A skilled facial plastic and reconstructive surgeon with a distinguished background, Dr. Paul S. Nassif has received international recognition by the media, patients and peers for his innovative surgical techniques. Known as a revision rhinoplasty specialist, Dr. Nassif is sought after by patients from around the world for help in correcting some of the most challenging complications cases. His work specializes in obtaining natural results in both rhinoplasty and aging face surgery.
For rhinoplasty, Dr. Nassif uses his skill as an artist and a surgeon to shape the nose to fit the face, rather than make it appear artificial. Patients marvel at how Dr. Nassif is able to create a nose that is both functional and aesthetically pleasing. In addition to his work with revision work, Dr. Nassif also specializes in rhinoplasty for ethnic noses, ensuring tailored results that look proportional to an individual’s ethnic and racial features.
As a specialist in aging face endoscopic surgery, Dr. Nassif skillfully conceals incisions by performing minimally invasive procedures that reduce the evidence of scars. A procedure that he developed, “The Anti-Gravity Facelift,” leaves no visible scars and has been noted for achieving natural-looking results in the shortest recovery time. To accelerate the healing process, Dr. Nassif uses platelet gel derived from a patient’s own blood cells.
Another situation with Body Dysmorphic Disorder, a patient may come in having multiple, multiple rhinoplasties and come in for another revision.
According to Dr. Nassif, sometimes you look at the nose and it is fine. However, the patient still feels the nose needs to be revised. What can happen is that nose is made smaller and smaller through multiple surgeries.
“You have to be careful with these types of patients because if you try and reconstruct the nose to make it normal appearing – which is larger and makes their breathing better – you are going to make them unhappy.”
“Even though the result is what I would expect, you are going to have an unhappy patient.”
These patients do need to have their noses repaired and reconstructed, according to Dr. Nassif. But, it may be best to have them evaluated and treated initially by a psychologist or psychiatrist.
Body Dismorphic Disorder is not to uncommon and we always have to make sure that patients are realistic about their surgical goals.
A recent People Magazine article dealt with Body Dysmorphic Disorder. They showed patients that had multiple, multiple, multiple surgeries that constantly fixing things that didn’t need to be fixed and possibly over doing things.
According to Dr. Nassif, “Body Dysmorphic Disorder is something that we do see not to infrequently.”
“It is one of these things that you have too, when you are interviewing a patient, make sure that they don’t have this issue. Sometimes a patient may come in with a perfect nose and feel that the nose is horrible. They will be self conscious about the nose and will perceive the nose to be very, very unattractive. When you examine the nose, the nose maybe perfect and very pleasant looking. In this situation the patient might want a drastic change in the nose. They may want to make a small, small nose that wouldn’t match their face or a complete different nose.
“These are patients that may have Body Dysmorphic Disorder. They are not the best patients to operate on, you’ll never make them happy, the best thing you can do for them is to get them into counseling or therapy to get them treated for this condition”.
Many patients wonder what their recovery will be like after a facelift. Here is an overview of what to expect after surgery.
Following facelift surgery, an overnight stay in an aftercare facility is recommended. Alternatively, an overnight nurse at your home may suffice.
Dressings are changed the next day and then reapplied for one more day. In about a week, the fine sutures are removed. The metal clips are removed in two weeks. Even though most patients experience very little pain after surgery, the surgeon will still prescribe pain medication as a precaution.
There will be some degree of swelling and bruising after surgery, it is unavoidable. Patients are instructed to use cold compresses to minimize swelling as much as possible. A short course of post-operative antibiotics and steroids are given to help prevent infection and excess swelling.
Recovery usually takes two to three weeks, which is necessary for bruising and swelling to resolve. However, many patients feel comfortable enough to return to work in two weeks. Even though the patient may be feeling better in two week, they are still cautioned to avoid vigorous activity for four weeks.
While scars can become pink during initial healing, over all they usually fade in about three months. During healing, the scars are easily disguised because they are located in the natural skin creases or by the hair. In some more persistent cases, makeup can be used on the scars until total healing has occurred, which could take up to six months.
Bear in mind that the aging process continues after surgery and that some relaxation of the tissues is common and will occur after the first few months.
Many of our patient ask what happens during a facelift. In most surgerues, the neck is addressed first. Liposuction can be used to remove excess fat in the neck area. If there are sagging neck muscles (platysma), they can be re-contoured into a more natural position.
After the neck is addressed, the incision for the facelift is begun in the temple and hair area and just above and in front of the ear. The incision continues around the lobe of the ear and ends in the hairline above the ear. In all cases, the incision is hidden by placing it in the natural crease of skin. For men, the incision is aligned to accommodate the natural beard lines.
The facial skin is raised outward, followed by tightening and repositioning the underlying facial muscles and connective tissues. After the excess skin is trimmed, the incisions are closed with metal clips and fine sutures, and a dressing is placed to protect the entire area. The facelift surgery tales about four hours.
