Facial Cosmetic Surgery

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Lip Enhancement

Full lips are often seen as the crowning element in a well-proportioned face. Lip enhancement using dermal fillers can create a desired effect with minimal invasiveness and downtime. Hyaluronic acid is a naturally occurring substance produced by the body that helps create volume. As we age, the hyaluronic acid decreases. Juvederm and Belatero are two dermal fillers composed of hyaluronic acid. Both can be used to restore volume and soften wrinkles. These products are very effective in “plumping up” the lips to define the vermillion border, where the red part of the lips meet the face, and improve the undesirable vertical lines around the lips. The procedure typically takes 30-45 minutes under local anesthesia. Results typically last 9-12 months.

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CO2 Laser Resurfacing

A carbon dioxide laser is used to improve the appearance of skin and repair damaged skin layer by layer. The CO2 laser minimizes fine lines around the eyes and mouth, and is effective in treating facial scars and hyperpigmentation.

The CO2 laser works by focusing a beam of laser energy to vaporize the upper layers of damaged skin. This is a controlled vaporization of the outer layer of the skin. Once the skin is treated, the healing phase begins and new cells form producing a smoother, tighter, younger-looking skin surface.

Postoperatively, a protective dressing will be applied. This may be removed in 1-2 days with placement of a new dressing. As the skin heals under the dressing it will gradually start to peel away from the new skin. This occurs over 7-10 days. The resurfaced “new skin” will initially have a pink appearance when the dressing is removed. Dr. Kirkpatrick will advise you to keep the skin moist, using a product such as Aquaphor, for 1-2 weeks after the dressing is removed.

Patients considering a CO2 laser resurfacing procedure with olive skin, brown skin, or black skin may be at an increased risk for pigmentation changes. These changes include both hyperpigmentation (darkening of the skin) and hypopigmentation (lightening of the skin or loss of pigmentation). Dr. Kirkpatrick will evaluate your skin during the consultation appointment. Recommendations on your treatment may change according to your skin classification. Also, individuals who have been treated with Accutane in the past 12 months may not be candidates for a laser treatment.

CO2 laser resurfacing treatment is performed under general anesthesia in our outpatient surgical facility. You are comfortable and asleep for the entire procedure. Recovery from a laser resurfacing procedure is around 10-14 days with minimal pain. Risks associated with laser resurfacing include: burns or other injuries from the heat of the laser energy, scarring, and obvious lightening or darkening of the treated skin. Also, laser resurfacing can activate herpes virus infections ("cold sores") and, rarely, other types of infection. Discuss any history of cold sores or other skin infections with Dr. Kirkpatrick during your consult.

You can reduce your risks by choosing a qualified surgeon who has received special training in laser surgery. One safety measure is to find out whether your surgeon has privileges to perform laser resurfacing with a CO2 laser at an accredited hospital. Even if the operation is to be conducted in your doctor's private facility, the fact that he or she has privileges to use that same laser in a hospital ensures that the institution’s experts have reviewed the doctor.

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Facelift/Necklift

A rhytidectomy, or facelift, is a procedure that addresses the key problems pertaining to aging and the appearance of the face. The ideal candidate for a facelift demonstrates skin laxity (sagging skin) around the lower face, jowls, and has deep wrinkles around the corners of the mouth called marionette lines. When the muscles and soft tissues of the face fall down and forward the result is a tired and aged appearance.

A facelift addresses this sagging of the face by repositioning the underlying facial muscles to their correct position and removing any laxity of the skin. The result is effective in giving you a more rested and youthful look. Aging can also adversely affect the appearance of the neck. As we age the neck also develops skin laxity (sagginess), as well as vertical bands or folds. These folds are formed by the edges of a large thin muscle in the neck called the platysma muscle. There can also be accumulation of fat deposits that can diminish the definition of the neck. When these conditions are present, a cervicoplasty (necklift) coupled with the facelift can dramatically improve and restore a youthful appearance to the neck. Liposuction, as well as contouring of neck fat by tightening the platysma muscle, is a vital component of the facelift procedure and helps create a natural and rejuvenated appearing neck.

Dr. Kirkpatrick knows the needs of every patient are different. Individualized approaches are taken in both the treatment planning process and the facelift procedure. Dr. Kirkpatrick generally performs a two-layer, or SMAS facelift. The SMAS (Superficial Musculo-Aponeurotic System) is made up of connective tissue which surrounds the muscles of the face. This layer can become lax over time, and it is essential to address the SMAS during a facelift. The result is a more natural and longer lasting outcome.

