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Brow Lift
Brow lift or lifting mannequin is an increasingly popular procedure. It elevates the outer brow (drooping eyebrow), reduces creases and tightens the temporal area. Brow lift is an outpatient procedure, performed under local anesthesia with or without sedation. The incision is small (3-5cm) in the temporal hairy area. The skin is elevated forward, muscles are tightend, eyebrows are lifted, and extra skin will then be trimmed. The incision is closed with auto-absorbable sutures. Bandages are not needed. After the procedure usually no pain swelling is managed with medications, head elevation and packs of ice. Results are natural looking, long-lasting and attractive. The procedure can be extended to all the frontal area, and can be done by endoscopy. In some cases Dr. Chehab combines brow lift with Botox injection or blepharoplasty to enhance the results.
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Ear Surgery
Otoplasty is usually done to set prominent ears back or to reduce the size of large ears. Ear surgery is usually performed as an outpatient procedure, between the ages of 4 to 14, but its possible to do it on adults. For young child Dr.Chehab recommend general anesthesia. For older children or adults, local anesthesia is recommended. The operation consists in exposing and remodeling the cartilaginous structure through an incision behind the ear. The technique will depend on the problem. Usually there are no visible scars. The patients head will be wrapped in a bulky bandage immediately following surgery, for a few days. Then it will be replaced by a headband. Stitches will dissolve. Children can go back to school after one week.
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Eyelids
Blepharoplasty is a procedure to remove excess skin with muscle and fat from the upper and lower eyelids. It corrects puffy bags and drooping upper lids. The operation is usually done on an outpatient basis, under local anesthesia alone or with oral or intravenous sedatives. For upper eyelid the incision is made in the crease and doesnt leave any visible scar. For the lower eyelid the incision is made just below the lashes or inside the eyelid (Transconjunctival).The fat is removed or transferred to smooth the lid-cheek junction. Sagging skin and muscle are trimmed. In some cases Dr.Chehab lifts the midface moderately through the lower eyelid incision. Sutures are removed three days after surgery, after what you can go out in public or back to work.
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Face Lift
As people age, the elastic fibers in the skin start decreasing. Stresses, sun exposure, effects of gravity can be seen in their faces. Jaw lines grow slack and jowly; folds and fat deposits appear around the neck; deep creases form between the nose and mouth etc The main goal of a facelift procedure is to give a younger and fresher look preserving the natural characteristics of the patient. eyelid surgery, fat transfer, sub-mental liposuction can be performed at the same time to effect a more complete facial rejuvenation. Its one of the most well-accepted and most frequently performed cosmetic procedures in the world. Facelifts may be performed under local anesthesia combined with sedation or under general anesthesia. Incisions usually begin above the hairline at the temples, follow the border of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp. Facial and neck skin is separated from the superficial muscular system. This layer is also separated from underlying tissues. Fat may be trimmed or suctioned, muscle is tightened, and excess skin is pulled up and back, trimmed and sutured into place, with auto-absorbable intra-dermic suture. After surgery the discomfort is minimal. The bandage is removed the following day and patients are then allowed to shower and wash the hair. Pain is little. Bruises are usually gone by the end of the first week. Patients feel and look okay quickly after a facelift. The scar is very fine, and usually undetectable. Two articles were published by Dr. Chehab:Facelift:Personal approach and Individual lifting.
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Facial implants and injections
As we age the appearance of wrinkles on our face is inevitable. We start to loose our fat from our upper face (cheeks).This gives us a sad gloomy look. Its a part of our aging process. Injection is indicated for the correction of coetaneous contour deformities of the dermis and for lip and cheek augmentation. Facial wrinkles may appears on the forehead,around and between eyes. The ideal treatment of these wrinkles is the botox injection. They disappear for a period of 4 to 6 months. The injection may be then repeated. The naso-labial fold may be injected with different fillers. The safest and the best is the hyaluronic acid. It may last up to one year. Sometimes Dr. Chehab uses implants to improve and enhance facial counters. They help provide harmonious balance to the face. Chin implant is inserted into a pocket over the front of the jaw line. The incision is placed inside the mouth. Cheek implant is inserted through an incision inside the mouth, near the upper lip. It augments both the frontal and the lateral arch of the cheek. Jaw implants are placed directly on the jawbone to create a stronger, more defined jaw line. Best results are obtained with fat injection.
