Website material: April 2011

Saturday, April 30, 2011

craniofacial surgery

Craniofacial (Face, Skull, Jaw and Chin)

In some cases, surgery is needed to correct major functional problems – for example, to create more space inside the skull to enable the brain to grow, or to provide better protection for prominent eyes, or to make breathing and/or feeding easier.

Introduction

Why will a patient need Craniofacial Surgery?

What Doctors are involved?

What Surgery is involved, what technique are involved?

Introduction

As craniofacial surgery is often carried out on very young patients, parental consent and consultation is a crucial part of the treatment process. Parents will be asked to consider very carefully any surgery that is requested for purely cosmetic reasons, whereas decisions relating to the surgical correction of severe functional problems are generally easier to make.

Surprisingly, operations on the face and skull are usually accompanied by very little pain. Swelling settles in a variable length of time, but in most cases the worst of the swelling will subside within the first two to four weeks. However, it will take up to six to 12 months for all the swelling to settle completely and for the final results to be appreciated.

Complications following craniofacial surgery are uncommon, but as with any operation are not unknown. Clearly, the more complex the surgery the higher the risk of complication, but statistically even for the most complex craniofacial procedures severe complications are very rare.

Why will a patient need Craniofacial Surgery?

Conditions that commonly require Craniofacial surgery includes:

1. Craniosynostosis

2. Craniofacial dysostosis

3. Hemifacial microsomia

4. Facial clefts

5. Romberg’s hemifacial atrophy

6. Deformational plagiocephaly

7. Craniofacial reconstructive for M-t-F

Craniofacial surgery can also be required to treat trauma cases that might involve injuries to the head or facial structures.

What Doctors are involved?

General Plastic surgeons, Oral & Maxillofacial surgeon, Craniofacial surgeon and Ear, Nose and Throat (ENT) specialist.

What Surgery is available, what technique are involved?

Visit our BGender clinic website (www.bangkokgenderclinic.com) Our sister website concentrate particularly on craniofacial surgery for M-t-F girls.

True Experts in Plastic & Reconstructive Surgery

Our Surgeons usually sub-specialized in the treatment of surgical condition in one or two of the subspecialties dictated by the various Plastic & Reconstructive divisions. This ensure that they are truly expert surgeon in the particular field of expertise in such areas as Facial cosmetic surgery: Face-lift, Brow’s lift and Neck-lift, Craniofacial Surgery (FFS), Rhinoplasty, Otoplasty. Body contouring procedures: Body Reshaping (Arm-lift, Thigh-lift, Buttock-lift), Breast Augmentation, Breast Reduction, Abdominoplasty, Liposuction and Reconstructive procedures for M-t-F girls (BGender Clinic).

The Doctors are supported by a dedicated team of house staff, anesthetists, nurses, pharmacist, case managers and other allied staff who work as a team to ensure the best care for our patients.

Page Title:

Bangkok Plastic, Reconstructive & Aesthetic Clinic: Plastic & Reconstructive Surgery Experts

Page description

Craniofacial Plastic & Reconstructive Surgery with Craniofacial Experts: Bangkok Plastic, Reconstructive & Aesthetic Clinic.

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Rhinoplasty

Rhinoplasty

A lot of people are unhappy with the size and/or shape of their nose. The nose is central to facial balance and many people opt for surgical nose reshaping, or rhinoplasty in an effort to find a more harmonious alignment of their features. Sometimes the problem can be more to do with the position of the chin or jaw, but patients tend to focus their dissatisfaction on the nose.

What can Rhinoplasty do?

What Surgery is available, what technique are involved?

What should I Expect, what Complications may occur?

What can Rhinoplasty do?

1.    Alter the hump at the bridge of the nose
2.    Reshape the tip of the nose
3.    Alter the length of the nose
4.    Alter the width of the nose
5.    Alter the width of the nostrils
6.    Restructure and reposition the nose after an injury
7.    Open up the nasal airways to help breathing

What Surgery is available, what technique are involved?

A nose reshaping operation is either performed from inside the nostrils
– this is referred to as a closed rhinoplasty; or else by making a small cut on the nose and elevating the skin – known as an open rhinoplasty.

The precise nature of the operation will vary depending on the area of the nose that is being treated.

Bridge (or dorsum)

If the bridge of the nose is being operated on, the surgeon removes the bone and cartilage that is causing ‘the hump’. The nose may then be broken to allow the remaining pieces of bone to be moved closer together, resulting in the narrowing of the nose.

