Facelift Surgery

At the practice of Dr. David P. Rapaport facelift surgery is considered the key to facial rejuvenation. A well-performed surgery can greatly improve the jowls and neck area, while maintaining a natural hairline and providing an overall refreshed and rested look.

Dr. Rapaport usually performs two-layered surgery, also known as a SMAS lift. Two-layered surgery treats both the skin and the underlying facial muscles and normally includes a necklift.

He emphasizes safety and rapid recovery for his patients. Many techniques advocated today carry with them a risk as high as 10 percent for temporary (three months or longer) facial nerve weakness (uneven smile, abnormal lip movement, etc.). In some cases, these injuries can be permanent. Before any surgery, Dr. Rapaport reminds his patients that no surgeon can guarantee that a complication will not occur; however, he also assures them with his personal track record. After hundreds of these procedures, his incidence of facial nerve injury is zero percent.

Recovery time varies by technique and expertise. In his experience, his patients usually require less than three weeks for bruising and swelling to diminish completely. Many of his patients even return to work as early as one to two weeks after surgery.

Commonly Asked Questions

• How long does facelift surgery last?
  While the surgery cannot stop gravity or the aging process, the effects of a facelift are, in some ways, permanent. For example, consider the case of identical twin sisters who visit a plastic surgeon and only one chooses to undergo facelift surgery. After ten years, the sister who had surgery may feel she would benefit from a secondary procedure, but she would still, at that point -- and forever, for that matter -- appear more youthful than the sister who never had surgery.
• What is the best age to have the surgery?
  There is no "best age" for facelift surgery. When a person feels that the improvement available is desirable, and a competent surgeon agrees, then there is no reason to wait until a specific age is reached or until the aging appearance is even more striking. Typically, this occurs from the late forties onward, with most patients probably having their first surgery in their fifties. On the other hand, there is no reason for a person in their seventies (or even older) not to undergo the surgery if they are otherwise a good candidate and in good biologic health (cardiovascular fitness, etc.).
• What about postoperative pain and recovery?
  Postoperative pain is in fact unusual following surgery. Bandages are removed the day after surgery, and swelling generally begins to improve from the third postoperative day. Sutures have generally all been removed by the fifth or sixth day, and makeup is allowed one week after surgery. In almost all cases, swelling and bruising are essentially gone three weeks after surgery, with most patients returning to work and other preoperative activities between one and two weeks following surgery.

If you have further questions, please feel free to contact us to set up a personal consultation.

Blepharoplasty

Dr. Rapaport performs this procedure, or eyelid surgery, to dramatically improve the effects of aging around the eyes. The eyes, in fact, often are the first facial features to show signs of aging.

Often, over time, the upper eyelids tend to develop loose and redundant skin folds. Upper eyelid blepharoplasty involves carefully removing excess skin and fat to create a more youthful appearance. The lower eyelids, as they age, tend to appear baggy. This is caused by a relative excess of bulging fat pockets in the lower lid and by a simultaneous loss of surrounding fat that also occurs with age. Lower eyelid blepharoplasty focuses primarily on removing and/or repositioning the fat of this area.

Dr. Rapaport often sees relatively young patients who opt for lower eyelid blepharoplasty due to premature bagging under the eyes. On these patients, he performs transconjunctival blepharoplasty. With the transconjunctival approach, he approaches the fatty tissue from within the pink of the lower eyelid, leaving no visible scarring. When performing this procedure on older patients, he generally makes an incision directly under the eyelashes so that a very small amount of skin and muscle can be removed as well.

Perhaps the most important caution in this surgery is that the surgeon avoid over-correction. When he performs blepharoplasty procedures, he is extremely conscientious about removing just the right amount of skin or fat. To remove too much may create a dry eye and/or an unnatural appearing, hollow look to the eyes.

In general, blepharoplasty is a remarkably pain-free procedure. Most patients return to work in fewer than ten days. If you would like to learn more or consult with the doctor, please contact us today.

Rhinoplasty

Dr. Rapaport offers rhinoplasty patients expertise and experience. Rhinoplasty is a procedure that involves changing the shape of the nose. Dr. Rapaport can make a nose larger or smaller, and adjust the shape of the bridge, tip, or nostrils with rhinoplasty. He can additionally correct crookedness, injuries, and breathing abnormalities that arise due to problems with the internal structures of the nose. He often increases his patients' self-confidence in addition to improving the overall balance and proportion of their faces.

Most of the patients Dr. Rapaport sees at his practice complain of a bump on their nose or a variety of imperfections in the shape, be it a bulbous tip or nostrils that flare out too widely. The classic procedure involves reducing or eliminating the bump on the nose, narrowing the nose, and refining the tip, while maintaining a natural appearance to the nose and face. Usually, this type of rhinoplasty involves no visible scars and a rapid recovery.

He also performs a more limited form of rhinoplasty known as "tip plasties." This technique involves improving the tip of the nose without altering its other portions. This type of rhinoplasty can often be performed in the Manhattan office under local anesthesia.

If you are considering rhinoplasty please contact us today.

