Facial Cosmetic Surgery

Reconstructive Surgery

Injectables

Skin Resurfacing

Neck & Face Lift Surgeon Sydney

Facelift (Rhytidectomy)

Aging of the face and neck is inevitable. As the years go by, the skin and deeper tissues loosen over the face and neck. Lines and furrows begin to form around the eyes and mouth, over the forehead, eventually spreading over the entire face, these lines deepen with time and become more noticeable. The eyebrows descend, bags and sags form around the eyes, jowls appear along the jawbone, and a fullness or dewlap forms under the chin. Many factors contribute to how quickly this process occurs including genetics, sun exposure, smoking, sleep, stress, diet, and others. It is not uncommon for patients to feel these changes come on very suddenly over a short period of time.

The facelift is designed to remove excess skin and fat and reposition the skin and deeper tissues to a more youthful position. Older techniques of facelift do not address the underlying structure of the face (the SMAS layer) and leave the patient with a tight unnatural appearing result.

There are many types of facelift – deep plane, SMAS lift, mini-lift, MACS facelift, Mid-facelift, lifestyle lift and S-lift to just name a few – the truth is that often these are just different names for the same procedure and some facelifts do not suit certain patients – Dr. Pincock is familiar with all these different types of facelifts through his formal Facial Plastic and Reconstructive training in the United States, and during your consultation can discuss which type of facelift is best suited to your type of face and stage of ageing.

The facelift incision generally begins in the temple hairline and extends slightly inside the ear canal. It then passes around under the earlobe continuing up behind the ear, and then back into the hair of the scalp. This incision is excellent not only for a great facelift but to maintain the hairline in a normal position, avoiding the past practice of moving the hairline which gives an abnormal or "done" appearance. An isolated facelift achieves its best result along the line of the jaw and neck, followed by the cheek or malar region. It does not, by itself, address the eyes, forehead or skin wrinkles. These require other procedures, such as a blepharoplasty (eyelift)and brow (forehead lift) or skin resurfacing. A combination of these procedures can be performed at the same time or at different times to suit the patient's cosmetic goals and lifestyle.

A facelift procedure alone takes about three to four hours depending on the type of facelift undertaken and is performed under general anesthesia in an appropriately accredited operating suite with specially selected anaesthetists. This can be performed as an outpatient procedure and you can go home a few hours after surgery. If desired, special after surgery care arrangements can be made in your home. Sutures are removed at five and seven days after surgery. There is always some decreased sensation or sensitivity of the face after a facelift, which is to be expected and fades away over the months after surgery. Most patients can return to work or their normal social life in two to three weeks. It generally takes six to eight weeks for the majority of the residual swelling to disappear. Good skincare and consistent sun protection are of extreme importance to the health and well being of your facial skin whether in preparation for a surgical procedure or for good overall skin health.

Facelifts and other surgical and non-surgical facial rejuvenation procedures are becoming much more popular for men as well. Because of different hairstyles and beard growth, variations of the incisions described are used which will be discussed in your consultation.

Necklift

A neck-lift is a similar procedure to a facelift but concentrated on the lower face and tissues of the neck, the skin incision is similar to a facelift and can be completely concealed behind the ear. The tissues of the neck and lower face are restored to a more youthful position and fat from under the neck is removed via liposuction or direct excision. The muscles in the midline of the neck are sutured together to treat and prevent unsightly banding in the neck that can occur with ageing.

By itself or in combination with a facelift or other facial rejuvenation procedure the neck-lift can produce dramatic results in the patient whose neck or chin has sagged with age or weight loss.

 

Mid-Facelift

Traditional facelift techniques are excellent at addressing the lower third of the face and neck, however some patient's faces age in a different pattern and the middle third of the face ages prematurely. This causes the cheeks to sag and deepens the mesolabial grooves (the groove between the nose and the cheek). This gives a tired and washed out look that patients find does not reflect how they feel.

The mid-facelift is a surgical technique that is directed towards the middle third of the face and is an excellent procedure for patients whose main problem area is the mid-face region or as an adjunctive procedure to a facelift for an overall facial rejuvenation.

 

Browlift/Forehead Lift

The effects of aging are inevitable and unavoidable and often the brow and forehead area show the first signs. The skin begins to lose its elasticity, the muscles that pull the brow down and the pull of gravity all affect the face, resulting in frown lines, wrinkling across the forehead, and an increasing heaviness of the eyebrows, this can lead to an older or even angry appearance that is not in keeping with how the patient feels.  The forehead lift or brow lift is designed to elevate the eyebrows and reduce frown lines.  This results in a more youthful expression by smoothing the forehead, opening the eyes, and removing the brow heaviness.  This procedure can be performed alone or combined with a facelift, blepharoplasty, and any other facial rejuvenation procedures desired.

A variety of techniques are available and consultation is necessary for selection of the most appropriate.  At this time the majority of forehead lifts performed by Dr Pincock use a minimally invasive surgical technique known as the endoscopic forehead lift or brow lift.

