JUST JUST FACES FACES A Guide to Facial Plastic Surgery J. Phillip Garcia, M.D., F.A.C.S. JUST FACES A Guide to Facial Plastic Surgery J. Phillip Garcia, M.D., F.A.C.S. Copyright ©2018 Revised 2006, Second Edition Revised 2006, Third Edition Revised 2009, Fourth Edition Revised 2012, Fifth Edition Revised 2018, Sixth Edition Garcia Plastic Surgery Institute 7807 Baymeadows Rd. East, #303 Jacksonville, Florida 32256 TABLE OF CONTENTS INTRODUCTION Purpose of this Book .............................................................................7 About the Doctor ..................................................................................9 Practice Philosophy and Our Commitment ....................................... 10 Treating the Inside ............................................................................. 12 Treating the Outside .......................................................................... 12 The Art of Facial Plastic Surgery ........................................................ 14 The Science of Facial Plastic Surgery ................................................ 14 Facts About Facial Plastic Surgery ..................................................... 15 Patience ............................................................................................. 17 Glossary of Terms ............................................................................... 18 CHAPTER 1: Pre-Procedure Considerations The Consultation ................................................................................ 22 Medical Clearance ............................................................................. 25 Tobacco & Alcohol ............................................................................. 25 Preparing for Surgery ......................................................................... 27 Medications & Supplements to Avoid ............................................... 28 Anesthesia .......................................................................................... 35 Post-Operative Considerations ......................................................... 42 CHAPTER 2: Cosmetic & Reconstructive Surgery of the Nose Introduction to Nasal Surgery ............................................................ 46 Preparing for Nasal Surgery ............................................................... 48 The Rhinoplasty Operation ................................................................ 49 After Nasal Surgery ............................................................................ 50 Before & After Rhinoplasty ................................................................ 56 3 JUST FACES CHAPTER 3: Cosmetic Surgery of the Aging Lower Face Introduction to Surgery of the Aging Lower Face ............................... 74 The Aging Process in Detail ................................................................. 76 Volume Augmentation ......................................................................... 81 Natural vs. Unnatural Results ............................................................... 83 The Aging Face Operation .................................................................. 84 Different Types of Facelifts................................................................... 88 Preparing for Aging Face Surgery ....................................................... 90 After Aging Face Surgery .................................................................... 91 Before & After Facelift Photos ........................................................... 103 CHAPTER 4: Cosmetic Surgery of the Aging Upper Face Introduction to Surgery of the Aging Upper Face ............................ 136 The Aging Process in Detail (Eyes & Forehead) ................................ 136 Different Types of Brow Lift Surgery .................................................. 137 After Brow Lift Surgery ....................................................................... 139 Before & After Aging Upper Face Photos ......................................... 141 Different Types of Eyelid Surgery ...................................................... 144 After Eyelid Surgery ........................................................................... 146 Before & After Eyelid Surgery Photos ............................................... 151 CHAPTER 5: Injectable Materials to Treat Wrinkling Introduction to Neurotoxins & Fillers ................................................ 179 What to Expect at Your Appointment ............................................... 182 Volume Augmentation: Fillers ........................................................... 184 Which Filler is Right for You? ............................................................. 191 Before & After Neurotoxin & Filler Photos ........................................ 193 CHAPTER 6: Skin Enhancement Introduction to the Skin ..................................................................... 236 Skin Care Treatments ......................................................................... 236 Chemical Peeling ............................................................................... 238 Dermabrasion .................................................................................... 240 After Skin Resurfacing ........................................................................ 243 Before & After Skin Resurfacing Photos ............................................ 247 4 TABLE OF CONTENTS CHAPTER 7: Cosmetic Surgery of the Chin & Cheeks Mentoplasty ........................................................................................254 Malarplasty ..........................................................................................256 After Chin & Cheek Augmentation ....................................................257 Before & After Chin & Cheek Surgery Photos ....................................259 CHAPTER 8: Cosmetic Surgery of the Ears The Otoplasty Operation ....................................................................265 After Cosmetic Ear Surgery ................................................................265 Before & After Otoplasty Photos ........................................................266 CHAPTER 9: Non-Invasive Advanced Aesthetic Therapy Partial vs. Complete Correction ..........................................................271 Progressive Peels ................................................................................273 Microneedling .....................................................................................274 Ultherapy .............................................................................................275 PDO Thread Lift ..................................................................................276 Before & After Aesthetic Treatment Photos .......................................278 CHAPTER 10: Skin Cancer, Facial Reconstruction & Facial Trauma Types of Skin Cancer ...........................................................................287 Treatment of Skin Cancers ..................................................................288 Before & After Mohs Surgery Photos .................................................293 Facial Trauma ......................................................................................301 Before & After Facial Trauma Photos ..................................................304 Scars ....................................................................................................312 Scar Revision .......................................................................................315 Lesion Removal ...................................................................................317 After Scar Revision & Lesion Removal ................................................317 Before & After Scar Revision Photos ..................................................320 5 FOREWORD Welcome to our practice. The purpose of this book is to inform, educate and answer all of the questions one may have before, during and after a cosmetic or reconstructive procedure of the face, head and neck. Our intention is that you use this book as a guide that takes you through all of our procedures in detail. We also intend for this book to be used as a patient care manual to give you all the facts on preoperative and postoperative care. We have included specific areas in the book where you can write down questions to be answered by any member of our staff. We suggest you read the entire book to better educate yourself with our procedures. Your thorough understanding of our practice and our procedures will help to facilitate our ability to better communicate with you throughout the process. 6 INTRODUCTION Purpose of this Book We have written this book to serve as a guide for anyone considering facial plastic surgery or any other services regarding your face. It is designed to help patients and family members through the process. We strongly encourage you to read the book prior to your consultation as we believe the more informed you are, the more fulfilling the consultation and the entire process will be. For your convenience, we have included areas for you to write down questions for us after every chapter. We would like you to remember several important facts: The first one is that we intend for the book to be used for educational purposes. Whether you allow us to partner with you here or whether you go elsewhere, it is our intent to make the reader more informed about the specialty of Facial Plastic Surgery. Also,