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MultiPurpose                                         Dr. Saurin Gandhi

Cosmetic Procedures


Eyelid (Blepharoplasty)

One of the first areas of the body to exhibit signs of aging is the area around the eyes. Under eye bags and sagging upper eyelids that come with age can be corrected through cosmetic eyelid surgery. This relatively minor cosmetic correction can refresh the appearance of the face and leave it looking years younger. Cosmetic eyelid surgery dramatically improves the appearance of tired, droopy eyes. This is accomplished by removing excess skin and pockets of fat from the upper and lower eyelids. Many patients combine eyelid surgery with other treatments, such as brow lifting to eliminate drooping eyebrows and various cosmetic dermal fillers or other agents to reduce facial wrinkling.

Who is a candidate for Eyelid Surgery?

Cosmetic eyelid surgery is best suited to patients in good physical health who have realistic expectations about the outcome. While most are more than 35 years old, some younger patients who have inherited droopy eyelids elect to undergo eyelid surgery at an earlier age. You may be a good candidate for eyelid surgery if you have any of the following conditions:

Upper Eyelids

  • excess skin that hides the natural fold of the upper eyelids
  • loose skin that hangs down from the upper eyelids
  • puffiness in the upper eyelids that creates a tired look

Lower Eyelids

  • excess skin and fine wrinkles of the lower eyelids
  • puffy "bags" and, in some cases, dark circles

Those who may not be well suited for eyelid surgery include patients who suffer from insufficient tear production or patients with severe dry eye syndrome.

The Eyelid Surgery Procedure

Cosmetic eyelid surgery can be performed on either the upper, lower, or both lids. The goal for the upper lids is usually to lift it by removing excess skin. For the lower lids, a combination of excess skin and fatty deposits are removed to eliminate the bag under the eyes. The result of either or both is a smoother, more youthful and well-rested appearance. Patients can expect the results to last for many years. Over time a small amount of excess skin or fat may be noticed. If this does occur, the skin or fat can easily and safely be removed.

Brow Lift / Forehead Lift

The brow lift is a rejuvenating surgical procedure aimed at restoring a more youthful appearance to the brow, forehead and indirectly, the upper eyelids. Patients seeking brow lifts usually have sagging brows and forehead skin. Typically this causes the patients eyes to look tired and upper lids to look heavy. They also notice deeper horizontal wrinkles in the forehead.

The brow lift is primarily designed to restore a more youthful position of the brow giving it a beautiful arched look. The operation involves the tightening or lifting of the select facial muscles responsible for the drop in brow position. At the same time it smoothes the forehead, reduces wrinkles between the eyes and can, to a lesser degree, reduce the appearance of skin excess in the upper lids.

Who is a candidate for Brow Lift Surgery?

A brow lift is most commonly performed in the 40 - 60 age range to minimize the visible effects of aging. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.

The Brow Lift Surgery Procedure

When performing a brow lift procedure, muscles and tissue areas that droop or cause creases are lifted or corrected to smooth the skin on the forehead to reduce frown lines and raise the eyebrows. There are several surgical brow lifting procedures, and during your initial consultation the procedure that works best for you will be recommended.

Brow lift surgery results in a more rested and revitalized appearance of the upper portion of the face. This surgery reduces the angry, unhappy, sad, or tired appearance. The improvement often lasts many years.

Facelift (Rhytidectomy)

In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jaw line slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look. After surgery, some patients appear 10-15 years younger.

A facelift can be combined with a browlift, eyelid surgery or nose reshaping for more dramatic results, or it can be restricted to the neck if the patient's problems center there. Incisions are made in inconspicuous places such as behind the hairline and in natural folds of the face and ears, and scars fade to near invisibility in time. Results of a facelift do not last forever, but in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.

Who is a candidate for Facelift Surgery?

Because people age differently, some people are candidates for a facelift in their late thirties while others wait until they are 60 or 70 years older. The best patient for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined.

