Facelift

Facial aging can take many different forms, including flattening of the cheeks, accentuated jowling, neck redundancy, and generalized wrinkling of the skin. Most of these telltale signs of aging are due to both an increase in overlying skin laxity and a loss of underlying subcutaneous tissue volume. In effect, the face deflates with age, leaving the sagging areas that we associate with aging.

  • Older facelift techniques tried to correct these two problems by way of skin tightening alone. Extensive dissection was used, and unusual tension was placed upon the tissues to correct the areas where sagging was visible. The procedures were expensive, recovery times could be extensive, and a pulled, “surgical” look to the face could be the end result.

    More modern Facelift techniques are designed to achieve less surgical, more natural final results with significantly reduced costs and downtime. While the lax tissues will still be tightened surgically, volume enhancement (with the patient’s own fat) will play a significant role in the overall rejuvenation of the face.

    You might consider Facelift Surgery if you have developed signs of facial aging that are giving your face a tired and aged look. Many of our patients say that they still feel like they are young, and that they want their face to match the way that they feel.

Types of Facelifts

The specific procedure to be chosen will be tailored by Dr. Lober to meet the individual needs of a given patient, with the ultimate goal of achieving a natural-looking, seamless rejuvenation of the face.

Limited incisions are utilized to tighten the cheeks and jawline.

Skin excisions are combined with tightening of the deeper tissue planes of the cheeks and jawline.

Extended incisions (in front of and behind the ears) and more extended surgical elevation of the face and neck are utilized to achieve optimal tightening of lax facial and neck skin.

Skin excision, tightening of the deeper tissue planes, and extensive fat injection (to enhance the volume of the midface and perioral regions) are utilized to achieve a natural-looking rejuvenation of the face.

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Surgery & Recovery

We perform all of our facial rejuvenation surgeries under iv sedation only. While we have the ability to put patients under General Anesthesia in our Surgery Center, we prefer to avoid this in our facial surgeries for a number of reasons. First, when the endotracheal tube is removed at the end of the procedure, there is a spike in blood pressure that can cause additional bruising and swelling.

  • Second, patients are much more at risk for postoperative nausea and vomiting with General Anesthesia (which can cause unwanted swelling and bleeding). And third, we do not believe that General Anesthesia is completely benign for patients over the age of 65. Many older patients can experience prolonged mental “fogginess” after General Anesthesia. This is almost never the case with IV Sedation.

    Facelift procedures typically last from 2 to 3 hours long. Patients are generally surprised at how little postoperative discomfort they experience after the procedure. Physical downtime (light activity, driving, etc.) from the surgery can be as little as 3 to 5 days. Social downtime (outings, social events, meetings, etc.) will generally be from 10 to 14 days.

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Eyelid Surgery

Eyelid Surgery (Blepharoplasty) is performed to brighten the eyes by removing excess skin, muscle, and bulging fat pads that can give a tired, heavy look to the entire face. You might consider undergoing Eyelid Surgery if you have developed sagging of your upper eyelids and bagging under your eyes. You may also consider Eyelid Surgery if you are having vision problems due to drooping of the upper lids.

Types of Eyelid Surgery

The Upper and Lower Blepharoplasty procedures are commonly performed together. They are also commonly performed with some form of brow elevation procedure. Often, this does not have to be a full Open Brow Lift but rather a limited lateral Brow Elevation that is easily added to the Upper Blepharoplasty procedure, and often performed through the same incision.

Upper Blepharoplasty removes excess skin and a small strip of muscle in the upper lid. It also commonly addresses laxity in the muscle (levator) which elevates the upper lid and can become stretched with aging.

Lower Blepharoplasty removes excess lower eyelid skin and the bulging fat pads that can give a tired, heavy look to the entire upper face. In addition, the deep groove underneath the lower eyelid bags (tear trough deformity) can be softened and filled out to give a softer and younger-looking transition from the lower eyelids to the cheeks.

blonde woman field white dress eyelid surgery recovery

Surgery & Recovery

All Eyelid Procedures are performed in our Surgery Center under IV Sedation only, without the need for General Anesthesia. The different procedures usually take from 45 minutes to an hour. You will be able to wash your hair after 48 hours and your sutures will be removed in 5 to 6 days. You will experience a maximum amount of swelling on the first postoperative day. Thereafter, you should wait at least 2 to 3 more days before resuming light activities. Heavy exertion, straining, and bending over should be avoided for the first week. Wait at least 10 to 14 days before resuming your normal exercise routine.

