Before & after pictures
Rhinoplasty

View gallery

Nose correction – rhinoplasty

The correction of the nose, also called rhinoplasty, is a procedure which improves the appearance and proportions of the nose in relation to the remaining components of the face. Sometimes it is performed to restore a proper nasal airway and, consequently, improve breathing.

What can such a nose surgery correct?

Rhinoplasty may correct:

• Nose size in relation to other parts of the face
• Nose width at the bridge
• Nose profile with its humps and depressions on the bridge
• Nasal tip if it is bulbous, drooping or upturned too much
• Nostrils if they are too big or too wide
• Nasal asymmetry and deviation
• Nasal septum setting
• Innate and post-traumatic defects

Who can undergo nose correction surgery?

The surgical correction of the nose is an individualized procedure and should fulfill the patient’s expectations. If the patient decides to undergo the surgery, he/she must beware of other’s opinions and avoid comparing the expectations with an idealized image.

Corrective surgery of the nose may be performed:

• At people aged 16-18 when the process of facial growth has completely finished
• At people enjoying good health
• At non-smokers
• At people who have realistic expectations in mind for the final results

What to expect during the consultation preceding nose correction surgery?

The consultation preceding nose correction surgery plays an important role in the treatment process. If the patient schedules an appointment with a doctor, he/she should expect a conversation concerning the following issues:

• the reason for nose correction procedure and individual expectations
• general health condition, previous surgeries, allergies to medications and substances
• taken medications, vitamins, herbal preparations, alcohol and smoking

Moreover the surgeon during such medical consultations:

• evaluates the general health status of the patient
• evaluates the patient’s face proportions
• discusses the risk and possible complications
• discusses the type of anesthetic applied during the surgery

How to prepare for nose correction surgery?

Prior to nose correction surgery, the following steps should be taken:

• laboratory examinations
• no smoking at least 4 weeks before the surgery
• no Aspirin or any other medications which contain acetylsalicylic acid and vitamin as well as other medications diminishing blood coagulation
• arrange someone to drive you home and ensure post-operative care during the first few days after the surgery.

Risk of possible complications:

The decision to undergo nose correction surgery is very individual and the patient should allow for any associated risk. The most frequent complications include:

• infection
• poor wound healing
• bleeding and hematoma
• nose asymmetry
• changes in skin sensation
• nose breathing problems
• persistent pain of the nose
• rough surface of the nose
• enduring nose swelling and skin discoloration
• disorders of nasal skin innervations (stiffening)
• disorders of airflow through the nose
• prolonging painfulness of the nose
• unfavorable scarring

Subsequent steps in nose correction operation

Step 1 – anesthesia

Proper medication are administered to guarantee the patient the highest comfort during the surgery. Depending on the indications and previous arrangements with the doctor, the surgery is performed under so called intravenous sedation, i.e. shallow anesthesia together with local anesthesia or under general anesthesia.

Step 2 – incisions

Nose correction surgery is performed using:

• closed procedure – small incisions are hidden inside the nose
• open procedure – incisions are made inside the nose and across the columella

Through these incisions, soft nasal tissues are lifted allowing access to such structures of the nose as bones and cartilages.

Step 3 – shaping nose structures

Depending on the recommendations, nose structures (bones and cartilages) are reduced or rebuilt by means of cartilages grafted from other parts of the body such as nasal septum, ear or rib cartilages. In the case of aquiline nose correction, the hump is reduced and nasal bones are joined in this region.

Step 4 – nasal septum correction

If the nasal septum is deviated, the procedure of its straightening is performed, which later facilitates nose breathing.

Step 5 – stitching

After nose structures are reshaped, the skin and soft tissues are redraped, and surgical incision are closed. If the ala of a nose are excessively developed, they are trimmed and the scars are closed with cosmetics sutures.

Step 6 – nose stabilization

A tape dressing is applied to the nose. In the case of bone structures correction, the nose is immobilized by means of a small slab plaster or the one made of elastomer. The structure and the septum of the nose are stabilized from the inside by means of proper tampons.

Step 7 – return to daily activities

When the procedure is completed, the nose and cheeks are swollen. Also bruising in the region of lower eyelids and cheeks is reported. It sustains about 2 weeks. The swelling of the nose and the surrounding area subsides within a few weeks. The swelling is usually bigger in the morning. Within the next few months the nose shape returns to its standard shape. The final effect is achieved after one year.

The surgeon will provide the patient with full and comprehensive information concerning the recommendations and follow-up care.

The durability of nose corrective surgeries

Mostly, the effects of nose correction procedures are permanent. However, within the next few years, the skin, soft tissues and cartilages of the nose may undergo slight changes, which in future may require further correction surgeries.

