Blepharoplasty (commonly known as eyelid surgery or eyelid lift) plays a vital role in facial rejuvenation. Removal of excess sagging skin around the eyes, gives a smoother and younger appearance, eliminating “tired air” and aging, and can be performed exclusively on the upper eyelid, lower eyelid or both.
Sometimes it may be necessary to complement blepharoplasty with other more or less invasive procedures (eg, treatment of wrinkles with botulinum toxin, treatment of dark circles with fat grafts, application of hyaluronic acid, suspending wires, lifting of the eyebrows …) for a better aesthetic result.
Otoplasty (Correction of Winged Ears)
Winged ears, also referred to as “detachable ears” or “fanned ears”, are the most common congenital anomaly of the outer ear. They result from a deformity in which a fold is not developed in the atrial cartilage, which causes the auricular pavilion to be away from the skull.
Although winged ears are considered a minor deformity, with no obvious physiological or functional consequences, they can be a source of discomfort, especially for school children.
Otoplasty is surgery that allows you to correct the shape, size, and position of the ears through an incision in the back of the ear.
What is the ideal height for the correction of winged ears?
The appropriate time for surgical correction should take into account atrial growth, cartilage consistency, psychological pressure and the child’s desire.
Winged ears can have a severe emotional and behavioral effect for a child. As such, their correction should be made during childhood, at preschool age (5-6 years). However, it also can and should be done in adults.
The nose is, unconditionally, a determinant of facial aesthetics and individual identity.
Rhinoplasty is a surgical procedure that restructures or reshapes the nose. It can address a variety of concerns, including:
- Nose size in relation to facial balance;
- Width of the nose on the back or the size and position of the nostrils;
- Profile of nose with visible humps or depressions on the back;
- Nasal tip enlarged or bulbous, inclined, facing up or down;
- Large nostrils, broad or upturned;
- Nasal asymmetry.
The importance of nasal morphology in facial aesthetics and individual identity, coupled with the particularities of nasal surgery, make rhinoplasty one of the most differentiated surgeries in Plastic and Reconstructive Surgery.
Frontal Lifting / Eyebrow Lifting
The brow lift / facelift corrects the effects of gravity and aging of the soft tissues of the forehead, returning a younger contour to the skin of the forehead, upper eyelids and eyebrows.
A resting young eyebrow is positioned above the orbital rim, with a gradual arc laterally and the lateral end of the eyebrow located above the inner extremity. With aging, it is common for the forehead to assume a flat or horizontal position with the collapse of the eyebrows.
The facelift is the surgery that allows you to rejuvenate the upper third of the face, allowing:
- Reduce lines of wrinkles that develop horizontally on the forehead and wrinkles on the side of the eyes (“crow’s feet”);
- Improve vertical lines and creases that develop between the eyebrows;
- Raise the eyebrows giving a more youthful appearance.
There are several methods of brow lift / brow lift, which involve different incisions in different locations, and can sometimes be used the endoscopic technique. The type of surgery is based on the facial characteristics and aesthetic preferences appropriate to each case.
Lifting Facial / Neck Lifting
The face lift / neck lift is the most comprehensive approach for the treatment of facial wrinkles and sagging face and neck caused by aging and / or weight loss. The procedure removes excess skin, tightens the underlying muscles and redirects the skin to a higher position, returning a more harmonious and younger contour of the neck and jaw, while eliminating or minimizing wrinkles in the middle and lower third of the face.
There are many different techniques with results that can be consistently reliable, safe and durable. The resulting incisions and scars will depend on the area of the face that is directed and according to the facial characteristics and aesthetic preferences of each case.
A well defined chin helps balance the face and creates an important part of your profile. The shape of the chin has a remarkable influence on the overall appearance of the face and neck.
Improvement of the shape of the chin can be accomplished with various techniques, which may include shrinking and projecting the chin by withdrawing a portion of bone or by increasing its size and projection using implants or bone advancement.
Augmentation mammoplasty is one of the most sought after plastic surgeries for women.
