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Facial Procedures •
Eyelid Surgery • Forehead/Browlift
• Ear Surgery
• Chin Surgery • Malar Implants • Facelift & Neck • Nose Surgery • Lip Enhancement • Laser Procedures
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Looking one’s best is a definite advantage in today’s world. A growing number of men and women are seeking facial plastic surgery to improve facial harmony, reverse premature signs of aging, or eliminate or minimize problems present from birth or caused by injuries or illness. The results of a subtle change or slight adjustment in facial appearance can improve facial balance along with improving a person’s self-confidence and sense of well-being from looking, feeling, and functioning at their best. Today’s cosmetic surgery and aesthetic procedures provide patients with the natural look they desire rather than the unnatural “pulled” look of yesteryear surgery. Many of these procedures require little down time, less cost, less risk, and can be performed at our surgical facility using local anesthesia. As with all facial rejuvenation procedures, good health and realistic expectations are prerequisites. A brief overview of procedures and corresponding links will answer some of your questions. For more comprehensive and detailed explanations, we welcome you to schedule a consultation with Dr. Bukachevsky for a personalized assessment of your specific needs and expectations.
Nose Surgery • Rhinoplasty Rhinoplasty is the surgical procedure for shaping the nose, a procedure that can make a noticeable difference by providing facial symmetry. This procedure can reduce or increase the size of the nose, remove an unwanted hump, change the shape of the tip or bridge, narrow the width of the nostrils, or change the angle between the nose and the upper lip. This surgery is also used to correct problems resulting from injury and can help relieve breathing difficulties by improving nasal function. In the procedure, incisions are made inside the nose, and in some cases, across the area of skin separating the nostrils. Bone and cartilage are sculpted or rearranged to provide a newly shaped nose making it harmonize better with other facial features. After surgery, a small splint is placed on the nose to protect and keep the nose stable for a few days. Some minor swelling and bruising of the nose and eyelids may occur the first day after surgery, and usually subsides within the first several days to a few weeks. A nasal dressing and splint are usually removed six or seven days after surgery. Whether the surgery is desired for functional or cosmetic reasons, during the presurgical consultation, the doctor will review photographs with you and discuss options available to evaluate what you can expect from a rhinoplasty.
Eyelid Surgery • Blepharoplasty / Forehead and Browlift • Browplasty Excessive skin around the eyes and wrinkling across the forehead can give a tired, angry, or sad expression on the face, which may not even reflect how we actually feel. The following procedures can provide a refreshed, youthful appearance to the eyes and forehead area. Blepharoplasty is the procedure that corrects droopy upper eyelids, and removes puffiness and bags under the eyes. In upper and lower eyelid surgery, incisions are made in the natural skin folds of the eyelids to remove loose skin, excess fatty tissue, and/or protruding muscle. Fine sutures are used to close the incisions, minimizing the visibility of any scar. In some cases, incisions can be placed on the undersurface of the eyelid resulting in no external scar. Forehead and Browlifts are procedures that alleviate sagging brows and diminish forehead wrinkles and deep furrows between the eyes. Incisions can be placed above the brow, at or behind the hairline for women, and above the brow or in the mid-forehead for men. The eyebrows are lifted to reduce the hooding of the upper eyelids. If the patient is balding or has a receding hairline, the incision will be made in the mid-forehead area to minimize scar visibility. Endoscopic techniques allow the procedure to be performed with smaller incisions placed behind the hairline. For a simple and temporary improvement of forehead lines, BOTOX® therapy is an effective cosmetic solution. The injectable procedure is safe, quick, and results last up to 4 months. For all surgical procedures, some swelling and bruising of the eyelids is expected, and usually subsides within a week. Sutures are usually removed within five days following surgery. For most patients, the recovery time for these procedures will not exceed a few weeks, although the doctor may advise you to avoid strenuous activities for longer periods.
Otoplasty is the surgical procedure used to reshape and modify the appearance of the ear, especially protruding ears. Children are the most likely candidates for otoplasty; however, the surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Successful otoplasty provides that the ears be in proportion to the size and shape of the face and head. Otoplasty will not alter hearing ability. The incision for otoplasty is behind the ear, in the natural fold where the ear is joined to the head. Portions of cartilage and skin may be removed, and shaped into a more desirable form. Permanent sutures are used to secure the new position. Soft dressings are applied to the ears and protect the ears for several days. After the surgery, mild discomfort along with minor swelling and bruising of the ears may occur, and usually subsides within a few weeks. A thin white scar is all that remains in the natural crease behind the ear, and is barely visible.