Nose correction surgeries are performed by dr Andrzej Bielecki – plastic surgery specialist within his own Private Healthcare Institution.

The post Nose correction surgery – Rhinoplasty first appeared on Kolasiński Clinic.

Hyaluronic acid is the main ingredient of such medications as: Juvederm, Voluma. These are synthetic preparations which do not cause any allergy. They are used to fill superficial and deep face wrinkles. All these preparations resolve after 12 to 18 months. In order to obtain a more durable effects of the corrections, the surgery should be repeated every six months. Hyaluronic acid is a natural polysacharide which constitutes a crucial structural element of the skin, hypodermic tissue, connective tissue and synovial joint tissue. An aging skin contains less and less natural hyaluronic acid. Applying its synthetic supplement makes the skin more elastic, tensed and the face oval gets smoother in the places of injection. The surgery of injecting the dedications hypodermicly is usually performed without any anesthetic. It consists in injecting an appropriate preparation intradermicly or hypodermicly in order to fill supeficial and deep wrinkles of the face. All the above mentioned preparations are used in the case of statistic wrinkles of the aging and flaccid skin caused by the gravity. They are most often horizontal and vertical wrinkles of the forehead and eyebrows, naso-labial folds, vertical wrinkles of the upper lip or ray wrinkles around the mouth. The effect of filling is visible immediately after the injection. Directly after the surgery, the place of the injection is slightly red. After 2-3 days a slight swelling can be notices and the feeling of burning or itching as well as slight pain.

Autologus Fat Transplantation

The transplantation of one’s own adipose tissue is applied in order to fill deep wrinkles, various losses of soft tissue of face and other regions of the body as well as to enlarge mouth. The surgery is performed under a local anesthetic. In the case of more sensitive patients, Emla anesthetic ointment. The surgery consists in extracting the adipose tissue from such regions of the body as the abdominal, hips and buttocks by means of probes, and implanting it in the regions of pits and facial wrinkles especially in naso-labial folds. A few days afterwards, quite a huge swelling of the operated area can be noticed as well as visible slight bruises. Three to four days later the symptoms disappear. About 60 to 70% of the transplanted adipose tissue is closed resulting in the permanent effect of filling. In the case of deeper changes, in order to gain a better effect, the surgery should be repeated after 2-3 months.

Liposuction of the submental region

The liposuction of adipose tissue can also be used to change the shape of the face. It happens very often that an oval face is characterized by the so called second chin. When it is caused by an excessive amount of the adipose tissue not by flabby facial-muscular system. The surgery is performed under a local anesthetic. By means of a slight incision of 2-3 mm, a probe is inserted which sucks the adipose tissue. Afterwards a pressure dressing is put, the aim of which is to model the skin and adjust it to the newly formed submental region. Bruises and swelling of the operated area may remain for 5-7 days. A permanent effect of the excision of the fatty tissue is achieved after 3-4 weeks.

Face-lift

In the case of an aging face, a gradual falling of facial system takes place resulting in gradual falling of the cheeks. The process is also connected with the change of the shape of face as well as deepening on wrinkles especially naso-labial folds. In such cases, soft tissues are pulled up that improves the appearance and removes visible signs of aging such as wrinkles or flabby face and neck skin.

Minimal Access Cranial Suspension Lift (MACS Lift) is the latest technique of face lifting. The surgery consists in skin incision and pulled off face skin. The fascio-muscular system of the face is lifted up by means of two or three stitches and the excessive amount of skin is removed. The surgery is performed under a local or general anaesthetic and allows for a very short, i.e. one-week-long, convalescence. The scars remaining after the surgery go along the region of the hairy skin as well as a small area before the ear. After several weeks they are almost invisible. A patient needs to stay in the clinic only one or two days afterwards. A dressing is put around the head that should be worn for 5-6 days. All swellings sustain for about 4-5 days and bruises remain in the region of the jaw for 6-7 days. The stitches are removed after 6 or 8 days.

The post Face Area Surgery first appeared on Kolasiński Clinic.

Eyelid surgery (medically called blepharoplasty) is a procedure to correct drooping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision.

However, it won’t remove crow’s feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows.

Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or brown lift.

If you’re considering eyelid surgery, this information will give you a basic understanding of the procedure – when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask our surgeon about anything you don’t understand.

The best candidates for eyelid surgery

Blepharoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with our surgeon.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.

Uncertainty and risk

When eyelid surgery is performed by a qualified surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risk by closely following our surgeon’s instructions both before and after surgery.

