Facial FAQ's

Eyelid Surgery (Blepharoplasty)

Does eyelid surgery (blepharoplasty) hurt?

Usually there is minimal discomfort, but expect to be swollen for a few days and some degree of bruising is also anticipated.

When will I look normal after eyelid surgery (blepharoplasty)?

One and two weeks. Most of the time, the sutures are removed 3-5 days after surgery, then you may use makeup.

Will my eyes be equal after eyelid surgery (blepharoplasty)?

Most people's eyes are not perfectly symmetrical before surgery, and therefore, they usually aren't exactly symmetric after surgery. Every effort is made to balance the eyes as much as can be achieved, however.

When can I wear contacts after eyelid surgery (blepharoplasty)?

Usually one week after surgery.

When can I wear makeup after eyelid surgery (blepharoplasty)?

After the sutures are removed, usually three to five days after surgery.

Can you see the scars from eyelid surgery?

The upper lid scars are hidden in the upper eyelid crease. The lower lid scars are right below the eyelashes, so they usually hide very well also

Will it be obvious that I have had eyelid surgery?

After a couple of weeks of recovery, most patients are told that they just look more rested.

Can I have eyelid surgery in the office?

No, the eyelid is a sensitive and delicate area where every safety precaution must be observed. Either a general anesthetic or sedation is needed to allow safe surgery on the eyelids. An anesthesiologist administers those agents while Dr. Kirn performs the surgery.

Browlift

How is the brow lifted?

Dr. Kirn uses the endoscopic method of lifting the brow where a surgical telescope and internal sutures are used to anchor the brow in a higher position. The lift is also accomplished by weakening the muscles which pull the brow downward.

Will I still need Botox after a browlift?

The browlift weakens the frown muscles between the eyebrows, and usually improves or resolves most of the horizontal forehead wrinkles. However, there are some people who have very strong muscles that still benefit from small quantities of neurotoxin (Botox or Dysport) in those areas even after a browlift.

Does a browlift fix wrinkles around the eyes / crow's feet wrinkles?

The browlift will raise the outer part of the eyebrow which improves "hooding" of the outer eye, but it does not fix smile lines/crow's feet wrinkles. Those are best treated with neurotoxin (Botox or Dysport) for most folks.

Is a long incision across the top of the head necessary for a browlift?

No, Dr. Kirn performs the endoscopic version where only 3 small (about 1 inch) incisions are placed behind the hairline.

Will I lose hair with the browlift?

Not normally. The incisions are small and no hair is cut or removed for them. Great care is taken not to damage any hair follicles adjacent to the incisions, so hair growth is usually normal surrounding the scars.

Facelift

I had a facelift years ago, is it possible to have another?

Yes, we frequently perform facelifts on folks who have had previous surgery. Sometimes, the second operation is simpler than the first, other times not. We try always to use the existing scars and avoid new incisions. As with all facial surgery, the treatment is customized to suit your needs and goals.

What sort of anesthetic is used for facelifts?

Most of the time, we use general anesthesia for facelifts, but conscious sedation is also an option. Patients usually prefer general anesthesia since it provides a pain free experience in the operating room.

How long do I wear the chin strap?

Most facelift and neck lift patients use a chin strap only on the night of surgery. This is made possible by the use of the fibrin sealant, Artiss. We see most patients in the office on the day after surgery and remove the strap. Likewise, MACS lift patients are usually placed into a chin strap on the night of surgery, but may discontinue it the day after surgery.

When will my result be mature?

Most people are ok to go out in public two weeks after surgery, but there can be a lot of difference from one patient to another. Final results usually take 3-6 months.

Is there financing?

Yes, we do offer financing through Care Credit.

Will a facelift fix my neck?

It is usually best to address both the face and neck at the same time if both areas are in need of rejuvenation. These decisions are customized for each individual patient and are an important part of the discussion during consultation.

Will a facelift fix my wrinkles?

Facelift operations are intended to restore the skin and fat compartments of the face to a more youthful position. Therefore, they are not direct treatments for wrinkles. Wrinkles which are due to excess skin are usually improved, but wrinkles due to sun damage and muscle activity are usually unchanged. Additional procedures may be necessary to decrease those types of wrinkles.

Will a facelift decrease my smile lines and folds at the corner of the mouth?

The facelift operation itself does not usually improve these areas substantially. However, we frequently combine fat grafting with the facelift to gain additional improvement of smile lines and wrinkles around the mouth.

How long do the results last?

Most patients can expect the result to last for 7 to 10 years for both MACS lifts, and traditional facelifts. However, longevity of the result can vary due to the quality of your skin, how well you maintain your skin, how much sun damage, weight changes, and other factors.

MACS Lift (mini facelift)

I would like to do a "mini-lift" and not a full face lift - which is right for me?

Making this determination is a component of the consultation. The only way to correctly answer this question is to examine you and discuss your goals and expectations. We always try to do the least amount of surgery possible to achieve the desired result. Usually, patients who are good candidates for "mini lifts" have age related changes in the cheeks and jawline, but minimal changes in the neck. Our preferred "mini-lift" procedure is the MACS lift.

