Face Procedures
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Select Your Procedure
Facelift
If you’re considering a Facelift
As we age and expose to the sun, our skin and the fat over our face tends to sag. This affects more over the mid face (cheek area) and results in nasolabial folds (laugh lines form the side of the nose to the lips). Some develop jowls and in others the neck tends to sag. The fat in the midface tends to drop vertically down and this results in a deflated face. Rhytidectomy or a face lift cannot reverse the effects of aging but it can certainly can turn the clock back so that you look a decade younger.
All facelifts are not equal and in the past it has been associated with stigmata of a tight and stretched face. It was as if women with facelifts could be recognized a mile away in a party. Well, the good news is that things have changed. Facelifts are now done very differently. The downtime is reduced to a week and surgeons are doing less to achieve more. A facelift by Dr. Rane has minimally to near invisible incisions after surgery. The predominant correction of sagging is vertically up so that your face looks full and not stretched. The before and after photos below will show you how a natural face can be created without the typical facelift look. It is as if a decade has been taken away from your face. Their face is not changed it is just more youthful and rejuvenated.
Types of Facelift:
- Full Facelift: Includes lifting your midface (cheek fat pads), improving your lines by your nose, eliminating your jowls and finally improving the contour of the next dramatically.
- Neck Lift: Eliminates your jowls and improves the contour of your next dramatically.
- Mid Facelift: Includes lifting your cheek fat pad. Commonly combined with eyelid surgery.
All Surgery Carries Some Uncertainty and Risk
When a facelift is performed by Dr. Rane, complications are infrequent and usually minor. You will have swelling over your face which will take 7-10 days to subside. You can rarely develop a hematoma or collection of blood. If it does you may require an additional surgery to remove the blood clots. Smoking can impair healing and this can result in some areas not healing. It is therefore very important to stop smoking prior to surgery to reduce complications. Rarely you may have some asymmetry of face temporarily due to the swelling. This will subside.
When Your Surgery Will Be Performed
A facelift will be performed at an outpatient surgery center, or a hospital. It’s usually done on an outpatient basis. If you have diabetes or high blood pressure, you may require a short inpatient stay.
Type of Anesthesia
Your facelift will be performed under local anesthesia and sedation if you have an S Lift. If you have a neck lift or a regular facelift the surgery will be done under general anesthesia so that you will sleep through the procedure.
The Surgery
A facelift usually takes 3-4 hours or somewhat longer if you’re having more than one procedure done.
The incision is placed in the sideburn or barely into your hairline. The incision then runs just around the cartilage in front of the ear and then tracks behind the ear onto the hair behind the ear. The skin and fat are then lifted and your fascia is then tightened. This allows the face lift to lasts much longer. The vertical direction of the facelift correction results in a very natural appearing face following the surgery. The fat is also trimmed and excess loose skin is then removed. Sometimes an additional incision is placed underneath the neck to allow correction of the neck. All the sutures are placed under the skin and do not need to be removed. A small drain is left at the end of the surgery to allow the blood to be drained. The drain is removed in a few days after the surgery.
After Your Surgery
There will be some swelling on your face after the surgery. The swelling can be reduced by application of ice and sleeping in the upright position. Facelift are not very painful and you will receive pain medications to reduce your discomfort. If you have persistent pain, please call me so I can check out whether you have a hematoma or not. There may some asymmetry of the face as there may be more swelling on one side than the other. The skin over the face may be numb for a very few weeks to a month or so.
Your drainage tube will be removed one or two days after surgery. The swelling and bruising will subside in a week to 10 days, so please be patient.
Getting Back to Normal
You will be up and about the next day or so. Take it easy and give some time for your face to heal. It may take 10 days to two weeks for the swelling to subside and you will be to visit your friends and attend social functions at that time. You can walk briskly in two weeks and you perform aerobic exercises in four to six weeks. You can apply make up on your face in a week to 10 days to camouflage your bruises if you have any.
Your New Look
As your swelling on your face subsides you will start seeing the results of the surgery. You will see that your face outline will be more defined and your will appear youthful. You will look in the mirror and thank yourself for doing this to your face.
Before & After Gallery
Mid-Facelift
If you’re considering a Mid-Facelift
As we age and over expose ourselves to the sun, our skin and the fat over our face tends to sag. This affects more over the mid face (cheek area) and results in nasolabial folds (laugh lines form the side of the nose to the lips). Some develop jowls and in others the neck tends to sag. The fat in the midface tends to drop vertically down and this results in a deflated face. A Mid face lift cannot reverse the effects of aging but it can certainly can turn the clock back so that you look a decade younger.
