Loss of facial contour and formation of wrinkles
When this slackening of connective tissue and drooping of excess skin occurs, the contour of the face is automatically altered. Deep ridges may appear near the nose and mouth, on the forehead or around the cheeks and eyes. In extreme cases, sagging cheeks, a double chin or wrinkles on the neck may be particularly disturbing, as they often make a person seem unflatteringly and prematurely older than they really are. Cosmetic surgery can help with this.
Forehead lifts, brow lifts, face and neck lifts are common procedures in plastic and aesthetic surgery. They are designed to restore the natural contours of the face by lifting the loose tissue back into place. Procedures such as a face, eyebrow, neck, forehead or brow lift can smooth out any disharmony and rejuvenate the face.
With the surgical techniques available in reputable cosmetic surgery today, the emphasis is on achieving the most natural results possible.
On the day of your face lift you will arrive at the Pyramid Clinic one and a half to two hours before your scheduled surgery. Our nursing staff and your specialist will prepare you for the operation ahead. This includes taking the “before” photos and marking the new facial contours on your skin. An experienced anaesthetist will explain the details of the general anaesthetic planned.
The face lift will take about three to four hours. The process involves lifting not only the upper layer of skin but also the underlying connective tissue and facial muscles. Fine incisions along the hairline and around the ear allow the deeper layers of tissue to be lifted. The muscle layer of connective tissue and the neck muscles are also released and lifted slightly at the same time. Then any excess skin around the cheeks plus any loose neck tissue is tightened.
A face lift requires a stay of one to two nights at the clinic. You should also plan for a two-week rest period after surgery.
The head bandage will be removed on the day of surgery. You will be able to carefully wash your hair again from the second day. The plaster and stitches will be completely removed after one or two weeks.
Unpleasant side effects such as a feeling of tightness, swelling and bruising generally disappear after seven to ten days. All signs of the operation should have substantially healed after approximately three to four weeks, often earlier.
Eyelid lift (blepharoplasty)
Drooping eyelids and bags under the eyes
Many people have a tendency towards drooping eyelids at a young age. While the upper eyelids may be saggy or droop, the lower eyelids may be affected by puffiness or bags under the eyes. In the majority of cases these are typical symptom of old age. However, some people have a genetic predisposition that can manifest early on, giving the individual affected a tired and sad look. If the eyelids sag heavily the vision may also be affected. Drooping eyelids occur when the fat under the skin shrinks and the skin relaxes over it and hangs downwards.
Surgery for drooping eyelids is performed in the Day Clinic of the Centre for Plastic Surgery and takes about an hour. You will leave the Day Clinic on the day of surgery, after staying for a short time.
Before the procedure our nursing staff and your specialist will prepare you for the operation ahead. This includes taking the “before” photos and marking the new lid contours on your skin. An eyelid lift is carried out under local anaesthetic or, on request, under general anaesthetic.
For an upper lid lift, an incision in the crease of your eyelid is made to remove excess skin and fatty tissue. The stitches will run along the natural crease of the upper eyelid and extend just beyond the corner of the eye.
The stitches will be removed three days after the eyelid lift (blepharoplasty). You will then wear small plasters over the incision sites for a further four days. Some temporary discoloration or swelling may occur. It takes about seven to ten days for everything to heal completely. Afterwards you will be able to resume normal eye care routines and apply make-up again.
We recommend taking things easy for a few days after the eyelid lift. Do not bend your head too far down or forward. Keep your head slightly elevated when sleeping. Apply sunscreen with a high protection factor and wear sunglasses when you go outdoors, to protect the scars from direct sunlight. In the winter months you should avoid exposure to extreme cold.
bags under the eyes
The lower eyelids may be affected by puffiness or bags under the eyes. These are a result of fatty deposits extending from the eye socket and bulging forward because the supporting membrane is too weak. They are not caused by water retention or fatigue, as it’s often claimed. Bags under the eyes are considered particularly unsightly as they make a person appear unwell, puffy-eyed or older than their years. Drooping eyelids are generally associated with the aging process but also frequently appear in young people who are genetically predisposed to them.
Surgery for bags under the eyes is performed in the Day Clinic of the Centre for Plastic Surgery and takes about an hour. You will spend a few hours in our care after surgery. You will be able to leave the clinic on the same day.
Before the procedure our nursing staff and your specialist will prepare you for the procedure. We will take some pictures of your eye contour and draw in the future contours of the eyelid. An eyelid lift is carried out under local anaesthetic or, on request, under general anaesthetic.
In surgery for bags under the eyes, we remove the fatty tissue via an incision below the eyelash line or inside on the conjunctiva. If wrinkles and baggy skin are already present, an additional incision will be needed.
The stitches will be removed three days after the procedure. You will then wear small plasters over the incision sites for four days. Some temporary discoloration or swelling may occur. It takes about seven to ten days for everything to heal completely. Afterwards you will be able to resume normal eye care routines and apply make-up again.
We recommend taking things easy for a few days after the eyelid lift. Do not bend your head too much and keep your head elevated when sleeping. Apply sunscreen with a high protection factor and wear sunglasses when you go outdoors, to protect the scars from direct sunlight. You should avoid extreme cold during the winter months.
Often there will be medical problems in addition to any aesthetic flaw (e.g. impaired breathing due to narrowing of the partition between the nostrils). This can be corrected during the same surgical procedure. Reconstructive nasal surgery also includes various corrective procedures, which might be indicated as a result of an accident or congenital abnormalities.