The Facelift Procedure

Traditionally, an incision is made that starts two to three inches above the ear in the hairline behind temple which extends down in front of the ear for two to three inches and around the ear lobe, and then into the crease behind the ear with an extension into the hair behind the ear. Modified techniques are becoming popular which reduce the length of the incision behind the ear and into the scalp. Dr. Saurin also uses the modified facelift approach, also known as the "minimal" facelift, on younger patients who generally have less skin laxity to correct and are thus able to have a shorter scar. In another modified approach, the incision stops short of the hairline and extends around and in front of the sideburn area to minimize the alteration of the sideburn or temporal hairline location. This technique also works well for men who may not have thick enough hair to cover scars.

After facelift surgery some degree of bruising and swelling will occur as well as temporary numbness in the face and neck. Makeup can be worn a few days after the procedure and patients are often back to work within two weeks.

The Botox® Cosmetic Treatment

we administer several tiny injections of Botox® Cosmetic directly into the muscles that cause moderate to severe wrinkles. The result is that the underlying facial muscles relax, resulting in a smooth, unwrinkled look. No sedative or local anesthetic is used because the pain associated with the procedure is minimal. A small amount of discomfort is felt when the needle is inserted and the liquid injected. This sensation lasts approximately 5 seconds. The entire Botox® Cosmetic injection procedure takes approximately 10 to 15 minutes.

Botox® Cosmetic is a simple, non-surgical, treatment that can smooth moderate frown lines between the eyebrows, forehead lines and crows feet. Botox® has been used to treat millions of people in the United States since its approval by the Food and Drug Administration (FDA). The treatment reduces the activity of the muscles that cause wrinkles in the upper part of your face. It is quick, easy and extremely efficient!

Who is a candidate for Botox®?

The best candidates for the procedure are those between ages of 25 and 65. Wrinkles in people over 65 are often not caused by muscle pull but sun damage so each patient must be evaluated on an individual bases.

Discomfort from a Botox® Cosmetic treatment is minimal and brief. Most patients compare the sensation to a pinprick. You may resume normal activity immediately but refrain from exercising or lying down for four hours after the treatment. You should see a marked improvement within a few days. Full effects of the treatment take three to eight days. The benefits will last for an average of three to four months.

Juvederm

Juvederm is a hyaluronic acid in the form of transparent viscoelastic gel. Over recent years, hyaluronic acid (HA) has emerged as the miracle compound for filling in wrinkles. HA is a natural substance that is found throughout your body. It gives volume to the skin, lubricates the joints and gives the eyes their shape. HA is a naturally occurring substance (complex sugar) found throughout the body in all living organisms. In the skin, HA fills the space between collagen and elastin fibers replenishing the natural support layers lost with aging while delivering essential nutrients and hydration over time, HA is gradually reabsorbed in the body.

Juvederm can be used for smoothing out folds and wrinkles, lip enhancements and shaping facial contours. The most common areas are the glabellar lines (between the eyebrows), the nasolabial folds (from the root of the nose to the angle of the mouth) and the lips, although other sites can also be treated.

No pre-test is needed. Juvederm is a natural, biodegradable substance of non-animal origin. The U.S. Food and Drug Administration (FDA) recently approved Juvederm for the treatment of facial wrinkles and folds, such as nasolabial folds, the lines between the nose and mouth.

Who is a candidate for Juvederm?

Juvederm is best suited to patients between the ages of 25 to 65. Juvederm comes in 3 different densities. You may be a good candidate if you have any of the following conditions:

Juvederm 18:

correction of fine wrinkles, such us "crow's feet or peri-oral wrinkles.

Juvederm 24 or 24HV:

correction of medium depth wrinkles, such as nasolabial folds, lip augmentation, forehead wrinkles, glabellar lines, obvious mild to moderate nasal furrows and cheek wrinkles.

Juvederm 30 or 30HV:

is more dense; used to fill skin folds, give cheeks and lips volume, and to fill very deep nasolabial, naso-genian folds.

The Juvederm Treatment

Juvederm gel is injected into the skin in tiny amounts to replace lost volume, lifting up and smoothing out unwanted wrinkles. dr. injects Juvederm into the treatment area using a variety of techniques to achieve the desired result. The treated area is numbed slightly with a topical anaesthetising cream before treatment.

