Face

Endoscopic Forehead/Brow Lift

A forehead lift, or brow lift, is designed to reposition sagging eyebrows that can cause a person to look tired, sad or angry. Endoscopic brow lift, or forehead lift, is the most common endoscopic procedure used by cosmetic surgeons. With this method, instead of the usual ear-to-ear incision, two or more tiny incisions, or “puncture type” incisions are made just at the hairline. The eyebrows are then repositioned to a higher level, resulting in a more relaxed, refreshed and youthful appearance.

Before	After	Before	After
Brow Lift ( Upper Lower Eylid Surgery) Description: 52 year old wished to have appearance about her eyes improved. She liked the look when elevating the outer aspect of the eyebrow with her finger. G.N. was 5’4″ and 117 lb. Patient had no recollection of the surgery after IV sedation by Dr. Pertsch. ‘After’ photographs taken 3 months one week after surgery. Patient also had upper and lower eyelid procedure at the same time.

Facial Implants

Men and women who wish to enhance their facial features may turn to this procedure. Facial implants can enhance your image as well as your self-esteem. Facial implants can help bring balance to the features of your face. These implants can bring the chin or cheekbones into balance or help define your chin. Others may use facial implants as a cosmetic enhancement to help bring a more youthful appearance to their aged face. Facial implant surgery can be performed alone, or in conjunction with a normal face lift. During facial implant surgery, your doctor may use local or general anesthesia, depending on the severity of the surgery.

The following is a brief description of the various facial implant procedures available. Each of these implants, in their own way, can bring your facial features into balance. During your consultation, the doctor can examine your current facial features and determine which implants will best serve your needs.

Chin Augmentation

Chin implant surgery may take 30 minutes to an hour. Your doctor will decide on the proper implant size, and insert it into a pocket over the front of the jawbone. The incision may be placed on the inside of your mouth, or in the skin just under the chin. Your sutures will be removed with in 5 to 7 days. Some swelling and discomfort may be present, and you may find it difficult to smile or talk.

Before	After	Chin Augmentation Description: Chin Augmentation: 31 year old male seeking improved profile: chin augmentation with silastic anatomical implant placed via incision hidden inside the mouth. Also: liposuction under his chin and neck.

Cheek Augmentation

Cheek implant surgery may take 35 to 45 minutes. If a cheek implant is being done in conjunction with another type of face lift procedure, the same incisions may be used; otherwise a small incision may be made inside your upper lip, or under your lower eyelid. Following surgery, your doctor will inform you of any dietary restrictions, as well as limitations. The ability to move your mouth and lips may be difficult for a few days.

Before	After	Cheek Augmentation Description: 36 year old wished to reduce appearance of long, thin face. 5 foot 7 inch tall 160 lb. man underwent malar and submalar augmentation using Implantech Malar Shell size large via intraoral approach (incision just above the gum line inside the mouth). Patient had no recollection of surgery after IV local anesthetic technique by Dr. Pertsch. Post op photos taken 1 year and 11 months after surgery (patient had Dr. Pertsch touch-up another surgeon’s rhinoplasty 1 year before these pictures were taken).

Lower Jaw Implants

Lower jaw implants usually take between 1 and 2 hours. Incisions are made inside the lower lip, and dissolving sutures are used. After your surgery, swelling may peak at 24 to 48 hours. Prolonged swelling may occur for several months. Your doctor will inform you of any dietary and exercise restrictions.

The best way to determine which facial implant procedure(s) is right for you is by making an appointment at Dr. Pertsch’s San Mateo or Mountain View offices. You can further discuss your ideal outcome and options available.

Otoplasty (Prominent Ear Reduction)

Otoplasty is a procedure designed to pin back the ears closer to the head or reduce their size. This procedure can be performed on younger individuals to avoid being teased from others. This results in more natural-looking ears. Ear reduction surgery may also be performed at a later age. The otoplasty procedure varies with every patient and his/her degree of ear deformity.

Before	After	Setback Otoplasty Description: J.M. a 32 year old mother of 2 always wore her hair down to hide prominent ears. Post op photos taken 3 years 8 months after surgery.

Facelift

The facelift (rhytidectomy) is a surgical procedure designed to smooth the loose skin on your face and neck, and to reduce the most apparent signs of aging in the facial area, giving you a more youthful appearance. The procedure involves reducing the creases from the nose and mouth, the slacking jaw line and sagging jowls and fat deposits around the neck by removing excess fat and tightening underlying muscles, then redraping the skin on the face and neck. Although the procedure cannot stop the aging process, it can turn back the clock on your facial appearance, giving you a younger, fresher look, which can also have a positive effect on your self-confidence.

Before	After	Facelift& Neck lift Description: 58 year old woman considering facial improvements for years. The last 2 years she thought more seriously about facial improvements. Also: upper and lower eyelid (blepharoplasty) and forehead (browlift) procedures

Rhinoplasty

Surgery of the nose is one of the most common of all plastic surgery procedures. There are individuals who have been unhappy with the appearance of their nose for their whole life, and there are individuals who have had their nose altered as a result of injury. Rhinoplasty offers a solution to these individuals. There are many ways rhinoplasty can improve upon one’s nasal appearance. This surgery can reduce or increase the overall size of your nose, change the shape of the tip or bridge, narrow or widen the nostrils. The consultation is an important part of the process because it allows the doctor to examine the current state of the nose and determine what can be done to enhance its appearance.

The rhinoplasty procedure usually takes an hour or two, though more complicated procedures may take longer. The surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then redraped over the new framework. After the surgery is complete, a splint is then applied to help the nose maintain its new shape.

Before	After	Before	After
Rhinoplasty Description: 28 year old sought aesthetic improvement of her nasal appearance as well as improved nasal airway. Before surgery she felt her nose looked bigger when viewed from the right side. She wanted it less rounded from the side view. Examination revealed the nose crooked, deviated to the right. The tip was lower than the ‘hump’ of the nose giving the rounded side view she didn’t like. She always had trouble breathing from the left side of her nose. Breathing was worse at night. Internal exam revealed the septum (a midline supporting structure) shifted to the left and partially blocking the airway. Because of the combined airway and cosmetic procedures performed at the same operation general anesthesia was selected (anesthesiologist present). After photos taken 1 year 2 months after surgery.

Eyelid Surgery (Blepharoplasty)

Blepharoplasty, or eyelid surgery, can enhance your appearance and your self-confidence by removing droopy or sagging eyelids. As people age, the eyelid stretches, muscles weaken, and fat accumulates around the eyes, causing “bags”, or excess skin to become prominent. During your consultation, the doctor will assess which of the four eyelids (top and bottom for both eyes) require surgery.