On the day of your rhinoplasty you will arrive at the Pyramid Clinic one and a half to two hours before your scheduled surgery. Our nursing staff and your specialist will prepare you for the surgery and will explain the planned anaesthetic procedure.
Rhinoplasty is performed under general anaesthetic and takes about two hours. It may be performed as an outpatient procedure in the Day Clinic or as an inpatient procedure, i.e. with an overnight stay at the Pyramid Clinic.
A rhinoplasty usually leaves a small scar on the base of the nose, or no visible scar at all, if the procedure is performed inside the nostril using the “closed” method. The skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to give the desired profile and shape. To achieve this, the nose is packed with gauze strips (a tamponade) and stabilised with an external plaster cast.
The tamponade is removed after two to five days and the plaster cast after one week. Afterwards your new nasal profile will be clearly visible, although some swelling caused by the surgery will still be evident at this stage. In the weeks that follow, this swelling will gradually disappear. The final results of the rhinoplasty can only be gauged after several months. It is also quite normal for the contour of your nose to change slightly within the first year following surgery. In rare cases some further corrective surgery may be required as a result.
You should avoid any sport or other strenuous activity for at least four weeks.
Ear corrections (otopexy)
Protruding ears are due to a congenital malformation of the ear cartilage or asymmetric development of certain parts of the cartilage. Corrective surgery will reshape the ear cartilage and “set the ears back” closer to the head.
For psychological reasons, we recommend the operation be performed at pre-school age so children do not suffer any teasing once they start school. However, some people affected by the problem do not seek corrective surgery until adulthood.
In addition to correcting prominent ears, procedures in ear surgery also include ear shaping and earlobe correction.
Before the procedure our nursing staff and your specialist will prepare you for the operation ahead. This includes taking the “before” photos and marking the new ear contours on your skin. Depending on the age of the patient, the procedure will be performed under regional or general anaesthetic. One of our anaesthetists specialises in anaesthesia in children.
The operation for protruding ears takes around one and a half hours. An incision is made at the back of the ear to expose the ear cartilage, which is then sculpted.
After surgery you will need to wear a close-fitting head bandage for five to seven days, then a headband at night for another six weeks. After about two weeks, the incision site will have substantially healed. There will be virtually no sign of the operation apart from a faint scar line.
You will need about seven to ten days off school or work. Do not do any sport for three to four weeks and wash your hair carefully.
Bulging eyes (exophthalmos)
About 40 to 60 percent of people who suffer from an overactive thyroid condition known as Graves’ disease will develop an endocrine ophthalmopathy – commonly referred to as protruding or bulging eyes. This is caused by an autoimmune disease, but the exact origins are as yet unknown. Due to increased fatty tissue in the eye socket and thickening of the ocular muscles, the eyeball is pushed forward, creating the effect of a bulging eye. The condition is often accompanied by severe headaches, a pressure sensation behind the eyes, light sensitivity, conjunctivitis and double vision. Apart from these unpleasant side effects, patients affected by this condition frequently suffer severe psychological problems as a result of the obvious facial disfigurement.
Medication or radiotherapy
Initial treatment focuses on correcting the overactive thyroid. This can be achieved by medication (radio-iodine therapy) or surgery (thyroid reduction). If the eye disease persists despite treatment of the thyroid problem, high doses of corticosteroids (cortisone) have proven to be effective. However, this form of treatment only works within the first year of developing the disease.
As a further form of treatment, external radiation therapy may be applied to the eye socket. However, the results of this treatment do vary a great deal and this option is also only effective in the early stages of the disease. If treatment with medication does not prove as successful as anticipated, surgery may well be recommended.
The specialists at the Centre for Plastic Surgery recommend transpalpebral orbital decompression, which involves removal of excess fatty tissue from the eye socket. This is achieved by making fine incisions on the upper and lower lid and has the effect of reducing pressure on the eyeball. Frequently an upper lid and lower lid correction to reduce the enlarged eye opening will be performed shortly afterwards.
Transconjunctival orbital decompression and the subsequent lid correction procedure carry a low risk of complication and are therefore suitable both for advanced cases of the disease, and instances where surgical intervention is desired for purely cosmetic reasons.
In more than 90 percent of cases this form of surgical intervention produces a lasting result. However, if the autoimmune disease flares up again and the problem recurs, a second operation – in this case bony orbital decompression (BOD) – may be considered in certain circumstances.
This alternative operation, bony orbital decompression, involves decompressing the eye socket by repositioning the socket walls. Due to the relatively demanding nature and high risk of this operation, it is only considered if the eyesight is at risk or there are severe medical problems associated with the eyeball.
After the surgery you are required to stay at the clinic for 4 to 5 days. We recommend that you rest and only return to work after 4 to 6 weeks. During those weeks you need to apply eyedrops and use sunglasses whenever you go outside to protect your eyes. Physical activities such as sport can slowly be started after 6 to 8 weeks.
The Face Atelier at the Centre for Plastic Surgery specialises in various minimally invasive methods to improve the appearance of the skin:
Botulinum toxin A or hyaluronic acid injections
- Forehead wrinkles, frown lines, crow’s feet, wrinkles around the mouth, nasolabial folds, cheek wrinkles, drooping corners of the mouth
- Dark circles under the eyes
- Lip volume
- Skinbooster treatments and liquid face lifts
- Age spots and pigmentation spots
- Spider veins, telangiectasia, spider naevi, port-wine stains, redness of the face
- Scar treatment
- Permanent hair removal
- Skin rejuvenation
An epxerienced team of experts
Our doctors have many years of experience and are highly skilled in the field of aesthetic surgeries. Treatment is provided using the most up-to-date equipment and facilities.