Immediately after the treatment, you can expect slight redness, swelling, tenderness or an itching sensation in the treated area. This is a normal result of the injection. The discomfort is temporary and generally disappears in a few days. After a lip treatment, the lips may become swollen and look somewhat uneven. It has been shown in clinical trials that Juvederm is effective for up to six months, but individual results may vary.

Scar Revision

Surgical scar revision can improve the way scars look by changing the size, depth, or color. However, no scar can ever be completely erased, and no technique will return the scar to its normal uninjured appearance. Surgical scar revision typically results in a less obvious mark. Because each scar is different, each will require a different approach.

Who is a candidate for Scar Revision

There are several factors that determine the positive outcome of scar revision; the location, size and age of the scar, just to name a few. The most important step in the treatment of scars is careful consultation between you and Dr. Saurin to find out what bothers you most about the scar, and deciding upon the best treatment.

The Scar Revision Procedure

Surgical scar revision is a method of removing a scar and rejoining the normal skin in a less obvious fashion. The surgical removal of scars is best suited for wide or long scars, those in prominent places, or scars that have healed in a particular pattern or shape. Wide scars can often be cut out and closed, resulting in a thinner scar, and long scars can be made shorter. A technique of irregular or staggered incision lines, rather than straight-line incisions, forming a broken-line scar which is much more difficult to recognize, may be used. Sometimes, a scar's direction can be changed so that all or part of the scar that crosses a natural wrinkle or line falls into the wrinkle, making it less noticeable. This method can also be used to move scars into more favorable locations, such as into a hairline or a natural junction (for instance, where the nose meets the cheek). Best results are obtained when the scar is removed and wound edges are brought together without tension or movement (pull) on the skin.

Depending on the scar, surgical scar revision might not be the procedure of choice. Dr. Saurin might suggest the use of dermabrassion, steroid injections, laser resurfacing, fillers, punch grafts or chemical peels. Each scar is different and each might require a different approach to achieve the best results.

Cheek, Chin & Lip Implants

Facial implants are used to enhance specific areas of the face, such as the cheekbones, or to bring balance to the face by improving the size and shape of the jaw line or chin. A number of different implants are available. Facial implants are often combined with other procedures. Cheek implants may be combined with a facelift to help prevent sagging skin and produce a more youthful appearance. Chin implants are often used with rhinoplasty (nose surgery) to help balance the facial features. Lip implants augment, alter, resize, reshape or lift your lips.

Who is a candidate for Cheek, Chin & Lip Implants

The best candidate for cheek augmentation is the individual with a long, narrow face or one with a very round face and flat cheeks. It can also benefit people with asymmetries or congenital defects. The best candidate for chin augmentation is the individual with a receding chin and a normal dental bite. If you were born with thin lips, or if aging has caused your lips to flatten, lip augmentation will help achieve a fuller, smoother appearance.

The Cheek Implant Procedure

Cheek implant surgery usually takes about 30 to 45 minutes. Usually an incision is made either inside the upper lip or lower eyelid. A pocket is then formed and an implant is inserted. Sometimes cheek implant surgery is done at the same time as another procedure such as a facelift, forehead lift or eyelid surgery in which case the implants may be inserted through incisions made for those procedures.

The Chin Implant Procedure

The procedure itself is quite simple and the actual insertion of the silicone chin implant only takes about half an hour. A small incision is made just under the chin or inside the mouth and the implant is slid into place. The incision is then stitched up with sutures and the face is taped up to prevent the chin implant from sliding out of place. If the incision is made inside the mouth, the surgeon will most likely use sutures that dissolve on their own.

The Lip Augmentation Procedure

There are several lip augmentation procedures available today to enhance the size and shape of your lips. All involve inserting a synthetic, biocompatible material such as Goretex, or a natural material such as Alloderm (which is made from human skin), collagen or fat, into your lips. You can even use tissue from your own body. Lip augmentation is performed under local anesthesia on an outpatient basis. Recovery takes about a week, after which your lips will feel normal.