The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling of the eyelids; and a slight asymmetry in healing or scarring.

Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

Planning your surgery

The initial consultation with our surgeon is very important. The surgeon will need your complete medical history, so check your own records ahead of time and be ready to provide this information. Be sure to inform our surgeon if you have allergies; if you’re taking any vitamins, medications, or other drugs; and if you smoke.

You should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along.

You and our surgeon should carefully discuss your goal and expectations for this surgery. You’ll need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional procedures are appropriate.

Our surgeon will explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, and the risks involved.

Don’t hesitate to ask our doctor any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing for your surgery

Our surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Eyelid surgery is usually done on an outpatient basis; rarely does it require an inpatient stay.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery, and to help you out for a few days if needed.

Types of anesthesia

Eyelid surgery is usually performed under local anesthesia – which numbs the area around your eyes – along with oral or intravenous sedatives. You’ll be awake during the surgery, but relaxed and insensitive to pain.

The surgery

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you’re having all four eyelids done, the surgeon will work on the upper lids first, then the lower ones.

In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids.

The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes.

Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.

After your surgery

After surgery, the surgeon will lubricate your eyes with ointment. Your eyelids may feel tight and sore as the anesthesia wears of, but you can control any discomfort with the pain medications prescribed by our surgeon. If you feel any severe pain, call our surgeon immediately.

Our surgeon will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. (Bruising varies from person to person; it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month.) You’ll be shown how to clean your eyes, which may be gummy for a week or so. Many doctors recommend eyedrops, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

Our surgeon will follow your progress very closely for the first week or two. The stitches will be removed five days to a week after surgery. Once they’re out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better.

Getting back to normal

You should be able to read or watch television after one or two days. However, you won’t be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.

Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and our doctor’s instructions, you’ll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses.

Our surgeon will tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It’s especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.

Your new look

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they’ll fade to a thin, nearly invisible white line.

On the other hand, the positive results of your eyelid surgery – the more alert and youthful look – will last for years. For many people, these results are permanent.

Before & after pictures
Eyelids Correction

View gallery

The post Eyelids first appeared on Kolasiński Clinic.

For the most part, the operation is done on children between the ages of seven and fourteen. Ears are almost fully grow by age seven, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

If you′re considering ear surgery for yourself or your child, this information will give you a basic understanding of the procedure – when it can help, how it′s performed, and what results you can expect. It can′t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask our doctor if there is anything you don′t understand about the procedure.

Complications and risks

When ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with and specific complications associated with this procedure.

A small percentage of patients may develop a blood clot on the ear. It may dissolve naturally or can be drawn out with a needle.

Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

Indications

Most surgeons recommend that parents stay alert to their child′s feelings about protruding ears; don′t insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

In the initial meeting, our surgeon will evaluate your child′s condition, or yours if you are considering surgery for yourself, and recommend the most effective technique. He or she will also give you specific instructions on how to prepare for surgery.

Ear correction

Ear surgery is usually performed as an outpatient procedure in our clinic. Occasionally, our doctor may recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight in the clinic.

Anesthesia

If your child is young, our 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, so you or your child will be awake but relaxed.

The surgery

Ear surgery usually takes about one hour and a half, although more complicated procedures may take longer. The technique will depend on the problem. The surgeon makes a small incision in the back of the ear to expose the ear cartilage. He or she will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete. Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.

In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time.

Recovery time

Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the clinic with a child until all the effects of general anesthesia wear off.

The patient′s head will be wrapped in a bandage immediately following surgery with antibiotics ointment, to promote the best molding and healing. Just before and three days after the surgery, antibiotics are taken orally. The ears may throb or ache a little for a few days, but this can relieved by medication. One week the patient cannot wash his or her hair and it is recommended to refrain from any school, professional and social life. Winter or summer vacations are the best moments to undergo the corrective surgery in the case of children.

Within seven days, the bulky bandage will be taken off and stitches will be removed in the clinic. The ears can be a little swollen and red. However these symptoms disappear after two or three days. Then our surgeon recommend a special headband, especially at nights.

Any activity in which the ear might be bent should be avoided for two months. Most adults can go back to work about seven days after surgery. Children can go back to school after seven days or so, if they′re careful about playground activity. You may want to ask your child′s teacher to keep an eye on the child for a few weeks. The cartilage rebuilts itself within the period of two to six months. After such a period of time becomes hard, elastic and resistant to damages.

Sometimes, however, the correction can leave a scar that′s worse than the original problem. Ask our surgeon about the effectiveness of surgery for your specific case.