The Cheek Fat Pad is that Fat that Overlies your Cheek Bone
It is extremely important to correct the cheek fat pad and elevate it to the new position just like you had it 10-20 years ago. In the past the cheek fat pad has been lifted up and out resulting in a wide cheek appearance that most patients did not like. Now a new FDA approved technique is available to elevate the cheek fat pad vertically up and therefore prevent the problem of widening of the cheek.
A new and FDA approved revolutionary approach to cheek lift (Midface lift)
These devices are called Endotines® and they can be used to elevate the brow, the cheeks and the neck. They provide a fast secure and reliable method of fixation as compared to a single suture. The multipoint fixation is unique and is a breakthrough in the method of fixation. It is designed for simplicity and reliability.
Endtotine cheek lift: A more youthful face is a full face not an empty deflated sagging face. Endtotines® are now available to lift the cheeks too.
They can be combined with your lower eyelid surgery without any additional incisions. If you do not need a lower eyelid surgery the device can be inserted through a small incision in the crow’s feet area and a small incision in the mouth. A small strip with the Endotine® is inserted after your cheeks are elevated and attached to the bone. Once again the device dissolves and disappears in six to nine months leaving the cheek elevated for a prolonged time. And the good news, the device in the cheek cannot be felt. The surgery can be done under local anesthesia or general anesthesia and recovery is short too.
All Surgery Carries Some Uncertainty and Risk
When a mid facelift is performed by Dr. Rane, complications are infrequent and usually minor. Your lower eyelid can temporarily sag and this will correct itself as swelling subsides. You will have swelling over your face which will take 7-10 days to subside. Smoking can impair healing and this can result in some areas not healing. It is therefore very important to stop smoking prior to surgery to reduce complications. Rarely you may have some asymmetry of face temporarily due to the swelling. This will subside.
When Your Surgery Will Be Performed
A mid facelift will be performed in my office or at an outpatient surgery center. The procedure takes one to one and half hours to perform
Type of Anesthesia
Your mid-facelift will be performed under local anesthesia and oral sedation or it can be performed under general anesthesia at an outpatient surgery center.
The Surgery
A mid face lift typically takes on to one and half hours to perform. If you are having a lower eyelid surgery the midface lift can be done through the incision of the lower eyelid surgery. If however you are not having a lower eyelid surgery a small incision is placed in the crow’s feet and small incision is placed inside the mouth so that you have minimal scar and tell tale signs of surgery to lift your midface. Once the incision is placed, the cheek fat pad is elevated in a vertical direction and midface device is inserted to hold the cheek fat pad in more youthful position. The incisions are closed. No drains are necessary.
After Your Surgery
There will be some swelling on your face after the surgery. The swelling can be reduced by application of ice and sleeping in the upright position. Mid Facelift are not very painful and you will receive pain medications to reduce your discomfort. If you have persistent pain, please call me so I can check out whether you have a hematoma or not. There may some asymmetry of the face as there may be more swelling on one side than the other. The skin over the cheek are may be numb for a very few weeks to a month or so.
Getting Back to Normal
You will be up and about the next day or so. Take it easy and give some time for your face to heal. It may take 10 days to two weeks for the swelling to subside and you will be to visit your friends and attend social functions at that time. You can walk briskly in two weeks and you perform aerobic exercises in four to six weeks. You can apply make up on your face in a week to 10 days to camouflage your bruises if you have any.
Your New Look
As your swelling on your mid face subsides you will start seeing the results of the surgery. You will see that your cheek outline will be more defined and your face will appear youthful. You will look in the mirror and thank yourself for having the procedure.
Before & After Gallery
Lower/Neck Facelift
If you’re considering a Lower Facelift / Neck Facelift
As we age and following over expose to the sun, our skin and the fat over our face tends to sag. This affects more over the mid face (cheek area) and results in nasolabial folds (laugh lines form the side of the nose to the lips). Some develop jowls and in others the neck tends to sag. The fat in the midface tends to drop vertically down and this results in a deflated face. Rhytidectomy or a face lift cannot reverse the effects of aging but it can certainly can turn the clock back so that you look a decade younger.
All facelifts are not equal and in the past it has been associated with stigmata of a tight and stretched face. It was as if women with facelifts could be recognized a mile away in a party. Well, the good news is that things have changed. Facelifts are now done very differently. The downtime is reduced to a week and surgeons are doing less to achieve more. A facelift by Dr. Rane has minimal to near invisible incisions after surgery. The predominant correction of sagging is vertically up so that your face looks full and not stretched. The before and after photos below will show you how a natural face can be created without the typical facelift look. It is as if a decade has been taken away from your face. Their face is not changed it is just more youthful and rejuvenated.