Sculptra

Dr. Rapaport, a leader in his field and injectable fillers is among the first doctors in the state to use Sculptra, an injectable filler which was recently approved by the FDA for specific medical conditions. It has been receiving a lot attention for its "off label" use in the aging faces of healthy women and men. One of the biggest problems in the aging face is the loss of natural fat especially in the cheeks and under the eyes. He has been using Sculptra on his patients with impressive results. Anywhere from 3-5 injection sessions are needed for maximal improvement. There is virtually no down time and no scars. Results have been shown to last about two years!

To learn more, please contact us today.

Restylane

Dr. Rapaport was among the first to use Restylane for face and lip enhancement in Manhattan. Restylane is a relatively new product that has been used for years in Europe and Canada for facial enhancement with great success. The FDA approved Restylane in December 2003 as a facial line filler. He often chooses Restalyne over collagen for his patients because, unlike collagen, it does not require a skin test as the risk of allergic reaction is almost nonexistent. Moreover, while it is not permanent, the effects of Restylane often last longer than those of collagen.

Recently awarded Allure Magazine's Breakthrough Award, Restylane effectively reduces the appearance of lines caused by aging and sun exposure. Want a movie star pout? This product is great for lip augmentation, instantly giving you fuller and sexier lips. It is also a preferred product to restore fullness around the mouth treating creases, marionette lines, and nasolabial folds.

If you would like to learn more, please contact him today.

Cheek/Chin Implants

Chin and cheek implants can help bring definition to the middle and lower portions of the face. Chin implants can strengthen a person's jaw and bring balance and harmony to the face, while cheek implants can bring definition and improved facial contour. Dr. Rapaport places chin implants either through an incision inside the mouth for "no visible scar," or through a small incision under the chin. Cheek implants are placed via the inside of the mouth. To learn more about facial implants, please contact our practice today.

Collagen (Facial and Lip Enhancement)

Dr. Rapaport has extensive experience using collagen for treatment of folds and deficiencies in the face, as well as for lip enhancement. Although it requires a skin test to determine compatibility, collagen remains the gold standard of injectable fillers for the face and has been used successfully in more than one million patients.

Fat Injections

Dr. Rapaport has used fat injections (also called fat transplantation or fat transfer) extensively to fill deficiencies in the face or other parts of the body. As a nationally renowned expert in liposuction, he often treats patients who have suffered from liposuction over-correction by less experienced surgeons. Corrective surgery, not uncommonly, involves fat transfers to help fill deficiencies caused by excessive removal of fat in the past. To learn more, please contact our practice today.

Browlift

Among the changes that may occur to the aging face are a dropping of the position of the eyebrow. This descent of the brow is one of the contributors to the eyes themselves appearing tired and, particularly, to the impression that there is redundant skin in the upper eyelid area. This procedure raises the position of the brow, thereby rejuvenating the appearance of the upper face and upper eyelid areas.

It involves a long incision stretching from ear to ear on the scalp, usually well behind the hairline. While this approach is still sometimes used, in the last ten years we also have had increasing experience with minimal incision surgery of the brow, also called endoscopic brow lift. This procedure involves much smaller and more limited incisions, through which specialized instruments are placed to create a similar lifting of the brow. At the time of a personal consultation, Dr. Rapaport will be able to indicate which, if either, procedure may be appropriate for you. To schedule a consultation, please contact us today.

Corrugator Resection

The corrugator muscle is the muscle that creates vertical wrinkles between the eyebrows, making a person appear to be scowling or angry. This muscle has received a great deal of attention in recent years, as it is the prime target for BOTOX® Cosmetic use. Whereas these injections can effectively weaken the corrugator muscle for three to four months, thereby reducing the appearance of lines and wrinkles, the surgical division of the muscle permanently weakens it. Dr. Rapaport has performed numerous cases of corrugator resection. This can be done through either a browlift approach or, more commonly, as is the doctor's preference, via the upper eyelid in conjunction with upper eyelid blepharoplasty. To learn more, please contact our practice today.

Liposuction-Neck

Removal of excess fat in the neck with liposuction can greatly improve a person's appearance in appropriate candidates. The procedure without a facelift is usually reserved for patients under the age of forty, as neck liposuction at more advanced ages comes with an increased risk of leaving loose skin and creating an overall older appearance. To find out more, please contact our practice today.

Liposuction-Face

Dr. Rapaport usually advises against liposuction of the face because, as the face ages, it looses fat. Fat that may seem excessive at a young age is often, in reality, "money in the bank" for the aging process in years to come. However, there certainly are some patients with excessive fat who would benefit from liposuction of the face. He is also experienced with an operation called buccal fat resection, in which a specific pocket of fat occurring under the cheekbones is removed via an incision inside the mouth, creating a subtle improvement in lower facial contour. If you think you might be a good candidate, please contact us today to set up a consultation.

Facial Surgery for Men

Dr. Rapaport is experienced at performing a variety of facial surgeries on men. These days, men are having an increasing number of eyelid surgeries, as well as chin implants and rhinoplasty. He is also quite experienced at performing facelifts for men. There are particular issues relating to scars and changes in the hairline to which he is very sensitive. He will work with his male patients to achieve the best results possible. If you would like to schedule a consultation, please contact us today.

 

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