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Aesthetic Surgery This section of the website describes many of the procedures which Dr. Stokes regularly performs. For a procedural overview, you may either select an area on the illustration, or choose a textual subject below. This is to serve as an overview only. If you have more specific questions, remember you can contact us through E-mail or by phone. Please do not hesitate to send questions!
Facial Plastic Surgery Procedures Rhytidectomy (Surgery of the Face) Facelifts are among the most commonly performed plastic surgical operations. This procedure is particularly useful at removing excess skin in the jowl and neck areas. The operation involves making an incision in front of the ear, and extending this incision behind the ear and into the hairline. Excess skin is removed and the result is a more youthful appearance. The scars generally heal very well and are often almost unnoticeable. This operation can be done under general anesthesia, or if you prefer, under sedation utilizing local anesthesia. Most people resume most normal activity within 10-14 days. As we get older, the brow and forehead are often those areas that show the first signs of aging. Due to the effects of sun and the pull of gravity, the skin begins to sag, resulting in frown lines, wrinkles across the forehead, and increased heaviness of the eyebrows and upper eyelids. These changes contribute to a tired, angry or sad expression that may not reflect the way you feel. A Minimally Invasive Browlift is very effective at elevating sagging eyebrows while eliminating many of the wrinkles of the brow and forehead. The scars are all hidden in the hairline, and the recovery time is usually quite short. Blepharoplasty (Surgery of the Eyelid) Blepharoplasty describes the operation which is performed to remove excess skin, pouching and sagging around the eyes. It also very effectively removes the "bags" which form under the eyes. The operation can be performed under local anesthesia easily, and both eyes can be corrected at the same time. Lower eyelids can even be treated without incisions in the skin with the "transconjunctival" technique. Recovery time is generally 5-7 days, and there is often some bruising around the eyes for a few days. Laser Resurfacing (Laser Wrinkle Removal) This is one of the most exciting developments in plastic surgery in recent years. The carbon dioxide (CO2) laser can be used to safely and effectively eliminate fine wrinkles on the face. This procedure has replaced chemical peels and dermabrasion in many plastic surgeon's offices. The primary advantage is the precision of the technique. It allows the surgeon to remove fine layers of skin one by one to achieve the desired wrinkle removal with minimal risk of complications. The procedure has the added benefit of causing some tightening of the skin. When the laser light is absorbed by the skin, it causes a shortening of collagen fibers (which are the main component of the dermis portion of the skin) which results in skin tightening. The recovery time varies with the degree of wrinkling which must be addressed. On average, patients faces are slightly red for several weeks after the surgery. In some cases, this redness may last for several months. Patients can begin to wear makeup approximately 8-10 days after surgery, and often return to work in 10-14 days. Many areas of the face can be effectively augmented with facial implants. Commonly treated areas include the chin (chin implant), the cheekbones (malar augmentation), and the lips (lip
augmentation). Several different types of implants are available and are used on an individual basis. One exciting new development in facial implantation has been the development of
Alloderm, which is a material made from human skin, which very effectively augments nasolabial folds (the area between the nose and the corner of the mouth), and lips. Facial implantation is
usually done under local anesthesia with IV sedation and on an outpatient basis. Recovery time varies with the augmented area, but usually is just a few To view before and after photographs of a lip augmentation patient, click on the icon to the left. Rhinoplasty (Surgery of the Nose) Nasal surgery can be performed for cosmetic or functional purposes. Most surgeries performed by Dr. Stokes are done for cosmetic purposes. Areas commonly treated with rhinoplasty include the hump on top of the nose, a tip which is large or poorly defined, and the width of the nose. Depending on the specific nature of your surgery, recovery time can vary from 5-14 days . There is often some bruising around the eyes and always some swelling. Often there is a need to place some packing gauze into the nose overnight. This is slightly uncomfortable, but most patients tolerate it very well. A splint is often placed on the outside of the nose for 5-7 days to protect the work which has been done. Rhinoplasty can be easily done under local anesthesia and IV sedation, but some patients prefer general anesthesia. Otoplasty (Surgery of the Ears) This procedure is performed when patients have ears which are too large, or stick out prominently from the head. The surgery takes only 1-2 hours and can be done under local or general anesthesia. Recovery is usually quite straightforward, and patients are usually quite happy with their new ears! Body Contouring Procedures Liposuction, Including Power Assisted Liposuction Liposuction is now the most commonly performed cosmetic procedure in the United States. The primary reason for this is the effectiveness of the procedure. We can now smooth out problem areas of fat with tiny incisions (4-8 millimeters), and a very short recovery time. The operation can be performed under general or local anesthesia with IV sedation. Power-assisted liposuction refers to a new technology whereby the tip of the suction tube vibrates at a rapid speed. This vibration loosens the fat cells so that they may be suctioned away gently with less trauma to the surrounding tissues. PAL is performed using tumescent technique. This involves infusing large volumes of saline, local anesthesia and adrenaline. This maximizes the effectiveness of the fat removal and patient comfort, and it helps to minimize bruising. Power-assisted liposuction has several important advantages over the older techniques of ultrasound -assisted liposuction (UAL) and suction-assisted liposuction (SAL). These benefits include increased safety, decreased anesthesia time, less bruising, faster recovery, increased efficacy and greater precision. Research has shown that power-assisted liposuction is an effective and safer way to eliminate unwanted deposits of fat. Abdominoplasty, Including Endoscopically Assisted Abdominoplasty (Tummy Tuck) For many women who have had children, the excess skin below the belly button is a significant concern. A tummy tuck is often the best solution to this problem. This operation involves an incision below the belly button which can usually be hidden in the hairline. Depending on the amount of excess skin present, and the looseness of the abdominal muscles, an endoscope can sometimes be used to minimize the size of the scar needed to achieve the desired result. Liposuction can also be simultaneously performed on other areas if appropriate. The operation is done under general anesthesia, and usually as an outpatient. Recovery time varies with the amount of skin resected and degree of muscle looseness. Most patients are off work for 10-14 days.
Enlargement of the breasts with implants is a very commonly requested procedure. Currently, saline filled implants are used, and are extremely safe and effective. Dr. Stokes performs many breast augmentation procedures, and has experience with some experimental implants including the soybean oil filled implant. The shape and size of the implant which is right for you can be determined at your consultation. The operation can be performed under local anesthesia with sedation, or general anesthesia. Most women return to normal activity within 5-7 days, and vigorous physical activity can be resumed within 2-3 weeks. We would like to stress that this operation is SAFE and effective utilizing the current saline implants.
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To view before and after photographs of liposuction and abdominoplasty patients,
click on the icon to the left.
To view before and after photographs of breast augmentation patients operated on by Dr. Stokes, click on the icon to the left.