If the eyes are windows into the soul, the nose is the focal point of the face.  For most Asians, rhinoplasty or a “nose lift” is probably the most commonly asked-about procedure in cosmetic surgery as a whole.  We tend to be dissatisfied with the shape and size of our noses, and wish we had a higher nasal bridge, a less bulbous tip, or both. For Caucasians, on the other hand, a common problem is an overly prominent nose, a “boxy” tip, or a dorsal hump.


Rhinoplasty is the proper term for what is commonly known as a “nose job”.  It can mean anything from a “nose lift”, or augmentation, to the surgical correction of structural abnormalities that lead to impaired breathing.  More often than not, however, it is performed to enhance one’s appearance by improving particular aspects of the nose, as previously mentioned, including:

• overall size in relation to the face

• nasal tip, which may be large, bulbous, or upturned

• wide or large nostrils

• the bridge

• the profile (whether humped or depressed)

• a deviated septum

How is it done?


First of all, it can be performed under a local anesthetic, sedation or general anesthesia, depending on your case.  The surgery begins either by making incisions hidden inside the nose (closed procedure) or across the narrow portion separating the nostrils.  The soft tissues of the nose are then raised, allowing access to structures which are to be reshaped, reduced or augmented.


These subtle or dramatic reworkings may involve the use of pieces of your own cartilage (typically from the nasal septum or ear), Goretex grafts or silicone implants.  If your septum is deviated, it may be straightened at this point and your breathing improved.


Finally, other incisions might be made to change the size of your nostrils, if needed.


What should you expect post-operatively?


This is an outpatient procedure, and splints and nasal packing will support your “new” nose in the first 7 days, while the inevitable bruising and swelling will gradually subside within a few weeks, revealing your refined and improved nose.  But it may take about a year for you to see the final, permanent result.


Risks and possible complications?


All surgical procedures carry a certain amount of risk, and though they are relatively small, those specific to rhinoplasty may include bleeding, infection, poor wound healing, numbness of the nose, breathing difficulties, unfavorable scarring, extrusion of implants or sutures, pain, and the need for revision rhinoplasty.

All in all, however, the complications are few and the benefits far outweigh the risks of rhinoplasty, a procedure that can change your life- for the better.





Alarplasty or alar trimming may be a stand-alone procedure performed on the nose, or part of a formal rhinoplasty.  It involves adjusting the width or position of the nostrils and re-shaping them, usually with dramatic results.  For most patients whose only issues are “flaring” or large nostrils, a simple alarplasty would be the most appropriate procedure.

Like rhinoplasty, it is an outpatient procedure and can often be done within an hour.   There are less complications, as it is a somewhat simpler operation, but these may include bleeding, infection and unfavorable scarring.  Recovery time is considerably faster and the final results are seen within a month or two, once the usual swelling and bruising subsides.



For those of us who long for the face we had in our early years and want to achieve a more youthful yet natural appearance, a rhytidectomy or facelift is often the best option.  This procedure involves removing the excess skin of the face and neck while tightening the facial muscles, resulting in smoother skin and a more defined facial contour.  More specifically, a facelift addresses the following:

  • Deep creases below the lower eyelids and along the nose down to the corner of the mouth
  • Sagging of the mid-face
  • “Jowls” caused by loss of muscle tone in the lower face
  • Loose skin along the chin and jaw

A facelift can also be combined with other “rejuvenation” procedures, such as a brow lift or eyelid surgery, to better achieve a well-balanced look.  It must be emphasized that a facelift cannot change your fundamental facial structure and cannot arrest aging.


Many patients ask about non-surgical options, and it is appropriate to state at this point that non-surgical rejuvenation procedures touted in the market will not achieve the same results as a surgical facelift.  They may delay the need for one in the short term, however, and may complement surgery to achieve excellent results.


How is it done?


This is an outpatient procedure and can be performed under sedation or general anesthesia.


