Facial plastic surgery and nonsurgical cosmetic procedures for the face have seen a dramatic rise in popularity in the last decade. More than ever before, men and women are turning to facial plastic surgeons to help them look more attractive and youthful.
According to the American Society for Aesthetic Plastic Surgery, nearly 11.7 million surgical and non-surgical cosmetic procedures were performed in the United States in 2007. Since 1997, there has been a 114% increase in surgical procedures, while cosmetic procedures such as chemical peels, Botox® injections, and injectable fillers, have increased by 754%.
Grant S. Gillman, MD, FRCS, one of the most experienced and highly trained facial plastic surgeons in western Pennsylvania, specializes exclusively in facial procedures. As Director of the Division of Facial Plastic and Reconstructive Surgery at UPMC, he is uniquely focused on the face, and further specializes in rhinoplasty and revision rhinoplasty.
Since facial plastic surgery is a highly personal decision, Dr. Gillman recommends that you schedule a complimentary consultation to determine whether he is the right surgeon for your needs.
Dr. Grant Gillman is among the most qualified and highly trained facial plastic surgeons in western Pennsylvania. He is Director of the Division of Facial Plastic and Reconstructive Surgery at UPMC, as well as an assistant professor with the University of Pittsburgh School of Medicine.
Dr. Gillman is board certified by the American Board of Facial Plastic and Reconstructive Surgery, the American Board of Otolaryngology, and the Royal College of Surgeons of Canada. He has been selected repeatedly by his peers as one of the “Best Doctors in America,” a distinction earned by no more than five percent of all physicians each year.
As a professor of surgery at one of the nation’s top medical schools, specializing exclusively in surgeries of the face, Dr. Gillman remains up-to-date on the latest techniques and procedures.
Dr. Gillman has written, contributed to, and edited dozens of articles and book chapters on the subject of facial plastic surgery, and delivered scores of talks both nationally and internationally. Each year, he teaches multiple courses in facial plastic surgery, and in addition, augments his own skills and training to remain at the forefront of emerging trends in this rapidly evolving field.
Dr. Gillman focuses on achieving natural looking results. His philosophy of patient care is founded upon a good doctor-patient relationship to help establish realistic expectations and achieve the most desirable results.
Below is a partial list of procedures performed at UPMC Facial Plastic Surgery. If you are considering facial plastic surgery, we encourage you to schedule a free consultation to help determine which procedures are most appropriate for your individual concerns.
Botox® is a non-surgical physician-administered treatment that can smooth or soften moderate to severe wrinkles and frown lines. Since its FDA approval in 2002, Botox® has become the most popular office-based procedure for facial rejuvenation.
This treatment uses a naturally occurring muscle-relaxing agent to relax specific facial muscles, thus softening and flattening the creases in the overlying skin. This can include furrows and wrinkles between the eyebrows, on the forehead, and around the eyes, as well as upper lip lines and neck bands.
The treatment involves minimal discomfort and results typically last between three and four months. Botox® is an in-office procedure that takes 15-20 minutes, and patients can leave and resume normal activity.
A brow lift or forehead lift is a facial plastic surgery procedure that lifts the brow and refreshes the areas of the face that are often first to reveal the signs of aging, such as the forehead, brow, and upper eyelids. A brow lift is frequently combined with eyelid surgery (blepharoplasty) or facelift surgery.
At UPMC Facial Plastic Surgery, two types of brow lifts may be performed: hairline and endoscopic.
The endoscopic brow lift is a minimally invasive procedure that requires much smaller incisions than a traditional brow lift, but with similar results. Each approach is individualized, taking into consideration the unique variables and anatomy of the patient, and customizing the technique to best suit their needs.
A chemical peel is a treatment designed to improve the texture and appearance of facial skin by using a topically applied solution to remove the damaged outer layers of the skin, thus stimulating the growth of new skin and collagen.
A chemical peel may be suitable to lessen the appearance of wrinkles, blemishes, scars, or uneven pigmentation by restoring a smoother, more youthful appearance with more even skin tone and texture.
In many circumstances superficial and medium depth peels can be carried out without anesthesia or with oral pain medication alone. Depending on the depth of the peel, recovery time may range from several days up to a week.
A weak or underdeveloped chin can compromise facial balance. Chin augmentation can have a dramatic effect on facial harmony and is frequently a suitable addition to rhinoplasty, as well as face or necklift surgery.
Depending on the type of implant, chin implant surgery alone will take between 30 minutes and one hour, although it frequently is combined with other procedures. Incisions are small and very well concealed, and the procedure involves minimal bruising, discoloration, and recovery time, resulting in a very high satisfaction rate.
The look and feel of the implant is completely natural, and is selected to best meet the needs of the individual patient.
Otoplasty, or ear pinning, is a procedure that is done to address ears that are too prominent or protrude too far from the head.