Chin Surgery • Mentoplasty / Malar Implants • Cheek Augmentation Mentoplasty is the surgical procedure used to
reshape the chin. A small, or receding chin, can make the nose appear
larger, whereas a prominent, or jutting chin can make the face look
off balance. Chin Reduction reduces the size of the chin, sculpting the bone to a more pleasing size. Incisions are made in the mouth or under the chin, and a shaping instrument is used to contour the facial bones. Cheek Augmentation, or malar implants, can eliminate the “sunken” appearance of the mid-facial area. Deep smile lines are smoothed out and the cheeks are elevated to a more youthful look. Small incisions are made inside the mouth, and a soft implant is placed over the cheekbone. Healing is rapid, and there are no external scars. Mid Facelift achieves similar results as cheek augmentation without the use of implants. After surgery, some discomfort is common, and can be controlled with prescribed medication. Bruising and swelling subside within the first few weeks. A liquid and soft food diet may be required for a few days after surgery.
Facelift • Rhytidectomy, Platysmaplasty and Submental Lipectomy Rhytidectomy is the surgical procedure that improves the lower face and neck, lifting the cheek, jaw line, and neck regions all in one process. Jowl pouches and folds around the neck and chin can all be modified in this single procedure, commonly known as the ‘facelift.’ Rhytidectomy is an effective rejuvenating procedure for an aging, tired face. The facelift incisions are hidden in the area of the sideburn around the ear lobe, and behind the ear. From these incisions, the skin is raised outward while the underlying connective tissue is repositioned and tightened. Some fat and excess skin may also be removed. Platysmaplasty, or the neck lift, and Submental Lipectomy, are procedures that shape and modify the neck area. Platysmaplasty helps to lift the neck and Submental Lipectomy removes fat under the chin, commonly referred to as a ‘turkey wattle’ or double chin. For both procedures, small incisions are made under the chin. After trimming excess skin, the incisions are closed with sutures. These procedures usually take from two to four hours. After surgery, a dressing is applied, and some mild sedatives may be prescribed for mild discomfort. Swelling and bruising subside within the first few weeks. Sutures are usually removed within the first week, and many patients return to their normal routines within several weeks. The facelift procedure is often combined with eyelid surgery and brow lift for the best overall result in facial rejuvenation. Additionally, the Thermage® procedure or Aluma™ Skin Renewal System can tighten the face without surgery, and safely improve the appearance of fine line and wrinkles around the eye area, lower face (jowls), forehead, and neck.
Laser Procedures and Resurfacing Surgery using lasers includes many procedures that can vaporize tumors, close blood vessels, reduce pigmentation, and treat skin wrinkles for smoother, fresher skin. Lasers make it possible to change tissue without making an incision. Laser surgery uses lasers to resurface sun damaged skin to reduce wrinkles around the lips, eyes, or the entire face, softening fine wrinkles, removing certain blemishes and smoothing the skin. Lasers work by producing a beam of energy that gently removes the skin tissue. The depth of laser resurfacing is dependent upon the type of laser, wavelength, power utilized, and pulse direction. Lasers have been used in cosmetic surgery for more than 20 years and have been proven to provide safe, predictable results. Alternative treatments such as deep chemical peels and dermabrasion have largely been replaced by laser procedures due to the precision and uniformity that laser resurfacing provides. Because laser resurfacing is so precise, Dr. Bukachevsky can tailor treatment according to the nature and extent of skin damage, skin type and your individual requirements for recovery time. Some patients may choose deeper resurfacing for its maximum effect, while others need only light resurfacing or desire a faster recovery. Whether you treat the whole face or specific areas, laser resurfacing does more than soften the appearance of imperfections. It can actually eliminate evidence or sun damage such as wrinkles and discoloration, and it can significantly improve depressions in the skin, such as acne scarring. If you have less photo damage, or if you desire a faster recuperation time, you may choose Fractional Resurfacing. CO2 Laser Resurfacing is a high-energy beam of CO2 light used to vaporize lines, wrinkles, scars, dark spots and other irregularities, layer by layer. This process also stimulates the formation over time of new, underlying collagen to provide better elasticity and support for the skin. The Bukachevsky Center uses the UltraPulse CO2 laser made by Lumenis, Inc., the world leader in lasers for 30 years. No other treatment option, including other types of lasers, surpasses the CO2 laser in its ability to diminish deep wrinkles. UltraPulse