Cosmetic facial surgery is described in many terms and can be quite confusing for patients. Years ago, facelifts included forehead lifts/browlifts, upper and lower eyelids, face and neck lift. A ‘mini’ facelift or lower facelift was commonly used to describe doing the face and the neck only. Other terms have been trademarked to describe surgical procedures for marketing purposes. The most important advice is to clearly communicate with the doctor what bothers you and what you would like changed. Secondly, it is imperative to listen to the doctor since he/she may be raising issues not previously discussed. Remember, you don’t know what you don’t know. Then, it is important to understand what is and is not going to be accomplished from the surgery. Realistic expectations are tantamount for a successful surgery.
Dr. Dabbah takes pride and great strides in providing his patients with a natural youthful face. If a patient asks for facial surgery that will result in a wind-tunnel look or an extremely tight face with unnatural creases, Dr. Dabbah will refuse to do the surgery. Dr. Dabbah wants his patients to look rejuvenated, not unrecognizable. He employs multiple approaches to achieve this goal. He will analyze the patient’s facial features and discuss all the concerns. He will then devise a surgical plan to address the issues discussed.
When deciding on the best cosmetic procedures or surgery, the quickest or least expensive option is more often than not, the worst decision. You should be looking for the best option. Listen well to the pros and cons of each cosmetic procedure or surgery. It may take a little longer to accomplish or cost a bit more but, if done expertly, you will not be disappointed in the short run and the results will be worth it years from now.
Dr. Dabbah performs all of his procedures and surgery himself with no assistant surgeon. He attends to his patients at each postoperative visit and considers the surgery “finished” when he discharges the patient.
Cosmetic Facial Surgery (Rhytidectomy)
A facelift is not a facelift is not a facelift. It depends on who you ask and how that surgeon defines and performs the surgery. No two surgeons are going to perform a facelift exactly alike.
Cosmetic facelift surgery is designed to improve the jowls of the jawline, remove loose skin and, more importantly, restore volume. As we age, our skin ages resulting in thinner, less elastic tissue. Deeper ligaments stretch, fat and tissue drop and we lose volume. Loss of volume occurs during aging. It’s important to restore that volume. Fat and tissue can be repositioned, underlying tissues can be tightened and excess skin can be removed without causing an unnatural look. And Dr. Dabbah’s perspective and approach to a male and female facelift differs. But, in either case, facelift surgery cannot improve the quality or texture of the skin. Other procedures such as lasers, peels and quality skin care are an absolute must to improve the skin quality.
Following facelift surgery, options such as Botox and filler injections will help treat frown lines, crow’s feet and deeper lines that are not addressed with the facelift.
A necklift is a cosmetic surgical procedure that improves the contour of the neck by removing excess skin, removal of fat and tightening of underlying muscles. It can sometimes be performed alone but is commonly combined with a facelift. I have had patients call it a chinlift.
As we age, we lose skin elasticity and develop hanging skin in the neck area. Usually this skin needs to be removed, however in younger patients, we can sometimes perform lesser invasive procedures to improve the neck. Some patients may be candidates for liposuction alone. Most need liposuction combined with a platysmaplasty. A platysmaplasty is a procedure to tighten the platysma muscle, the muscle in the neck responsible for the vertical bands. We continue to age and performing a platysmaplasty lengthens the longevity of the necklift.
If you have excellent skin tone and elasticity but are unhappy with fat in the neck region, you may be a candidate for an injectable alternative. The FDA recently approved deoxycholic acid, Kybella, which dissolves fat. It’s a procedure that is done in the office by injecting Kybella into the areas of fat. Contact us to find out more about this exciting nonsurgical option.
Liposuction and Platysmoplasty
Patients who come in with minimal hanging skin but complaining of an aging neck can sometimes get away with contouring of the fat and tightening of the neck muscles. The only incision is under the chin and we rely on the skin retraction to give the contour.
Cosmetic Eyelid Surgery (Blepharoplasty)
Cosmetic eyelid surgery, also known as a blepharoplasty, is helpful for those who feel that their eyes are heavy or make them look tired. It may be hanging skin of the upper lids or more involved such as fatty pockets of the lower lids. More advanced procedures today involve preservation of the fat surrounding the eyes. Rather than removing the fat and creating a hollow appearance, fat is placed back where it belongs and the overlying muscles are repositioned and tightened. This allows for a youthful appearance and maintains volume in this area. As in all facial surgery, skin quality is extremely important and peels or lasers may be necessary to get rid of wrinkles or lines. Dr. Dabbah does not change the shape of your eyes and, though it should not need to be said, ascertains that your eyes can and do close. Many doctors and surgeons opt to inject fillers or fat into the lower orbital area. This can be problematic and lead to asymmetry and a flattened look. As in all facial cosmetic procedures, Dr. Dabbah’s intent is to help make you look like you, but better and more youthful.