All Surgery Carries Some Uncertainty and Risk
When a lower facelift and necklift is performed by Dr. Rane, complications are infrequent and usually minor. You will have swelling over your face which will take 7-10 days to subside. You can rarely develop a hematoma or collection of blood. If it does you may require an additional surgery to remove the blood clots. Smoking can impair healing and this can result in some areas not healing. It is therefore very important to stop smoking prior to surgery to reduce complications. Rarely you may have some asymmetry of face temporarily due to the swelling. This will subside.
When Your Surgery Will Be Performed
A lower facelift and necklift will be performed in my office under local anesthesia and some oral sedation.
Type of Anesthesia
Your facelift will be performed under local anesthesia and sedation if you have an S Lift. If you have a neck lift or a regular facelift the surgery will be done under general anesthesia so that you will sleep through the procedure.
The Surgery
A lower facelift usually takes three hours or somewhat longer if you’re having more than one procedure done.
The incision is placed in the cartilage of your ear along a natural shadow line. The remaining incision is placed behind your ear so that it is barely visible. The skin and fat are then lifted and your fascia is then tightened. This allows the mini facelift to last much longer than a typical S Lift. A small incision is placed in an area underneath your chin and the youthful contour of the neck is obtained by performing a corset plastysmoplasty. This unique technique allows plication (gathering) of the sling of muscles of the neck so that the vertical bands that you have, will disappear. The vertical direction of the mini facelift correction results in a very natural appearing face following the surgery. The fat is also trimmed and excess loose skin is then removed. All the sutures are placed under the skin and do not need to be removed. A small drain is left at the end of the surgery to allow the blood to be drained. The drain is removed in a few days after the surgery.
After Your Surgery
There will be some swelling on your face after the surgery. The swelling can be reduced by application of ice and sleeping in the upright position. Mini facelift is not very painful and you will receive pain medications to reduce your discomfort. If you have persistent pain, please call me so I can check out whether you have a hematoma or not. There may some asymmetry of the face as there may be more swelling on one side than the other. The skin over the face may be numb for a very few weeks to a month or so.
Your drainage tube will be removed two to three days after surgery. The swelling and bruising will subside in a week to 10 days, so please be patient.
Getting Back to Normal
As your swelling on your face subsides you will start seeing the results of the surgery. You will see that your face outline will be more defined and your face and neck will appear youthful. You will look in the mirror and thank yourself for doing this to yourself.
Your New Look
As your swelling on your face subsides you will start seeing the results of the surgery. You will see that your face outline will be more defined and your will appear youthful. You will look in the mirror and thank yourself for doing this to your face.
SmartLip and Lower Facelift and Necklift Combination
Combination of SmartLipo™ and a mini facelift gives you the best combination to achieve a youthful face and neck.
- Performed under local anesthesia in my office
- SmartLipo™ allows laser to remove fat under your neck
- Lower facelift restores the deeper tissues to give you a more youthful contour of the neck
- Significantly reduced bruising and swelling
- Supports your active lifestyle
- Results last much longer than fillers or SmartLipo™ when used alone
Before & After Gallery
Eyelid Surgery
Eyelid Surgery or Blepharoplasty
If You’re Considering Eyelid Surgery:
Eyelid surgery, aka Blepharoplsty, is where fat and skin are removed from the upper and lower eyelids. This surgery can correct:
- drooping upper lids
- puffy bags below eyes
As we age, the skin over our upper eyelids tends to droop and if uncorrected it can even obstruct your vision. With aging your mid face (cheek) tends to droop and the septum that holds the fat around the lower eyelids tends to bulge, All this adds to a aged tired eyes. The upper and lower eyelid surgery can correct this but unfortunately cannot correct the wrinkles around the eyes. Additional procedures like chemical peel or skin resurfacing with Fraxel can correct this. The eyelid surgery is commonly performed with a facelift or a brow lift.
This information will help give you the basic instructions to help you understand the procedure. If you have any other questions please do not hesitate to set up a consultation with me.
The Best Candidates for Eyelid Surgery
The best candidates for this surgery are over the age of 35 and have excess skin over their upper and lower eyelids. Sometimes baggy eyelids can run in families and you may require a surgery to correct his earlier than others. If you notice that your cheek fat pads have slid down on your face resulting in nasolabial lines (smile lines running from your nose to your lips on the sides), they can all be corrected at the time of the lower eyelid surgery.
If you have problems with your vision or excessive dry eyes you need to get this checked by your ophthalmologist. Patients with bulging eyes may have thyroid and this may need to checked by your doctor or an endocrinologist.