The surgical correction typically takes about two hours, is done on an outpatient basis, and involves minimal discomfort. Incisions are made inconspicuously in the crease behind the ear so that they are out of view, and are closed with dissolvable sutures.
A light dressing is in place for several days and one can generally resume normal activity within the week. For many individuals, the positive results of otoplasty have a major impact on the their self-esteem.
Many people show initial signs of aging in the area around the eyes, making them look tired, fatigued, or heavy in that area. As a result, this is often the first area for which they seek refinement.
Blepharoplasty, or eyelid surgery, refers to plastic surgery that can be performed on both the upper and lower eyelids. These procedures refresh and refine the look of the eyes and can take years off of an individual’s appearance.
Upper eyelid surgery can correct a droopy or hooded appearance around the eyes, making the eyes look more open, brighter, and refreshed. A lower eyelid procedure can create a more youthful appearance by addressing the excess fat and tissue under the eye and smoothing the junction between the lower eyelids and midface.
All incisions are inconspicuous—concealed either within the natural creases of the eyelids or behind the eyelid itself. Surgery is carried out under local anesthesia or intravenous sedation, takes typically from one to two hours, and is done on an outpatient basis.
A facelift procedure helps to reduce the visible signs of aging by removing excess skin and sagging tissue in the face, jowls, and neck. It can help redrape the facial skin, smooth the jaw line in the area of the jowls, and restore a more youthful neck contour.
Incisions are well hidden around the ear and at/within the hairline to preserve the hairline and render results that look natural and are long lasting. Many individuals are choosing to have a facelift at a relatively younger age, and in many cases a more limited procedure (a “mini-lift”) is a reasonable and effective alternative.
Facelift surgery can be readily combined with other procedures such as eyelid surgery (blepharoplasty), a forehead or brow lift, chin implant, or neck liposuction, as needed. Depending on the specifics of the surgery, a facelift usually takes several hours and is carried out under either general anesthesia or intravenous sedation (twilight anesthesia).
In more limited procedures such as the “mini-lift,” patients may go home the same day, but for more extensive procedures most choose to stay overnight following surgery.
Facial reconstructive surgery can take many forms depending on what issues are being addressed. Most reconstructive surgery is done for injury-induced facial deformities, skin cancer, postraumatic scarring, and revision rhinoplasty.
Reconstructive surgery can improve a patient’s appearance and enhance their self-confidence. Since many procedures fall within the realm of facial reconstruction, the combination of procedures required is tailored to suit the individual after extensive review of the patient’s injuries or facial defects.
As people age, there is a certain amount of fat loss or atrophy from the face, resulting in a thinner, hollowed look in certain areas in the face. The normal healthy full volume of a youthful face is diminished.
Facial plastic surgeons have long recognized the importance of volume enhancement in creating a younger, healthier, more rejuvenated look. With fat transfer, fat cells are harvested, or removed, from one area of the body — typically the abdomen, thighs, flanks, or buttocks area — purified, and then injected with a small needle or cannula into facial areas most affected by loss of volume or fullness. Such areas might include the cheeks, cheekbone area, hollow grooves below the eyelids, and lips.
With volume enhancement beneath the skin, the face looks younger and healthier, and the appearance of overlying wrinkles and deeper lines will improve. Often, more than one session is required, but the final result is natural and without looking pulled or stretched.
Depending on how many areas are being enhanced in this manner, the procedure might only require a local numbing agent applied to both the fat donor and recipient sites, or intravenous sedation. Fat transfer procedures typically take one to two hours and are done on an outpatient basis.
Injectable fillers are among the most popular treatment options for facial aging. These non-surgical, office-based procedures are an effective way to improve the appearance of deep facial wrinkles, folds, and lines.
Injectable fillers are a suitable option for patients with early to moderate signs of aging and for those who are not interested in more involved surgical procedures. Many injectable fillers are on the market, such as Restylane®, Juvederm®, Radiesse®, Perlane®, and Sculptra®, and are designed for different applications in various areas of the face.
Results are natural looking, can be appreciated immediately, and may last anywhere from four to 18 months or more. The injections result in minimum down time, discomfort, swelling, or bruising, making them a reasonable option for filling wrinkle lines and enhancing facial volume.
Rhinoplasty, or cosmetic nasal surgery, is an operation that reshapes the nose to approve its appearance or to correct deformities. Whether the procedure is designed to remove a hump, refine the tip, narrow the nose, reduce the overall size, or straighten a crooked nose, the resulting nose that is softer and more balanced can highlight the rest of the face.
It is important for the patient to work closely with their surgeon to set realistic expectations and create a plan together for a natural looking, elegant nose that harmonizes well with the rest of the face. Rhinoplasty is usually carried out under a general anesthetic, and will generally take between two and three hours, depending on the complexity of the procedure.
Most patients can go home comfortably on the day of surgery. Splints, casts, or dressings are all removed after one week, with changes already appreciable at that time. Most patients can resume daily activities within seven to 10 days.
