Facial

RHINOPLASTY

Rhinoplasty is a surgical intervention aimed at changing the shape of the nose, increasing or decreasing the size, or just improving its contour. This procedure is also able to narrow the nostrils, or change the angle between the nose and the upper lip, raising or lowering the nose tip. It is not only performed for aesthetic purposes, but it also corrects congenital problems, or traumatisms, and some nasal respiratory problems, which can affect the patient’s quality of life.

The first step in a nose surgery or rhinoplasty is to ask your surgeon the reasons for undergoing the procedure, the expected results, trying to be objective all the time. In this visit, your surgeon will advise you about the procedure to follow for achieving the result that better suits to your expectations. Once the maneuvers have been decided, the surgeon will advise you about the most appropriate surgical technique (open or closed).

Rhinoplasty can be carried out since puberty, with general anesthesia in most cases, so it requires at least overnight in the hospital. The intervention lasts between 2 and 3 hours, depending on the complexity of the case and technique employed. It is frequent that the patient feels discomfort the first days after surgery: facial swelling, nosebleed, bruises, etc. However, it is not a painful procedure and the patient can return to normal life in about a week after the intervention. Dr. Tarragona does not use nasal packing in rhinoplasties (unless a septoplasty is required), which increases the comfort of the patients undergoing this intervention. Stitches and the nasal splint are removed approximately in a week. Final results are achieved after one year.

How is the procedure?

Nose skin is separated from its supporting skeleton, composed of bone and cartilage, by using different surgical techniques, which allows accessing to reshape the nose structure. Different maneuvers are then performed to re-shape this bone-cartilaginous structure. The skin is finally redistributed on this new support. If it is performed by closed approach, incisions are made inside the nostrils, but, if it is done by opened approach; an incision is made at the columella base.

What kind of surgical techniques are there?

There are two approaches for rhinoplasty:

  • Open or external approach: a small incision is made in the columella to raise widely the skin from the tip to the nasal dorsum.
  • Closed or endonasal approach: based on internal incisions (endonasal).
What are the advantages of each type of surgical technique?

The closed approach allows the surgery being carried out faster, and with lower risk of inflammation and edema, producing a less visible scar because it is located at the vestibular level. On the other hand, the external approach consumes more time but allows correcting deformities and being more thorough in the treatment of the nasal tip, as this is easier to manipulate.

Can I choose the type of surgical technique?

The technique must be chosen by your surgeon according to different factors (kind of problem to be solved, patient’s clinical history, etc.), because different techniques are indicated depending on the case. Communication with your surgeon is vital in any treatment. During the first visit, your case will be evaluated, and the surgeon will explain you how is going to be the complete process, including the surgical technique.

At what age can rhinoplasty be done?

It can be done from early ages (14-15 years in girls and a little older in boys), because in the puberty, the nose is almost completely developed.

How long is a rhinoplasty?

The procedure lasts from 1 to 3 hours, although it depends on the case complexity. It may be longer.

Is hospitalization required?

Patients will usually spend one night after the surgery, being discharged the following day. However, it will depend on the type of anesthesia used (local with sedation or, more frequently, general anesthesia) and the evolution of the patient.

How is the recovery process?

A splint is usually placed in order to help maintain the new shape of the nose. Dr. Tarragona usually does not place plugs. Nevertheless, they may be necessary in cases of associated septoplasty, or when obtaining septal cartilages for a nasal reconstruction. The patient should remain at rest with the head elevated during the first day. Local cold should be applied. Bruises will disappear in about 2 weeks. Nasal splint and stitches will be removed in about 1 week.

When can I return to normal life?

Most of patients who undergo rhinoplasty feel good in 2 days, being able to make normal life in about a week.

Are the results long-lasting?

Yes. Improvement is progressive and gradual. Nevertheless, a minimum swelling can be maintained for few months, especially at the nose tip, and between the eyebrows for few weeks. The final result is obtained in 1 year approximately.

Is rhinoplasty a complicated procedure?

When rhinoplasty is performed by a qualified plastic surgeon, the complications are infrequent and, if there are, they are usually minor. However, it is very important to be in good hands, as the nose is the most prominent and visible structure of the face, and any defect will be perceived by the patient and the others.

What kind of complications can I have?

As a surgical procedure, complications may occur such as bruising, nose bleeding, asymmetries, contour irregularities, or reactions to anesthesia.

Will the surgeon advise me on what type of nose is best for me?

In prior sessions to the intervention, the patient should inform the surgeon about the reasons for undergoing the treatment, as well as his wishes and expectations. Dr. Tarragona will inform you about the impact that this procedure can have on your life.

