is 2 weeks.


Collapsed mid face with shrinkage
of the cheek mound leads to a haggard drawn appearance.
This starts to occur in the forties. It is corrected through
a small incision in the upper gum line where a mid face
implant is inserted giving a more youthful appearance
to the cheeks. Recovery from this surgery is quick, and
most patients can be socially acceptable in 2 weeks.

High cheekbones are essential for
good facial harmony and they give the face a nice attractive
chiseled look. Flat cheekbones emphasize the fullness
of the midface. If you wish you had the "high cheekbone"
look as seen in many models, these implants will help.
These are inserted through a small incision in the upper
gum line and placed over the cheek bone to enlarge and
raise the malar prominence. Recovery from this surgery
is quick, and most patients can be socially acceptable
within 1 week.

Deep lip cheek grooves consist of
a valley and a hill on the outside of the valley. The
simplest technique to correct the problem is to insert
Gore-Tex or other permanent fillers through the nose down
the bottom of the valley, filling it in, making the groove
less deep. A cheek mount lift can also be used to pull
up the hill outside the groove. If there is no bruising
patients recover within days.

These depressions start at the corners
of the mouth and make the mouth appear to turn down. The
addition of a permanent 3-Dimension volume filler such
as Gore-Tex or AllodermTM is successful in decreasing
the depth of the groove. Following surgery there is some
swelling that settles quickly, but by 1 week patients
look presentable.

Fallen cheek mounds result in deep
lip cheek grooves. Lifting the cheek mound is performed
through an incision in front of the ear or beside the
eye and the mound is lifted and repositioned in a more
lateral and upward position thus lessening the depth of
the groove. Sometimes Gore-TexTM and other permanent fillers
are inserted in the valley of the groove (See lip cheek
grooves).

Some ethnic groups as well as Caucasians
have lips that are too full. Usually it is the lower lip,
but can be the upper lip. A small amount of the inner
part of the lips is removed to reduce the vertical height
of the red lip. Post operatively, there is some swelling
but in 2 weeks most patients are socially acceptable.

There are 3 problems that occur with
the aging lip:
1. Lips become thin.
2. Upper lips become wrinkled.
3. The upper lip elongates or lengthens.
As we age the vertical height of the
red lip thins and the arch of the lip line flattens. Some
people are born with thin lips. Augmentation or enlarging
lips can be permanent or temporary. A lip augmentation
test allows Dr. Ellis to create the desired size of the
lips the patient wishes. Permanent augmentation is performed
with the insertion of Gore-TexTM or the use of a permanent
injectable filler. For temporary augmentation, collagen
or hyaluronic acid fillers are used. Wrinkled lips are
treated with the laser (See laser resurfacing). A long
white upper lip is treated with a subnasal lip lift where
the scar is hidden under the nose.


Some patients have weak chins that
need to be moved forward to give a stronger chin profile.
The insertion of a wrap around implant can project the
chin and give it some width so that it does not become
too pointy. The implant is inserted with a tiny incision
under the chin. Patients recover within 2 weeks.


Some patients have chins that appear
too large for facial harmony. To reduce the chin, an incision
is made in the lower dental gum area inside the mouth.
There is a fair amount of swelling postoperatively, but
most patients look presentable in 2 weeks.

For the younger patients who have
localized areas of fat in the front of their necks or
under the jaw line, liposhaving is an excellent technique
where the fat is nibbled and vacuumed away. Depending
on the volume of fat, no skin tightening procedure is
required as the skin is young enough to shrink by itself.
The resulting contour becomes more natural.


Some patients do not like narrow jaws
where the angle is too soft. Some like the angle to be
well defined giving a chiseled look. These implants are
placed through the mouth outside the boney jaw and placed
at the angle where they become locked in place. There
may be more swelling with these implants and it may take
2 weeks to look socially acceptable.

This surgery is a procedure used to
"pin back" or reposition protruding ears. This
problem frequently causes deep emotional scarring rather
than physical impairment in the younger child just going
to school and often goes unnoticed by parents. "Twilight"
anesthesia is used for adults and a general anesthetic
is used for children. There is little discomfort with
this surgery.

Aging produces sagging of the cheeks,
jowls, and neck. Patients can wait until the sagging is
significant or start earlier as preventative maintenance
so that sagging does not become too obvious and the changes
are subtle. The skin and the deeper tissues are elevated
and pulled back with the excess skin being removed. This
surgery can be divided into 3 sections: the neck, the
jaw line, and the cheek mound. The surgery requires repositioning
of the deeper structures under the skin to return to a
more youthful appearance. The localized areas of jowl
fat can be vacuumed away with liposuction or liposhaving.
Recovery can be as prompt as 2 weeks depending on how
extensive the surgery was.


With aging, ear lobes become too big.
Ear lobe reduction is most often performed at the same
time as a facelift surgery, but can be performed as an
isolated single procedure. Recovery is quick with minimal
bruising.

There are some patients who have had
previous cosmetic surgery who have not had a satisfactory
result.
With years of teaching and experience, Dr. Ellis can analyze
the current problems and suggest what surgical techniques
might be needed to get an improved result.
Most cases of revisional surgery occur
as a result of steps that were not performed, steps that
were performed with too much or too little removed, or
cases where there was an abnormal healing process that
took place. Careful analysis by Dr. Ellis with the original
photos or snap shots and, if possible, the previous operative
notes performed by the surgeon will lead to the understanding
of the patient's cosmetic and structural problems and
what surgical techniques are best used to improve these
problems.


Further surgery by Dr. Ellis will
lead to an improvement of the problems but perhaps not
full resolution of all the problems. Although perfection
is the goal, it is not always attained! However, Dr. Ellis
guarantees he will do his best to maximize the surgical
result.
If you have had problems with a surgical
result, Dr. Ellis would like to offer his expertise in
facial plastic surgery to help you solve your problem.
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