Revision rhinoplasty is surgery that is done to address disappointing cosmetic or functional (breathing) outcomes that resulted from prior nasal surgery. Revision rhinoplasty, like any other revision surgery, can be a more difficult and complicated surgery and may take longer than the original operation.
In most cases, a revision procedure can achieve noticeable improvement, even when “perfection” may not be achievable. Revision surgery will vary from person to person depending largely on what changes are desired and what was done in the initial operation.
The revision procedure is based on careful assessment of the patient’s medical records and individual concerns, and a methodical analysis of what can be done to achieve the optimal outcome.
While it may be impossible to completely eliminate scars, scar revision can transform an unsightly scar to help camouflage it and allow it to better blend into normal facial features. Scar revision may require a variety of techniques and in some cases more than one procedure, but the goal is a result that is much less conspicuous and apparent.
Like any other cosmetic procedure, scar revision requires technical expertise, patience and an eye for perfection. Many factors play a role in determining the optimal approach to a given scar, such as skin type, size, shape, and location. All of these issues are taken into account when determining the best technique for each case.
Scar revision is done as outpatient surgery, and depending on the extent of the facial scarring, may be performed as an office procedure or in the operating room under either local anesthesia or intravenous sedation.
The nasal septum is the midline partition within the nasal passages that separates the two sides from one another. A “deviated septum” refers to the condition where the septum is off to one side inside the nose, compromising the breathing through that side. It may be seen in a nose that is crooked on the outside, but in many cases a deviated septum is present without anything being apparent on the outside of the nose.
Septoplasty is surgery that straightens the nasal septum to correct chronic breathing problems caused by structural abnormalities within the nose. The surgery takes from 45 minutes to an hour in most cases, and is done on an outpatient basis, involves minimal discomfort, and has about a five to seven day recovery time.
In addition, revision septoplasty is frequently performed on patients whose previous surgery elsewhere did not provide optimal results.
It is very important for a patient to be well informed about the facial plastic surgery process and understand what to expect. The following are general answers to commonly asked questions about facial plastic surgery.
Physicians who are certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology are held to the highest, most rigorous standards for medical training, clinical experience, and expertise. Board certification is considered a benchmark of excellence in that specialty, and is an important factor when choosing a facial plastic and reconstructive surgeon.
Facial plastic surgery, or cosmetic facial plastic surgery, changes the shape and appearance of the nose, jaw, neckline, ears, cheeks, eyes, or forehead and can also reduce the signs of aging. Reconstructive facial plastic surgery rebuilds or fixes abnormalities of the face due to trauma, previous surgeries, diseases, or congenital defects.
The best time to begin the plastic surgery process depends on the patient. It is important for the patient to be completely ready to make the physical changes, and to understand the process, surgery, and the effects the procedures can have on the their life. It is also important for the patient to trust and feel comfortable with his or her surgeon.
After any surgical procedure some discomfort can be expected.
Generally this is mild and easily controlled with pain medication. Many patients need nothing more than extra strength acetaminophen after two to three days.
Patients are asleep and comfortable during surgical procedures. This is generally achieved using either intravenous sedation or general anesthesia. Since sedation is involved either way, patients will need someone to be with them for the night following surgery.
Most procedures are done under anesthesia, so patients feel no pain and are comfortable.
Patients are given in-depth instructions on pre- and post-operative care to ensure a speedy and successful recovery, and are fully informed prior to surgery about the potential risks related to the procedures.
Surgical procedures can take a few hours depending on how much work is being done. Non-surgical or office-based procedures can take minutes. Specific timeframes will be discussed at the time of your consultation.
Most surgical procedures are done on a same day basis. This varies depending on the type of surgery, the length of surgery, the time of day surgery is carried out, and the patient’s wishes. An overnight stay can frequently be arranged if preferred. Several procedures allow patients to go back to work and daily activities immediately, but others require a longer recovery time.
Non-surgical or office-based procedures often involve little or no bruising. Postoperative bruising and swelling from surgical procedures begins to resolve by the end of the first week. Full resolution of bruising or swelling may take one to three weeks, and varies from person to person. Bruises may be camouflaged fairly easily with makeup such as a concealer stick.
Aerobic activities should be avoided for a minimum of two to three weeks following surgery, depending on the procedure. Any activity that might increase blood pressure may increase the amount of time it takes for postoperative swelling to resolve. Contact sports should be avoided for six weeks following nasal surgery.
The results of surgical procedures that reshape the nose, eyes, chin, ears, jaw, or cheeks are permanent, but the natural aging process will continue. Non-surgical procedures such as Botox® or wrinkle fillers may need some follow-up procedures months to years later.
To schedule a free consultation with Dr. Gillman, contact him for an appointment at his Shadyside office location.
Shadyside Medical Building5200 Centre Avenue, Suite 211Pittsburgh, PA 15232
Appointments: 412-697-FACE (3223)
Affiliated with the University of Pittsburgh Schools of the Health Sciences
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