Patients seek out the advice of Board-Certified Plastic Surgeon Dr. Lavinia Chong for her history of performing cosmetic procedures with natural-looking outcomes. While she is known for her rejuvenating facelifts and neck lifts, she also offers patients options for targeting smaller, more specialized areas. These types of cosmetic procedures target patient concerns and offer solutions for improving the appearance of their eyes, brows, and lips.
And for patients who are not looking for a major enhancement (as seen with a breast reduction, breast lift, or mommy makeover), there are a couple of breast procedures which may be performed under local anesthesia. These procedures are for patients who are simply looking to remove their saline implants (downsizing to a more active yoga or surfer breast), or to immediately address a change in breast aesthetics (for example, unilateral deflation when there has been a ruptured saline implant resulting in breast asymmetry). These smaller cosmetic procedures performed under a local anesthetic offer minimal downtime, and provides patients a simple solution to their immediate concerns.
Evolving Techniques: Eyes
Dr. Lavinia Chong provides options via direct excision for the upper and lower eyelids:
- Upper Blepharoplasty is the term for an upper eyelid lift. This procedure for men and women, when performed by itself (as opposed to in conjunction with a facelift or fat grafting), can be performed under local anesthesia. The incision line is hidden in the crease of the lid. The week following your surgery, you’ll return for a visit to have your sutures removed by a member of your surgical team. Our patient in the above featured photo shows Pre-op Blepharoptosis (left photo) and Post-op correction with an Upper Blepharoplasty (right photo).
- Lower Pinch Blepharoplasty (ideal for men or women): improvement of the appearance of wrinkling of the lower lid (below the eye) is made by the resection of wrinkled, excess skin.
Evolving Techniques: Lips
Perioral Rejuvenation is a great refresher for those looking to regain a bit of their natural aesthetic. Some patients begin to notice a change over time, following dental work, or a change to bone structure as bone density is lost during the course of the aging. Some change may also be attributed to loss of facial volume and skin laxity, which also may occur during our natural aging process.
The Upper Lip Lift is a perioral rejuvenation procedure which is performed under local anesthesia. Prior to your procedure, numbing is applied and you will be given a light sedative to help you relax. Because you will be relaxed, you will need to arrange to have a driver (a family member or trusted friend) pick you up after your procedure. Sutures are removed one week post-op.
During the procedure, to shorten the length of the upper lip area, excess tissue is removed. The incision line is discreetly situated at the base of the nose creating a refreshed Glogau-Klein Point (Cupid’s Bow). This mini-procedure lifts your natural lip line back up into view. By bringing this naturally beautiful curvature back into focus, most patients no longer need lip filler for enhancement.
Downtime for a lip lift under local anesthesia is minimal (in comparison to that of a facelift), but these incision lines do require special attention and care as this is potentially a very mobile area when eating, drinking, and speaking. For patients looking to further enhance or address their lipstick lines, they may resume injectable dermal fillers as desired once post-op swelling resolves and incision lines are healed.The Lateral Lip Lift is intended for those patients who have developed an extreme downward turn at the corners of the mouth. This procedure addresses the appearance of the oral commissure (the corner area where the upper and lower lips meet). Prior to your procedure, the skin is marked in select points of this cheilion region (the furthest corner of the outline of your lips). An incision is made, focusing on the white roll of what is referred to as the vermiliocutaneous junction (what some may refer to as the edge of their lip line). In one week’s time, sutures are removed.
Evolving Techniques: Brows
Dr. Lavinia Chong provides options (ideal for men and women) via direct excision for the brow area as well:
- Unilateral or Bilateral Sliding Brow Lift: Many of our facelift patients often ask how they can also improve the appearance of their brow. For some patients, an endoscopic brow lift may be exactly what is indicated to address their concerns. But there are times when it may not be an appropriate option as it requires a longer operating time utilizing specialty equipment and is performed under Monitored Anesthesia Care (MAC Sedation). Some patients may not be a qualified surgical candidate (relating to the type of anesthesia required, their dynamic facial structure, or potential lack of time available for recovery). In these cases, patients may be presented with a cosmetic approach performed under local anesthesia. The sliding subcutaneous brow lift (pre-op and post-op photo above) offers patients a shorter operating time, a well-placed scar with little to no intrusion in the appearance of the hairline, and optimal lateral brow elevation.