lasers have been used in over 400,000 procedures worldwide and are considered the gold standard in the industry. Active FX™ is an effective single treatment fractional laser resurfacing procedure using CO2 laser energy to treat fine lines, wrinkles, acne scars, and depressions, freckles and age spots. The treatment’s results are smoother, tighter, younger-looking skin, without patients undergoing the deep redness, general anesthesia, and lengthy downtime of traditional C02 laser skin resurfacing. Compared to other laser skin resurfacing “fractional” technologies, Active FX cuts procedure time in half; can treat the eye are; requires only one treatment; is less costly; and uses “established” CO2 laser technology. A complete face can be treated in a single treatment in less than 30 minutes, and the required downtime can be as short as four days, essentially a long weekend. DeepFX Fractional Laser treatments treat the deep layers of skin, but keep downtime to a minimum. With DeepFX Fractional treatments, deep wrinkles, skin texture and scars are dramatically improved after just one treatment. DeepFX is commonly used on the face, around the lips, for crows feet, the neck, upper chest, hands and arms. DeepFX procedures involve treating only a fraction of the skin’s surface, leaving bridges of untouched skin to aid in the regeneration process. Each laser pulse removes a narrow column of tissue while simultaneously treating surrounding skin. This deep heating causes immediate collagen contraction and long-term collagen remodeling. The result is softening and smoothing of wrinkles and scars, and improved skin texture. DeepFX is typically performed in the doctor’s office and lasts for about 20 minutes. An anesthetic cream may be used prior to treatment to aid with comfort. Immediately following the treatment, treated skin will feel warm and will be similar in appearance to a deep sunburn. Over the next several days, a gentle washing and moisturizing regimen is prescribed. As the skin heals, it will begin to flake and there will be noticeable improvement in wrinkles, fine lines and scars. Laser Removal of Skin Lesions includes the removal of birthmarks, skin growths, facial spider veins, warts, and some tattoos. Most conditions take more than one laser treatment, although some respond to a single treatment. Many laser surgeries are performed as an outpatient procedure. After surgery, some swelling and crusting of the skin is normal. Prescribed ointments keep the skin supple and reduce skin redness that usually subsides in a few weeks. Continued technologic advances provide constant opportunities for laser surgery. The Bukachevsky Center takes pride in discussing the latest advances with you.
Lip Enhancement • Cheiloplasty Full lips are associated with youth and beauty. However, sun exposure, pollution, health, heredity, and lifestyle habits can all contribute to aging of the lips. In addition to thin lips, other aging effects include nasolabial folds, the smile lines that extend from the sides of the nose area down to the corners of the mouth; perioral lines, the vertical lip lines that extend above the lip border; oral commissures, the marionette lines that extend out from the corners of the mouth; and, vermilion border, the loss of the lip roll, or definition of the lip border. These effects can be improved with surgical alterations or the use of a variety of filler materials, or in some cases, a combination of both is desirable for optimal results. For lip augmentation, a piece of tissue (skin, fat, or muscle) is borrowed from somewhere in the patient’s body and grafted into one or both lips. For a subnasal lip lift, soft tissues around the lips can be advanced upward, resulting in more visibility of the red lip. Scars are hidden along the lip line or base of the nose. For lip reduction, or for patients with generous lip size, the incision is placed inside the mouth and is invisible. Non-surgical injectable fillers, such as Juvederm™ and Restylane®, are other
options that can provide fuller-looking lips, add definition to
lip borders, and improve vertical lip lines.
When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Once a scar forms, it is permanent but may be made less visible or relocated surgically. Different scars require different treatments. Skin flaps, skin grafting, Z-plasty, dermabrasion, laser resurfacing, and steroid injectables are various methods used to make scars less visible. All surgical possibilities are discussed in the patient’s initial consultation. After facial scar revision surgery, some swelling, bruising, and redness are common. Decreased activity, cold compresses, and rest are also part of the patient’s after care recommendations. Some scars may require a year or more to fully heal and achieve maximum improved appearance.
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Dr. Bukachevsky : Cosmetic Surgery and Aesthetic Procedures |
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| Bukachevsky Center for Facial Rejuvenation |
Cosmetic Surgery and Aesthetic Procedures