All Surgery Carries Some Uncertainty and Risk
When eyelid surgery is performed by Dr. Rane, complications are infrequent and usually minor. You may notice that there is some asymmetry or residual swelling. You may notice that you may feel some stitches over the outside of the eyelids for a few weeks to a month. The knots will dissolve and go away. The upper eyelids tend to remain swollen for slightly longer than the lower eyelids. Rarely your lower eyelids may drag a little while they are healing but this will settle shortly.
Planning for Your Surgery
Your first consultation is very important. This is because you will need to give your complete medical history. Be sure to check your own records before so you are ready to give out your information. Let me know if you have any allergies, taking vitamins, medications, and if you smoke.
Discuss your goals with me. I will explain to you how my technique differs from others and decide whether you need upper or lower or both to be corrected. the many techniques and anesthesia that I will use. I will also tell you the type of anesthesia and where the surgery will be performed. A detailed quote about the estimated costs will be given to you. This will include surgeons fees anesthesia fees and facility fees.
Where Your Surgery Will Be Performed
Surgery for the upper eyelids if performed by itself will be done in my office. If you are having surgery to both upper and lower eyelids, you will have your surgery done at an outpatient center so that you can go home on the same day.
Type of Anesthesia
Upper eyelid surgery is done under local anesthesia but you will need general anesthesia if you are having both upper and lower eyelid surgery.
The Surgery
Blepharoplasty usually takes two hours, depending on the extent of the surgery. If you’re having all four eyelids done, I will probably work on the upper lids first, then the lower ones.
I generally begin my surgery on the upper eyelids by making the incision over the eyelid fold. The incision allows removal of excess skin and fat from the upper eyelids giving it more definition. The lower eyelid incision is made just at the level of the eyelash margin. The skin and fat are exposed. There are quite a few things I do differently. During the surgery, I do not excise fat from your lower eyelids. Instead I re-drape the fat so that you do not have hollow sad eyes. I also place stitches that will allow elevation of your cheek fat pad that commonly sags due to aging. The incision is then closed. As a result of the surgery, you will notice that the deep lines below your lower eyelid will become near invisible as your cheek fat pad rises up, giving you a more youthful appearance.
After Your Surgery
After your surgery you will notice that your eyes will be swollen and bruised. Application of ice and sleeping upright will help to keep the swelling down. You will benefit by having some artificial tears like Refresh to keep your eyes from drying out. You may have difficulty in focusing for the first few days following surgery. You will not be able to wear contact lenses for a week to two weeks following surgery so keep your glasses handy. You will notice that one eye may swell up more than the other and they will look asymmetrical. The swelling will decrease in the first few days quite dramatically but it may take a couple of weeks for all the swelling to reduce completely.
Getting Back to Normal
It may take a few days to a week for the swelling to subside making it difficult to drive. Wearing sunglasses may help. After a week to ten days you should be able to go to work or attend social functions. Your eyes may remain dry for the first few weeks so use artificial tears to keep them well lubricated. You should be able to walk briskly or be on a stationary bike in three weeks but aerobic exercises should not be done for around six weeks.
Your New Look
You will heal gradually and everyday your eyes will continue to look better. They will appear more youthful and less tired. The results will last for many years to come.
Before & After Gallery
Browlift
A new and FDA approved revolutionary approach to brow lift, cheek lift and neck lift
If You’re Considering a Browlift
As we laugh and express ourselves everyday unfortunately we develop lines over our forehead. The eyebrows get heavier and sag. Our upper eyelids start having excess skin. You look in the mirror and see nothing but wrinkles, lines and a tired look. You catch yourself looking in the mirror; lifting your eyebrows and suddenly everything appears right. If you do, you are a right candidate for an eyebrow lift.
A new and a revolutionary way for a browlift
In the past, surgeons had to make a long incision over the scalp from one side to the other to lift the brows up. Those days are gone. Newer techniques using limited incisions and endoscopes now allow the surgeon to accomplish the same with a much less recovery time. Newer devices are now available to keep the brows elevated. These new devices have very fine tacks on them so that the brow is held in the new position while it heals. After nine months or so these small devices turn to water, dissolve and go away.
These devices are called Endotines® and they can be used to elevate the brow, the cheeks and the neck. They provide a fast secure and reliable method of fixation as compared to a single suture. He multipoint fixation is unique and is a breakthrough in the method of fixation. It is designed for simplicity and reliability.