Tip

When the tip of the nose is operated on, the cartilage that makes up the tip-support needs to be partly removed or reshaped. This is done through the nostril, or by making a small cut in the bit between the nostrils (known as the columella) in an open rhinoplasty.

Length

A surgeon can adjust and reduce the central structure of the nose, known as the septum, to help shrink the tip and reduce the overall length of the nose. Adjustment to the tip cartilages also helps adjust nasal length.

Width

By breaking and repositioning the side nasal bone, a surgeon can also reduce the width of the nose and achieve a narrower appearance.

Additional rhinoplasty

Surgeons can also add to the nose using cartilage grafts from the septum or, occasionally, silicone implants, in what is called an additional rhinoplasty. This type of operation is used to build up a ‘flat’ bridge or tip.

The above techniques can also be used to straighten and refine a nose that has been broken through injury, and to relieve breathing difficulties.

What should I Expect, what Complications may occur?

Operations take between 90-180 minutes, depending on the technique being used. Following an operation, patients usually need to spend one or occasionally two nights in hospital. You will need to have a splint held over your nose by tape for seven days, and a pad under your nose for 12 hours.

Allow two weeks off work following a nose operation. In terms of exercise, you should be able to walk a distance after three-to-five days, and to swim after three weeks, although strenuous exercise should be avoided for four-to-six weeks.

Most closed rhinoplasty operations (those carried out through the nostril) usually take about two weeks to settle. There will be no external scarring, but if a nose is broken as part of the surgery there will be noticeable bruising around the eyes for about seven-to-ten days, with yellowing around the eyes for 10-20 days.

If you have the tip of your nose operated on, 60% of the changes will be apparent after three weeks, while the remaining 40% of the changes will evolve over several months or even a year.

If you undergo an open rhinoplasty whereby the columella is cut and the nose-skin opened up, so exposing the cartilages directly during the operation, the surgeon has a better view and this can be more accurate for changes to the tip. However, the swelling will be greater and the recovery time longer.

As with all operations, there are risks involved. After a rhinoplasty, some patients experience an altered sense of smell, while others find that their nasal breathing is affected. Minor bleeding is common while heavy bleeding is very rare but can be severe. Some patients experience pain for a number of weeks. Slight irregularity in the bone or cartilage may be felt or occasionally seen. Some patients will be dissatisfied with the outcome of a nose reshaping operation. Usually it is best to accept what improvement has been achieved and not opt for a further operation. However, it is sometimes reasonable to consider a further slight adjustment. You should establish from your surgeon in advance what the conditions for a re-operation would be, and what any arrangements for payment would be.

For people who return for additional surgery, there is also a risk that the structural scaffolding of the nose could collapse. The nose is a delicate structure, and too much surgery can weaken and damage it.

True Experts in Plastic & Reconstructive Surgery

The Doctors are supported by a dedicated team of house staff, anesthetists, nurses, pharmacist, case managers and other allied staff who work as a team to ensure the best care for our patients.

Page Title:

Bangkok Plastic, Reconstructive & Aesthetic Clinic: Plastic & Reconstructive Surgery Experts

Page description:

Rhinoplasty with Rhinoplasty Experts: Bangkok Plastic, Reconstructive & Aesthetic Clinic.

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Liposuction

Liposuction

Liposuction is a procedure that can slim and reshape parts of the body, and is one of the most popular cosmetic procedures worldwide.

For patients thinking about liposuction, it is important to remember that this treatment is not a cure, but can help to correct and improve bodily contours in areas that are resistant to weight loss.

As a surgical technique, liposuction works by removing pockets of fat in areas that are beyond the reach of diet and exercise. It is most effective for people who are near normal weight and have firm, elastic skin. It should not be thought of as a substitute for losing weight.

Areas commonly affected and operated on

What technique are involved?

What should I Expect?

What Complications may occur?

Areas commonly affected and operated on

The areas of the body most commonly treated by liposuction are:

· Abdomen, flanks and buttocks

· Male Breasts

· Thighs

· Neck

· Knees

· Arms

What techniques are involved?

Liposuction is carried out using a thin, hollow tube called a cannula that is inserted through the skin through tiny incisions. The cannula is then used to loosen the fat and create a nicer shape within the body part being treated. A special vacuum or suction device is attached to the cannula, and the fat is sucked from the body, with any incisions being sewn up at the end of the operation. The procedure takes between one to three hours to perform, depending on the size of the treatment area(s).

