FACIAL PLASTIC &
RECONSTRUCTIVE SURGERY
Michael C. Neuenschwander, MD


What is a Facial Plastic Surgeon?

What is a facial plastic surgeon?
Appearance plays a big role in the lives of most people.  We begin the day looking in the mirror-washing our face, brushing teeth, combing hair, shaving, putting on make-up.  For some, the reflection can cause displeasure due to accidents, birth defects, or other signs such as premature aging.  Many of these conditions can be improved surgically and many people choose to put their faces in the hands of a facial plastic surgeon.  A facial plastic surgeon specializes in performing cosmetic and reconstructive surgery on the face, head, and neck region.

A facial plastic surgeon is typically board certified in otolaryngology, the specialty addressing surgery of the head and neck.  These surgeons perform the majority of elective facial plastic surgery procedures in the United States.  The facial plastic surgeon has spent five to six years in post-graduate surgical training.  Training includes one year of post-graduate training in general surgery and at least four additional years of specialty training in head and neck surgery and facial plastic surgery.  Concentrating on the complex anatomy, physiology, pathology, bio-chemistry, and bacteriology of all the organs and structures of the head and neck, provides the facial plastic surgeon a strong focus on the anatomical region being treated.

When do you need a facial plastic surgeon?
The reasons for facial plastic surgery are varied.  Some patients suffer from birth disfigurements such as birthmarks, cleft palates, and congenital facial deformities.  Others are victims of accidents, burns, diseases, and the treatment required for such diseases.  Many choose to change some of the signs of premature aging or the shape or size of a facial feature that has bothered them for years.

A facial plastic surgeon performs the following:

1. Rhinoplasty: Surgery of the nose where cartilage and bone are reshaped and reconstructed; excess bone or cartilage may be removed.  Recovery time is approximately one week.  
   
2. Blepharoplasty: Surgery of the eyelids where fat and excess skin, bags, pouches, wrinkles in the eye area are removed.  Recovery time is approximately one week.
   
3. Rhytidectomy: In facelift surgery, excess skin is removed and muscles are tightened.  Recovery time is approximately two weeks.
   
4. Forehead Lift: Surgery to minimize forehead lines and wrinkles, and elevate brows to reduce lid drooping.  Recovery time is about 10 days.
   
5. Submental Lipectomy: Surgery beneath the chin to eliminate "double" chin; excess fat is removed.  Recovery time is approximately one week.
   
6. Mentoplasty: Surgery of the chin where a receding chin is augmented with an implant or a too prominent chin is reduced.  Recovery time is about one week.
   
7. Facial Reconstruction: Surgery to repair or reconstruct facial features in victims of cancer, facial trauma, and birth defects.
   
8. Collagen Implant: An injection of natural protein which puffs up and raises skin tissue to smooth out and make less visible wrinkles and scars.  Recovery time is about three hours.
   
9. Chemical Peel: Controlled removal of the outer layer of skin with specific chemicals.  Recovery time, depending on the nature of the chemical, is from one to three weeks.
   
10. Botox: Injection of chemical to temporarily weaken the muscles of the face that cause deep wrinkles such as crow's feet and frown lines.  Recovery time is immediate.

How to find a facial plastic surgeon
The American Academy of Facial Plastic and Reconstructive Surgery instituted a toll-free number, 1-800-332-FACE in the United States and Canada, that provides inquirers the names, addresses, and telephone numbers of facial plastic and reconstructive surgeons in the inquirer's area who specialize in the inquirer's desired surgical procedure.

In addition, as with many things, word of mouth is often best.  It is helpful to talk with friends, relatives, and co-workers who have had or may know someone who has had facial plastic surgery.

You may want to ask the following questions:

•  How did they locate the surgeon?
  
•  Were they happy with the results?
  
•  Would they return to the same surgeon for another procedure?

General practice physicians may also be able to recommend facial plastic surgeons with whom they may have worked.  It is still important to validate the training, skills, and experience of the surgeon.  The directory of Medical Specialists, available in public libraries, can be used to check the credentials of any referral you may have been given.  Facial plastic surgeons will be listed under the heading "Otolaryngology."

One aspect of facial plastic surgery that cannot be ignored is the patient's mental and emotional attitudes.  Facial surgery can help you increase self-confidence because, for most people, when they look better, they generally feel better.

Choosing a facial plastic surgeon
One of the most important factors for successful facial plastic surgery is the relationship between the patient and surgeon.  An initial consultation provides the patient and surgeon an opportunity to discuss all that is involved in the desired procedure.  It is advisable for the patient to write questions down before the consultation.

You may want to ask the following questions:

•  Am I a good candidate for this procedure?
  
•  How long will the operation take?
  
•  What is the recovery time?
  
•  What are the risks involved?
  
• Is post-operative medication necessary?
  
•  What is the charge for the procedure?

The patient should be prepared to be candid with the surgeon about their medical history, any medications, allergies, habits, and background which could affect the outcome of the surgery.  The surgeon will also explain to the patient their experience in the area of facial plastic surgery the patient is considering.  Some consultations may include computer imaging to show the patient what the surgery might accomplish.  The surgeon can also describe what anesthesia the surgeon uses for each of the surgeries the patient is contemplating.  The surgeon might also advise on supportive surgery to enhance the outcome of the specific surgery.  It is crucial for the patient to find out about all aspects of the proposed surgery.