If the intervention is due to an aesthetic purpose, your surgeon, according to his experience and knowledge, will evaluate if your expectations are real, taking into account the nasal structure, texture, and thickness of the skin, which are different in each patient. Therefore, bidirectional communication between patient and surgeon is essential. The objective will be to achieve a harmonious result with the patient’s own features.

EYELID SURGERY – BLEPHAROPLASTY

This set of surgical techniques are aimed at the rejuvenation of the look and the middle facial third, removing the excess of skin, the bags of fat, and the dark circles that so often produce an appearance of fatigue.

It can be done on the upper, lower or both eyelids. Eyelids can be corrected separately or performed together with other facial aesthetic surgeries, such as lifting or facial lipofilling, creating spectacular results.  It is not only performed for aesthetic purposes, it also corrects functional problems (as drooping of the eyelid can affect vision).

Generally, the excess of skin in the eyelid appears with aging. This is why the patients who undergo this treatment usually have 35 years old or more.

The length of the surgery ranges from 1 to 2 hours, depending on if it is performed on the upper, lower or both lids. Hospitalization depends on the type of anesthesia employed, usually performed with local anesthesia and sedation, thus, the patient can return home in a few hours. Once the patient is discharged, the stitches will be removed after 5-7 days and between 7 and 10 days after the intervention you will be able to return to work.

It is a common and simple surgical intervention. If it is performed by a qualified plastic surgeon, it presents a few complications, and produces a high degree of satisfaction.

How is the preoperative?

In the first visit, Dr. Tarragona will evaluate the quality of your vision, the tear production, and your general health status. Your facial anatomy will be evaluated thoroughly. The doctor will decide which procedures are the best to improve your appearance.

How is the surgery procedure?

If it is performed in the 4 eyelids, the surgery will start with the upper ones.

In cases in which it is necessary to remove the skin, the incisions are made in the natural lines of the upper eyelids, just below the lashes in the lower ones. Therefore, scars are hidden inside the natural structures of the eyelid. Through these incisions the skin is separated from the fat and the muscle, extracting the excess of fat, skin and muscle.

In cases in which there are only excess of fat, the procedure can be carried out through a transconjunctival approach, producing a non-visible scar.

The incisions are closed with very fine sutures that produce a minimum scar.

How long does the procedure last?

The duration of the intervention ranges from 1 to 2 hours.

Is hospitalization necessary?

It will depend on the type of anesthesia applied (it can be general or local), although it is usually done under local anesthesia and sedation, thus hospitalization is usually not necessary.

How is the recovery?

After the procedure, the surgeon will recommend you apply an eye ointment to avoid corneal injuries, cold compresses or local ice, and to sleep with the head elevated in order to reduce the edema.

The stitches are removed between 5 and 7 days after the surgery. Your surgeon will tell you which medications you should have topically and/or orally.

Who is a good candidate for eyelid surgery?

Normally, the excess of skin on the eyelids is a sign of aging. The loss of elasticity in the skin and muscles (as a result of the passage of time, the accumulation of fat, and in some cases, certain type of diseases), causes bags in both upper and lower eyelids that produce a more aged or tired appearance. For this reason, patients who undergo this procedure are usually above 35 years old.

In some patients with family history, or with some heart or kidney disease that causes bags in eyelipids, the surgery can be performed at a younger age.

When will I be able to return to normal life?

Most of patients who undergo a blepharoplasty can start reading or watching TV in 2-3 days. However, you would not be able to use contact lenses. It may take a while to use them, up to 2 weeks, and even then, you may feel uncomfortable. Normally, after a week or 10 days you will be able to go back to work.  You should maintain a relative rest for 3 to 5 days and avoid strong activities for 3 weeks.

Are the results long-lasting?

The result of the surgery is very favorable and long-lasting, and, in general, the bags of the eyelids do not usually reappear.

What complications can occur during the surgery?

When the intervention is performed by a qualified plastic surgeon, the complications are infrequent and minor. However, as a surgical procedure, usual complications may occur such as hematomas, swelling, etc.

After the intervention, minor complications may appear such as double or blurred vision, temporary edema of the eyelids, and slight asymmetries in healing. Sometimes, after blepharoplasty, there is some difficulty in focusing the images, i.e. images may look somewhat blurred. This disappears in 2 or 3 weeks after the intervention. Conjunctivitis and subconjunctival hematoma (red eye) may also occur, which improve with appropriate treatment. In the first days, it is normal if, during the sleep, the eyelids do not close completely.

OTOPLASTY OR EAR SURGERY

Otoplasty is a surgical procedure aimed to re-locate the protruding ears in order to get them more attached to the head, or to reduce their size. These ears are usually characterized to have a hypertrophic conchal bow, a lack of antihelical fold, or both. The procedure is aimed at improving these anomalies to get a more harmonious ear pavilion.

