Facelift Procedure - Clearwater, Florida

Procedure:
The facelift procedure does just what it implies. Loose sagging skin on the face and neck is surgically lifted from the underlying tissues and restored to its proper position. The facial muscle complex is also tightened for a longer lasting result. Areas of fatty tissue can be removed. As excess skin is trimmed away, the incisions are closed with fine sutures.

A turban-type dressing may be used to hold light pressure on the face and neck, limiting the amount of bruising and swelling.

Normally, the procedure takes three to five hours to perform, depending on the amount of surgery planned.

Recovery:
Although the initial healing process takes two to four weeks, maximum improvement continues during a five-month period. Thus, if you are having a facelift for a particular event, plan accordingly. Some scarring is to be expected and is permanent, but the incisions, having been made wherever possible within hairlines and skin creases, usually fade and are not very noticeable.

Lip Augmentation

Lines and Wrinkles

Extremely thin lips may be augmented by injection with several new filler substances now available.

The challenge has been to find substances that are simple to inject, yet are not readily absorbed by the body. We believe that the new filling agents will be longer lasting, and fewer repeat injections will be necessary.

Upper Lip Augmentation - Before

Upper Lip Augmentation - After

We have found that dermal/fat grafts taken from another area of the patient's body seem to work very well. They provide the fullest lips and the results have lasted for years. This procedure can be performed in the office under a local anesthetic with intravenous sedation.

The lips tend to swell significantly after this procedure and it takes about two to three weeks for this swelling to disappear.

Skin Resurfacing - Before

The discovery of the rejuvenating effects of Retin-A and Alpha Hydroxy Acids has ushered in an explosion of new products and lasers for skin care.

This technology has been able to reverse some skin damage caused by weather and environment, either delaying the need for surgery or complementing the results afterwards.

Skin Resurfacing - After

Retin-A
Retin-A is a Vitamin A derivative and minor skin irritant that stimulates blood flow, hydrating the skin and filling out small wrinkles. However, the benefit is diminished after you stop using it.

Glycolic Acid
Glycolic acids are mild fruit acids that tend to loosen surface skin cells so that older, patchy skin is more easily exfoliated, leaving younger, softer, smoother skin.

Trichloracetic Acid and Phenol Peels
These stronger acids are excellent for removal of deeper wrinkles, however the results are not very precise or as controllable as lasers. They are used mainly for smaller areas not requiring laser treatment.

Lasers
Lasers are superior for resurfacing the skin. Healing time is approximately 10 days and skin redness takes four-to-twelve weeks to fade, depending on depth of treatment. Experience and post-operative care are important in achieving the optimal results.

Botox
Botulinum (Botox) is used to treat forehead lines, worry lines and crow's feet or laugh lines. It works by blocking the impulse from the nerve to the muscle fibers and generally lasts for three-to-five months.

Tissue Fillers
Fat, Restylan, Juvederm, Sculptra and other fillers are useful in enhancing thin skin and filling in skin depressions. Progress continues to make them longer lasting.

Micro-Peel
Retin-A and glycolic acid gradually remove blemished, dry, older surface skin, but take time to work. Micro-Peel powers away this skin in a matter of minutes- getting a jump start on a fresher appearance. Micro-Peel alone will not remove deeper wrinkles.

Facial Skin Care
One of the services available to everyone, not just our surgical patients, is our skin care program provided by licensed medical aestheticians. Our European deep-cleansing facial treatment includes relaxation massage, extractions and a soothing hydration facial mask.

Our office is blessed with wonderful Aestheticians who can evaluate your skin, treat it with the latest in skin care products and establish a personal home skin care plan.
In just four months, you will see the difference-- softer, lighter, healthier skin.

Cosmetic and Medical Tattooing
For those who lack the ability or time to properly apply their facial make-up, there is now a solution - cosmetic pigmentation.

Sterile colors are available to tattoo eyebrows eyelids and lips. This procedure is performed after applying a topical anesthetic so that the whole process is painless.

Forehead Lift - Before

Forehead Lift - After

Nearly everyone over forty may find that gravity and squinting have caused their eyebrows to sag. This sagging is a major contributor to the "old and tired" look. Try standing in front of your mirror. Lift your forehead skin with your fingers - you will notice the improvement.

