Saturday, April 9, 2016

PLASTIC SURGERY SLIDING GENIOPLASTY

Sliding Genioplasty
Sliding Genioplasty is also called “Chin Advancement”, is a plastic surgery procedure designed to change the shape of the chin to harmonize with the other facial features.

Preparation before Surgery
  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
  • What to do on the night before and morning of surgery
  • The use of anesthesia during your brow lift
  • Post-operative care and follow-up




Surgical Procedures
This procedure is performed from an incision inside the mouth below the lower lip. The sliding genioplasty is used in more severe cases or in cases where the chin needs to be lengthened or moved backward. The actual bony chin portion of the jaw is then cut and advanced or moved back. This segment is then secured with a tiny bone screw or wire.

Post-Operative Care
Redrape the skin at the level of the labiomental fold with Mastisol (Ferndale Laboratories, Ferndale, MI) and Steri-Strip tape. Advise patients to stay on a soft diet and to rinse frequently with saline solution until the first postoperative visit.
You may return to normal activities within 5-10 days.

Possible Risks and Complication
Over reduction, under reduction, nerve damage, necrosis, poor cosmetic outcomes, reaction or rejection of implants or bone filler, hematoma, infection, permanent change in sensation as with pain or tenderness, step down problems, gum recession, tooth root exposer, tooth loss, chin ptosis, blood clots, non union between the bone segments or screw and or plate misplacement.

Preparation before Surgery:
  • Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
  • Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
  • You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
  • Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
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PLASTIC SURGERY FOREHEAD AUGMENTATION

Forehead Augmentation (Forehead Contouring Surgery)
Forehead contouring is a cosmetic surgery involving a patient’s forehead area from the upper eyebrow to the scalp line, and from one side to the other of the head. When a patient is undergoes a forehead contouring surgery, the earlier mentioned facial area is made slightly smoother and less protrusive.

Preparation before Surgery
  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding




Special instructions you receive will cover:
  • What to do on the night before and morning of surgery
  • The use of anesthesia during your brow lift
  • Post-operative care and follow-up
Surgical Procedures
The scalp advancement involves making an incision that begins right at the hairline. The forehead soft tissues will be elevated almost as in a forehead lift, along with elevating soft tissues in an area under the hairline to allow the hairline to be pulled forward creating a lower hairline. If the hairline has receded on each side of your forehead then a few more incisions might have to be made along each side to remove more skin. The most common pattern of these incisions would be almost the shape of a triangle because the surgeon needs to remove the distance between the receded areas. If the area of recession is large then you will also be advised before the procedure that you will be required to have hair grafts to fill that area further. A lower incision will be made removing an area of skin and the incision will be closed using medical staples.
A forehead contouring surgery starts with a scalp incision. Following this, surgeons usually use bone cement to perform the augmentation of the forehead area. During this process, if the surgeons locate bony irregularities and/or protrusions in the brow area, these will be smoothed out as well, to give the patient an aesthetically pleasing and smooth appearance.

Post-Operative Care
Aesthetic forehead surgery is usually done as an outpatient procedure. Depending upon what other procedures may be done with it, it may require an overnight stay in the surgical facility. A wrap-around forehead dressing is put on at the end of surgery and is removed the next day. In some cases, a drain may be removed (not commonly) and it is removed the next day also. Ther6e is some mild pain afterward but much of the forehead skin will be numb for awhile. Pain is easily controlled by pills. There will be some swelling afterwards which is driven downward by the dressing and gravity which affects the eyes and upper cheeks. It is most evident by two days after surgery and is largely gone within seven to ten days after surgery. Most patients return to work in two to three weeks. Dissolveable sutures are used in the scalp so there is no need for suture remocal. One can return to working out in two weeks after surgery.

Possible Risks and Complication
Complications arising from a forehead contouring surgery are minimal since bone cement is used instead of silicone implants. When a silicone implant is inserted and used in a forehead contouring procedure, numerous complications can arise. Some of these include fluid accumulation, visible borders of the implant, and implant extrusion.
In contrast, the use of bony cement shows minimal complications following the surgery. The only one that may come up is contouring irregularities. However, most surgeons minimize this risk by sculpting and smoothing out the bone cement using specialized instruments. Unlike other surgeries, the likelihood of patients suffering from extrusions and/or infections is extremely rare with this surgery, as well.