Expectations

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don′t expect both ears to match perfectly-perfect symmetry is both unlikely and unnatural in ears. If you′ve discussed the procedure and your expectations with the surgeon before the operation, chances are, you will be quite pleased with the result.

Before & after pictures
Ear correction

View gallery

The post Ear problems first appeared on Kolasiński Clinic.

Botulinum toxin has become a ubiquitous drug for all seasons. A myriad of applications for the treatment of facial aging are now available that can be performed safely and effectively with minimal side effects. Botulinum toxin is produced by the bacterium Clostridium botulinum. In 1980, botulinum toxin started finding medicinal use for certain conditions, such as the treatment of strabismus in children, facial spastic disorders as well as asymmetries caused by facial nerve paralysis, deep glabellar furrows in patients with benign essential blepharospasm. It is use in the effacement of dynamic or hyperkinetic facial lines, it has also found use in treating conditions such as dystonias (cervical dystonias), facial and generalized muscle spasms, cranial nerve VII disorders, incontinence, autonomic disorders, blepharospasm, general spasticity and strabismus, migraine headaches, jaw pain and spasm, hyperhidrosis, and involuntary movement disorders.

There are at least seven different substances (serotypes), mostly proteins. However, only one of its type is used in medicine, namely neurotoxin of A type available in the form of solution called Dysport (from Ipsen Ltd.) and Botox Cosmetic (by Allergan). Botulinum toxin type A is the most powerful biological endotoxin, whose biochemical and physiologic effects. Primarily serve to block the release of acetylcholine at the neuromuscular junction in affected mammals, thus inhibiting focal muscle contraction.

Indications

The cosmetic form of botulinum toxin is a popular non-surgical injection, applied to various aspects of facial rejuvenation, that temporarily reduces or eliminates wrinkles in the region of 1/3 of the upper part of the face, i.e. the region of the forehead, frown lines between the eyebrows, and the so called crows feet around the eyes, rarely in the region of the mouth, chin and neck.

Studies have also suggested that botulinum toxin is effective in relieving migraine headaches, excessive sweating, under the arms to prevent perspiration, and muscle spasms in the neck and eyes.

Patient selection

Not all individuals are candidates for botulinum toxin injections. Among those who should not receive such injections are those who are sensitive to the ingredients, patients with neuromuscular diseases (such as myasthenia gravis, Eaton-Lambert syndrome, or amyotrophic lateral sclerosis) and pregnant also lactating women.

Injections should be applied with caution and discretion in those patients on anticoagulation (aspirin therapy), patients treated with aminoglycosides, penicillamine, or calcium channel blockers, as these drugs have been known to possibly potentiate clinical effects.

Patients who have unreasonable expectations or psychological issues that would prelude a satisfactory outcome should be excluded from treatment.

Patients should understand that the effect of botulinum treatment can last several months but will not achieve a permanent change nor will it produce the same effect as surgical rejuvenation, including facelift.

Treatment

Botulinum toxin works in the region of neuromuscular connection. It blocks the transmission of nerve impulses to muscular fibers paralyzing muscular contractions. As a result, muscles become lose and flaccid smoothening the skin face. Injections are performed without anesthesia or Emla can be used. The toxin, after having been injected, spreads in the radian of 1 to 3 cm from the injection place and removes only dynamic wrinkles such as mimic wrinkles of the face, depending on the muscles that are activated.

Botulinum toxin starts to work after 72 hours since the medication was injected, but the cosmetic effect is gain after 2 weeks. The toxin works for 5 to 6 months. It can be used only 2 to 3 times a year every 4 or 6 months. Even though the botulinum toxin does not pose any danger, some temporal side effects may appear such as slight pain during the injection, redness or small haematomata in the regions of injection or slight temporal swelling of those regions.

Complications

Potential transient adverse local effects include: rash, pain, edema, erythema, ecchymosis, headache or hyperesthesia at the injection site.

Systemic complication are very rare but they may include flu-like symptoms or distant skin rashes. The other rare but more frequently reported events are adverse or undersirable soft tissue effects that relate mostly to technique and result in temporary soft tissue malposition (such as blepharoptosis, brow ptosis, cheek ptosis, and lower eyelid ectropion or retraction, etc.).

The treatment with botulinum toxin may rarely result in the formation of antibodies that may reduce the effectiveness of subsequent treatments for cosmetic or other clinical uses. This may happen more frequently when toxin is given more often than recommended or at higher doses.

Botulinum injections can be a safe and effective temporary treatment of fine facial lines and wrinkles, can produce a temporary improvement of facial and periorbital shape, and can serve as a useful adjunct in a variety of plastic surgical procedures.

The post Botulinum (botox) first appeared on Kolasiński Clinic.