What is the difference between a MACS lift and a traditional facelift?

The MACS lift is a "short scar facelift" or a "mini-lift." It is useful for patients with minimal aging in the cheek and jawline, but not particularly useful for patients with a lot of aging in the neck. The advantages of a MACS lift are: generally quicker recovery, less time in the operating room, shorter scars, and lower cost. It is frequently combined with fat grafting and eyelid surgery, just like traditional facelift operations.

Is the MACS lift the same as procedures I've seen advertised on TV?

The MACS lift uses strong sutures to create a firmly anchored "foundation" to support the skin. This provides longevity of the result. Other operations which lift the skin only and do not provide support will not have long lasting results, although they can look good for a short while.

Facial Fat Grafting

Is fat grafting permanent?

When fat cells are transferred (grafted) from one part of the body to another, some of them live in the new location, but others fade away. Those cells which live remain in their new location for years. Over time, natural aging processes will lead to a gradual loss of fat cells in certain areas, so repeat fat grafting or other procedures may be needed to restore fullness.

How many fat grafting sessions will I need?

Fat grafting is best thought of as a process, rather than a single treatment. We perform fat grafting in the office as well as in the operating room. Generally, one to three treatment sessions are required to achieve optimal results, but it varies from patient to patient. Sessions are usually spaced 3 to 6 months apart.

How is fat grafting performed in the office?

Fat grafting in the office is very similar to having a dental procedure. A local anesthetic is used both at the area where the fat is taken from and the area where it will be placed. There is usually minimal discomfort, but patients typically sense some sensation of pressure. There is usually swelling and/or bruising for a few days after the procedure.

Necklift

Can I just lift my neck?

In some cases, where there is minimal aging in the face, an isolated neck lift operation is a good choice. However, if the jowls are prominent and/or there are other significant age related changes in the face, it is best to address both areas at the same time.

Nose surgery (Rhinoplasty)

Will my nose be packed after rhinoplasty?

Only in extremely rare situations does Dr. Kirn pack the nose. When a septoplasty is performed along with a rhinoplasty, soft silicone rubber splints are placed inside of the nose and remain for 5-7 days after surgery. These splints allow him to avoid the need of nasal packing.

When will I look normal after rhinoplasty?

The external nasal split and dressings will remain for 5-7 days and will be removed, along with any stitches, at the first postoperative visit. Some folks will have bruising, usually under the eyes, which will last another week or so. If there is no bruising, you will look "normal" except for some residual swelling in the nose after the dressings are removed in most cases.

How will we decide how to reshape my nose?

Dr. Kirn uses a computer imaging system which allows the patient to preview the anticipated surgical changes. Although it is not 100% accurate, and the surgical process is much more complex than just changing the photos on the screen, computer imaging really provides the patient, and the surgeon, an excellent pre-surgical plan. Always during the imaging process we want feedback from the patient to guide each modification.

Will my breathing be affected by rhinoplasty?v

If the only reason to modify the nose is for cosmetic purposes, then breathing is rarely affected. However, for patients who have breathing problems, many of those can be addressed at the same time as the cosmetic procedure.

How long does it take to get to the final result after rhinoplasty?

It usually takes a year to reach the final result in rhinoplasty. The long time for maturity is actually an advantage in rhinoplasty since the gradual change makes it more difficult for others to observe the changes as they occur. Most of the change is completed within the first 3-6 months, but the tip usually matures last, which can take up to one year.

Chin Implant

Is a chin implant right for me?

This determination is best made in concert with your surgeon. During the consultation, your profile and front photographs will be modified on the computer to give you and Dr. Kirn the best idea before surgery of whether a chin implant enhances your appearance, and if so, what size implant to use.

Do chin implants affect how my teeth fit together?

No, chin implants do not affect how the teeth fit together. If your teeth do not fit together correctly, then you will likely benefit from discussing that issue with your dentist, orthodontist, or oral surgeon. Dr. Kirn does not perform this sort of procedure.

What type of chin implant is used?

Dr. Kirn prefers porous polyethylene (Medpor®) implants. These are solid implants that remain in place and are secured to the bone. Because they are porous, they allow the surrounding soft tissues to grow into them so they very well accepted by the body and blend with it nicely. They feel like bone and do not move over time.

Is the chin implant permanent?

Yes, the implant is permanent and designed to integrate with the body by allowing the surrounding tissues to grow into it.

Will I be able to feel the implant?

The implant will feel like bone, just the same as your chin bone feels right now. Sometimes, patients can detect a slight bump at the edge of the implant, but that is uncommon.

Where is the scar located for chin implant placement?

An incision located under the chin is used for chin implant placement. Generally, this incision is about an inch and a half long and may be located in an existing skin crease. Dr. Kirn does not use an incision inside the mouth due to the risk of infection associated with that approach.