There are many variations on the procedure, ranging from a traditional facelift to a limited incision or neck lift.  The traditional approach involves incisions beginning at the hairline along the temples, around the ear, down to the lower scalp.  The excess fat can be sculpted, underlying soft tissue and muscle lifted and excess skin trimmed.  A necklift may also be done at this juncture through an incision under the chin.


The limited incision facelift is a viable alternative, using much shorter incisions, usually at the temples, around the ear, and possibly in the lower lid creases.  This modification is also known as a mid facelift, and aims to reduce sagging of the cheeks and hollowing of the lower eyelids in order to achieve a more youthful, less haggard appearance.  A neck lift addresses loose neck skin, sagging jowls and excess fat beneath the chin, with an incision that starts in front of the ear lobe, continuing behind the ear.  Once the procedures are completed, the incision lines are well concealed in the hairline and natural creases of the ear and face.


Once swelling and bruising subsides within a few weeks, a more youthful appearance will be apparent, and this goes a long way towards improving one’s self confidence.  With realistic expectations and in the hands of a good surgeon, a facelift should markedly improve your appearance yet look natural and subtle, not “over-stretched”, as happens when a facelift is poorly done.  Therefore, choosing a well-trained plastic surgeon is of paramount importance and can never be overemphasized.


What to expect post-operatively?


A bandage will be placed around your face to minimize swelling and bruising, and, temporarily, a small tube may be in place to drain excess fluid or blood that might otherwise collect underneath the skin.


The final result of your facelift will be apparent after several months, when the swelling subsides completely and the incision lines have matured.  It is important to start (if you haven’t already!) life-long sunscreen protection to help extend your new youthful look.


Risks and possible complications?


Although complications are not common, you must decide whether or not the potential risks are acceptable and your goals achievable through a facelift.  Possible complications specific to the procedure may include unfavorable scarring, bleeding, infection, seroma, poor wound healing, facial asymmetry or skin contour irregularities, nerve injury with weakness of facial muscles or numbness, fat necrosis and skin loss, hair loss at the incision sites, persistent pain and the possibility of revision surgery.  In some cases, it may be necessary to perform a staged procedure.



While most Asians are blessed with smooth, unfurrowed foreheads, there are still many patients who can benefit from a browlift to reduce deep wrinkles and raise the eyebrows by resuspending skin, muscles and fasciae.  Also known as a forehead lift, this procedure can minimize horizontal creases across the forehead, vertical “frown lines” above the bridge of the nose, and reposition sagging brows that overhang the upper eyelids, while raising the eyebrows to restore a more alert and youthful appearance.  This procedure is often performed in conjunction with eyelid surgery, facelift, and/or other rejuvenation techniques.

How is it done?


A brow lift can be performed under local anesthesia, sedation or general anesthesia.  In a coronal brow lift, incisions are usually placed and hidden in the hairline, lifting the forehead, removing excess skin from the scalp and correcting creases and frown lines between the brows.   For patients with receding hairlines or significant hair loss, incisions are alternatively placed within the brow line and excess skin trimmed off there instead.  This is a viable alternative for Caucasians who tend to have better results in terms of scarring at the brow line.


What to expect post-operatively?


Your forehead may be taped and your head loosely wrapped with a bandage to minimize swelling and bruising immediately after the procedure.  A thin tube may also be placed to drain excess blood or fluid that might otherwise accumulate underneath the skin.


Swelling will subside over several weeks and incision lines mature over several months, at which time the final results will be fully apparent. In order to extend the result of your procedure, life-long sun protection is a must.


Risks and possible complications?


Although complications are not common, you must decide whether or not the potential risks are acceptable and your goals achievable through a browlift.  Possible complications specific to the procedure may include unfavorable scarring, bleeding, infection, seroma, poor wound healing, skin contour irregularities, nerve injury with weakness of facial muscles or numbness, skin loss, correctable hair loss at the incision sites, an elevated hairline, eye irritation, eyelid disorders that cannot be addressed by just a browlift, persistent pain and the possibility of revision surgery.