It is usually performed in children between 4 and 14 years old, and in adults without any risk associated to the age. The intervention lasts from 1 to 2 hours.

It usually does not require hospitalization, because it is performed under local anesthesia and sedation. In young children it is recommended the use of general anesthesia.

For one month, the patient must sleep with a tape that will maintain the shape of the new ear. In 10 days, the stitches will be removed. After 5-7 days you will be able to return to work or school, taking care of physical activities. The full recovery is achieved after 3 months.

Although infrequent and minor, surgery-related complications may occur such as infections, anesthesia reactions, asymmetries, recurrence of the deformity, etc. In case of prominent ears, otoplasty offers almost immediate results; nevertheless, and in case of atrial reconstruction the results will appear after a little more time.

How long does the intervention last?

It usually lasts between 1 and 2 hours, although in severe cases it can last more time.

Is hospitalization necessary?

It is frequently performed as an outpatient procedure. Depending on the technique used, the duration of the surgery and the degree of difficulty of the reconstruction may require hospitalization.

How is the recovery?

During the intervention, Dr. Tarragona will place a bandage that will be removed after 24 hours. Once it is removed, the patient should apply ointment impregnated gauzes daily and keep them for 3 days, protected with a band without pressure. It is necessary to sleep a month with this band and not to practice sports for at least 30 days after surgery. The stitches will be removed in 10 days and after 3 months, the recovery will be complete.

How is the preoperative?

In the previous sessions, Dr. Tarragona will evaluate the problem and will recommend the most appropriate technique for you. This ensures that patient and doctor will decide together the shape and the size of the ears.

How is the surgery?

By correcting protruding or prominent ears, the incision is generally made on the back surface of the ear, producing an imperceptible scar. Then, the auricular cartilage is reduced by its weakening, permanent sutures, or partial resection of cartilage, leading to folding in adequate locations and producing a natural appearance. A bandage is placed in order to maintain the new location of ears and allow them healing properly. All incisions are made at retroauricular groove level; thus, scars are not visible.

When is an appropriate time to operate?

You should avoid sun exposure or excessive cold, so the best time is at the end of summer or winter.

At what age is more appropriate to operate?

Structures of the auditory pavilion are much more moldable in childhood, thus this is the optimal time for the intervention, and also because they have no complete social awareness for this issue. However, during adolescence, or reached maturity, these procedures can also be performed with equally satisfactory results.

When will I be able to return to normal life?

Usually, patients can return to normal life in a week, being careful with physical activities.

Are results long-lasting?

The result is permanent. A retouch is rarely necessary.

What complications can occur?

Complications are minor such as hematoma, ecchymosis, recurrence of deformity, and asymmetries.

FACE AND NECK LIFT

Lifting is a technique aimed to improve the most visible signs of aging, tensing the muscles of the face, deleting the excess of fat, and redistributing the skin of the face and neck. The loss of young contours may be associated to the thinning of the skin, loss of the facial fat, sun damage, smoking, genetic inheritance, and stress. It is performed mostly in patients aged 40-60 years old.

Stretching is always performed in an operating room, from a clinic or a hospital. The surgery can be performed with general anesthesia, the most usual procedures, or local anesthesia and sedation, depending on each particular case (more or less extensive surgery, personal wishes of the patient, etc.).

The exact placement of the incisions varies according to the structures of the face and the technique used. Incisions are initially done at the level of the temples; thus, they can be hidden with the hair. Incisions are then extended following the natural line, just in front of the ears and behind the earlobe towards the back of the scalp.

If it is necessary to working on the neck, a small incision can be made behind the chin. The skin is usually separated from the fat and underlying muscles. The fat can be removed or liposuctioned around the neck and chin to improve the shape of the face. Then the underlying muscles are tensed and, finally, the skin is removed, eliminating its excess.

Once the surgery is performed, a small tube behind the ears can be placed for a few days to drain any liquid that may accumulate. A light bandage is also usually placed.

The procedure lasts several hours, and the hospitalization depends on the type of anesthesia used. Most cases are performed with general anesthesia, so the patient must remain hospitalized until the following day. Although the results are long-lasting, many patients can repeat the treatment after 5 or 10 years. It is recommended to keep your head high for a few days in order to reduce the inflammation. After 10 days or 2 weeks you will be able to return to work.

Some complications may occur such as hematomas, motor or sensitive nerve injury, infection, unsightly scars, and anesthesia reactions. Risks can be reduced by carefully following the instructions of your plastic surgeon, both before and after the surgery.

How long does the procedure last?

It usually lasts between 3 and 6 hours, depending on the procedure.