Here is How They Work
Endotine® Brow lift:
- Transbleph: While you are undergoing a surgery for an upper eyelid to remove excess skin, the area just above your eyebrow is exposed and a small Endotine® device is inserted through the same incision. The device is held in place, the eyebrow is elevated and held in place at that location with the aid of the device. The device can be felt like a small bump for a couple of months and then turns to water and dissolves and goes away. The procedure can be done under local anesthesia and your recovery is no more than a few days. You can go back to work a few days after surgery and within a few weeks you will notice the refreshed look. It is simply amazing how technology advances and makes your recovery quicker.
- Transforehead: The procedure is essentially the same as above and can be performed in conjunction with an upper eyelid surgery. Two small incisions are made in the scalp behind your hairline measuring 1-2 inches in length and the device is placed in the bone under your scalp. The device can be felt like a small bump for a couple of months and then turns to water and dissolves and goes away. The procedure can be done under local anesthesia and your recovery is no more than a few days. You can go back to work a few days after surgery and within a few weeks you will notice the refreshed look.
- Endtotine cheek lift: So now you ask can you not lift my cheeks and make it full and not saggy anymore. Sure! A more youthful face is a full face not an empty deflated sagging face. Endtotines® are now available to lift the cheeks too. They can be combined with your lower eyelid surgery without any additional incisions. A small strip with the Endotine® is inserted after your cheeks are elevated and attached to the bone. Once again the device dissolves and disappears in six to nine months. And the good news, the device in the cheek cannot be felt. The surgery can be done under local anesthesia or general anesthesia and recovery is short too.
- Endotine Neck lift: And finally, an Endotine® strip to elevate the sagging neck. A small incision is made just in front and behind the ear lobule and the skin over the neck is lifted under local anesthesia in the office. The device is inserted and the fine hooks allow the fascia under the skin to be elevated. The fine hooks face on the deeper surface and therefore cannot be felt under the skin. The device once again disappears in a few months. The recovery from the necklift is much shorter and as the procedure is done under local anesthesia you can go back to work very soon.Please visit www.coaptsystems.com for more information. You are welcome to come and see me for a consultation if you want find out whether any of these procedures are the right choice for you.
Before & After Gallery
Ear Reshaping
Otoplasty – Ear Reshaping Surgery
If you are considering reshaping your ears
Some of us born with ears that are not shaped correctly. This is more common than you think. One just needs to look at Prince Charles and you may feel you have something in common with the British Royal family. Many children are teased in school due to the protruding ears. It bothers them a lot. Protruding ears can be corrected during childhood or during adulthood. Normal ears have a fold that sets it back close to the head. This fold is sometimes absent in children at birth. As a result of this the ear cannot fold back and tends to stick out. Sometimes the cartilage in the central part of the ear is also too large and deep, making the ear stick out further. It commonly affects both sides but sometimes affects one side only. The problem can be more severe on one side and less on the other
Initial Consultation
During the initial consultation, I will examine your or your child’s ear and see whether there is any abnormality in the shape and size of the ear. I will also measure the extent of protrusion over the upper, middle and lower part of the ear.
The Surgery
The surgery can be performed at any age after three years. It is not unusual for adults to come for surgery too. The surgery can be performed under local anesthesia in my office for adults/older teens but requires general anesthesia for a child. The procedure takes one to one and half hours to perform.
The surgery involves placing an incision behind the ear in the fold and involves removing some skin. The cartilage in the ear is scored to recreate the fold that was missing. The fold that is created is very natural and thereby making it very difficult for anyone to know that a surgery had been performed on the ears.
Dr. Rane has performed many of these procedures with a technique that is unique and involves scoring the cartilage in a specific way that allows creation of a fold that is rounded and looks just like a normal ear fold (see before and after pictures below).
After the surgery stitches are placed to close the incision and a head bandage is applied to reduce the swelling. The head bandage needs to be worn for five to seven days. After that a tennis head band can be worn for 10 days. No contact sports for six weeks are essential to prevent injury to the ears.
Getting Back to Normal
The swelling subsides very quickly following the surgery. There may be some tenderness on the cartilage for a few weeks.
All Surgery Carries Some Uncertainty and Risk
When a ear reshaping surgery is performed by Dr. Rane, complications are infrequent and usually minor. You will have swelling over your ears which will take 7-10 days to subside. You can rarely develop a hematoma or collection of blood. If it does you may require an additional surgery to remove the blood clots. Infection is extremely rare after this procedure. Rarely one ear may protrude more than the other by a small degree but generally the extent of asymmetry is minor.
Your New Look
As your swelling on your ear subsides you will start seeing the results of the surgery. You will see that your ear fold outline will be more defined and your ears will look normal and natural. You will look in the mirror and thank yourself for doing this to yourself.