Dr. Christian George Drehsen, M.D.

Can a double chin be fixed ? yes it can be but the method used to correct it requires an evaluation by an experienced plastic surgeon. It can be summarized in 3 methods depending on the amount of fat deposited ,the amount of loose skin and the underlying depth of the neck anatomy ,(the deeper the better!) The simplest method mostly reserved for younger individuals with contractile skin and favorable neck contour is a simple but aggressive liposuction . in older individual with neck bands or more blunted neck an open approach may be necessary requiring a more extensive shaving of the fat layer and modification of the neck anatomy by plicating the muscle bands and deepening the neck contour .Finally when a substantial amount of skin looseness is added to the combination of fat deposit plus muscle bands ,the answer is a true neck lift which is the product of a lower face lift !

Great question ,dont we all worry about lengthy surgeries and their potential long term harm , but there is a difference ,especially when one talks about your own face or your own teeth where only 2 things count : the right esthetic choices and a natural finish ! A wavy incision properly placed is quasi invisible but take 2 to 3 times longer to complete than a very visible straight line and simple one hour one direction face lift and its pulled look doesnt ccome close match the beauiful and natural results of my 3 h Refresherlift ,longer but well worth if ,especially as your are sedated with numb skin for over 3h . For your own edification please visit ww.cliniqueps.com

hi Amazingly enough, modern techniques of nose surgery , even when addressing septum or nose deviation issues , are very well tolerated .Postoperative pain is often feared as being very heavy, is rather light and easily controlled by medications . The social embarrassment is modest and usually relates to some nose bandages worned for 2 days and a nose splint worned for 7 to 10 days. The nose is usually not packed which allows for a reasonably comfortable breathing and swallowing. Swelling around the eyes usually abates after 4 days , Moderate traces of bruising can last b for up to 10 days .In conclusion , the nose bruising and discomfort do not linger ,the benefits there for a lifetime .For references take a look at our nose procedures at cliniqueps.com.

Excellent question,cheek liposuction provides indeed a permanent cheek thinning as long as one keeps its own weight unchanged .A more limited and permanent thinning of the mid lower cheek occurs after buccal fat pad removal .In this latter case too aggressive a removal could produce some significant hollowness especially after a severe weight loss . Consulting an experienced board certified plastic surgeon is advisable to choose the safest appropriate procedure . You can see some beautiful results at cliniqueofplasticsurgery.com Dr Christian Drehsen , Board certified plastic surgeon

The answer is yes and is not uncommon, but the extent or potential benefits vary from case to case. A waiting period of at least 12 months is standard. When in doubt, choose a qualified surgeon.
Good luck to you.

Is brow lift surgery permanent? Yes, but some softening will normally occur. Brow lift is often essential if one seeks to correct a sad, angry, or tired expression, or to simply glamorize the eyes. In my *Refresherlift* experience of about 1000 cases, my *DualPlane* Brow Lift has been used in about 70% of the cases to successfully improve one's aging expression. A modest excess elevation is performed in some cases, in anticipation of a minimal recurrent drop of the brow. Plenty of examples can be seen on our website at www.cliniqueps.com
demonstrating beautifully the effect of our DualPlane Brow Lift.

Can a nose be reshaped without surgery? YES, non surgical Rhinoplasties with fillers can suffice in a number of cases as a primary or a secondary surgical operation. However, filler Rhinoplasties do present some definite limitations in the quality, permanency, and extent of the correction, as well as some serious inherent risks! Their primary role in my mind is to offer in some cases a reasonable alternative to an expensive or risky surgical procedure. *As a primary approach* (in a non operated nose), a filler can often be used to camouflage some flaws of the bony or the soft part of the nose, i.e., bridge dip, bony irregularities, mild deviations, tip support or asymmetries, impaired breathing, or to raise the nasal bridge or improve tip
definition as well as chin /nose ratio. *As a post-surgical corrective method,* fillers can be quite helpful for minor post-rhinoplasty flaws and often for the same indications than in the primary approach. Caution: In untrained hands especially, filler injections in the nose have produced some disfiguring consequences! In my opinion: Filler Rhinoplasties, whether primary or secondary, should be performed solely by surgeons specifically trained in surgical rhinoplasties such as Board Certified Plastic surgeon, Facial Plastic surgeons, or E.N.T surgeons. The severity of the complications can be due to the "injector" over fill with semi permanent fillers or the blockage of the nasal skin limited arterial circulation and its resulting disastrous skin loss.
In summary:
-Effective with limitations: YES
-High risk potential in untrained hands: YES
-Do your homework!