Body contouring encompasses numerous procedures. Liposuction, abdominoplasty, body lifts, thigh lifts and arm lifts (brachioplasty) are just a few. Statistics show that the numbers of surgical procedures have increased their fastest rate in the recent years due to massive weight loss patients. These cosmetic procedures are very popular here in South Florida, as tank tops and bathing suits reign.
Abdominoplasty comes in a variety of forms from mini to full. Analyzing the abdomen involves assessing the amount of skin and skin quality, the abdominal muscles and the distribution of fat. Mini abdominoplasties may also be called lower tummy tucks. This operation focuses on the area between the pubic region and the belly button. A mini tummy tuck leaves a limited scar. A full tummy tuck involves contouring the entire abdomen from the pubic region all the way up to the lower sternum and ribs. The full tummy tuck leaves a scar from hip to hip but patients are satisfied with the result and the scar is never a concern since Dr. Dabbah takes the extra time to perform a unique skin closure. Occasionally liposuction is combined with this surgery and other times fat is directly removed without the need for liposuctioning.
Massive weight loss, by dieting or gastric bypass surgery, leaves patients with large amounts of redundant skin, and sometimes fat, on their bodies. Removal of the excessive skin and fat is necessary to achieve a more contoured look. A lower body lift removes excess skin circumferentially around the trunk. It includes a tummy tuck along with the removal of skin and fat from the flanks, hips and outer thighs. The scars are lengthy but patients gladly make the exchange for the significantly tighter and contoured body. Brachioplasty (arm lift), abdominoplasty (tummy tuck), reduction mammaplasty (breast reduction) or mastopexy (breast lift) are all procedures which can help the patient achieve the desired look after large amounts of weight loss.
Liposuction is ideal for those who are at or near their ideal body weight but have fatty deposits they cannot get rid of with proper diet and exercise. Liposuction allows contouring of these areas and results in the happiest patients. Liposuction is not a form of weight loss and is not a substitute for proper nutrition. Although there have been high tech advances in liposuction machines, the philosophy remains the same. Select the right patient, select the appropriate procedure and perform the surgery properly. The surgeon’s expertise determines the result, not the machine used.
Thigh lifts are usually best suited for those who have lost a significant amount of weight such as in bariatric surgery. The upper leg and thigh are left with handing skin and sometimes, fat. Loose skin can be removed in a similar fashion as an arm lift. At times, liposuction is necessary to remove additional fat prior to the thigh lift. Scars are placed on the inner aspect of the thighs and the length varies depending on the severity of the loose skin.
Brachioplasty is the surgical term for arm lift. Hanging skin and excess fat is removed from the upper arm through an incision. The length of the incision is determined by the severity of the problem. Scars may extend from the armpit to the elbow but, again, Dr. Dabbah performs his unique closure so patients are generally so pleased with the result that they are very accepting of the scar. Armlifts have become rather popular here in South Florida. Patients don’t want to hide their arms in long sleeves because of the heat. And many times, it is difficult for these patients to fit their arms into long sleeves.
Breast enlargement or augmentation, is a surgical procedure to enlarge the breasts and is one of the most common cosmetic surgical procedures, surpassing liposuction. Breast implants, saline or silicone gel, are placed through an incision at the areola or underneath the breast at the breast crease. During your consultation, Dr. Dabbah will discuss the different implants, placement of the implants, and advantages and disadvantages to each. Also in consultation, Dr. Dabbah will discuss the size. It is important to choose implants that are proportionate to your body and to consider your exercise regimen. Although breast augmentation is generally not appropriate for women under the age of 18, there are young women, as well as older women, who have developed asymmetrically or not at all. Breast augmentation, with or without a breast lift, may be indicated and actually appropriate for their emotional and physical well-being. As in all surgery Dr. Dabbah performs breast augmentation on women who have realistic expectations.
