Cosmetic Surgery

Earlobe Repair

Quick & easy procedure to repair earlobes that have been stretched, split or torn from wearing earrings. Unsightly and lumpy keloids can also be repaired under local anesthesia Earlobe repair is performed by Dr. Joanna Chan with suture removal one-week post-procedure. Ears can be repierced in-office 6 weeks later.

Subcision  

Subcision is a simple and safe office surgery procedure for treatment of depressed acne scars. Can combine with laser, microneedling, and chemical peels for optimal results.

Scar Revision

Surgical revision of scars with injections, lasers, or local anesthesia surgery.

Blepharoplasty (Upper Eyelid)

Saggy or drooping eyelids can be an age-defining feature for many people. It is a major reason people consider eyelid surgery (blepharoplasty) to remove the excess sagging skin and to create a more alert and youthful eyelid appearance. The blepharoplasty procedure is safe, and it can be performed under local anesthesia while you are awake. The numbing procedure is similar to getting a skin biopsy. The excess tissue is removed, and the scar is hidden in the crease of the eye. Incisions are virtually unnoticeable after they have healed.

Pain medications and relaxing medication are given orally 1 hour prior to the eye lift procedure, so a driver is necessary. Consents must be signed before taking these. After the area is numbed, the procedure itself is essentially pain-free, and the recovery is associated with minimal discomfort. Most people do not need narcotic medication afterwards, but you will have a prescription to take if needed. You will need a driver because you will be unable to drive home due to the pre-medications given. You will be able to see well immediately after the procedure. The whole procedure, including numbing, takes about 2 hours, and your driver will be called prior to finishing the procedure.

In some patients, blepharoplasty can improve vision by increasing the peripheral vision and providing a less obstructed field of view. Often, you must have severely droopy eyes hanging over the eyeball, in order to qualify for insurance reimbursement. The cosmetic eyelid lift is not covered by insurance, as an artfully designed lift is created to maximize the cosmetic benefit, rather than taking the minimal amount to allow you to see better.

The risks associated with the procedure are similar to having a biopsy. There is a risk for pain, bleeding or bruising/hematoma, infection, and decreased sensation in the upper eyelid, which improves with time. You will take an oral antibiotic to prevent infection. Nearly every patient has baseline asymmetry, where one eyelid is worse than the other. It is possible to reduce the asymmetry with surgery, but perfection may not be possible. The position of the eyebrow remains unchanged.

Prior to eye lift surgery, you need an eye exam with an optometrist or ophthalmologist stating that your eyes are healthy, noting if you have any history of dry eyes or reasons that you cannot have an upper eyelid lift. If you do have dry eyes, you can still have surgery, though a smaller amount must be taken.

The eye lift blepharoplasty procedure, including all the visits before and after the surgery is a package price. You will have a pre-operative visit 1 week prior to the blepharoplasty procedure where photographs will be taken, consents will be signed, and questions answered. You will receive a prescription for sedating medicine that you must bring with you. If you use Latisse, you may resume this medication 6 weeks after the blepharoplasty procedure (FDA approved to improve the thickness and length of eyelashes). The aging process will continue, and you may want to repeat the blepharoplasty procedure at some point in the future. However, depending on your health and other factors, an upper eyelid blepharoplasty can last on the order of 10 years.

Smokers, diabetics, and patients on blood thinners are at increased risk of surgical complications because they heal more slowly. You should stop any blood thinners (aspirin, fish oil, Vitamin E, ibuprofen – see list) 2 weeks prior and limit alcohol intake. Arnica pellets can be purchased, which will improve bruising. You should start taking 5 pellets, 3 times a day, beginning a week prior to surgery. These can be purchased on Amazon.com or most Whole Foods stores. You will eat as normal prior to surgery, and take your pre-operative antibiotics. Do not wear any makeup on the day of surgery and do not wear contact lenses.

Prior to the blepharoplasty procedure, a purple surgical pen will be used to create precise markings to designate where the excess skin and fat pads need to be removed. These markings may stay on your skin for 1-2 days after surgery but will fade easily. During the procedure, the decision for how much tissue to remove will be made based on an evaluation of factors such as your underlying facial muscle structure, bone structure and the symmetry of your eyebrows.

After surgery, you should apply cold packs (or frozen peas) every hour for 5 minutes over each eye. The ice can reduce the swelling and keep bruising to a minimum. Sleep on two pillows and avoid bending over where your head is below the level of your heart. Expect minimal, mild discomfort during the immediate recovery period. If the pain is severe or any abnormal symptoms develop, call the office immediately.

While you recover, your eye area will be bruised and possibly swollen almost shut, particularly during the first few days. It may take a few weeks for healing to be complete, during which time you should not wear eye makeup. You can wear makeup on the cheek area, where a bruise may develop. You can resume wearing contact lenses when the eyelid swelling subsides enough to allow the lenses to be comfortable. If you wear eyeglasses, you can put them on carefully at any time after surgery.

Sutures are removed in 6-7 days, although you may have a black eye or experience bruising which may last 7-10 days. Some patients have delayed swelling, though most experience a full recovery by 2-6 weeks. Collagen continues to remodel over 6-12 months. Most patients have a follow-up visit at 6 weeks, 6 months, and a year after the procedure. During this recovery time, sunscreen and sunglasses are critical to improve wound healing and scar appearance. You can use silicone gel and massage to improve the recovery process.

The upper eyelid blepharoplasty is a procedure associated with a very high satisfaction rate and improved self-image. It can easily result in a more natural and youthful appearance and erase 5-10 years, while not changing the shape or overall character of your face. You can protect your investment by using skin firming cream, reapplying sunscreen every 2 hours while outside or driving, and continuing to see a board-certified dermatologist for your skin care needs.

Thread-Lifting & Local Anesthesia Lift

Instalift provides lifting and a more defined jawline for those not wanting a full face lift or neck lift surgery. Threads are inserted under local anesthesia to stimulate collagen over years. Excess skin can also be excised under local anesthesia, with scars hidden in folds.