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Nasal Surgery

Nasal surgery, also known as rhinoplasty, encompasses surgical procedures designed to correct aesthetic features of the nose as well as to correct functional breathing problems. Nasal irregularities are commonly due to inherited traits. They can also be due to injuries to the face that may cause damage to the nasal bones and cartilage. Such “deformities”, including prominent dorsal humps, crooked noses, bulbous tips, beak noses, and pinched noses, can be improved with nasal surgery. Such aesthetic changes to the shape and the size of the nose are typically considered to be cosmetic in nature.

  • In contrast, rhinoplasty procedures designed to improve the flow of air through the nasal passages are commonly considered to be functional in nature. A markedly deviated septum can often cause complete occlusion of airflow through one (or both) of the nasal airways. In addition, enlarged Inferior Turbinates can block the flow of air in both of the nasal airways. As such, Septoplasties (straightening of the deviated septum) and Turbinectomies (reduction or removal of the inferior turbinates) are commonly covered by most insurance plans when medically necessary.

    You might consider nasal surgery if you want to improve the contours and proportions of your nose or if you simply want to be able to breathe better. Rhinoplasty procedures that are done well should not make you look like a different person. The real goal of these procedures should be to make changes (often subtle) that bring your nose into better harmony with the rest of your face.

Types of Nasal Surgery

Irregularities of the tip of the nose (too big, too small, unbalanced, etc.) can often be corrected by simple manipulation of the cartilage framework that gives shape to the nasal tip. Refinements can be made by repositioning the cartilage and suturing it into new positions, reducing the amount of cartilage present, and adding cartilage in areas where it may be deficient.

Irregularities of the dorsum of the nose (pronounced hump, “ski slope” dorsum, crooked nose, etc.) often require manipulation of both cartilage and bone. If indicated, it may also require controlled fracturing of the nasal bones on either side of the nose to change the base and the width of the entire nasal complex.

Rhinoplasty surgery may also include straightening of the nasal septum and reduction of the inferior turbinates of the nose. These procedures are most commonly performed to improve airflow through the nose. Septal adjustment may also be required to improve the external appearance of a crooked nose.

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Preoperative Evaluation

Before proceeding with rhinoplasty surgery it is of utmost importance that you discuss both your motivations for the surgery as well as your postoperative expectations in detail with Dr. Lober. It is the patient’s responsibility to be very clear about their concerns and what their expectations for the surgery are. And it is Dr. Lober’s responsibility to make sure that these concerns and expectations can and will be met by the intended nasal surgery. In short, it is essential that both the patient and the surgeon be on the same page when it comes to the planning and the execution of any form of rhinoplasty procedure.

plants nasal surgery recovery

Surgery & Recovery

We perform the majority of our nasal surgeries under general anesthesia in the privacy of our own surgery center in Athens, GA. Surgeries limited to only the nasal tip typically take up to one hour. Full rhinoplasty procedures, involving both alterations in the tip as well as the nasal dorsum, can take up to one and a half to two hours. The addition of a septoplasty and/or turbinectomy can take slightly longer.   

  • Patients undergoing nasal surgery will typically wear an external nasal splint for the first 4 to 5 days. If an internal nasal packing is required (for septal procedures), it will be removed within 48 hours. Patients are advised to avoid strenuous activities (including bending over and heavy lifting) for at least the first postoperative week. 

    Physical downtime (light activity, driving, etc.) from the surgery can be as little as 3 to 5 days. Social downtime (outings, social events, meetings, etc.) will generally be from 10 to 14 days.

mother daughter beach ear surgery

Ear Surgery

Ear Surgery (Otoplasty) is designed to improve the contours and proportions of the ears.  Most commonly, these procedures are used to make protruding or ‘stick out’ ears less prominent in appearance. Ideally, prominent ears are best corrected after the ears have matured in size with natural whole-body growth.  This typically occurs by the ages of five to seven years old.  Nevertheless, the procedure can be performed at any age in adults if the opportunity to do so was not made available during childhood.

  • An Otoplasty, or Cosmetic Ear Surgery, is a surgical procedure designed to change the shape, position, and/or the size of the ears. The ultimate goal is to reshape the ears so that they are in harmony with the other facial features of that individual patient. What is thought to be a perfectly shaped ear on one person may not fit in well at all with the overall facial features of a completely different person. In essence, the ears must be sculpted in order to match the other facial features of the specific patient.

