Traditional browlift: The patient’s hair is tied back near the incision site and then Dr. Dufresne makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. The incision may be placed further back or made along the skull bone joints to minimize visibility in patients with thinning hair or who are bald. Then the forehead skin is lifted, tissue is removed, muscles are adjusted and the eyebrows may be lifted. Excess skin is trimmed and the incision is closed with stitches or clips. Then the stitches will be protected with gauze or bandages. Traditional-surgery patients may experience some numbness and discomfort at the incision. Numbness could be replaced by itching, which will subside within six months. Your head may need to be elevated for two to three days to reduce swelling. Bandages are removed in one to two days, and stitches or clips are taken out in two weeks. Hair near the incision may fall out or thin, but normal growth should return within weeks or a few months.

Endoscopic browlift: After the hair is tied as with the traditional procedure, Dr. Dufresne makes three to five short incisions behind the hairline. The endoscope is placed in one so the doctor can see beneath the skin without having to make a large incision, while he lifts the skin and adjusts muscles through the other incisions. If the eyebrows are lifted they will be stitched or screwed (temporarily) into place. Then the stitches will be protected with gauze or bandages. Endoscopic surgery patients may experience some numbness, discomfort and swelling around the incisions, though there is less itching than with traditional surgery. Stitches or staples are removed in a week; temporary fixation screws are taken out within two.

With both procedures, you will be on your feet and able to wash your hair in a day or two, and many patients return to work or school in 7-10 days or less. Swelling and bruising should fade by the third week.

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In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jaw line slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look. After surgery, some patients appear 10-15 years younger.

Incisions are made in inconspicuous places, behind the hairline and in natural folds of the face and ears, and scars fade to near invisibility in time. Results of a facelift do not last forever, but in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.

In general, Dr. Dufresne separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. Dr. Dufresne then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp. Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. They may also wrap your head loosely in bandages to minimize bruising and swelling. You will need to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. If you've had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don't be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you'll be looking normal. Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer. Avoid strenuous activity for at least two weeks.

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Blepharoplasty (Eyelid Surgery)

By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes, but the procedure can be combined with others such as a facelift and Botox ® treatments to achieve these results.

The procedure is done under general anesthesia and usually takes 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). Then Dr. Dufresne removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. Eyes can be sensitive to light and wind and may be slightly irritated for a short while; Dr. Dufresne may prescribe eye drops and cool compresses to counteract these discomforts.

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Rhinoplasty (Nasal Surgery)

One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt).

Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.

Surgeons use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an "open" procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed.

For a short time after surgery you may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.

Complications are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia.

Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but not for cosmetic purposes . We do not participate with any insurance and Dr. Dufresne is paid-in-full prior to any surgery date. However, we will submit your claim to your insurance for you. If your insurance company decides to cover the procedure, a reimbursement check will be sent to you.

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Cervicoplasty and Platysmaplasty (Neck Lift)

The neck lift is usually part of the facelift. Cervicoplasty is the procedure used to remove excess skin that is sagging on the neck. Platysmaplasty is a procedure that removes or alters the neck muscles. Typically, a neck lift will last two to three hours under general anesthesia; if you are having a neck lift in conjunction with other surgeries, the time will vary accordingly. Your exact procedure will depend on your desired results and your own personal circumstances. In order to undergo a neck lift, you must be in good general physical and mental health.

If you have fatty pockets under your chin, liposuction may be used in conjunction with cervicoplasty. A small incision will be made under the chin where the fat is to be removed. The incision will be closed with stitches and will be covered with Steri-Strips or gauze.

If you have weakened or loose neck muscles, this may cause the appearance of neck "bands." To correct this, Dr. Dufresne may propose platysmaplasty surgery. Platysmaplasty is performed by making small incisions under the chin and possibly behind the ears to access the platysma (neck muscle) and manipulate it accordingly. In certain cases, Dr. Dufresne will remove some of the muscle.

After the surgery, you will experience swelling and bruising that can last for several days. You may feel tightness or tingling. It is also common, as it is in most surgeries, to experience numbness. These are all very normal in the first few weeks following surgery and should not be cause for concern.

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Scar Revision

Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. Scars are by definition permanent, but surgery can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands.

There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, flap surgery and Z-plasty (repositioning a scar so that it aligns with the face and is less noticeable). The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, your body’s healing mechanism, the size and depth of the wound, how much blood supplies the area and the thickness and color of your skin.

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Otoplasty (Ear Surgery)

Otoplasty is done to set prominent ears back closer to the head or to reduce the size of large ears. The operation is usually performed on children between the ages of four and fourteen. However, adults may have this procedure as well and there are generally no additional risks associated with ear surgery on an older patient.

Otoplasty is usually performed as an outpatient procedure in a hospital or a doctor's office-based surgical facility. If your child is young, your surgeon may recommend general anesthesia, so the child will sleep through the operation. For older children or adults, the surgeon may prefer to use local anesthesia, combined with a sedative. The surgery usually takes two to three hours.

Most commonly, Dr. Dufresne makes an incision in the back of the ear to expose the ear cartilage. He will then possibly sculpt or remove some cartilage and bend it back toward the head. Stitches may be used to help maintain the new shape.

The patient's head will be wrapped in a bandage following surgery to promote the best molding and healing. The ears may ache at first, but this can be relieved by medication. Within a few days, the bandages will be replaced by a lighter head dressing similar to a headband. Stitches are removed, or will dissolve, in about a week. Any activity in which the ear might be bent should be avoided for a month or so. Adults can go back to work a few days after surgery. Children can go back to school after a week. The surgery will leave a faint scar in the back of the ear that will fade with time.

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