Procedure Information:

Facelift

A facelift is one of the most sought after and satisfying aesthetic surgical procedures. It can remove many, but usually not all wrinkles. It can also remove much of the sagging skin of the face and neck. Excess fat can be removed or sculpted as needed. The facelift will give you a more youthful, fresher, and natural appearance, avoiding an over-operated appearance. Your expectations must be realistic, since there are limitations to what it can accomplish. Magazines and non-medical articles may lead you to believe a facelift is a simple procedure; in fact, it is real surgery.

A facelift requires complex incisions that are expertly placed to make them inconspicuous. A dissection of the skin, contouring of the fat, and tightening of the underlying muscles is performed during this procedure. It should be performed only by a qualified, capable, and experienced plastic surgeon. It is Art.

The result is a blend of your individual anatomy, scientific principles, and the skill, style, and artistry of the surgeon. Dr. Singer performs many variations of the facelift (rhytidectomy), including the short scar technique, limited incision facelift, mid facelift, and partial facelift. Every face is unique and the sculpting and variations of the location and orientation of the incisions required for each patient should be individualized.

In some cases, a partial limited minimal incision facelift or neck lift may be all that is required to restore a more natural, elegant, and youthful appearance to the face. A facelift can turn back the clock, but it will not stop the process of aging. Heredity is important. If your parents aged slowly, you probably will, too. Your diet, general health, time spent in the sun, smoking, weight gains and losses, emotional traumas, and type of skin will all play a role in determining how long the improvement will last. For many men and women, a rhinoplasty can improve the shape of the nose, while eyelid surgery, forehead lift, dermabrasion, or cheek and chin implantation can enhance the results achieved by the facelift.

Most of the women and men who would benefit from a facelift are between 40 and 70 years old. However, there are exceptions. Some people age prematurely and may consider improvement at an earlier age, while others age more slowly and can successfully undergo the surgery in their seventies or eighties. Please contact us today to learn more about how we can help you.

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Mid Facelift

A mid facelift is a surgical alteration of the cheek area. Fat and muscle tissues of the cheek are removed or tightened in an upward direction to produce a firmer, tighter, and younger appearance. Deep furrows between the nose and upper lip are particularly responsive to this treatment. Although full recovery can take up to three months, most patients who undergo a mid facelift can return to work within a few weeks of their procedure.

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Minimally Invasive Facelift Options

Mid Facelift

For patients who do not require a full facelift, but have begun to notice drooping of the cheeks and mid-face, Dr. Singer offers the mid facelift. Unlike traditional facelift surgery, only incisions hidden behind the hairline are required to complete the mid facelift and gently provide a more youthful skin position.

Buccal Fat Removal / Cheek Reduction

Some individuals are self-conscious about the appearance of their cheeks, and feel their cheeks look round or chubby. These "cherub cheeks" or "chipmunk cheeks" can result from a variety of conditions. Young individuals may temporarily have full faces, (baby fat), which will naturally slim with time. Others simply have a genetic predisposition to carry fat in their face, and finally some have full faces as a result of their general body type.

Goals of Buccal Fat Removal

The technical name for some of the fat in the cheeks is, 'Buccal fat.’ The Singer Surgical Centre offers buccal fat removal, also called cheek reduction surgery, as a solution to those who want to reduce the size of their cheeks. Removal of these fat pads can slim the cheeks and contour the face. This can help people achieve a more chiseled and defined look.

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Forehead & Brow Lift

A forehead, or brow lift, is often performed in conjunction with eyelid surgery. It should be considered when there are deep forehead wrinkles, frown lines between the eyes, lines over the nose, or winkled, sagging upper eyelids caused by drooping eyebrows. If a patient has only eyelid surgery but leaves the other problems uncorrected, the result may not be ideal. Sometimes simply raising the eyebrows or redraping and smoothing the forehead will be enough, and an eyelid procedure will not be needed.

Dr. Singer will help you determine the procedure, or combination of procedures, that is appropriate for you.

BOTOX® Cosmetics - injections to temporarily smooth the lines
Coronal lift - forehead improvement with an incision behind the hairline or at
the hairline
Endoscopic or temporal correction - limited small incisions behind the hairline

Forehead procedures make you look younger and more alert, often correcting a sad or angry appearance. The goal is a natural improvement that does not show the appearance of having been operated on or looking surprised. Please contact us today to learn more about how we can help you.

