Facial Plastic Surgery
Facial plastic surgery is concerned with improving the appearance and function of facial structures. With an in-depth knowledge of structures of the head and face in addition to extensive training in plastic surgery techniques, North Shore ENT offers a special expertise in facial plastic surgery.
Dr. David Chrzanowski, our facial plastic surgeon, is a fellowship trained, board-certified facial plastic and reconstructive surgeon as well as a board-certified head and neck surgeon. Dr. Chrzanowski’s facial plastic and reconstruction specialties include both surgical and non-surgical options.
Dr. Chrzanowski can help you achieve the results you want using the latest products and technologies and minimally invasive techniques. He is familiar with the pros and cons of each technique and can help you arrive at a treatment plan that meets your needs. Dr. Chrzanowski performs all Botox, fillers and surgery himself. At no point will an assistant or nurse perform any treatment.
To schedule a cosmetic consultation with Dr. Chrzanowski, call 978-745-6601, or fill out the form below.
Cosmetic Interest Form
BOTOX AND FILLERS
There are a variety of injections that can be used to reduce lines and wrinkles on the face and enhance the lips, including Botox and dermal fillers such as Juvederm and Restalyne. The choice to use Botox or fillers depends on the nature of the problem. Dr. Chrzanowski can help you select the right technique for you based your budget and desired results.
Our most popular procedure, Botox, is a temporary muscle weakening agent that allows selective improvement in dynamic (moving) facial expression lines. Although Botox can improve facial expression lines, it doesn’t make resting lines go away and a filler may be required for resting lines.Botox is a purified protein product that is administered with a tiny needle directly into the muscle that requires treatment. Botox injections have been used safely for over 20 years. Results typically last three or four months, but sometimes last longer with repeated use.
Many fillers are currently available and more are on the horizon. The original fillers were Zyderm and Zyplast, collagen products derived from cowhide. Collagen typically lasts for 3 months, however, with the advent of new types of fillers, Collagen has become a less desirable option and is rarely used today.
In 2003, Restylane, a new filler derived from hyaluronic acid became available in the United States. Hyaluronic acid a naturally occurring substance in your skin that helps to add volume and hydration. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form as skin loses hyaluronic acid. Because hyaluronic acid is identical across species, testing is not necessary. Perlane, a sister product to Restylane, was FDA approved in May of this year. Its larger particle size allows for more robust augmentations.
In 2006, Juvederm, another hyaluronic acid product much like Restylane, was FDA approved for use in the United States. Juvederm is degraded by the skin more slowly than Restylane and usually lasts longer — typically more than six months. Juvederm is manufactured by the same company as Botox and is Dr. Chrzanowski’s hyaluronic acid filler of choice for most patients.
With a duration of about twice that of collagen, hyaluronic acid fillers have soared in popularity and are now the most common fillers used. Their use has expanded beyond the original FDA approved use (treating smile lines) to lip augmentation, tear troughs, the brow and the pre-jowl areas.
Radiesse and Sculptra are dermal fillers that also gained FDA approval in 2006. Radiesse is a dermal filler that contains calcium hydroxylapatite (CaHA) microspheres and starts the process of neocollagenesis, which stimulates a steady growth of the body’s own collagen. Radiesse produces longer lasting results than Restylane or Juvederm and may last a year or more. Sculptra is a polylactic acid which is a biodegradable polymer that also stimulates the production of collagen. Sculptra provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas. Scuptra requires a series of injections, and although the filling effect is not immediate, it may last up to two years.
All fillers are administered in the office with either a topical or an injectable anesthesia.
An Upper FaceliftOne of the earliest signs of aging is the drooping of the eyebrows. This causes the eyes to appear smaller or deeper set and accentuates crows feet (the wrinkles often found at the outer corners of the eyes). In addition, furrows may appear horizontally and vertically as the brow descends. These conditions can be dramatically improved with a forehead lift. We often will recommend this in conjunction with, or in place of, a facelift to help in facial rejuvenation.
