Archive for the ‘Facial Surgery’ Category

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Deep Facelift in Westchester County, NY

Wednesday, November 30th, 2011 by admin

Dr. Goldberg is now offering the Deep Facelift for patients in the Westchester County, NY area.

The Deep Facelift allows Dr. Goldberg to address aspects of the aging face that a traditional facelift cannot.  As we age, the cheek fat under the lower eyelid begins to descend.  As this happens, it leaves behind a hollow ridge under the eyelid often referred to as the “tear trough”.  Where the bottom of the lower eyelids meet this tear trough, they become visible and give the appearance of lower eyelid “bags”.

The goal of the deep facelift is to re-elevate this upper cheek fat to where it once filled the tear trough and obscured the lower eyelid bags.  In many cases, this maneuver alone can correct the appearance of the lower eyelids without even operating on the eyelid at all.  The elevated cheek tissue also gives the cheeks a more full and youthful appearance.

A traditional facelift focuses on repositioning the skin and the tissues just under the skin.  This is very important, and is generally done by Dr. Goldberg in combination with the deep technique.  The problem, however, with using the traditional technique to address the upper cheek fat is that it is not directly manipulating that tissue.  For a traditional facelift alone to move this fat, it would have to do so indirectly by pulling on the skin and tissues just beneath.  Overaggressive attempts at this can give a very unnatural, “pulled” appearance.

The deep facelift, by contrast, directly elevates the cheek tissue without pulling on the skin at all.  This allows for an anatomic correction without distortion.  The procedure is a short addition to the traditional facelift operation with no additional visible scars.  A small incision is made inside the upper lip which is closed with dissolving stiches.  The oral incision is relatively painless and heals very quickly.

The procedure is simple and safe, and uses techniques well established in other forms of facial surgery.  Because Dr. Goldberg, and his team, are additionally well versed in complex facial reconstruction, they are able to use their experience to offer, improved, more natural, facelift results.

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Early Surgical Intervention Best for Babies with Cleft Palate

Monday, May 16th, 2011 by Newswriter

Baby with cleft palateBirth defects can be devastating for a parent, but fortunately many common defects can be treated quickly and safely. Cleft lip and/or palate, which occurs when the lip or roof of the mouth fails to fuse properly, is one of the most common birth defects, with over 7,000 cases in the United States each year.

A recent article on Women’s Health explains some of the keys to effective treatment of oral-facial clefts: prenatal screening and diagnosis, early surgical intervention, and a well-coordinated care team who can look after all aspects of treatment and recovery.

Before Birth

It begins with prenatal ultrasounds, which can detect most cases and allow time for parents to prepare themselves emotionally. Doctors and parents can develop a treatment plan. Parents should anticipate some problems, such as difficulty feeding their baby, frequent ear infections, speech difficulties, and dental problems.

Surgery

Oral-facial cleft surgery is most effective within the first year of life, with cleft lip often being repaired by 3 months and cleft palate between 6 and 18 months.

After Surgery

Babies should have repeated visits with a number of specialists to ensure proper development after the surgery. Ear-nose-throat specialists, speech therapists, orthodontists, audiologists, and psychologists can identify any post-operative issues that may arise.

There are also some steps that you can take before pregnancy to reduce the risk of this common birth defect. Women can take 400-microgram folic acid tablets to aide in cell production and DNA synthesis. Quitting smoking and avoiding secondhand smoke are also very important. Be sure to talk to your doctor about any medications you may be taking, as well as any family history of oral-facial clefts.

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Why do People Look “Plastic” After Plastic Surgery?

Monday, April 18th, 2011 by ndgoldberg

Whether we know it or not, our brains recognize patterns as familiar or unfamiliar.  If we drive past a snowman in July we might not know what we just saw but something will strike us as weird.  The same thing happens if we see a person with young beautiful eyes and an old mouth with jowls.  We might not realize what looks wrong, but our brains recognize the pattern as unfamiliar.

The problem can be a result of patient’s shopping for procedures rather than asking the doctor what combination of procedures would help most. Obviously financial constraints may limit the surgery that someone can have at any point.  However, trying to focus the procedures to the areas that need them most so that a discordant look is not created can go a long way toward preventing this unwanted outcome.

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Minimally Invasive Technique Relieves Facial Paralysis

Wednesday, March 23rd, 2011 by Newswriter

Beautiful womanA new technique that restores facial movement with only a small incision and no major bone work will soon be bringing smiles back to sufferers of lower facial paralysis. The procedure, which involves transposing a facial tendon, was successfully employed in reanimating the faces of 17 patients.

“The primary goal of all facial reanimation protocols is to restore facial movement that is controlled, symmetrical and spontaneous,” writes Dr. Kofi D. Boahene and his colleagues, who published the report in the January/February issue of Archives of Facial Plastic Surgery. A previous method involved moving the temporalis tendon, which is attached to one of the muscles on the side of the head that allows us to chew, with an incision at the temple. This also required surgical dissection of the temporalis muscle.

The procedures were performed between 2006 and 2008 at the Johns Hopkins University School of Medicine in Baltimore. The single, small incision is made through a skin fold on the side of the nose or through the mouth, which is much less visible than an incision into the temple. No patients encountered any post-surgical complications and all achieved improved facial expression symmetry and enhanced voluntary motion.

After the facial surgery, directed physical therapy is necessary to retrain the patient’s facial muscles. “The visible movement gained from dynamic muscle transposition,” the authors write, “does not translate into a spontaneous controlled smile without intensive neuromuscular retraining.” The patient practices a “Mona Lisa” smile by raising the corners of the mouth, and then learns to smile by contracting the temporal muscle.

Over time, this becomes natural and spontaneous for the patient, so that the patient’s mind links smiling to the temporalis muscle rather than the muscles previously responsible. In order for this to be successful, patients must be highly motivated and dedicated to their physiotherapy, but the rewards may be well worth it.

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