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Neck Lift

As we age, the muscles and skin of the neck begin to sag and lose definition. Jowls droop as skin and muscles loosen, while fat deposits along the jaw line and under the chin create fullness, or a double chin. Some patients inherit this appearance of a double chin. The neck muscles weaken and separate creating vertical "cords.” Neck contouring procedures are performed in conjunction with facelifts, or alone. They are ideal for sculpting areas that will not improve with diet and exercise. There are several options for improving the jaw line and neck:

Liposuction
Minimal incision neck lift - through a small incision under the chin.
Limited lower face neck lift - through the small incision under the chin and inconspicuously placed incisions behind the ear.

If your chin is small or "weak," a chin implant may be performed in conjunction with the neck lift to further improve your jaw line and profile. Dr. Singer will individualize the procedure for you, depending on your anatomy and the elasticity of your facial tissue. He will utilize the minimally invasive techniques to accomplish the ideal aesthetic natural improvement. Please contact us today to learn more about how we can help you.

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Surgery of the Nose

No other aesthetic surgical procedure today has achieved wider acceptance than rhinoplasty; the reshaping of the nose. It is an especially satisfying procedure that can be performed at any time after the middle teenage years. Desire and overall health, not age, are the determining factors.

The degree of improvement possible is limited by an individual's basic nasal skeleton and skin thickness, but wide noses and nostrils can be narrowed, noses with a hump can be straightened, drooping noses can be lifted, and bulbous tips can be reduced.

The object is to create a nose that is in harmony with the other facial features, and is natural in appearance.

Rhinoplasty for cosmetic reasons, or to correct deformities from injuries, is frequently performed in combination with internal nasal surgical procedures to correct breathing problems.

If this is the case, medical insurance will often cover a portion of the surgical fee.

Nasal surgery can be performed at the same time as a facelift, eyelid surgery, chin augmentation, or other cosmetic surgery procedures. Please contact us today to learn more about how we can help you.

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Chin and Cheek Augmentation

The facial appeal of men and women we consider to be especially attractive is not necessarily because of perfect features. More often it is because their eyes, nose, cheeks, chin and lips are in harmony and balance. The nose is in proper relationship to the eyes and chin. The cheekbones have an appropriately strong definition in relationship to the length of the face and the size of the nose.

Few of us are fortunate enough to be born with these ideally proportioned facial features. Nature’s omission, however, can be rectified by aesthetic plastic surgery.

A weak or recessive chin can be improved with an implant or micro-fat grafting. Similarly, malar augmentation can enhance flat cheeks.

Both cheek and chin augmentation create a new, natural look that is in harmony with other features. They can also be performed in conjunction with other cosmetic facial surgery such as a facelift, recontouring of the nose, eyelid surgery, or a forehead lift. Please contact us today to learn more about how we can help you.

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Ear Surgery

The facial appeal of men and women we consider to be especially attractive is not necessarily because of perfect features. More often it is because their features are in harmony and balance. Excessively large or protruding ears are often a source of ridicule, teasing, and embarrassment.

Aesthetic ear surgery can reshape the "outstanding" ear, by altering its size, position, or configuration. The improvement, which lasts a lifetime, usually results in feeling less self-conscious about one's appearance.

Otoplasty may be performed on adults or children anytime after the ear has achieved its nearly normal adult size, which is usually after five years of age.

Timing is always an important consideration. Undergoing the procedure at a young age has two benefits: the cartilage is extremely pliable, allowing greater ease of shaping, and the young patient will experience the psychological benefits of the cosmetic improvement for their entire lifetime. Please contact us today to learn more about how we can help you.

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Micro-Fat Grafting

Benefits of Fat Transfer

Your own body material is used
30-50% of transferred fat lasts permanently
Large amounts of fat are usually available
No possibility of allergy
Natural, more youthful appearance
Can be used for wrinkles, folds, cheekbones, hollows under eyes, chin enhancements
Fat transfer combined with BOTOX® Cosmetic provides significant results without invasive surgery for the upper face
Can give the appearance of a mini facelift

As we age, sun exposure, gravity, frowning, smiling, chewing, and squinting all have effects on our appearance. The underlying tissues responsible for a youthful appearance of the skin start to break down. As the fatty tissue of the face is re-absorbed, the underlying support of the skin is lost resulting in facial wrinkles, drooping, and hollows.