With the endoscopic forehead lift a very thin fiber-optic keyhole telescope is placed through three to five tiny incisions behind the hairline.  The whole procedure is performed under the skin while Dr. Pincock manipulates the keyhole instruments on a video monitor. During the procedure the corrugator muscles that cause the brow to furrow and cause deep grooves in the skin can be weakened or divided. The endoscopic brow-lift procedure has stood the test of time and gives patients a long-lasting result.

This procedure takes approximately an hour and a half and is performed under general anesthesia. It can be performed as an outpatient procedure and you can go home a few hours after surgery. Bruising and swelling is variable, but most patients are able to resume normal activities in two weeks.

Blepharoplasty (Eyelid Surgery)

The eyes are the focal point of the face  and when we interact with others eye contact is perhaps the most important way we express ourselves.  Bright open eyes convey beauty, vigor, and youth.  However, eyes that sag due to excess skin and are puffy due to excess fat convey a tired older appearance even though you may feel energetic and rested.  The Blepharoplasty, or eyelid surgery or eye-lift, can correct these problems.  Two problems seen in aging eyelids cannot be corrected by Blepharoplasty alone, which are dark circles and wrinkles.

For the upper eyelids the incision line is placed at the natural eyelid crease.  Excess skin, muscle and fat are then removed.  Because the incision is placed in a natural crease, it is frequently almost invisible after surgery.  A number of options exist in performing lower eyelid surgery.  The traditional subciliary approach places the incision just below the eyelashes.  Excess skin and fat are trimmed.  While this technique is used in some special cases there are more advanced techniques that have been developed that have a lower risk of scarring. The most common approach used by Dr. Pincock is the trans-conjunctival approach, where the incision is placed inside the eyelid, invisible from the outside.  While excess fat can be removed through this incision, excess skin cannot.  Excess skin can be removed just below the eyelashes in a "pinch technique" or in some cases laser resurfacing or a chemical peel can both tighten excess skin and remove wrinkles at the same time.

Most Blepharoplasty surgery is performed with either light sedation and local anesthesia or general anesthesia given by our specially selected anaesthetists. Sutures in an upper eyelid procedure are removed in five days, the sutures used in a lower eyelid procedure usually dissolve within a week.  You can usually return to work in one week.  Contacts can be worn after two to three weeks.

Rhinoplasty (Nose Reshaping or Nose job)

Desiring a change in the shape of the nose is one of the most frequently requested facial plastic surgery procedures. The nose is the most prominent facial feature, and it is very common to meet patients who have been unhappy with the appearance of their nose for most of their lives. Patients can become shy and introverted, and in extreme cases their personal and professional life may suffer. Rhinoplasty can have a profound effect on appearance and, when done well, can boost confidence and self esteem.

Alternatively patients who have been very happy with the appearance of their nose undergo some form of physical trauma with a resultant nasal fracture and change in the shape of the nose. Uncorrected this can be devastating for some patients with a serious loss of self confidence that can affect personal relationships and work performance.

The object of rhinoplasty surgery is to create a harmonious natural appearing balance between the patient's nose and other facial features. It is extremely important for you to communicate your desires to Dr. Pincock, so that an exact plan is developed for your surgery that is tailored personally to your nose.

With any surgical procedure on the face it is important to ensure that your surgeon has the appropriate training, this is especially true of rhinoplasty. It is imperative to ensure that your surgeon is well trained and has the necessary skills for performing rhinoplasty. Many surgical maneuvers can be performed to change the nasal shape, making it smaller or shorter, making the tip narrower, straightening the nose, removing a dorsal hump etc. In modifying the shape of the nose, however, the function should not be sacrificed. Not all the surgeons undertaking this procedure have the knowledge, skills, or experience required to perform this complex surgery. Facial plastic surgery and otolaryngology training dedicates an extensive part of its program to rhinoplasty, and Facial Plastic Surgeons are often uniquely qualified to perform this procedure. They are not only trained in techniques that make your nose smaller or straighter, but also in those that preserve or improve your nasal breathing. For these reasons you should only ever have your rhinoplasty performed by a surgeon who has Ear, Nose and Throat (Otolaryngology) training.

Many people who are happy with the appearance of their nose require a rhinoplasty for breathing problems, this is often called "functional rhinoplasty" and sometimes it is necessary to straighten your septum or address your sinuses at the same time. In these cases, insurance may cover some or the majority of the costs involved with your surgery.

At your initial consultation, Dr. Pincock will perform a thorough diagnostic evaluation, occasionally including an examination with a small fiber-optic telescope. Other diagnostic tests can be done, depending on the severity of the problem, but they are seldom required.