In cases where the eyebrows have sagged, removal of skin alone from the upper eyelid will not fully correct drooping eyelids. This is a two-fold problem, requiring a two-fold approach. The brows must be lifted to their proper position over the bony brow by removing some of the loose, stretched forehead skin above them. The forehead lift also improves forehead wrinkles and "crows feet" around the eyes.

Procedure:
The incision is made on the forehead in the least visible spot-- above the eyebrows or inside the hairline. The procedure is usually performed under a local anesthetic with light sedation.

Recovery:
Stitches are removed 10-14 days after surgery. Patients choosing the forehead or brow lift should expect a temporary period of itchiness and numbness on the scalp, directly behind incision. This usually disappears in three to four months.

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Robert F. Bialas, M.D.
Clearwater Center For Cosmetic & Plastic Surgery
609 Lakeview Rd., Clearwater, FL 33756
Phone: (727) 447-4536

As we get older, the skin of the eyelids loses its elasticity and begins to sag. In the upper eyelids, the loose skin can droop over the eyes and obstruct vision.

In the lower eyelids, folds or bags develop as the cushioning layer of fat around the eye loosens and slides forward.

Eyelid Surgery - Before

Eyelid Surgery - After

This operation removes the loose skin and fat around the eyelids, restoring a more youthful appearance.

Procedures:
Eyelid surgery is an outpatient procedure routinely performed in the office. Local anesthesia with intravenous sedation is all that is required for comfort and safety.

The incisions are made in the creases of the eyelids so when they heal, they will be difficult to notice. The loose fat and skin are then removed. Naturally, everyone wants all excess skin removed, but an extra millimeter or two is usually left so that the eyelids can close well enough to protect the eye.

Recovery:
Eyelid sutures are removed in three to four days. Bruising and swelling are usually gone in a few weeks. You can return to work in one week. Strenuous activity should be limited for three weeks.

Nasal Surgery - Before

Nasal Surgery - After

The anatomy of the nose is determined genetically, most people seem to prefer a nose that is straight, thin and slightly raised at the tip. Its size should be proportional to the rest of the face, especially the chin.

The nose takes its shape from the structural framework of the underlying cartilage and bone. The overlying skin may also contribute to the appearance of the nose. If it is very thick, it will assume a shape of its own and may not readily conform to the sculpting changes made in the underlying framework during surgery.

This is one of the reasons it is more difficult to make changes to the nose in middle age or if scarring has occurred following a nasal injury.

If there is a deviation of the nasal septum, usually the result of a broken nose, it may block passage of air through the nostril. The airway-obstructing cartilage can be removed at the time of rhinoplasty, thereby improving nasal breathing.

Procedure:
This surgery is commonly performed as an outpatient procedure under general anesthesia. The incisions can be made inside the nose or on the columella outside the nose. In either case, they are difficult to detect. The underlying cartilage and bone is then trimmed, revised or built-up with grafts to produce the desired result. At the end of the procedure, the nose may be packed with special gauze or splinted to provide support and control bleeding. Sutures are removed about one week after surgery.

Recovery:
There may be considerable bruising and swelling after rhinoplasty, especially if any bones need to be broken. The swelling may take three to twelve months to disappear.

Besides the nose, another important element in the facial profile is the chin. The chin projection should balance the nose. If the chin is too short, the nose will project from the face, looking relatively large, when actually it might be normal in size. In such cases, a chin augmentation often helps provide the desired look.

Procedure:
This procedure can be performed in two ways.
• Splitting the lower half of the jaw bone (mandible) and
sliding it forward
• Extending the skin and inserting an implant in front of the
chin bone If there is a problem with jaw growth and
overbite, the first procedure is preferable. But if there is
no problem with dental occlusion, the implant procedure
is simpler and can done as an outpatient procedure
under a local anesthetic.

Recovery:
Recovery after simple augmentation of the chin usually takes one to two weeks. Surgical repositioning of the jaw bone itself takes several months for recovery. Both can bring dramatic results.

Chin Implant - Before

Chin Implant - After

Protruding Ears:
Ears that protrude often lack the natural fold that bends the ears back toward the side of the head. This is a congenital deformity making the ears appear larger than they actually are.

For psychological reasons, this deformity is best corrected before the child starts school and is teased by other children.

Procedure:
This is an outpatient procedure. We surgically create a fold in the cartilage through an incision behind the ear. This allows the ear to assume its normal position closer to the head.

Recovery:
Stitches are removed after 10-12 days. Ears should be protected with a sweatband for two to three weeks.