Injection of a variety of soft tissue fillers, specifically your own fat, can fill out depressed areas of your face, minimize the nasolabial folds next to the mouth, smooth hollows under the eyes and enhance cheek bones , the chin, and jaw lines through three dimensional contouring.

Fat is also useful if you always wanted fuller, more fashionable, lush lips, or wish that your once larger lips were still that way today.

The results of micro-fat grafting are variable depending on age, genetics, skin quality, and location of the injection. The underlying reasons for loss of the tissue or lack of its development, and your general medical condition, also play significant roles in the results.

It is generally felt that patients retain 30-50 percent of the injected fat over the long-term. A second or third session of fat injections often results in a longer lasting and improved cosmetic result. Fat injections can be performed alone or in conjunction with other surgical procedures.

Please contact us today to learn more about how we can help you.

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Lip Enhancement

If you always wanted fuller, lusher lips, or wish that your once larger lips were still that way, there is an increasing assortment of procedures that can give almost any woman more sensuous lips. As we age, the lips lose their fullness. The distance from the tip of the nose to the upper lip lengthens as gravity makes the upper lip descend.

Lip lift, also known as lip augmentation, will increase the fullness of the lips, which creates a more attractive contour and appearance of youthfulness.

The Singer Surgical Centre offers a variety of techniques and procedures which can enlarge, reshape, or otherwise help improve asymmetrical or uneven lips. Some of these results are temporary while others are more permanent:

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INJECTIONABLE FILLERS

Injectable fillers are semi-liquid materials which are injected to fill out the lips and provide a cosmetic improvement. The procedure is repeatable in order to maintain results, carries little risk of problems, and is partially permanent, depending on your individual anatomy and the material being used. Dr. Singer uses the following injectable fillers at his practice:

Collagen
Restylane®
Perlane®
JUVÉDERM™ Injectable Gel
Hylaform® and Captique™
Micro-Fat Grafts
Micro-Fat Grafting (Injection)
Radiesse®
Sculptra®

GRAFTING:

Dermis fat
Fascian™
AlloDerm®

SURGICAL ADVANCEMENT TECHNIQUES:

Local flaps
Lip Shortening

Dr. Singer will discuss the various options, advantages, and disadvantages, of each procedure with you and then develop with you an individualized approach to your treatment — one based on your specific anatomy and aesthetic desires. The results can be dramatic while looking natural. Please contact us today to learn more about how we can help you.

"We offer a number of non-surgical procedures that allow you to reverse the signs of skin aging without having to commit to plastic surgery," explains Dr Singer. "Our skin care programs and procedures are customized to meet each individual patient's needs."

At Singer Surgical Centre, we strive to provide the best in techniques and technologies for all of your skin care needs. Our La Jolla practice is renowned in California — and worldwide — for outstanding patient care and quality treatment.

As we age, sun exposure, gravity, and ongoing muscle motions that produce frowning, smiling, chewing, and squinting, all have effects on our appearance.

The underlying tissues responsible for a youthful appearance of the skin start to break down, resulting in facial wrinkles, laugh lines, and hollow-looking features.

The injection of a variety of soft tissue fillers can fill out sunken areas of your face and provide definition to your cheeks and chin.

Fillers are also useful if you always wanted fuller, more fashionable, lush lips, or wish that your once larger lips were still that way today.

The subcutaneous fatty tissue below the skin supports the skin against gravity, provides shape, contour, and definition to the skin. Replacement with fillers like micro-fat grafting makes the skin look tighter, more defined and healthier through three dimensional contouring.

The youthful fullness of the mid-face is restored by improving the balance between the amount of facial skin and the underlying supportive tissues.

Soft tissue fillers function by plumping up the creased and sunken areas of the lips, cheeks, chin or forehead. This produces a smoother more youthful appearance. While there may be some improvement in deep surface wrinkles, there is a greater improvement of the deeper lines by resurfacing of the skin with laser or dermabrasion treatment. Soft tissue fillers may be injected as individual procedures or in conjunction with other facial procedures to further enhance the results.