With most modern rhinoplasty techniques the majority of incisions are made inside the nose, but occasionally a small incision will be made between the nostrils. The skin is then separated from the underlying bone and cartilage, which are then reshaped according to the desired shape, this may require cartilage grafts from the nasal septum, in revision rhinoplasty these grafts can be obtained from auricular (ear) cartilage, rib cartilage, cranial bone or implant materials. The incisions are then closed. A splint is typically applied to the outside of the nose and needs to stay for about a week.

Dr Pincock will see you in the office five to seven days after surgery to ensure that healing is progressing well and to clean out your air passages, so as to ease your breathing. Some swelling is expected after the surgery, and you may need to use medications or nasal spray to keep your nasal passages open. Keeping the head elevated and applying cold compresses helps to reduce the swelling. Pain is usually minimal, but you will be prescribed pain medications to take as needed. The splint and the sutures will be removed in about a week. The majority of the swelling resolves during the first month, but your nose will continue to adjust its shape over the next twelve to eighteen months.

Chin Augmentation (Mentoplasty)

A well proportioned bone structure is the foundation upon which the natural beauty of facial structure is based. The appearance or profile of a strong chin or jaw line conveys attractiveness, confidence and strength of character and the placement of chin implants (mentoplasty) is a surgical procedure that improves the patients profile by giving the impression of a stronger chin or jaw line. It is commonly combined with rhinoplasty to balance the nose or with neck procedures to improve the angle between the chin and neck.

If you decide to have a chin implant, it is done through a small incision underneath your chin. It is well hidden and usually heals with a barely noticeable scar, it can also be performed through the mouth which leaves no scar at all. Sometimes submental liposuction is performed as well, in which excess fatty tissue is removed under the jaw line. Fine sutures are used to close the incision, and a dressing is typically placed.

Some swelling can be expected after the procedure. Dr. Pincock will see you a few days after surgery to ensure that you are progressing well. Pain is usually minimal and can be controlled with prescribed medications. A soft food diet may be required for a few days after surgery. The sutures will be removed in about a week and swelling gradually resolves over the next month.

Chin implants can significantly enhance the aesthetic effect of other procedures, such as a facelift or nasal surgery. Prominent cheek bones have been among the more popular facial traits lately and can be reproduced by placement of small implants. The implants are made of synthetic material compatible with the human tissue and are available in a wide variety of sizes and shapes

Facial and Neck Liposuction

Facial and neck liposuction are procedures that are usually part of another facial cosmetic procedure such as a facelift or necklift, however sometimes certain patients can have a small problem area that requires the removal of small deposits of fat such as the fat associated with a double chin or extensive jowls that benefit from liposuction without requiring a more extensive procedure. In these cases facial and neck liposuction can be a fantastic way to help achieve your desired appearance without a larger procedure.

 

Ear Surgery (Otoplasty)

Ear surgery (technically known as Otoplasty) is generally performed for children or adults to set prominent ears back closer to the head and reduce the size of large ears. Surgery may also be helpful for "lop ear," "cupped ear" and "shell ear," large or stretched earlobes, torn ear lobes and lobes with creases. The desired effect is normal appearing ears with regular folds and shape.

Otoplasty is usually performed on children between the ages of four and 14 as correction is much easier in young children, when the cartilage is still thin and pliable. Additionally, large or protruding ears can be a source of significant discomfort and embarrassment and thus the earlier the surgery is performed, the less teasing a child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on the adult patient.

The procedure is generally performed under a general anesthetic, and takes from two to three hours. During surgery, incisions are made just behind the ear in the ears' natural folds. Some cartilage and skin is usually removed and then the cartilage is set back with permanent sutures. The incisions are closed with fine sutures and soft dressings are applied, cushioning the ears. The dressings remain for a few days. Some discomfort is expected, so pain medications are prescribed and can be taken on an as-needed basis. Patients can usually resume their daily tasks in five to ten days after the procedure.

Fat Injection (LipoStructures)

As we age, our faces change shape. The typical youthful appearance of fullness in the upper and middle thirds of the face with a narrower, defined lower third gives way to an upper and middle third of the face depleted of soft tissue and fat and a lower third that loses its definition with sagging and the appearance of jowls, the hallmarks of ageing. As the support underlying the skin further disappears, the skin falls into wrinkles and folds. As the cheek becomes smaller, bags under the eyes become more prominent. As the jaw line and chin further lose their prominence, the jowls enlarge and as the youthful fullness of the brow and upper eyelid dissipates, an empty sack of skin is left behind. All these changes can leave a person with a shrunken, almost skeletal appearance.

Since shrinkage of the subcutaneous tissues is the primary manifestation of aging, replacement of the atrophied tissue by restoring volume is an obvious method of rejuvenation. Diffusely augmenting the structure of the forehead, cheeks, mouth, chin and jaw line restores the fullness of youth. With fat injections, the patient's own fat is used to alter the structure of the face, correcting asymmetry and restoring the fullness of youth, naturally and subtly. The advantages of fat are that it is taken from the patient's own fat stores on the thighs or abdomen and its long lasting effects.