Christian Drehsen, Board Certified Plastic surgeon

Great question. The technique is important as some techniques commonly advertised can often make the forehead look higher! Our "dual plane brow-lift" technique will lower the hairline as it elevates the brow, producing a well-balanced, more youthful and appealing look. Please take a few minutes to see several before & after examples at:
www.cliniqueofplasticsurgery.com

As a board certified plastic surgeon, my key interest is cosmetic improvement of the nose and restoration of proper facial balance. During a rhinoplasty procedure, we commonly repair significant septal deviations or old nasal deviations from fractures and sometimes inject enlarged tubinates to improve restricted breathing capacity postoperatively. Empty nose syndrome is seemingly a complication associated with aggressive turbinates removal and sinus procedures. These treatments are usually reserved to Ear, Nose andThroat specialists (Oto rhino laryngologists) and unlikely to be performed in cosmetic procedures!

Yes, an earlobe reduction is a simple procedure easily done under local anesthesia. However, when a stretched earlobe, also known as "Pixie ears," is the result of a poorly secured previous facelift, the procedure is more challenging and might sometimes require a secondary facelift with a revision in a vertical direction, such as with the refresher lift.

As always, if it it too good to be true...it's another scam!!

Facial liposuction which is mostly indicated for the neck and chin area is just like any other area of liposuction , permanent with very rare exceptions , Obviously the procedure will only succeed for the right indication and excess skin looseness not a real problem but also if you maintain your weight after surgery .Weight gains after liposuction may not affect the suctioned area but will likely affect the surrounding area . Good luck with our procedure.

Christian Drehsen MD
Board certified plastic surgeon

Upper and lower lid surgeries rarely need redo when the surgeon performs the right sequence of procedures or basically evaluate that nothing around the eyelids truly needs a correction that subsequently will affect the lid position and possibly create the need for a revision .
A common example in my consultations is the case of patients that underwent an upper lid trimming without proper treatment of a droopy brow . The same issue exists when considering treatment of the lower lids without regard for a droopy cheek that may require a cheek lift that will subsequently affect the lower lid repair . In one word my advice in facial rejuvenation is always to consider the face as a whole and especially to evaluate the need for a brow or cheek uplift prior to engaging in a trimming of the lid' skin or in simpler terms check where your belt should be before adjusting your cuffs .

Christian Drehsen M.D.
Board Certified Plastic Surgeon

Hi Dear,

Having had an extensive experience in face lifts (over a 1000) I have become convinced that when the projected results of a face lift justify the operation, it is the right time. My personal approach focuses a lot on restoring an engaging, dynamic and youthful expression, not merely tightening the skin! Why let aging damages worsen irremediably when a procedure done at a relatively early age will produce splendid results and continue to be enjoyed for years?

If you want, check it out and look in the mirror and gently lift your cheeks up and back with 3 fingers.If the improvement is obvious, correcting the early neck fullness, early jowls and a tired look, you get it's time!! Often people believe that fillers will do the job, beware because more and more filler issues are arising (a.k.a. "Pillow Faces" ) and sometimes very difficult to correct. Fillers fill not lift! Computer imaging is invaluable to preview results, seek a surgeon that provides it .

For some illustrations, you can visit my refresherlift.com site. Hope this helps.