If eyes are the window to the soul, then the eyelids are the frames that tend to sag, puff up and suffer from deep wrinkling as we age, making us look older and more tired than we really are.  For some patients, excessive sagging of the upper lids may even result in impaired vision.  In order to restore a youthful appearance to this area, a blepharoplasty or eyelid lift is the most appropriate procedure to perform.  Some patients also request this procedure in order to achieve a more Caucasian look or develop a double lid.

Upper eyelid surgery is appropriate for reducing puffiness due to excess fatty deposits, and correcting loose and sagging skin that can impair vision, while lower lid surgery is performed to remove excess lid skin and fine wrinkles, to correct “bags” under the eyes, and to correct drooping of the lower lid.  Blepharoplasty therefore involves removing excess skin and transposing or resuspending muscle and fat to create a fuller contour.


 Blepharoplasty may not be suitable for patients with serious eye disorders such as glaucoma, dry eye, detached retina, Graves’ ophthalmopathy, for example.



How is it done?


This is an outpatient procedure, and can be performed under local or general anesthesia.  For an upper blepharoplasty, the incision is placed in the natural crease of the upper eyelid, which allows fat repositioning, removal of excess skin and tightening of surrounding tissue.  For correction of lower lid problems, the incision can be placed just through the lower lash line or inside the lower eyelid (a transconjunctival incision) to remove or redistribute excess fat.



What to expect post-operatively?


Immediately after the procedure, cold compresses and lubricating ointments may be applied.  Swelling and bruising are expected in the early post-operative period, and some irritation in the area is not uncommon, but can be controlled with compresses and medication. Final results may be apparent after several weeks, but incision lines may take 6 months to 1 year to fully refine.


Risks and possible complications?


Although complications are uncommon, you must decide whether or not the potential risks are acceptable and your goals achievable through a blepharoplasty.  Possible complications specific to the procedure may include unfavorable scarring, bleeding, infection, seroma, poor wound healing, numbness, temporary burring of vision, dry eyes, difficulty closing the eyes, temporary lid lag (drooping of the lower lid) and ectropion (outward rolling of the lower lid), eye irritation, persistent pain and the possibility of revision surgery.




Ear surgery or otoplasty is the appropriate procedure for patients with misshapen ears due to defects present at birth or due to trauma, or ears that simply “stick out” and are perceived as too prominent or too large. It involves remodeling or excision of ear cartilage in order to decrease size, set the ears more posteriorly, closer to the head, or to correct other deformities to create a natural shape and balance between the ears and face.  This is an excellent surgery for both adults and children over the age of 5, in that minor corrections can have a profound impact on self-esteem and overall appearance.

How is it done?


 This procedure is performed under local or general anesthesia on an outpatient basis.  Incisions are generally placed on the back of the ear, and surgery involves techniques to reduce the enlarged, prominent conchal cartilage.  Non-absorbable sutures are then used to secure the newly-shaped cartilage and the incisions are closed, hidden in the natural creases or just behind the ear.


What to expect post-operatively?


Results are visible almost immediately after surgery, once the bandages placed to support initial healing are removed.  This is especially true of procedures done to correct protruding ears, while more extensive ear surgery may have to be done in stage.


Risks and possible complications?


Complications are uncommon, but those specific to this procedure may include bleeding, asymmetry, infection poor wound healing, numbness, unfavorable scarring, persistent pain and need for revision surgery.  Swelling and bruising should be expected to some degree, but will subside within a few days to weeks.





This procedure is also known as a mentoplasty and is employed to reshape the chin through a variety of surgical techniques, including augmentation or enhancement with implants, and reduction bone surgery.  Chin surgery can address a “weak” or small chin, an overly prominent chin, or asymmetry, and is often used to harmonize overall appearance in conjunction with a rhinoplasty.








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