Various kinds of anesthetic can be used and the decision on which is best depends upon your preference, along with the size of the areas to be treated. In most cases, patients will only need to be in hospital for a few hours, but an overnight stay may be recommended if a large amount of fat is to be removed.

There are various liposuction techniques available, but no single technique works for all patients.

What should I expect? (Treatment/ Procedures & Outcomes)

Each liposuction procedure will be tailored to a patient’s needs and physical condition. At the end of the operation, tight bandages or elasticized clothing will be applied to the area to minimize swelling and help the body conform to its new shape. With the exception of showering, this garment should be worn both day and night for at least two weeks and thereafter for another four to six weeks.

If a small amount of fat is removed during an operation, patients should be able to return to work within a day or two. However, you may need extra time off if the liposuction was more extensive. Patients can usually return to their usual routines within three to four weeks. The effects of the operation should be long-lasting, so long as a patient’s weight remains stable.

What complications may occur?

Complications are infrequent, although there can be considerable pain following this procedure, particularly if a large amount of fat has been removed. The following are commonly experienced by patients:

· Stiffness and pain

· Swelling

· Bruising

· Numbness

· Unusual sensations

· Fine thread veins

· Lumpy appearance as remaining fat settles

True Experts in Plastic & Reconstructive Surgery

Our Surgeons usually sub-specialized in the treatment of surgical condition in one or two of the subspecialties dictated by the various Plastic & Reconstructive divisions. This ensure that they are truly expert surgeon in the particular field of expertise in such areas as Facial cosmetic surgery: Face-lift, Brow’s lift and Neck-lift, Craniofacial Surgery (FFS), Rhinoplasty, Otoplasty. Body contouring procedures: Body Reshaping (Arm-lift, Thigh-lift, Buttock-lift), Breast Augmentation, Breast Reduction, Abdominoplasty, Liposuction and Reconstructive procedures for M-t-F girls (BGender Clinic).

The Doctors are supported by a dedicated team of house staff, anesthetists, nurses, pharmacist, case managers and other allied staff who work as a team to ensure the best care for our patients.

Page Title:

Bangkok Plastic, Reconstructive & Aesthetic Clinic: Plastic & Reconstructive Surgery Experts

Page description:

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Facelift

Face lift

A face-lift is used to address age-related problems with the lower half of the face, from the eyes and ears downwards. Anything above the eyes is treated with a brow-lift. The neck lift removes skin from the neck.

A face-lift involves elevating and repositioning the skin and soft tissue of the face. During the procedure, cuts are made in front of the ear, extending up and forward along the hairline; redundant skin is then removed, and the remaining skin is hitched and re-draped over its new foundations and sewn into position. Fat and tissue is redistributed and sometimes added to the face.

Face-lifts are generally successful procedures and can have dramatic results, often setting the clock back about ten years. However, patients need to be aware that no face-lift will ever make them look 18 again, and you should be aware of the limitations before you agree to undertake surgery. Brow-lifts, for example, which use the same surgical principles and techniques as craniofacial surgery, allow access to the upper face and have different effects.

Face-lifts are commonly performed under general anesthetic, or with local anesthetic and sedation. The operation takes between two to five hours, and patients are likely to need to stay in hospital overnight.

Pain is not a major problem with facial surgery, and complications arising from face-lifts are never usually very serious. However, all patients need to be aware that there is the chance of sustaining damage to the facial nerves. This can cause weakened movement of the eyebrow and lip, although such repercussions are not common and generally improve over several weeks.

Following surgery, patients commonly experience:

· Feelings of tightness when opening mouth

· Swelling and bruising

· Feeling low and depressed in the first week

· Discomfort at night (sleeping upright with ice packs applied to cheeks is recommended)

Stitches can be removed and after ten to fourteen days patients can think about returning to work or going out in public. Within four weeks, you will be feeling more like yourself, albeit a younger looking version. However, patients are advised not to judge the final result of a face-lift for about six to nine months.

True Experts in Plastic & Reconstructive Surgery

Our Surgeons usually sub-specialized in the treatment of surgical condition in one or two of the subspecialties dictated by the various Plastic & Reconstructive divisions. This ensure that they are truly expert surgeon in the particular field of expertise in such areas as Facial cosmetic surgery: Face-lift, Brow’s lift and Neck-lift, Craniofacial Surgery (FFS), Rhinoplasty, Otoplasty. Body contouring procedures: Body Reshaping (Arm-lift, Thigh-lift, Buttock-lift), Breast Augmentation, Breast Reduction, Abdominoplasty, Liposuction and Reconstructive procedures for M-t-F girls (BGender Clinic).