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PLASTIC SURGERY CHIN AUGMENTATION

Chin Augmentation 
(Genioplasty or Mentoplasty)
Chin augmentation is a plastic surgery procedure to reshape or enhance the size of the chin. It may be done either by inserting an implant or by moving or reshaping bones.

Preparation before Surgery
The surgeon will personally meet with you during the consultation. He will examine and evaluate you. He will then show you before and after pictures and then explain the surgical procedure from beginning to end. This explanation will include what surgical technique he will use, where the surgery will be performed, what type of anesthesia, and a step-by-step explanation of what the recovery will be like. You will then meet with the patient care coordinator, who will explain the scheduling details and the cost.





Surgical Procedures
Incisions are typically made in one of two locations: either beneath the chin within a natural or crease or inside of the mouth where the gum and lower lip meet. To build up a receding chin with an implant, the surgeon will made the incision then gently stretch the tissue to create a space into which the implant is then inserted. To reduce a prominent chin, the surgeon will made the incision and then sculpt the bone to the desired shape and size.

Post-Operative Care
You will feel some discomfort and soreness, which you can easily control with medication.
You may feel some numbness in your chin for up to 3 months, and a stretching sensation around your chin for 1 week. Most of the swelling will be gone by 6 weeks, depending on the type of procedure you had.
You might have to stick to a liquid or soft diet for at least a day or two.
You’ll probably have the outside bandage removed within a week of surgery. You may be asked to wear a brace while you are sleeping for 4 – 6 weeks.
You can resume light activity the day of surgery. You should be able to return to work and your usual activities within 7 – 10 days. Your doctor or nurse will give you specific instructions.

Possible Risks and Complication
The most common complications of chin augmentation are:
  • Bruising
  • Movement of the implant
  • Swelling
Other possible complications include:
  • Damage to the teeth
  • Loss of sensation
Rare side effects include:
  • Blood clots
  • Infection that can sometimes require removing the implant
  • Pain that does not go away
  • Numbness or other changes in skin sensation
Preparation before Surgery:
  • Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
  • Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
  • You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
  • Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.

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PLASTIC SURGERY CHIN REDUCTION

Chin Reduction 
is a cosmetic surgical procedure that reduces the size of the chin by shaving down the bone through an incision made in the lower gums. Chin reduction surgery begins with the surgeon making an incision inside the mouth (near the lower lip) or under the chin. Using specialized instruments, the surgeon detaches the bone at the tip of the chin and then reshapes and removes the excess bone to properly proportion the contour. The tip is then repositioned with the remaining section of chin and held together using wires and plates. The incisions are sutured to complete the procedure.




Duration of the operation:
The surgery duration is approximately 2-3 hours

Post operative care:
In cases where the incision was made inside the mouth, regularly use antiseptic mouthwash during the first week to keep the wound clean. If incision is located underneath the chin, clean the external wound twice each day after being released from hospital. Keep wound dry for 2-3 days. Liquid diet such as soups, shakes, etc. for first few days. Eat soft food for 7-10 days.

Recovery period:
Most patients are able to go back to work within a week after surgery. However your surgeon may suggest you take 1-2 weeks off work. A soft diet is recommended for about a week and strenuous activities should be avoided for up to 2 weeks. Any situation which might involve facial contact should be avoided for up to 6 weeks.

Possible risk and complications:
All surgeries have inherent risks. With chin reduction surgery, the patient may experience swelling for several weeks or months while the bone heals. Infection is a less common risk to weigh when considering chin plastic surgery. Another potential side effect to consider following chin reduction surgery is small nerve damage. If small nerve damage occurs, this can cause the patient to experience numbness in the lower lip and chin.

Anesthesia use:
Chin Reduction procedures are undertaken using general anesthetics.

Hospital admission:
It depends on your preferences as well as your surgeon’s. Chin reduction can be performed on an out patient basis, in the hospital, or in an ambulatory surgical suite

Preparation before Surgery:
  • Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
  • Blood and urine samples will be collected for routine preoperative laboratory tests.
  • Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
  • You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
  • Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
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