Age brings changes to the eyes much as with other facial features and drooping eyelids are one of the first signs of aging. The muscles around the eyes often weaken, allowing fatty tissue to protrude through them, producing the commonly seen bags or pouches. This often is associated with the aging process, but it also may be an inherited characteristic, or related to certain diseases. Although an eyelift can improve the look of your eyes and tighten the skin, it doesn’t remove dark circles. In addition, as the eyebrows descend, an accumulation of excess skin above the eyes can lead to a tired, hooded appearance, causing makeup to rub off onto the upper lid. Sometimes these hoods can be so prominent that they affect vision. If this is the case, an eyelift may be covered by insurance.Blepharoplasty (eyelift surgery) is designed to eliminate excess skin and fat in your upper and lower eyelids. Most commonly, both upper and lower lid corrections are done during the same procedure, but lid corrections can be performed on just the upper or the lower lids. The incisions are hidden in the skin creases or on the inside surface of the lower eyelids. After the excess tissues are removed the wound is meticulously closed.Dr. Chrzanowski lifts and firms your eyelids without changing the shape of your eyes, giving you a natural look. The surgery can be performed in the office with a local anesthesia. After surgery some temporary swelling and bruising of the eyelids may develop. Minimal restrictions are placed on activity for one week and you may resume normal activities the following week. Eye makeup may be worn after the first week.
A Younger-Looking You
Facelift surgery has become one of the most popular and well-known forms of cosmetic surgery. Dr. Chrzanowski is trained in the latest facelift techniques, including minimally-invasive ones. Although a facelift won’t make you younger, it will give you a more youthful look, erasing years from your face.The surgery is designed to remove or reduce wrinkling caused by loose skin, and to lift and tighten sagging tissues of the lower face and neck. The incisions are placed in front of and behind the ear in the natural creases of the skin and in areas which help hide the scars. Dr. Chrzanowski also tightens the underlying muscles of the face in order to give the smoother skin a solid foundation to rest upon and give you longer-lasting results.The degree of improvement depends upon the amount of wrinkling and sagging of tissues present. The results can be dramatic if wrinkling is marked, but may be more subtle if the patient is younger and has only early sagging. No operation, of course, can permanently prevent aging, but with surgery you can be restored to a more youthful appearance.
As the years go by you may wish to have additional rejuvenation procedures to lessen other signs of aging. The facelift does not speed the aging process and actually serves to help slow the sagging.The surgery is performed on an out-patient basis. You can resume non-stressful activities during the first week. In about 10 days you can wear makeup and resume most normal activities. Final healing can take several weeks.
It is important to understand what a facelift can and cannot do. It can smooth the skin on the face, cheek, and neck areas. However, it does not improve the eyelids, eyebrows, horizontal forehead creases, or the small vertical creases about the lips. Other procedures discussed here may be combined with a facelift to give a rejuvenated appearance to the entire face.Mini FaceliftA minimally-invasive facelift can give your face a more youthful look without a major disruption of your life. The technique delivers impressive results similar to a traditional lower facelift with a less likelihood of complications and a quicker recovery.
FACIAL & SKIN CANCER RECONSTRUCTION
Reconstruction of the skin and deeper tissues of the face may be necessary because of injury or following removal of skin tumors, or even with congenital facial deformities.Dr. Chrzanowski usually performs the reconstruction in an outpatient surgery facility. If cancer is present, the doctor works in conjunction with a Mohs surgeon. (Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer.) The Mohs surgeon removes the cancer in the first surgery and Dr. Chrzanowski reconstructs the face after the cancer is removed. Tissue from an adjacent region is used to repair the defect so that the tissue matches the surrounding areas as closely as possible. More than one operation may be necessary to achieve the best result. Since these reconstructions can vary depending upon the defect, we will discuss with you all of the steps planned for your reconstruction at the time of your pre-operative visit to our office.
Facial sculpturing is a method of removing fat from the neck to redefine the jaw line. Sculpturing is performed by removing neck fat with liposuction. Although it’s most often done in conjunction with facelift surgery, facial sculpturing may be done by itself without a facelift.