Christian Drehsen, MD, Board Certified Plastic Surgeon

This could be a double question.

1 About Post Operative Recovery:

Pain is not a common issue in face lift recovery and is well controlled by medication and prevention of swelling with cold compresses, cold mask, etc. Swelling and distortion are often disturbing but virtually always fade away around the 5th or 6th day. A short course of steroid can help but is not advised if fat grafting is performed as part of the lift. Most lifts are socially presentable after 7 to 10 days unless some severe bruising has occurred. A face lift become quite natural after 5 to 6 weeks and continue changing for several months .

2 About Results Versus Expectations:

If you are lucky enough to have a board certified plastic surgeon that performs computer imaging, the anticipated results will be much less of a surprise and reduce your anxiety. If your surgeon has designed your procedure well enough to avoid the feared "Face-lift look", your results should ideally be a fresher, rejuvenated face with a more engaging look. My practice focuses a lot on improving an aging expression, restoring youthful volumes and a vertical type of up lift such as my RefresherLift. The focus in my mind is the reason that virtually all my patients have received plenty of compliments on their new look from their entourage that has remained wondering if they had lost weight, exercised, changed hair style, etc. but have never suspected a face lift! A face lift ideally should restore in your face the vitality your still carry at any age.

Best of luck to you!

Christian Drehsen MD, Board Certified Plastic Surgeon

Cheek implants are usually indicated for a rather poor projection of the cheekbone areas. The modified implants that fill the mid cheek have now been replaced by fat injection, mid face lift or even injectables. Not a minor enhancement of the cheekbone areas some injectable like Radiesse can do a great job for a long time.

In a word, no. If done by a well-trained practitioner, ideally a plastic surgeon with a good esthetic sense (so look at his website!), in some cases, fat injection and/or minor surgical correction of the lip can be indicated to obtain a stunning result. My only word of caution is, do not use permanent fillers (i.e. silicone, bellafill, or other filler containing non-reabsorbable components) beside hyaluronic acid base fillers since H.A. can be easily dissolved and with time disappear.
Enjoy your experience.

You pose a very interesting question! In my extensive experience, however, doing a true abdominoplasty along with a delivery might not the best choice for several reasons. The main one being often the need to repair the separated belly muscles (to regain a flat stomach and best performed on the entire length of the 2 muscles often spread above the belly button) ,the potential detrimental effect of weight excess, potential surgical complications and limiting recovery, their effect on breast feeding, and finally the lack of a timely natural recovery. Most often in my experience, the so-called tummy tucks commonly performed by the delivering Ob/Gyn were due to the circumstances, barely a mini tuck with an often mediocre skin and muscle repair! Unless your tummy changes from the pregnancy are minimal, my advice would be for you to give yourself time to enjoy your new baby, lose the excessive weight that you have gained, restore your body fitness and schedule with the right perspective and family help your true abdominoplasty! A tummy tuck well planned and artistically performed by a board certified plastic surgeon can indeed be can be a life changing procedure for women that have suffered significant skin and muscle changes after a single or multiple deliveries. The before and after surgery preparations, the esthetic goals such as placement of the incision low, hopefully below bikini line, in the natural creases, a flat stomach, a pretty belly button, a trimmed waistline, etc., as well as the risk and potential complications, should be clearly explained by your plastic surgeon before your surgery.

Christian Drehsen, M.D. Board certified plastic surgeon

At 17, if you are a boy, or 16 for a girl, while you indeed need your parents' approval, your nose has virtually reached its adult size and can be operated on without issues. Correcting a nose is trying to harmonize the different parts of the nose, such as the bridge or hump and tip within themselves or to make the nose blend with the other facial features. I would recommend a plastic surgeon with experience and also preview of his/her plan by computer imaging.

Dr. Christian Drehsen, MD

A pediatric urologist or a pediatric plastic surgeon would be fine and important to see at his age.