FACELIFT
A facelift, or rhytidectomy, addresses the lower two-thirds of the face to maintain a naturally beautiful face, neck, and jawline. While it does not stop the aging process itself, it does reset the starting point for natural aging. Depending on the patient’s skin quality, a facelift may last anywhere from five to ten years.
Is a Facelift Right for Me?
It may be confusing if you are looking to find the best surgeon to perform your procedure, as there can be a wide range of accreditations and certifications that represent certain benchmarks of education and experience in the field. However, The American Board of Plastic Surgery (ABPS) is the only board recognized by the American Board of Medical Specialties (ABMS) to certify surgeons in plastic and reconstructive surgery.
In order to become certified with the American Board of Plastic Surgery, a physician must:
- Have graduated from an accredited Medical School
- Completed at least 5 years of surgical training following medical school, with a minimum of 2 years of plastic surgery residency training
- Pass comprehensive oral and written exams
Dr. Nitta is a Board Certified Plastic Surgeon with the ABPS. In addition, she also has her board certification in Otolaryngology & Head and Neck Surgery, providing her with additional knowledge and expertise to apply to her practice.
The Procedure
Incisions are hidden in the natural creases around the ear and into the hairline. The skin and fat are lifted and the underlying muscle is tightened, while excess skin and fat are removed. The length of the incision will vary depending on the patient’s needs. The details of the procedure will be customized to the individual, in addition to standard differences for male and female patients.
Recovery
We keep all of our patients overnight at the surgery center. All male patients will have drains, whereas female patients rarely need them. The reason for this is that males have proportionately more blood vessels in their face, and therefore, tend to bleed a little more. The next morning, all dressings and drains are removed and you may return home. Another large dressing will then be placed, which will remain on for four days. On the fourth day, the dressing is removed, and Dr. Nitta will remove the stitches around the ear. You will then be placed into a “face bra.” This stays on for another week, at which time the remaining sutures in your hair are removed. Your face will be swollen with some bruising, but that will resolve itself in about two weeks. The majority of the visible puffiness will be gone within a month, but your face will remain mildly swollen for several months as it heals. Most patients are happily seen in public with makeup after two weeks.
Brow Lift
A brow lift, or forehead lift, is a procedure that lifts the eyebrows, resulting in a refreshed appearance to the forehead and the area surrounding the eyes.
Is a Brow Lift Right for Me?
One of the most popular procedures for both men and women, a brow lift works by lifting the eyebrows, removing the weight off the upper eyelids. As a result, the procedure softens the horizontal forehead lines, the frown line, and the furrows between the eyebrows. It also reduces lateral hooding and softens crow’s feet. In women, it will restore and enhance the shape of the eyebrow.
Many patients choose to do this in conjunction with eyelid surgery, which complements the effects of a brow lift nicely.
The Procedure
A brow lift can be performed in a number of different ways. The procedure you chose will depend on your hairline and how much elevation is needed. The procedure most often performed by Dr. Nitta utilizes the endoscopic technique combined with a limited temporal incision, keeping all incisions hidden within the hairline. Dr. Nitta utilizes the Endotine® system to reduce the chance of hair loss at the incisions.
Recovery
You will have a large head dressing on and require a drain after surgery. The drain is removed the next day, and the dressing a few days later. You will wear a band around the forehead for the next few weeks. There is mild discomfort and minimal bruising.
EAR SURGERY
Otoplasty is the clinical word for ear surgery of the external ear. It is commonly performed on children and teenagers with overly prominent ears. The procedure sets the ears back closer to the head so that they do not stick out. While big ears are not a medical problem, the teasing and ridicule that can occur may create problems all their own. The surgery can be done in patients as young as seven years old to help dramatically improve self-esteem and quality of life.
The Procedure
The surgery takes approximately 2-3 hours, and generally requires a single incision behind each ear. It is performed as an outpatient procedure in a surgical facility.
Dr. Nitta performs all varieties of ear reconstruction in her private practice, as well as with her volunteer work in Ecuador. She is Board-Certified in both Otolaryngology (Ear, Nose and Throat) and Plastic & Reconstructive Surgery, providing her with excellent expertise and knowledge of all aspects of the ear.
Recovery
Following surgery, patients will be given a post-operative headband that will need to be worn for one week. In most cases, sutures will dissolve on their own. After one week, normal activity may be resumed. However, swimming is restricted for 6 weeks.
RHINOPLASTY
Commonly known as a nose job, a rhinoplasty is a procedure performed in order to change the shape, size, and appearance of your nose. It may involve reducing a hump, straightening an otherwise crooked or broken nose, or making the tip of the nose smaller. If you are unhappy with the outward appearance of your nose and are looking for an improvement, a rhinoplasty procedure may be a good choice.
Is a Rhinoplasty Surgery Right for Me?
Before discussing the outside of the nose, there are two other important factors to evaluate; the inside of the nose and the chin. If you have difficulty breathing through your nose then there may be an obstruction of the air passage due to a twisted septum or enlarged turbinates. Surgery may be needed to clear the obstruction so that the airways do not become too small. The chin is another important factor in the aesthetic appearance of the nose. If the chin is small or weak, the nose may appear to be larger than it really is. In these cases, a chin implant is recommended to achieve better facial harmony.
The best candidates for a rhinoplasty are people who are looking for improvement in their appearance, not perfection. Dr. Nitta will help discuss your options to achieve a realistic expectation of your results. If you are a smoker, you are not a candidate for this procedure.