- Mini-temporal Lift: a corner hairline incision raises sagging skin, creating a more youthful-looking brow by addressing the outer third of the brow line.
- Unilateral or Bilateral Brow Lift by Direct Excision: with direct excision an incision is made along the top of the brow line, and excess skin is removed creating an improved appearance of the natural arch of the brow.
Effective Elective Procedures for the Breast:
Breast Implant Removal can be performed under local anesthesia when the breast implant is a smooth, saline-filled implant, and if there is no presence of capsular contracture in either breast.
A complimentary high-definition ultrasound via Clarius HD can be performed in-office at the time of your consultation. This type of imaging gives Dr. Chong a better visual, as to whether you would be a candidate for this type of local procedure. We routinely use the Clarius HD ultrasound with our patients who are five-year years post-op from their silicone breast augmentation. While we are generally looking to confirm the integrity the silicone breast implant shell (for the detection of silent ruptures), we have found this device very helpful in determining the presence and Baker Grade of a capsule (the scar tissue which forms around the breast implant).
Patients also have the option of including a breast lift, or fat grafting to the breast, but it is important to note, that these additional procedures would either need to be staged procedures (performed during a separate operation), or all procedures may be performed together under Monitored Anesthesia Care (MAC Sedation). For this type of sedation, a pre-operative appointment is required for surgical clearance, and the anticipated recovery is longer.
Breast Implant Deflation is another option some of our patients may choose in the event of unilateral deflation (when one saline implant ruptures resulting in an immediately deflated appearance). Some patients who may not have enough time to take time off (for surgery or recovery time), have pronounced asymmetry following unilateral deflation, or who may not have room in the budget for an immediate breast implant exchange may simply opt to have the remaining implant deflated, choosing to remove the implant shell at a later date. Deflation patients also have the added benefit of having an opportunity to “try on” implants prior to exchange, just as they did at their primary breast augmentation. Call the office today at (949) 644-1400 to see if you would be a good candidate for this procedure!
Board-Certified Plastic Surgeon
Dr. Lavinia K. Chong is a second-generation, board-certified female plastic surgeon in Newport Beach, California. Our well-trained staff is hand-chosen by Dr. Chong to ensure patients are consistently served by the highest level of customer service, providing a patient-centered approach. Our private Newport Beach Surgical Suite maintains a vigorous Quality Assurance program. Our facility which is located in Orange County, California is accredited by AAAASF, the American Association for Accreditation of Ambulatory Surgery Facilities.
Buccal Fat Pad Removal and Submental Liposuction are not listed, does Dr. Chong offer these procedures?
Yes, she routinely performs Submental Liposuction (Chin Lipo) and Buccal Fat Pad Removal! But these two procedures are performed under Monitored-Anesthesia Care (MAC Sedation) for patient comfort. They also require pre-operative labs, a pre-operative appointment, and have a bit of a longer, more regimented recovery time than the mini-procedures listed above.
What is Buccal Fat Pad Removal?
The Buccal Fat Pad is what creates the area commonly referred to by our patients as their cherub cheeks or chipmunk cheeks. Those chunky cheeks make us adorable when we are young. And for many people their buccal fat is part of their endearing appearance, defining their unique aesthetic identity. But as some patients mature, they begin to desire a more defined, smoothly angular appearance. They have developed strong defined cheek bones and slender jawlines, and those chunky fat pads are now just a distraction.