The main reason that women seek this type of surgical intervention is to restore or improve breast shape and / or volume when it is small or disproportionate to the body, as in cases of:
- Breast hypoplasia (small volume breast);
- Breast atrophy;
- Breast asymmetry;
- Loss of volume (after pregnancy or weight loss process).
Increased mammoplasty with fat grafts (transfer of fat from a body site to the mammary region) or the introduction of silicone gel prostheses is the primary surgical option for the correction of this type of problem.
The use of silicone gel prostheses to increase breast volume has marked a new era in the history of Plastic Surgery. This intervention is performed by making a small incision and placing a silicone gel prosthesis behind the mammary gland or behind the large pectoralis muscle, with distinct indications for each case.
There are several techniques for approaching this surgical intervention:
- Via peri-areolar;
- Axillary pathway;
- Via infra-mammary.
There is no one way better than the other. This choice is discussed according to the physical characteristics of the patient and their individual desires.
In most cases, the patient chooses the access route according to their desire. However, when performed with care and discretion, all pathways are adequate and result in discrete scars (less than 4 cm).
There is a great diversity of prosthesis of different forms and different textures. With the wide variety of prostheses available on the market, each patient will have a type of prosthesis more suitable to achieve their desire. It is up to the surgeon to guide the choice of the most appropriate size and form in order to meet the patient’s desired results. Always balance the size of the patient, your chest and your breasts so that the final result is harmonious and natural.
Breast Replacement Revision / Replacement
The main reasons that lead to the need for revision / replacement of breast implants are:
- Development of mammary deformity due to capsular contracture;
- Rupture of the mammary prosthesis;
- Change in breast shape and volume (may be associated with surgery to correct breast fall – breast lift);
- Desire to change the size of breast implants.
Mastopexy / Breast Lift
Breast prosthesis or breast fall is one of the most common breast dysmorphisms, caused by weight loss, post-gravid atrophy, aging and loss of skin elasticity.
Mastopexy is the surgery performed to solve this problem. There are several approaches to raising the breast.
The scar resulting from mastopexy can be:
- Just around the areola;
- In the form of a vertical scar;
- In the form of “L” or “J”;
- In inverted “T”.
- The best technique and the best scar are defined according to the anatomical characteristics of the breast. In many cases, it may be necessary to place a breast prosthesis during mastopexy to restore lost volume (mastopexy).
Breast hypertrophy is a frequent complaint among women, characterized by an excess of skin, mammary gland and fat, which together give rise to several complaints, such as pain in the neck and shoulders, grooves in the shoulders caused by the loops of the bras, changes in the skin in the infra-mammary groove, as well as psychological factors due to exaggerated breast volume, often associated with limitations in sports and other social activities.
There are several techniques of reduction mammoplasty. The resulting scar can be:
- In the form of a vertical scar;
- In the form of “L” or “J”;
- In inverted “T”.
Breast reconstruction is undoubtedly one of the noblest areas of Plastic and Reconstructive Surgery, not only because of the technical complexity that may be related to the reconstructive process, but also because of the positive impact on the lives of those who need it.
There are several types of reconstructive options:
- Alloplastic reconstruction – using breast expander and / or prosthesis;
- Autologous reconstruction – transferring tissue from the body (abdominal tissue – TRAM / DIEP flap, gluteal and thigh tissue (SGAP, IGAP and TUG), back tissue (large dorsal flap);
- Fat grafts – transferring fat from one location of the body to the mammary region.
The selection of the reconstructive technique to be used takes into account different factors, such as the age of the patient, general condition, smoking, psychological profile, pathological history (eg diabetes mellitus), surgical history (eg abdominal surgery), adjuvant radiotherapy of the patient.
Arm Lift / Brachioplasty
The arm lift or brachiplasty is a surgical procedure that removes excess skin and fat from the inner and lower face of the arms, allowing the remodeling and improvement of the arm contour.
Surgical options are gradual in the face of the problem, ranging from liposuction to removal of excess skin and fat resulting in a linear scar extending from the elbow to the armpit.