Best Canditates

In young children, the decision to proceed with Otoplasty is going to be made primarily by the child’s parents themselves.  In fact, it is not uncommon for one of the parents to have had this feature present in either themselves or in other members of their own family.  Often, the parents will make this decision based upon a desire to avoid future teasing of the child about the prominence of their ears by other children.

Adults choosing to proceed with Otoplasty often do so because they feel that their ears are out of proportion to the rest of their head and face.  They may not have had the opportunity to have had the surgery performed as a young child.  And after years of feeling self-conscious about their appearance, they have decided that they simply want to improve the appearance of their ears.

Types of Ear Surgery

Like any other form of cosmetic surgery, the actual procedure itself must be specifically tailored to each and every individual patient. The unique anatomy of that individual must always be taken into account when designing the actual procedure. And as is always the case, the expectations for correction must always be very clearly agreed upon by both the patient and Dr. Lober prior to proceeding with the surgery.

In other cases, removal of a small amount of cartilage and suturing of the cartilage folds may be necessary to achieve an improved appearance to the ears. In these procedures, the incisions will be completely hidden behind the ear, making them completely unnoticeable to other people.

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Surgery & Recovery

Dr. Lober prefers to perform Otoplasties in young children within the hospital setting, on an outpatient basis.  These procedures will all be done under General Anesthesia for the safety and comfort of the child. In adults, Otoplasties can be performed in the privacy of our own Surgical Center.  The procedure is typically performed under IV Sedation, although General Anesthesia is always an option if desired by the patient.

  • Ear Surgeries usually only take from one to one and a half hours to perform. Incisions will be designed to be well hidden, and are most commonly placed on the backs of the ears. The external stitches used are typically all absorbable.

    Upon completion of the procedure, non-adherent dressings will be placed on both ears, and a compressive wrap will be placed around the head and ears. This will be removed in three to five days. Thereafter, the patient will be asked to wear a looser headband at night for at least the first two weeks to help remodel the ears.

    Patients are advised to avoid strenuous activities (including bending over and heavy lifting) for the postoperative first week. Physical downtime (light activity, driving, etc.) from the surgery can be as little as 3 to 5 days. Social downtime (outings, social events, meetings, etc.) will generally be from 7 to 10 days.

Brow Lift

The Brow Lift (or Forehead Lift) is a procedure that elevates the forehead tissues into a higher, more youthful position. The procedure elevates the eyebrows and removes the ‘heaviness’ from the upper eyelids that can occur with aging. It can also smooth out the wrinkles across the forehead and above the nose (‘frown lines’) that can develop with time. You might consider undergoing a Brow Lift if you have developed a tired, ‘heavy’ look to your upper face. The Brow Lift is often performed in conjunction with Eyelid Surgery and other Facial Rejuvenation procedures to achieve a fresher, younger look to the entire face.

Types of Brow Lifts

The type of procedure that is chosen is very much dependent upon the specific anatomy and the desired results for the individual patient. When you meet with Dr. Lober he will review the different types of brow lift options that you have, and what he thinks is the best option for you!

This incorporates an incision across the entire length of the anterior scalp and can produce the greatest amount of elevation of the forehead.

This utilizes very limited scalp incisions to endoscopically elevate the forehead and bring it into a higher, younger-looking position.

This approach utilizes incisions limited to the temporal scalp on each side to elevate the lateral aspects of the forehead and eyebrows.

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Surgery & Recovery

All three Brow Lift options are performed in our Surgery Center under IV Sedation only, without the need for General Anesthesia. The different procedures can take from 45 minutes to 90 minutes. No drains are used, and you will be able to wash your hair after 48 hours. Your sutures and/ or staples will be removed in 7 to 10 days. You should be able to resume light activities within 2 to 3 days, including driving and going out to the store. Wait at least 10 to 14 days before getting back to your normal exercise routine.

brunette white dress woman neck lift surgery

Neck Lift

A neck lift can encompass anything from simple liposuction alone to limited submental muscular tightening to more extensive lower face and neck skin tightening. The specific procedure must be tailored to the individual patient’s needs.

water neck life surgery recovery

Surgery & Recovery

All Neck Lift Procedures are performed under IV Sedation. Excess fat may be removed, the neck muscles may be tightened, and excess skin may be removed, depending upon the desired results for the individual patient. Physical downtime for Neck Lift Procedures is minimal. ‘Social’ downtime may vary from several days to up to a week.