DIFFERENT TYPES OF RHINOPLASTY
Open Rhinoplasty
Open rhinoplasty is usually reserved for people who need to have their nose majorly reshaped. An open rhinoplasty, one could say, is the “most serious” of rhinoplasties. The procedure usually involves incisions inside the nostrils, as well as one along the connecting wall between them (also known as the columella). From there, the skin and tissue is gently lifted, thus giving the doctor a better view and access to the structure of your nose.
Closed Rhinoplasty
Closed rhinoplasty is similar to the open procedure, though much less altering. In general, closed rhinoplasty is used for people who want to make minor tweaks and adjustments to the appearance of their nose, but not something that will immediately stand out. Unlike in open rhinoplasty, incisions are made only inside the nostrils, and then the skin and tissue are pulled back to allow the doctor to restructure and reshape the bone and cartilage, and thus craft the nose of the patient’s dreams. Unless you suffer from major issues with your nose, it’s most likely that the doctor will recommend a closed rhinoplasty.
Secondary Rhinoplasty
Sometimes, minor issues can occur after a nose operation, thus requiring a secondary intervention. This can either be done as an open or closed procedure, depending on how serious the issues that need correcting are. Secondary rhinoplasty is not something to worry about, as it’s quite normal. Also sometimes referred to as revision rhinoplasty, it’s sometimes used to correct issues that persist even after the initial intervention.
A Word on Filler Rhinoplasty
While often referred to as “rhinoplasty”, this procedure isn’t a surgical one, per se. In filler procedures, rather than reshaping the existing structure, the doctor will inject filler into the nose, to make it more even. For example, if your nose has an outstanding protrusion that upsets the symmetry, the doctor can add some filler, to make the nose seem more even. Filler rhinoplasty can be a good option for people who are considering getting an intervention on their nose, but aren’t quite decided about the permanent results. Since filler rhinoplasty is only temporary, such a procedure can help give you a general idea of what your nose could look like after an actual rhinoplasty.
Which Is Right for You?
It’s common to assume that your problem is immense and will need a lot of correction, but such an impression usually stems from self-confidence issues and may be disproportionate to the truth. But not to worry. During your initial consultation, Dr. Nitta will help you figure out which type of rhinoplasty is the right one for you. She will also work with you on designing the new shape of your nose, as well as on establishing some realistic goals for your nose operation.
The Procedure
IDr. Nitta generally performs a closed rhinoplasty, where all of the incisions are kept inside the nose, hidden from view. Occasionally, if the patient has a large asymmetric tip, or previous nasal surgery, a small incision at the base of the nose will be required. A skin incision is also required if the nostrils need to be reduced. Additionally, in a nose that has had surgery before, additional tissue from the ear or rib may be required.
Recovery
After the procedure, your nose will be packed and you will have a splint on the surface of your nose. The packing is removed after 5 days, and the splint after one week. Immediately after the splint is removed, your nose will begin to swell. You will be given flesh-colored tape to place on your nose. The initial swelling will decrease by about 70% in two months, though it will take at least a year before all of the swelling has resolved. The appearance of the nose will continue to change for about one year.
Patience is a virtue for this surgery, but for many patients, the resulting confidence in their improved appearance is well worth it.
EYELID SURGERY
A blepharoplasty, or eyelid lift surgery, refreshes the eyes to give a more youthful appearance, and it’s one of the most desired surgical procedures among men and women of any age. The procedure can be performed on either the upper eyelids, lower eyelids, or both, and will immediately rejuvenate the appearance of your eyes and refresh your face.
Is a Eyelid Surgery Right for Me?
Excess skin and fat in the upper and lower eyelids may give the appearance of looking tired, having puffy eyes, or looking older.
A blepharoplasty can be performed at any age, when excess skin and fat in the eyelids negatively affects the appearance. Hereditary factors usually determine when eyelid surgery may be most beneficial. Examples of hereditary factors can include excessive fat in the lower lids and the rate at which the brow drops over the course of aging. An eyelid lift is often combined with a brow lift when a droopy eyebrow is a contributing factor to the eyelid.
The Procedure
Incisions are made in the natural crease of the upper eyelid and just under the eyelashes in the lower lid. For younger patients that only have excess fat, the incision can be placed inside of the eyelid. Excess fat is removed from the eyelids, then the skin is trimmed. Skin removal of the lower eyelid is done very conservatively to avoid the hollowed out, round, or surprised look. Other minor surgeries may be performed during this time to correct less common abnormalities of the eyelid.
Recovery
Recovery from an upper eyelid lift is rather quick. The sutures are removed 3-4 days after the procedure, and there is minimal swelling and bruising.
Recovery from a lower eyelid lift is a bit different. All sutures are dissolvable. There may be more bruising and swelling. 70% of the swelling will be resolved within one month; however, it may take up to 8 months for the swelling to be completely gone. Despite the swelling, there is an immediate visible improvement.
LIP AUGMENTATION
Lip augmentation refers to improving the visual plumpness or fullness of the lips. When considering lip augmentation, it’s important to know that there is no technique that is totally permanent, though there are some procedures that last longer than most.
Non-Invasive
For a minimally invasive lip augmentation, facial aesthetic fillers such as Juvéderm® are a great option. Results last anywhere from 4-9 months.
Surgical
A surgical option is to use your own tissue. It is a procedure that transplants dermis, fascia and/or fat to the lips. Dr. Nitta prefers using a dermal fat graft for larger augmentations. Approximately 70% of the graft becomes incorporated into the lip, making it a more permanent solution. Fat injections can also be used, with a 50% incorporation rate. The grafts will eventually shrink with time. The lips lose fat