Lumps, Bumps, Skin Cancers, Pigmented Lesions & MolesIf you have skin cancer, blemishes, moles or tattoos, surgical excision may be an option. Even though most moles are not dangerous, a certain type of flat, deeply colored variety may precede a highly malignant skin tumor.Excision of lesions may be done in an outpatient surgery setting or in the office. There usually is a small scar which results from this type of surgery, but these generally blend well with the surrounding skin.
Another common way of contouring the facial framework to achieve greater beauty is through malar (cheek) augmentation. Traditionally, strong cheekbones have been considered signs of beauty because they add to the definition of the face and help improve facial harmony. In addition, some malar implants may give a more youthful appearance to the face and can enhance the results of a facelift.The surgery is done with a local anesthetic and mild sedation or twilight anesthesia. The implant is placed through an incision in the mouth hidden under the upper lip above the gum line. Dissolvable stitches are used and there is no visible scar. There is minimal discomfort associated with this surgery and swelling resolves rapidly. You can return to work and other activities within two to four days.
Creating Facial Balance through Chin AugmentationFacial balance starts with an ideal bone structure which can be achieved through sculpturing and contouring your existing facial framework. One of the most commonly performed procedures to accomplish this is mentoplasty, or chin augmentation. A mentoplasty can bring a receding or weak chin into better harmony with other facial features and create a more pleasing balance. Because mentoplasty can improve the results of a rhinoplasty or facelift, it often is done in conjunction with these procedures.After numbing with a local anesthetic, an incision is placed usually underneath the chin in a preexisting skin crease. An implant is placed underneath the soft tissue at the point of the chin to enhance the chin’s projection. Improvements are noticeable immediately after surgery, although some swelling is to be expected. An external dressing is usually applied and left in place for a few days to aid in stabilization during the healing process.
Making them InconspicuousEars are ideally positioned close to the side of the head. Anyone with protruding ears knows the hurtful teasing their ears may provoke. This harassment is even more intense in primary school-age children. Classroom teasing can be avoided by having corrective surgery before the age of six, but it can be done at any age, even adulthood. Other outer ear deformities can be corrected by surgery as well.In young children a general anesthetic is used. In adults, a local anesthetic with IV sedation usually is preferred. The surgery is performed through incisions behind the ears so no scarring is visible. A sweat-band bandage is worn for several days after surgery, and often longer to protect the healing ears at night. You can return to your normal routine in one week.
Rhinoplasty is the surgical procedure for correcting structural deformities of the nose. It involves redesigning the nose either by removing excess tissues or correcting insufficiencies to improve overall nasal contour and function. As a board-certified head and neck surgeon as well as a fellowship-trained facial plastic reconstructive surgeon, Dr. Chrzanowski’s has an in-depth understanding of the nose and it’s underlying structures, making rhinoplasty one of his special areas of expertise. Dr. Chrzanowski can perform complex nasal reconstruction and revision rhinoplasty in addition to shortening a long nose, narrowing a wide one, reducing a wide tip, lowering a high nose, or straightening a crooked one. He is trained in both closed and open nasal approaches and can place the incision in relatively hidden positions, such as inside the nostril or underneath the nose, to avoid visible scarring. Dr. Chrzanowski will sit down with you and discuss your goals for the look of your nose, and create a natural-looking nose that blends in with the rest of the features of your face.
Rhinoplasty is usually performed on an outpatient basis. You may be required to wear tape or an external splint for a about a week. During this time you can resume non-stressful activities like bathing, shampooing and walking. Within two weeks after surgery, most patients can return to full activities the nose will look relatively normal and the surgery won’t be noticeable. Although most of the swelling will be resolved within the first two weeks following surgery, the final results may not be evident for several months due to the normal healing process.
There are a variety of techniques which may be used to improve the appearance of scars. The overall goal of improvement is to minimize the appearance of the scars. You must realize that it is not ever possible to completely remove all traces of a scar since the body can only heal by forming a new scar. Thus the goal of scar revision is to render a scar less conspicuous. Scar revision is done either in the office setting or in an outpatient surgery setting. Healing generally takes several days and there usually is minimal restriction on activities.