There are many types of fillers now available to fill in skin lines and creases to restore a youthful appearance. Some fillers can also provide volume and fill in cheek and under eye hollows, enhance cheekbones, lips, and the chin area. These fillers can produce a non-surgical mini facelift:

BOTOX® Cosmetic: Although technically not a filler, this muscle relaxant is best used in the upper face and neck and as an adjunct in the lower face to diminish muscle movement. This temporarily gets rid of muscle movement lines for a younger, smoother look. Read more about BOTOX® here.

Collagen: Collagen is a naturally occurring protein that provides support to various parts of the human body. Collagen injections are used to increase fullness in the lips or to fill in facial lines and wrinkles. Collagen injections act as a temporary replacement for the decrease in natural collagen that occurs as we age. Read more about Collagen here.
- Zyderm® / Zyplast® Injections: You will need a pretreatment test dose to ensure your body will accept the collagen without an allergic reaction.
- Cosmoplast®: A new collagen material that doesn't require skin test. Read more about Cosmoplast® here.

Hyaluronic Acid Products: Hyaluronic Acid is the naturally occurring sugar that is found in the human body, in the skin, cartilage and the eye. In the skin, hyaluronic acid fills the space between collagen and the elastin fibers. It delivers nutrients, hydrates the skin by holding in water, and acts as a cushioning agent.
- Restylane®: Restylane® is clear gel made from a natural, safe, and effective completely biodegradable substance called Hyaluronic acid that contains no animal proteins. Restylane® provides natural beauty enhancement and is considered extremely safe. It can be used to add volume and fullness to your skin, reducing wrinkles, and augmenting facial features. Restylane® can be used in conjunction with Radiesse® injections to fill out both the deeper and more superficial lines of the face. The dramatic results are immediate and can last six to nine months. Read more about Restylane® here.
- Perlane®: Perlane® is a denser form of hyaluronic acid, designed for more pronounced wrinkles, facial folds and depressions. Read more about Perlane® here.
- JUVÉDERM™ Injectable Gel: Next generation non-animal Hyaluronic acid dermal fillers lasting 6 months or longer.
- Hyalaform® and Captique™: These are other types of Hyaluronic acid products that last 4-9 months. Read more about Hyalaform® here. Read more about Captique™ here.

Sculptra®: Sculptra® is a breakthrough injectable filler composed of poly-L-lactic acid, related to re-absorbable suture material, which is carefully injected beneath the skin to plump the area and gradually thicken facial skin. This is a good filler to restore youthful fullness to the mid- and lower-face. Initially, you may require two to three applications of Sculptra™ to achieve ideal results. It lasts 18 to 24 months. Read more about Sculptra® here.

Radiesse® (Radiance™): Radiesse® is purely synthetic. It is comprised principally of calcium hydroxyapatite, a natural substance that is already found in your body. Radiesse® injections will build up the tissues of the face, reducing deeper folds and creases, and restoring fullness. Radiesse® requires no skin test and the results are instantaneous. It is used off-label cosmetically and lasts 9 to 24 months. Read more about Radiesse® here.

Micro-Fat Grafts: Candidates for fat injections are those with facial contour defects, patients who have lost fat and overall volume, and want to use a filler that is totally natural for them. There is no chance for rejection or allergic reaction, since fat is your own tissue. It is generally felt, that 30% to 50% of the micro-injected fat remains permanently. Read more about Micro-Fat Grafts here.

INJECTABLE FILLER RESULTS DEPEND UPON:

Age
Genetics
Skin quality
Location of the filler
Underlying reason for the loss of tissue or lack of its development
Your general medical condition

Dr. Singer will discuss the various options, advantages and disadvantages of each procedure with you and then develop an individualized approach with you to your treatment. Please contact us today to learn more about how we can help you.

For more information on other facial cosmetic procedures performed by Dr. Singer visit his other site www.FacesBySinger.com.

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Robert Singer, M.D., F.A.C.S.
9834 Genesee Ave., Suite 100
La Jolla, CA 92037
Phone: 866.660.0206

Map & Directions

Listed in “Best Doctors in America”
Included in Town & Country, “Best Cosmetic Surgeons in the Country”
Chosen by peers - San Diego Magazine and San Diego County Medical Society, “Best Doctors” and “Best Plastic Surgeons”.
Selected by La Jolla Light Newspaper, “Best Plastic Surgeon”
Past President of The American Society for Aesthetic Plastic Surgery
Past Chairman of the Board of Trustees of the American Society of Plastic Surgeons

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