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Facial Procedures
  What are the different types of chemical peels?
  What are AHAs?
  What are TCAs?
  What is Phenol?
  Are there any risks?
  What can a browlift do for me?
 

What are the advantages of blepharoplasty (eyelid surgery)?

 

Will I have visible scars from blepharoplasty?

  How soon after eyelid surgery can I wear my contact lenses?
  What are the risks?
   
   
BOTOX® Cosmetic
 
  How frequently can/should I have injections?
  Are there After-Care instructions for a BOTOX® treatment?

 

Will insurance cover my procedure?
We do not participate with any insurance. Dr. Dufresne is paid-in-full, by the patient, before the date of the surgery. However, we will submit your claim to your insurance company for you and if there is any refund, it will be sent to you.

How long does the rhinoplasty procedure take?
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.

Can I wear glasses after nasal surgery?
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.

What are the risks of rhinoplasty?
Complications are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia. Also, a second procedure is required in about one out of every ten cases.

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What problems can a facelift correct?
A facelift can reduce signs of aging (wrinkles, lines, sagging skin, drooping brow) by removing excess fat, tightening the underlying muscles, and redraping the skin around the neck and face. Facelifts can be done alone or in conjunction with a forehead lift, eyelid surgery, or nose reshaping. 

Are there any special concerns for men interested in a facelift?
Men may have to shave behind the neck and ears where areas of beard-growing skin have been repositioned.

When can I go back to work after a facelift?
Most patients return to work about ten days to two weeks after surgery.

Will my scars be visible?
Scars are usually hidden by the hair or the natural creases of your face and ears. In addition, they will fade as time passes and should be scarcely visible.

What is collagen and what does it do?
Collagen is a naturally occurring protein found in the second layer of skin (the dermis) which “plumps up” the skin, joints, bones and ligaments. Injectable collagen is derived from purified bovine collagen, which is similar to human collagen after processing. It was approved by the FDA in 1981 and is produced in various thicknesses for individual patient’s needs.
Injectable collagen counteracts the effects of gravity, sun exposure and years of facial muscle movement by filling in wrinkles, lines and scars, adding fullness to areas of the face such as the lips, cheeks and forehead and sometimes other areas of the body such as the neck, back and chest.

Will I see results right away from collagen and how long do the results last?
Yes, although at first the site will look too swollen. This is because part of the injection consists of salt water, which your body will absorb in the first few days. Results may begin to fade in a few months or may last indefinitely, depending on the patient’s age, genetic background, skin quality, lifestyle and body site.

Who should not have collagen injections?
Patients who suffer from autoimmune diseases, who have allergies to beef or bovine products or to lidocaine (the anesthetic agent contained in the syringe with the collagen material), or who are pregnant should not undergo collagen injections.

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What are the different types of chemical peels?
There are three types of chemical peels, ranging from mild to strong -- alphahydroxy acids (AHAs), tricholoroacetic acid (TCA) and phenol

What are AHAs?
AHAs are the gentlest of the three types of chemical peel and consist of a group of glycolic, lactic and fruit acids. AHAs are used to smooth and brighten skin by treating fine wrinkles, dryness, uneven pigmentation and acne. They are typically applied once a week or as part of a daily regimen. Treatment takes 10 minutes or less. Sometimes AHAs, Retin-A (a prescription medication containing Vitamin A) or hydroquinone (a bleach solution) are used to thin the skin and even its tone as a pre-treatment for TCA peels.

What are TCAs?
TCAs are commonly used for medium-depth peeling to treat fine surface wrinkles, superficial blemishes and pigment problems, sometimes in combination with AHAs. TCAs are the preferred treatment for darker-skinned patients. Multiple treatments may be required, but treatments only last 10-15 minutes and recovery time is shorter than with phenol.

What is Phenol?
Phenol is the strongest chemical peel and treats deeper skin problems such as coarse facial wrinkles, pre-cancerous growths, and areas of blotchy or damaged skin caused by sun exposure, aging or birth-control pills. It is used only on the face. Full-facial treatment can last an hour or two and recovery can take a few months, with possible permanent skin lightening and removal of freckles.

Are there any risks?
All three treatment types carry potential risks such as infection and scarring. TCA peels may produce some unintended color changes in the skin, while phenol peels may reduce or eliminate the new skin’s ability to make pigment evenly or at all, thus causing a lighter or uneven skin tone that must be protected from sunlight.

What can a browlift do for me?
Browlifts can revitalize drooping or lined foreheads by tightening skin and muscles above the eyes, smoothing wrinkles and raising the eyebrows, helping you to look less angry, sad or tired. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.

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What are the advantages of 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 can last 45 minutes to a few hours, depending on how much work is done. The effects of blepharoplasty can last for a long time and are sometimes even permanent.

Will I have visible scars from blepharoplasty?
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) to minimize scar visibility. If no skin needs to be removed during surgery, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

How soon after eyelid surgery can I wear my contact lenses?
Contact lenses may not be worn for two weeks. Glasses may be worn immediately.

What are the risks?
Complications from the procedure are uncommon, but can include infection, reaction to anesthesia, double or blurred vision for a few days, temporary swelling of the eyelids, tiny whiteheads, and difficulty closing eyes when going to sleep. Uneven healing and scarring, and ectropion (pulling down of the lower lids) are very rare and may require surgical correction.

Patients with thyroid problems, dry eye, high blood pressure, diabetes, detached retina, glaucoma or other health problems should consult with an ophthalmologist about eligibility.

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BOTOX® Cosmetic

Will my facial expressions continue to look natural?
Although the results are visible, a treatment with BOTOX ® Cosmetic will not radically change your facial appearance or make you look as if you "had work done." The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.

 

When will I see results?
Within days, you may see a marked improvement in the moderate to severe frown lines between your brows. Lines continue to improve for up to a month, and results usually last for 4 months. In clinical trials, nearly 90% of men and women rated the improvement in their appearance as moderate to better 1 month after treatment. Results may vary. A touch-up may be given 14 - 21 days after the initial treatment for $75, if needed . This does not apply to the central frown treatment, as full paralysis is not expected with this limited injection.

What are the risks?
The most common side effect is a mild amount of droopiness in an eyelid ("sleepy" eye) that lasts about 10 days without treatment. This is a rare occurrence. As with any time you get an injection anywhere in your body, a small bruise is possible.
If the lower eyelids were treated, puffiness may occur for up to 2 weeks.
Women who are pregnant, breast-feeding or who hope to become pregnant, and people who are taking certain antibiotics, have neuromuscular disorders or an allergy to BOTOX® should not have injections. Also, patients with neuromuscular disorders such as ALS, myasthenia gravis or Lambert-Eaton syndrome may be at increased risk of serious side effects.

What if I don't like the results?
Results will fade after a few months. If you discontinue treatment, the frown lines will gradually look like they did before treatment.

How frequently can/should I have injections?
BOTOX® Cosmetic can be used every 3-4 months, depending on how the muscles respond. The average is 4 months, less around the mouth.

Are there After-Care instructions for a BOTOX® treatment?

  • Stay upright for 4 hours, if the eye area was treated
  • Do not rub the eye area
  • Make faces for 2 hours after the injection to help muscles absorb the BOTOX®

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Dr. Craig R. Dufresne, M.D., serving the surrounding areas of Washington D.C., Virginia, and Maryland.

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