The Doctors are supported by a dedicated team of house staff, anesthetists, nurses, pharmacist, case managers and other allied staff who work as a team to ensure the best care for our patients.

Page Title:

Bangkok Plastic, Reconstructive & Aesthetic Clinic: Plastic & Reconstructive Surgery Experts

Page description

Facelift (Rhytidoplasty) in Bangkok, Thailand

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Eye lift (Blepharoplasty)

Eye lift (Blepharoplasty)

The skin loses its elasticity and our muscles slacken with age. For the eyelids this results in an accumulation of loose skin which collects as folds in the upper lids and forms deepening creases in the lower lids. At the same time there is slackening of the muscle beneath the skin allowing the fat, which cushions the eyes in their sockets, to protrude forward to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood before any skin changes.

Bags are caused by an accumulation of fat and with age the skin stretches and the muscles around the eye weaken.

What Surgery is available, what technique are involved?

What should I Expect?

What Complications may occur?

What Surgery is available, what technique are involved?

An eyelid reduction (blepharoplasty) removes the surplus skin and protruding fat to produce a more alert appearance and reduces the morning swelling. Sometimes it is only necessary to reduce the skin, sometimes the skin and the fat and sometimes just the fat. If only the fat is being removed from the lower eyelids, then this can be removed from the inside of the lower eyelid avoiding an external excision (transconjunctival blepharoplasty).

What should I Expect?

Both upper and lower eyelid surgery can be carried out under local anesthesia or under general anesthesia in a hospital.

In a typical procedure the surgeon makes incisions following the natural lines of your eyelids; in the creases of upper lids and just below the lashes in the lower lids. These incisions are extended a little way into the crow’s feet or laughter lines at the corner of the eyes. Through this incision surplus fat is removed and excess skin and sagging muscle removed.

If you have a pocket of fat beneath your lower eyelids without surplus skin then the fat may be removed through the inside of the lower eyelid.

The resurfacing laser can be used at the same time as a transconjunctival blepharoplasty to tighten the external skin and reduce wrinkles, although there is no external scar there is residual redness in the skin which will last a few months.

Following surgery it would be best to keep your head elevated for a few days to reduce swelling. Cold compresses can also help. The surgeon will normally apply some suture strips or steri-strips as support to the eyelids after surgery and if these become crusted they can be replaced. Cleaning the eyes with water is useful and the surgeon may advise the use of eye drops or ointment.

The sutures are usually removed after 3 to 5 days and soon after you will be able to use make-up. Sometimes you will be advised to use the suture strips or steri-strips as support to the lower eyelids for a week or so.

The closure of the eyes appears tight after surgery because of the swelling and because skin has been removed. If closure is not complete at night the patient should apply some eye ointment before going to sleep. This sensation will settle as the swelling goes down.

The eyes appear watery after surgery, partly because of swelling under the conjunctiva (chemosis) and partly because the tear ducts are swollen and do not drain as readily. This will last a few weeks. Although there is bruising it can quite readily be disguised with make-up and dark glasses. The scars will be pink for a few months, but eventually they become almost invisible.

What complications may occur?

You can reduce the risks by closely following your surgeon’s instructions both before and after surgery. You should tell him of any thyroid disease, high blood pressure, diabetes or eye disorder such as detached retina or glaucoma. It may be that he/she will wish you to be checked by an Ophthalmologist.

Occasionally a pool of blood can collect under the skin after the operation has finished (hematoma) this usually disperses spontaneously over 2 or 3 weeks but it may need to be drained if it is large. Quite commonly the margin of the lower lid is slightly pulled away from the eye during the first day or two after surgery due to swelling. This will settle on its own or with the help of suture strips or steri-strips. Very occasionally another operation is necessary.

Sometimes tiny white cysts can appear along the stitch line. They are nothing to be concerned about but can be pricked out with a needle. Blindness is an exceptionally rare complication.

True Experts in Plastic & Reconstructive Surgery

The Doctors are supported by a dedicated team of house staff, anesthetists, nurses, pharmacist, case managers and other allied staff who work as a team to ensure the best care for our patients.

Page Title:
Bangkok Plastic, Reconstructive & Aesthetic Clinic: Plastic & Reconstructive Surgery Experts

Page description:
Blepharoplasty (Eye lift) with Blepharoplasty Experts: Bangkok Plastic, Reconstructive & Aesthetic Clinic.

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