Buccal Fat Pad removal is sought by both men and women, and is a common procedure within our Asian clientele. During this conscious sedation procedure, there is a mucosal incision (inside the cheek) at the site of the buccal fat dissection. Patients may be advised to ice on and off for 48 hours, and rinse with a dilution of warm salt water. And soft foods and smoothies are suggested to provide a more restful experience post-op, allowing the incision site and incisions time to heal.
It is advised to avoid strenuous activity during recovery. And patients are reminded that final results may not be seen until 3-4 months post-op in order to allow for reduction of post-operative edema (swelling). Patients seeking a slimmer, V-shaped jawline may chose to have Masseter Reduction via injectables such as Botox once post-op swelling has resolved.
Do mini-procedures have the same health requirements for surgery?
Surgical patients must be in good health prior to their cosmetic procedure. In the spirit of a cooperative surgical plan, we request that patients disclose all past and current health history, included current treatments and medications. Patients undergoing local procedures are not required to have bloodwork prior to their procedure, as you are awake and relaxed, with local anesthesia being delivered directly to the surgical site.
Whether you are having a procedure under local anesthesia, or under Monitored Anesthesia Care (MAC sedation), patients are required to stop smoking no less than 90 days prior to their procedure. Smoking deprives the body of oxygen required for optimal healing, resulting in wide, raised scars. Patients should also be at a healthy weight prior to surgery in order to ensure consistent, optimal results.
Are there any special instructions for the days following surgery?
The day of surgery, you will need someone with you for 24 hours. It is important that you stay ambulatory, spending 10 minutes every two hours engaged in light walking indoors. For any type of surgery above the shoulders (any facial surgery), it is important to keep your head elevated (do not bend forward or over). Continue to keep your head elevated, including when sleeping, throughout the week following your procedure.
Can I resume my regular workout routine immediately after surgery?
Your workout routine will be restricted for a time, and clearance will depend upon the type of procedure. Strenuous exercise is generally not advised for at least two weeks after surgery. If having a Breast Surgery, upper body workouts may be restricted for a longer period of time. Please request clearance prior to resuming your regular workout routine and activity schedule, as you will want to allow your body sufficient time to heal.
When can I begin using a scar treatment?
The need and indicated use of a scar treatment will depend upon the type of procedure. If cleared to use a scar treatment, we often recommend Silagen Scar Refinement Duo (Day & Night) beginning one month following surgery (once all incision lines have healed). This would be particularly important for patients having a dorsal roll lift. It is important for patients to remember UV rays can make their way through clothing, and a UV protectant can help protect the scar as it heals. Add the benefit of a silicone protectant to improve the healing process and you have a great solution for optimal healing.
Should I have a Mini-procedure before I have a Facelift?
Mini-procedures are great options for the patient on the go, the budget-conscious patient, and the patient looking for a subtle pick-me-up. The time required for surgery is minimal; recovery time is often minimal. We suggest that patients begin with a surgical consultation. This provides an opportunity for Dr. Chong to review your natural aging process, discuss your goals, and provides the teaching opportunity to learn how different procedures help address different goals. A mini-procedure may first be suggested due to a patient’s budget or time constraints for recovery, or it may be suggested as the best option for their most pressing goal. Click here to learn more about The Goal of a Facelift!
Can I add a mini-procedure to another surgical procedure?
Absolutely! Any of these procedures may be added to any breast surgery (Reduction, Explant, Lift, Implant Augmentation), Abdominoplasty (Tummy Tuck), Panniculectomy, or Puboplasty, as time allows. You may even be able to add it to your Newport Beach Mommy Makeover. And patients routinely add an Upper Lip Lift, Brow Lift or Eyelid Lift to their Facelift & Neck Lift Surgery.
If you have had a facelift, neck lift, or fat grafting procedure in the past, an upper lip lift may help provide an even more rejuvenated, refreshed appearance.
Review your options with Board-Certified plastic surgeon Dr. Lavinia Chong.