Dr. Khiem D. Lai, M.D.

Thank you for your question!
It is safe when you find a well-trained physician who likes doing it. You know, you may damage a facial nerve or inadvertently cut a blood vessel, causing profuse bleeding. Then you are not safe.

I don't use general anesthesia, so there is no risk associated with it. I control the pain with local injections and a mild sedation to make you feel relaxed, the techniques I have learned doing lots of skin excisions and liposuction. Most of my patients have reported minimal or no pain during the surgery, and very little post-operatively if there is any.

Yes, it is a safe but challenging operation since you want to look younger and more attractive when you are considering it. It will depend much on your expectations and the surgeon's if the outcomes make you both feel satisfied with the work.

There are multiple factors that will affect the aesthetic results. I have already discussed with you in my other posts.

To me it is a safe procedure, still you need to be careful and chose the right physician to meet your expectations.

Dear Friend!
Thank you for your question. I just want to take this opportunity to apologize to other Friends for not being able to answer your questions. I have been a bit busy with my personal stuff recently.

To your question: how long do the effects of a facelift last?

This is the question that we ask ourselves when we consider performing a facelift. The procedure has been evolving since I started doing it. Some surgeons think five years more or less, and it depends more on the surgeon who does it than on the techniques. I think it also depends on the individual aging process as much as, if not more than, the lift itself.

You know, there is a science of facelift as of any other surgical procedures, still we do aesthetics here. I don't think I can measure and be precise, or predict the results accurately. There are so many factors that may affect the outcomes. I do think it is an art form, so it depends on the performer and his or her work at that particular time when it is being formed. It may therefore vary a bit.

We have learned a lot about face-lift as an aesthetic procedure. Yes, we remove the redundant skin as we pull it up and sew it back along a designed curve to hide the cut. Yes, we also lift the sagging tissue under the skin after we have separated it from the skin.

There are areas where the skin anchors deep to the bone. Here are where some surgeons do release it to slide the skin over it. I am not sure if it helps much, since now the skin is under greater tension over a continous wider area. And, it will alter the 3-dimensional shape and become flatter over it when you redrape the skin. The flatness may improve the look in some cases, so it can be a good technique. You don't see the effect of the lifted soft tissue under but you see the contours over the skin.

This procedure is not a lift for me per se. I do facial contouring. I do cut and pull the skin and the sagging soft tissue up and anchor them to a higher point. You know, it is so safe now to do this type of surgery. I can take my time to do the work. I see the face as a whole with separated areas that need to improve.

I usually start with removing fat where needed and notice where there is some loss of volume. Every person is different in shapes and forms here. Then, I cut the skin along the lines that I think I can remove the skin where needed. This may not be a good analogy, but like you fix anything you may open it up totally and re-assemble it. This is a difficult task for me since everything is in its place originally. I just spend time on the particular areas that I think I can improve it and leave other areas as they are, so I don't screw up the other areas. If I need to do a revision, it is easier and will improve. I try not to make mistakes where there is no need to touch it.

Liposuction and fat-grafting are so effective. Although some fat graft may not live, the skin over it always improves its tone and elasticity. I appy the same principles as I do lipoabdominoplasty, but it is more complex, more difficult and time consuming to do facial contouring and rejuvenating it at the same time.

I may not have answered your question directly. If you only want to know on the average how long a face-lift lasts. I would say around five years. If you are the right person for a facelift technique, it may last longer. However, you should look younger naturally, not a tight facial skin.

Khiem Lai, MD

Aesthetic Physician and Surgeon

Thank you for your question.
The answer is no. You will not lose your double chin if you don't have any procedure done to change the shape or size (volume) of your chin. But your weight loss may change how your face looks in general.

Thank you for your question.
I may have answered this question before.
I don't think there is any harm. Still there are risks when you do any surgical procedure. Since I only do aesthetic surgery, the thing that I often see is the altered shape of your eyelid. And if it is not done well, there may be complications that affect your eyelid functions such as closing and opening your eyes.

Thank you for your question.
Answering to you directly, Yes, I believe so since some skin and soft tissue may be removed and where you make the cut. It will always become less volume. It is important to have the best shape that makes your eyes look more pleasing, and it also depends on your eyes shape. You may not see the results after weeks or months. So be patient. Rember we can always improve the results if you don't screw up the shape at your first surgery. Don't rely on before and after photos. Every eye is different on every individual.

Thank you for your question.
It takes me at least an hour and a half to complete the procedure that I prefer, upper or lower eye lid surgery. I don't ever over-correct, removing too much skin or soft tissues (usually some fat). And I do the local anesthesia myself, so it may take me a bit of time. It's a safe procedure and I try my best to get the aesthetic results that both the patient and I are happy about.

Thank you for your question.
Please discuss with your doctor what change do you want with your ear (or ears) as you are seeking a plastic procedure? I am not sure what specific concerns you have considering plastic surgery. As with other plastic surgeries, there are risks and a wound healing process. And I guess you are considering an aesthetic procedure. Ask your surgeon if he can do and get the results that you expect. To answer your answer directly, you need to avoid the things that you should when you have any plastic procedure done. You need to let your surgeon know your concers, the more specific, the better.
I do facelift and I try not to alter the natural shape and size of your ear on both sides.

Thank you for your question.
I don't think you can't speed up the healing process but may prolong it if you don't follow your post-op care instructions. The healing process is different depending on each individual and the procedure done. I think I have talked about this in my other posts. Just be patient, your wound is healing naturally if the procedure was done well.