Mini-lipoabdominoplastia / Lipoabdominoplastia
É um procedimento cirúrgico que tem como objectivo remodelar a zona do abdómen, permitindo a remoção do excesso de pele e gordura da região abdominal, as estrias da parte inferior do abdómen e a correção da flacidez da parede abdominal (diástase dos rectos abdominais) que ocorre, frequentemente, após a gravidez.
A cirurgia é feita realizando uma incisão que fica escondida pela roupa interior ou bikini podendo ser necessário a realização de cicatriz no umbigo (mini-lipoabdominoplastia vs lipoabdominoplastia).
Liposuction / Liposculpture
Liposuction is a procedure that allows you to sculpt the body by removing fat that does not respond to diet and exercise, leaving a more desirable body contour and a smooth transition between the aspirated and unadulterated areas. This procedure can be applied to almost any area of the body.
The main treatment areas are:
Gluteoplasty is a procedure designed to improve the size, shape, and overall appearance of the gluteal region.
It is indicated for the cases of sagging, diminishing volume and / or loss of contour of the buttocks and lateral part of the thighs.
Gluteoplasty can be performed by:
- Silicone gel prostheses;
- Fat grafts – transferring fat from one location of the body to the gluteal region;
- Fill with synthetic material such as hyaluronic acid.
Lifting of thighs
For many people, the thighs become an increasingly problematic area as they age, while others find that the thighs remain stubbornly resistant to diet and exercise even after a massive weight loss.
Thigh lift surgery reshapes the thighs by reducing excess skin and fat, resulting in an improvement in the contour of the thighs and lower body.
There are several techniques available that allow you to customize the procedure of lifting the thighs according to the individual needs of each case, from liposuction to removal of excess fat, until the removal of excess skin and fat from the inner face of the thighs , resulting in a scar in the inguinal fold.
Intimate Surgery and Genital Rejuvenation – Labioplasty
Increasingly, women are asking for aesthetic procedures to improve the appearance of the vulvar region. Hypertrophy of the labia minora can cause irritation, pain and difficulty in wearing clothes, especially sports clothes or tighter clothing.
Labioplasty is a surgical procedure that is designed to change the size or shape of the labia minora, making them generally smaller or correcting any asymmetry.
Labiaplasty can also be performed on the labia majora.
Through female genital rejuvenation surgery, women can achieve:
- Increased self-confidence;
- Improved appearance of lips and vulvar region;
- Restoration of the younger appearance of the female genitalia;
- Greater comfort during exercise and intimate situations;
- Improved ability to wear tighter clothes, such as sportswear and swimwear.
Botulinum toxin (Type A) is a cosmetic injection that blocks the nerve signals that cause the muscles to contract. This effect relaxes and softens the appearance of lines and wrinkles caused by repetitive movements on the face, most commonly between the eyebrows, around the eyes (“crow’s feet”) and forehead wrinkles.
Botulinum toxin can also be used to correct and balance facial asymmetries, relax neck bands, reduce excessive sweating (treat hyperhidrosis), treat migraines and treat other excess muscle contractions.
Botulinum toxin injections can usually be completed on the day of the initial evaluation.
The needles used are very small and thin, causing minimal pain. Depending on your specific concerns and conditions, it will take several injections to achieve the desired result.
Fillers (Hyaluronic Acid)
Fillers are a minimally invasive type of cosmetic injection used to add volume, change the contours of the face and fill in the very marked wrinkles. Common areas for injecting are on the face, neck and hands, resulting in a fuller, softer, and younger appearance. Dermal fillers are among the most popular aesthetic procedures, allowing immediate results to be obtained, with very few associated risks and little recovery time.
The fat grafting procedure transfers the fat from areas where it is in excess, such as the thighs or abdominal region, and injects it into areas with a deficit in volume. Commonly injected areas include the hands, face (including the lips), depressions in the skin (eg, scarring, etc.), breast and buttocks (for augmentation).
In the case of the face, transfer of fat allows correcting facial creases, acne scars and volume to sunken areas of the face and lips.
This procedure is safe, long lasting and well tolerated, producing natural and harmonious results.
Book your evaluation appointment now and have the body,
you’ve always dreamed of!
Dr. Gustavo Coelho