Breast reconstruction is an option for women who require a mastectomy or lumpectomy for breast cancer. As an avid supporter in fighting breast cancer and finding a cure, Dr. Dabbah hopes that he will no longer need to perform breast reconstruction. However, he derives a deep satisfaction in helping breast cancer patients with the breast reconstruction process. Breast reconstruction can be immediate or delayed following a mastectomy. Commonly, expanders are placed and an expansion process begins soon after the surgery. Once the desired size and shape is achieved, surgery is performed to remove the expander and replace them with permanent implants. It is important to obtain a consult prior to your breast cancer surgery, as there is a lot of information available to help you make the best decision regarding your reconstruction. If you have had breast reconstruction and considering a revision, Dr. Dabbah will provide you with a second opinion regarding your options.
Breast Reduction (Reduction Mammaplasty)
Cosmetic breast reduction surgery, or reduction mammaplasty, is a surgical procedure to reduce the size of the breasts by removing breast tissue and fat. Many women with large breasts complain of their size, the weight of their breasts and even back or neck pain. There are various techniques to a breast reduction and during your consultation, Dr. Dabbah will determine which technique is best for the patient. In most cases, limited incision surgery is possible, limiting the amount and length of the scars. However, the scars fade in time and Dr. Dabbah’s patients are thrilled with the results, which always includes a breast lift, or mastopexy.
A breast lift, or mastopexy, is a surgical procedure to lift and reshape the breasts. If your breasts droop or sag, this may be the right operation for you. A breast lift creates a more youthful appearance by repositioning the tissues and nipple areolar complex. A mastopexy will likely make your breasts smaller since it does involve removing excess breast skin. Dr. Dabbah will discuss your options regarding a mastopexy since some women also want to restore fullness to the upper breast region. Implants can be placed at the time of the breast lift and is known as an augmentation mastopexy.
Men may be faced with a condition known as gynecomastia in which one or both breasts are enlarged. The etiology is usually unknown. Dr. Dabbah will discuss whether liposuction alone is possible or if direct removal of tissue is needed. Dr. Dabbah is seeing many more young adults and men for gynecomastia surgery.
A skin care consultation may be one of the best things you can do for your skin health. Our medical aesthetician provides facials and treatments to address aging, acne and sun damage. We only use the highest quality products such as Environ, Obagi and ZO Skin Health.
Microneedling and rolling are two great options to deliver skin care products into your skin cells. It also may help with stimulating collagen production.
If it is small blood vessels that are bothersome, we have a laser that specifically addresses that.
If a deeper chemical peel, or TCA peel is needed, Dr. Dabbah performs those in the office. These peels help to make your skin more youthful and glowing.
For the deep lines of the face and mouth, fillers and medium depth peels are not enough. Dr. Dabbah uses the gold standard, a deep phenol peel. A phenol peel can soften, if not eliminate, the deep lines and wrinkles of the face. Dr. Dabbah finds the results to be more pleasing than the laser, which can leave the skin with a stiff, more plastic, look. The phenol peel is a great component to facelift surgery.
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Surgery is not for everyone and everyone may not be ready for surgery. Many nonsurgical options can provide the cosmetic improvement you seek. As with surgery, Dr. Dabbah performs all procedures himself.
Botulinum injections, commonly known as Botox and Dysport, are the most commonly performed procedures in this country. Several more companies are awaiting FDA approval for their brand of Botulinum. These injections weaken or paralyze specific muscle groups so they can relax resulting in fewer lines and wrinkles, a smoother contour of the forehead and elevation of the eyebrows. Results typically last 3-4 months and patient satisfaction is extremely high.
Products that add volume are known as “fillers” These are able to give you fuller lips, soften smile lines, improve contour along the jawline and decrease the appearance of various lines and wrinkles. The most common are hyaluronic acids such as Juvederm Ultra, Ultra Plus, Juvederm Voluma, Restylane, Perlane and Restylane Silk. All of these are FDA approved and may last anywhere from 6 months to a year or more. Remember, the result is only as good as the expertise of the injector as well as the amount of filler used.
Sculptra Aesthetic is a different option for adding volume. Although patients have to wait weeks to two months for the results to be seen, it stimulates your own cells into producing collagen. The result is subtle, but real. Many patients who don’t want others to know they have done injectables opt for Sculptra Aesthetic.
Kybella is an injectable approved by the FDA to dissolve fat under the chin area of your neck. If that is something that concerns you, call us for a consultation to determine if you are a good candidate for that procedure.
Patients who wish to have fullness to their lips and tire of the constant filling can opt for PermaLip, a silicone implant. PermaLip is fully formed and can be removed if, for any reason, the patient wishes to remove it or change to a larger or smaller implant. The procedure is done in the office under local anesthesia.