Thank you for your question.
This is a very very difficult question that you have asked to me.
I haven't the shape of your nose in relations to other structures of your face and more importantly what shape you want, how it makes you look more aesthically attractive. Then I can see if I can do anything to make you happy, not much that I really think it looks good on you. So ask yourself why you want to change your nose shape. Remember you could not see how that shape looks on your face until it was done. You might not like it then. I don't use software to show you before and after pictures, and I don't rely on it. There are so many factors that may affect the outcome. So just work with your surgeon and he can do his best to get the shape that you want if it is in his ability.

I don't think I have really answered your question but hopefully made you think more about it.

Thank you for your question.
It is tough to fix scars anywhere on the body. We want scars to be less noticeable, flat and more like skin tone. You ask eyelid scars. If you still have enough skin there, I will try to remove the skin with the scars and reshape your eyelids but you need to wait for 6 months after your previous surgery. If you don't have enough skin there, I cannot do much. We may try to inject steroid to flatten the scars and soften them and wait until we can do the revision. Usually the scars get better with time; so If your eyelid shape is good, just be patient. As with any aesthetic surgery, you should not expect perfection. There are many factors that affect the outcome. Your skin and soft tissue are living things, not a piece of plastic or clay. They change with time. And like a sculptor, your doctor can only do that much considering safety first.

Thank you for your question.
Yes, aesthetic plastic eyelid surgery is safe. Still any surgical procedure carries some risks and complications. I only do aesthetic blepharoplasy; so I can say it safe. The problem that I may have to deal with is the aesthetic outcome. It depends on so many factors, not the surgical technique itself.

Thank you for your question.
To answer your question directly, it takes 3 to 6 months to really see the results. It depends on the particular patient and the procedure done. The healing process varies a lot. I try not to injure the soft tissues and control the bleeding without so much cauterization and minimize the damage to the skin.
Normally you may have swelling for the first few days; if you have bruises, it takes a week or two to resolve. I do remove sutures that I do to close the skin in a week or so. You look pretty OK in 2 to 3 weeks. Be patient. If there is a adverse problem or complication, especially aesthetic concerns, we can always deal with it, since I do it conservatively and can improve the results later if we need to.

Thank you for your question.
There are a few techniques to do necklift and it may be combined with facelift. I don't do deep necklift. So you should always communicate with your doctor if you have any concerns.
I just give you my post-op care instructions that I tell my patients. You may expect swelling especially in the first few days; and if there are bruises, it will take a couple weeks to resolve. I do remove the sutures in a week to 10 days. You should be able to move your neck almost fully in 2 weeks but be aware the wound is still healing. If you don't move your neck side to side a lot when swimming, you can start doing it in 2 weeks. I advise you to go back to swimming in 6 weeks.

Thank you for your question.
In general you breathe better as the swelling is going down. It may take a few days or sometimes weeks. I don't know how your surgeon dressed your wounds and if he or she needed to remove some sutures. The inflammation and healing process may be different from person to person. If you didn't have any breathing problem before surgery and the procedure was done well (no complications), you should breathe almost normally now after 10 days post-op. A sure thing is asking your doctor and may have him or her have a look (and make an exam) of your nose.

Thank you for your question.
It depends on the specific procedure you have done and the style of your swimming. In general, if your head is above the water, you can start swimming after 2 weeks or so; but if you swimming butterfly style, I would advise at least 3 months. You just need to be aware that you have had the procedure done, don't let too much sudden pressure on it. So anywhere about 6 weeks you may enjoy swimming again.

Thank you for your question.
I guess you mean aesthetic plastic eyelid surgery. To my patients, I advise to wear sunglasses the day of surgery when they are good to go home but on the day of surgery and maybe the next day too, if it is still swollen a lot, you have to have someone to drive you. Since eyelid surgery does not affect your vision, you just need to wear your reading glasses if you need to and you should put on teardrops if your eyes are dry.
Sunglasses you can wear whenever you want to wear to protect your eyes from the bright light.
And makeup you can wear whenever you want just keep the wound clean and moist. Don't touch the wound too much if you don't have to. And try to avoid makeup powder get in the wound, it may irritate it or cause allergic reactions.

Thank you for your question.
You don't have to and some doctors don't think it helps. Still I recommend and give antibiotics after the procedure and pain med to take as needed.

Thank you for your question.
Every doctor has his or her way to do the procedure and will answer your question. I only tell you what we expect if I do it.
The first couple you may have some swelling. I only cut the skin and manipulate soft tissue, your vision should not be affected. We don't worry about damaging any nerves there but I do need to control bleeding, so you don't have a big bruise. If you have bruises, it may take a week or two to resolve. I close the skin with unabsorvable sutures, so you need to have suture removal in a week. There may be some swelling in the morning for a couple weeks. At sixth week it should be good. But healing time may be 3 to 6 months or even longer. And remember each person is different.

Thank you for your question.
You should ask your doctor when you have any questions or concerns.
I just give you my answer to my patients.
You can touch you nose whenever you feel like doing it, just don't push or pull hard on it and be careful if you touch the wound, keep it clean and moist with antibiotics oilment, not wet. Follow your doctor instructions.

Thank you for your question.
You can expect significant swelling in the first few days, but you may have swelling for weeks or even months especially in the morning. We just need to monitor the process and treat if there is a complication.