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SurgiWire

A new technique has been developed to reduce or eliminate prominent contour depressions, lines and scars on the face. It uses a wire that is placed under the skin via a needle to completely encircle the area to be released. The wire is gently sawed back and forth until the depression, groove or retraction is completely released. Following the release, the area can be injected with fat or some other filler or left alone. This technique has great application for the naso-labial grooves (between the nose and corners of the mouth), the marionette lines (from the corners of the mouth to the jawline), the lines radiating around the mouth, forehead lines, frown lines, transverse neck lines and facial scars. The procedure can be performed under local anesthesia or twilight anesthesia with minimal post-operative swelling and down-time.

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Procedures

Rhinoplasty

Being centrally located, the nose should blend harmoniously with the other facial features and not draw attention to itself.
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Neck Lift

The necklift is a procedure to tighten and better define the jawline and the areas below it. In some instances, this effect can reach all the way down to the collar bones
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Face Lift

Surgeons use the term "facelift" to describe any procedure on the face that results in a tighter, more youthful appearance.
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Revision Rhinoplasty

The operation consists of correcting areas of asymmetry and deformity resulting from a prior surgery.
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Eyelid-Brow Lift

The eyes are the first features noted when people meet. And having puffy, sagging or wrinkled eyelids can convey a false image of being tired, sad or old.
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Lips

The lips should be full and wide with the upper lip slightly rotated, revealing the lower portion of the front teeth.
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Articles

The Telltale Signs of a Bad Rhinoplasty

Having revised thousands of rhinoplasties, I have noticed certain features common to all.

Even a structurally symmetric, aesthetically pleasing nose can be a poor result if it is out of proportion with the other facial features by being too small or too large. However, the real clues to a poor result are the asymmetries, malpositions, disproportions and decreased function that are seen. We can see collapse of the side walls and/or nostrils producing a “pinched look” or asymmetry between the two sides. The bridge can be too low or too high, and the tip can be overly rotated or not rotated enough. There can be too much “nostril show” from aggressive cartilage resection causing upward migration of the nostril rims. Or too much nostril show from failure to raise the columella (area between the nostrils). Also, irregularities or distortions in the nasal tip can occur which can present technical challenges to the revision surgeon. There can be deflections or angulations of the tip or the entire nose. As mentioned above, nostril asymmetries are particularly common with one nostril appearing higher or wider than its companion. Finally, there can be a worsening of breathing , especially if a reductive rhinoplasty was performed. Making a nose smaller has to be accompanied, many times, by measures to assure that the airflow is not compromised. This means correcting any septal deviations and/or turbinate enlargement, as well as maintaining adequate openings through the nostrils and the areas above called the internal valves. I’ve included photos of a nose showing most of these deformities with the subsequent post-operative results, after I corrected them.


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