After the facelift procedure, a facial pressure dressing is applied. The dressing is removed by Dr. Kirkpatrick the following day. As with all surgery, there exists the possibility of complications. The most common complication following facelift surgery is hematoma. Hematoma refers to a collection of blood under the skin. If a hematoma develops, depending on its size, it may require intervention such as drainage, or re-operation. The current literature reports the incidence of hematoma to be about 3% in female facelifts. The incidence is slightly higher in males because of a greater blood supply in bearded skin. Patients should be aware that the incidence of this complication in Dr. Kirkpatrick’s hands is significantly lower. This likelihood is a result of multiple factors, including the gentle handling of the soft tissue and very careful, time-tested technique. Dr. Kirkpatrick is a Central Florida Board Certified Surgeon. He employs techniques that minimize the risk of complications to skin and muscle. He believes that the facelift is an elective procedure, and as such, all risk of nerve, muscle, or skin damage can and should be avoided.

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Eyelid Surgery

Eyelid surgery, or blepharoplasty, is a common cosmetic procedure, typically performed on men and women between the ages of 40 and 60. Blepharoplasty effectively reverses the signs of aging in the upper and lower eyelids. Upper Blepharoplasty is generally used to remove loose or drooping skin from the upper eyelid, which creates a “hooding” appearance. For upper blepharoplasty, the incisions are placed in natural folds to make the scars as invisible as possible.

Lower Blepharoplasty is generally done to treat and remove herniated fat from the lower eyelid that creates the “bags” underneath the eyes. The incisions are made through the inside of the lower eyelid, which makes the scar completely invisible. A portion of the orbital fat is removed and dissolving sutures are placed. Occasionally, excess skin of the lower eyelid can be removed but the decision to do so is made on an individual basis.

Blepharoplasty is typically performed under sedation. Patients can expect some minor swelling and bruising around the eyes, and can return to work or school in approximately 5-7 days.

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Cheek & Chin Enhancement

Cheek enhancement can create higher, more prominent cheekbones to define the midface region. Silicone cheek implants are placed surgically through an incision inside the mouth, leaving no visible scar. The implants have several different sizes and shapes. Based on the patient’s facial structure and preferences, Dr. Kirkpatrick will select the appropriate implant to restore or enhance the midface, and meet the patient’s goals.

Chin enhancement is a procedure that is commonly performed on both men and women. The chin is an important facial landmark, which helps define a person’s profile by separating the face and neck. Chin implants can create a wider, stronger jawline for a more distinct appearance to the lower face. During surgery, a biocompatible, solid silicone implant is placed through an incision inside the mouth. Occasionally, Dr. Kirkpatrick will place the implant through an incision under the chin when combined with a neck lift or liposuction procedure. A chin implant is often performed in conjunction with a rhinoplasty to help balance facial proportions.

Both cheek enhancement and chin implant surgeries generally take 60-90 minutes, and are done on-site as an outpatient procedure in one of our state of the art surgical suites. It’s important for patients to understand that human faces are asymmetric to some extent. Cheek and chin implants will likely not result in perfect symmetry of the face, but can significantly improve a natural balance and harmony of the facial appearance.

Browlift

The browlift is a common cosmetic procedure to effectively eliminate sagging skin, droopy eyebrows, or wrinkles on the forehead. The forehead is an area that often exhibits the long-term effects of sun, wind, and gravity on your skin and face. When forehead wrinkles appear, or the eyebrows and upper eyelids feel heavy, surgically repositioning the skin and muscles of the forehead can provide a more youthful, friendly appearance. A browlift is often performed in combination with other cosmetic procedures. Dr. Kirkpatrick typically uses an “open” approach where the incision is carefully concealed just at or behind the hairline. The surgery usually takes one to two hours, and is done on-site, in one of our state of the art surgical suites. A pressure dressing is applied at the completion of the surgery and removed after one to two days. Generally, patients can resume work or school in seven to ten days.

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Rhinoplasty

Rhinoplasty is one of the most common cosmetic procedures performed in the United States. With the nose being located in the middle of the face, it is easy to understand the significance it has on the appearance of the face. The entire shape of the nose, or just a certain area (like the tip or the bridge) of the nose, can be enhanced and altered with a rhinoplasty. The procedure can correct deformities of the nose by reshaping, rearranging, or removing bone and/or cartilage. The typical goal of rhinoplasty is to create a nose that looks natural and achieves a balance with other facial features.

There are two approaches when performing a rhinoplasty, the open technique and the closed technique. Depending on the desires of the patient, which will be discussed in the consult, Dr. Kirkpatrick will determine which approach will lead to the best result. Dr. Kirkpatrick typically uses the open technique. This consists of an incision across the columella (skin that separates the right and left nostrils).

When considering rhinoplasty, the functionality of the nose must be considered and addressed if needed. The nose functions to humidify, clean, and warm the air that passes through the nasal passages. The internal anatomy will be evaluated during the consult. Occasionally, Dr. Kirkpatrick will recommend a CT scan to evaluate the septum and turbinates. A deviated septum or enlarged turbinates may need to be addressed during the rhinoplasty procedure to ensure maximum functional benefit is obtained for the patient. Patients wear a nasal splint for 5 days after the procedure, and can typically return to work in approximately 7 days.

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