Facial Cosmetic Procedures

Cosmetic Medicine of the face seeks to improve appearance (and in some cases function) through treatments, medical regimens and surgery. Cosmetic Medicine of the face is a comprehensive plan individualized to each patient that begins with a detailed conversation, complete examination and an analysis of photos. We look at the skin, the subcutaneous tissues, muscle and bone structure. This, along with a patient’s hereditary make-up, exposure to the sun and/or smoke contributes to the aging process.

Anti-aging, or more appropriately, graceful aging, involves helping a patient maximize their wellness and overall health. Good skin care, avoiding the sun, a healthy diet and routine exercise, form the foundation for a natural, healthy appearance.

Drs. Chang & Vander Kolk

Facial Rejuvenation

We frequently hear a patient say “I want to look as young as I feel” or “I want to look refreshed.” We like to think of it as balanced aging. We identify a patient’s major area of aging, analyze their anatomy and make a plan to correct it. We then balance the treatment with the other areas of the face that will continue to age if nothing is done. It is not for everyone, (some want to begin treatments slowly and address their major areas of aging – see individual procedures below), but it does allow us to create a natural look that is harmonious and developed for each individual patient.

Analysis – Facial aging changes in all areas

Treatment – Balance rejuvenation ( Brow lift, Upper & Lower Blepah, Facelift & Peri-oral Dermabrasion

See Drs. Chang, Vander Kolk and Collins' before and after pictures for facial rejuvenation.

Blepharoplasty (Upper & Lower Eyelid)

Our understanding of the youthful eyelid has recently changed and with it, the approaches we take with our treatments and surgical techniques. The youthful eyelid is full, not hollow, and has smooth contours and skin. Careful analysis of the skin, fat pads, muscles and bones allow us plan our blepharoplasty to achieve the best natural look to the eyelid.

Analysis – Excess skin, bags under eyes with hollow area between eyelid and cheek.

Treatment – Upper eyelid, skin removal only. Lower lid, skin tightening, fat bag shaping and restylane injection to fill the hollow.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for blepharoplasty.

Botox

Wrinkles are caused by thinning of the skin and subcutaneous tissue, sagging tissues and muscle movements. Particularly in the upper facial region where muscles are close to the surface, Botox can weaken to a variable degree (as chosen by the patient) the muscles and smooth the skin without removing the ability to express your feelings or the look in your eyes.

Analysis – Forehead wrinkles due to heavy eyelid skin.

Treatment – Botox of forehead after upper lid blepharoplasty.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for Botox.

Brow Lift

Too often in the past, surgeons have lifted the brows to the point of causing an unnatural, startled look. However, a conservative elevation of the brow can balance the face, diminish the upper eyelid fullness and give a less tired or angry appearance. Combining this procedure with Botox treatment to diminish wrinkles and further shape the brow, tends to maximize results

Analysis – Sagging brow, full upper eyelid and “angry” wrinkles.

Treatment – Endoscopic brow lift and Botox injections.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for brow lifts.

Facelift

Threadlift, lifestyle lift, lunchtime lift, MACS lift, Endoscopic Lift, Midface lift – all words used to market a treatment to change the “face” of aging. All of these types of facelifts have been performed by the physicians of Cosmetic Medicine at Mercy.

Drs. Chang, Vander Kolk and Collins begin with an analysis of the patient’s face to understand the hairline and hairstyle, shape of the face, fat distribution, fascial support and underlying bone structure. We then discuss a patient’s health, desires, and image they are looking to achieve. Photos and examples of other patients’ results help to refine our plan for surgery. Ultimately, the goal is a younger, refreshed look - natural and not too tight, subtle but substantial.

Analysis – Recent Lifestyle lift with an unhappy patient and poor result.

Treatment – Facelift, Blepharoplasty, Sculptra injections.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for facelifts.

Facial Implants (Chin & Cheek)

Facial implants are used to change shape, define angles, add depth and character to the underlying foundation of the face, the cheekbone, jaw and orbital structures. Safe and effective, these implants are placed on the facial bones to build up the structures of the face. In addition to discussion of an individual patient’s concerns and anatomy, computer simulation of the surgery on a patient’s facial photos, can help with planning and understanding of what can be done.

Analysis – Early laxity of face and lack of definition in cheeks.

Treatment – Malar (cheek) implants.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for facial implants (chin & cheek).

Fillers/Injectables

The development of safe and effective fillers has revolutionized cosmetic medicine. Used alone in the early stages of aging (35 to 50) they help diminish many of the more obvious changes of facial laxity and the pull of gravity. They are also a tremendous adjunctive treatment for facial cosmetic surgery (ages 40 to 75+).

The key is safe and effective treatment by a trained and knowledgeable provider. At Cosmetic Medicine at Mercy, we frequently work in association with our physician assistants, who have extensive training and experience in providing this treatment.

Unfortunately, there is no safe, permanent filler. Technology is bringing us closer with Sculptra and fat transfer (liposculpture), however, permanent fillers have significant risks and potential long-term problems as aging progresses.

Currently, each filler is chosen for a particular problem and the treatment customized to the individual patient. New techniques include, filling hollow areas of the cheek, along the jawline, the tear trough (hollow or groove between the eyelid and cheek) and to refill the brow and cheeks as aging occurs.

Analysis – Nasolabial folds, tear trough and cheek flattening.

Treatment – Radiesse to the tear trough, medial (inner) cheek and nasolabial folds.

See Drs. Chang, Vander Kolk and Collins before and after pictures for fillers/injectables.

Neck Lift

Yes, sometimes just a neck lift will treat the area of aging that bothers you the most. While a facelift includes a neck lift, many surgeons won’t do just a neck lift. They prefer to treat all the areas of aging even if they are less of an issue for the patient. However, this can be great first step for treatment of aging with little discomfort, limited bruising, and minimal swelling.

Analysis – Neck laxity, limited jowls or upper face aging.

Treatment – Neck lift with blending of the jawline to the neck. Aesthetician assistance in cover make up.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for neck lifts.

Otoplasty

While prominent or “dumbo” ears are often thought of as a birth defect, insurance companies do not always agree. Fortunately, an otoplasty can safely and relatively easily fix the problem. This allows patient to have more choices in their hairstyle and aims to also boost confidence. The key is a natural shape that does not interfere with hearing and wearing glasses.

Analysis – Prominent ears.

Treatment – Improve shape by suturing the fold and decrease projection by setting the ears back.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for otoplasty.

Peels & Lasers

The key to treating blotchy skin is to begin early so less invasive treatments, like Retin A and microdermabrasion, will be effective. As we get older, deeper wrinkles and pigmentation issues can be treated with peels and lasers that allow for control of the depth of the treatment, which provides a safer, easier treatment. We also remind patients to avoid smoking and sun exposure – the two main factors in aging skin.

Analysis – Fine wrinkles and color blotches.

Treatment – Obagi Blue (TCA) peel.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for peels & lasers.

Rhinoplasty (Nose)

The nose is the center of the face and sticks out further than any other structure. It is the key to breathing and blockage can cause changes in breathing, sense of smell and decreased exercise tolerance.

While each nose is unique, a good discussion and examination will provide important details for treatment. Fortunately, computer simulation can be advantageous in planning treatment and performing surgery. Ultimately, the key is balancing the shape of the nose to the patient’s facial structures.

Analysis – Nasal obstruction from a broken nose with associated abnormal shape.

Treatment – Septoplasty (reconstructive and insurance approved) and cosmetic rhinoplasty.

See Drs. Chang, Vander Kolk and Collins' before and after pictures for rhinoplasty.

Please Call for an appointment: 410.332.9700

Email our physicians and staff