Is hospitalization required?

It depends on the type of anesthesia used, but you will usually spend one night after the surgery, being discharged the following day. The type of anesthesia will depend on the complexity of the surgery.

How is the recovery?

Compressive bandage during the first 6-10 hours postoperatively, local cold, and a compression garment for neck and cheeks during the first 10 days. The stitches will be removed every week. You must take analgesics and have your blood pressure well controlled. It is convenient to keep the head elevated for a few days after the surgery in order to reduce the inflammation.

In the first evaluation, your surgeon will explain you in detail the processes of intervention and recovery.

Who is a good candidate for lifting?

Patients are usually between 40 and 60 years old, women and men, whose face and neck begin to “fall or drop down” but whose skin still retains some elasticity. It is also performed successfully in patients aged between 70 and 80 years old.

¿When will I be able to return to normal life?

You usually will feel a little discomfort after the surgery. The feeling of numbed skin disappears in a few weeks or months. The appearance of the face will be normal after a few weeks. Most of patients are well after 2 days, however resting should be maintained during the first week. The majority of patients return to work between 10 days and 2 weeks after the intervention.

Are the results long-lasting?

Lifting is a long-lasting treatment; however, the passage of time will continue affecting your features. Therefore, some patients will undergo a new lift after 5 or 10 years.

Can complications occur during the procedure?

When lifting is performed by a qualified plastic surgeon, the complications are infrequent and minor. Some complications may occur such as hematomas, temporary or permanent damage to the nerves controlling facial muscles (very rare), infection, and anesthesia reactions. Scarring problems are more common among smokers.

How is the preoperative period?

In the first visit, the face, including the skin and the underlying bony structures, will be evaluated. Surgical possibilities will be then discussed.

You should consider that lifting does not stop the aging process.

How is the surgery?

The placement of the incisions and the steps of the surgery vary greatly depending on the degree of involvement of the structures of the face and the technique preferred by your surgeon. The initial incisions are usually done at the temples, hidden in the hair; they are extended following the natural line in front of the ears and on the neck. A small incision can also be made behind the chin. Then, the skin is separated from the fat and underlying muscles. The fat is removed; the underlying muscles are tightened, and finally, the excess of skin is eliminated.

MENTOPLASTY OR CHIN SURGERY

Mentoplasty or chin surgery is a surgical procedure aimed to re-shape the chin, either by enhancement with an implant of fat tissue or by reduction surgery on the bone; improving the aesthetics and proportion of facial features.

This intervention can be performed by using three techniques:

  • Implant the prosthesis in the chin: This implant can be made of different materials, such as solid silicone, Medpor®, etc. It is possible to use an incision inside the mouth in order to place the implant, in the groove between the gum and the lower lip (intraoral route), or a small incision in the skin below the chin, similar to use in the lower facial third lifting or neck (external route).
  • Fatty tissue infiltration: Fat tissue from the same patient can be used, carrying out a lipostructure. Permanent results are obtained with this technique.
  • Advance or reduction surgery on the bone: This technique is carried out by advancing horizontal bone sections (or osteotomies), also by using the intraoral route. In these cases, the edge of the bone is displaced and immobilized in an exact and precise way, allowing correcting the defect and, if necessary, it is also possible to conveniently shorten a face that is too long.

Hospitalization will depend on the type of anesthesia used, however, if bone section occurs, hospitalization may be necessary. After the intervention, the area is immobilized, providing satisfactory results.

What different kinds of procedures are there?
  • Implant: silicone, Medpor®, etc.
  • Fatty tissue infiltration of the patient himself, achieving permanent results.
  • Advance or reduction on the chin bone.
Is hospitalization required?

It depends on the type of anesthesia. If the procedure is performed with local anesthesia and sedation, hospitalization is not necessary. Nevertheless, if the surgery is done with general anesthesia, hospitalization is required for one day.

How is the recovery process?

It may be necessary to immobilize the area after the surgery, by using a bandage, which will be removed few days later.

How is preoperative period?

The surgeon may recommend a chin surgery or procedure to a patient who undergoes a rhinoplasty, to achieve better facial proportions, since the size of the chin can increase or minimize the perceived size of the nose. The facial profile is improved too. It can also be agreed how many millimeters of advance will be achieved, and to perform a simulation prior the surgery.

Summary
Facial Surgery
Service Type
Facial Surgery
Provider Name
Dr. Tarragona,
Passeig de Gràcia, 60,Barcelona,Barcelona-08007,
Telephone No.+34932058334
Area
Barcelona
Description
Dr. Tarragona, rhynoplasty, eyelid surgery, otoplasty, face lift, neck lift, face and neck lift, mentoplasty

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