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Fat injection Lipofilling
Fat injection or lipofilling is the most preffered procedure by dr. Chehab to plump up sunken cheekbones, fill in stubborn facial lines, create more filled lips, and improve the appearance of hollow cheeks, thin lips, an aging forehead, eyes and scars. Lipofilling is an office surgery. Anesthesia is local. The fat is harvested from areas of blocked fat in the body (hips, thighs, abdomen...).Fat cells in these areas do not respond to alimentary regimen or physical activities. When they are transferred to the face, they carry this information so the face does not loose as before the fat injection. There is no risk of allergy or rejection in this operation. The harvested fat is re-injected immediately in the designed facial areas, in multiple criss-cross layers. The procedure takes from 30 to 60 minutes. Patients may experience minimal discomfort and minimal swelling for 2-4 days. Normal activities can be resumed immediately. The procedure may be repeated 2 to 3 times with 2 months intervals, depending on the take of fat cells, after what the result is permanent. In some special cases, fat injection is useful for buttock augmentation.
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Hair Transplantation
There are multiple causes of hair loss: genetic, hormonal, bad nutrition, medications, stress and scarring. Male pattern baldness starts in the crown, temples and frontal hairline. Females hair loss generally affects the whole scalp. The occipital and temporal areas are the donor areas. In these areas the hairs will not fall in our lifetime. We place several hundred micro-grafts per session. Its an outpatient procedure with local anesthesia. The session takes an average of 2-4 hours. After the grafts are inserted a bandage is placed over the scalp for 24 hours. Transplanted hair starts to grow around the second month after the procedure, and then it can be treated as your normal hair. The most important aspect of the procedure is to obtain a natural look. Transplanted hair lasts for life.
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Lip augmentation.
The goal of lip augmentation is to enlarge the lips, create a plumber or more sensuous appearance,with surgery or by injecting them with a filler material. These fillers give a fuller look to the vermillon which is the visible pink portion of the lips. Lip augmentation uses a variety of materials to create fuller looking lips: Hyaluronic acid, Gor-Tex, Synthetic materials. Dr.Chehab prefers fat injection wich is the best and safest method for lip augmentation. Fat offers a natural feel and movement. Individual results vary and usually the best results come with more than one fat transfer procedure. For those with thin and rolled in lips, surgery is the best choice. Under local anesthesia a small incision is done on the inner side of the lip (inside the mouth), the lip is everted, results are permanent. Silicone injections are banned by the FDA and should not be considered.
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Nasoplasty
Nasoplasty, or surgery to reshape the nose is one of the most popular procedures. The ideal nose varies from face to face depending on ethnic background, age, skin type and others. The most important matter sought by plastic surgeons is to provide a naturally looking nose that goes accordingly to the patients own facial appearance. At the same time patient may elect also to have chin or cheek implants. Nasoplasty can enhance your appearance and self-confidence. It can be performed after 15 years old to meet aesthetic goals or for reconstructive purposes. Anesthesia is general or local with sedation. Most of incisions are made inside the nose. Occasionally a small external incision is necessary (open rhinoplasty). Bone and cartilage are sculpted, to refine the nasal dorsum and the nasal tip, naso-labial and fronto-nasal angles are corrected. Lateral nasal bones and nasal apertures may be narrowing. Correction of septal deviation is possible. Immediately after surgery a nasal mesh will be placed inside the nasal passage for two days. An external plastic splint will be placed to protect and support the nose. It will remain in place for a week.
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