Plastic Surgeons

Scottsdale Plastic Surgeon Dr. Maffi is board certified by the American Board of Surgery and the American Board of Plastic Surgery. He is a member of the American Society of Plastic Surgeons and a fellow of the American College of Surgeons. Dr. Maffi’s plastic surgery training was completed at the prestigious Mayo Clinic in Rochester, Minnesota, where he is now a clinical instructor.

Upon finishing his fellowship, Dr. Maffi was fortunate to join internationally recognized plastic surgeon, Dr. Jack Friedland, where he received extensive training in aesthetic facial rejuvenation surgery. This experience, combined with his training at Mayo Clinic, has allowed Dr. Maffi to gain exceptional expertise in all aspects of aesthetic plastic surgery, including the latest procedures in breast and body contouring, with a special emphasis on facial rejuvenation, such as facelift, eyelidlift, browlift and nasal surgery.

This plastic surgeon in Scottsdale Arizona also has a special interest in caring for the under-served and those who are less fortunate. He has devoted time to working with the indigent at the county hospital in Phoenix and he has traveled to third world countries, such as Viet Nam, performing correction of congenital defects, such as cleft lip and palate deformities.

Are you considering a forehead lift in New York City? Forehead lifts are used when there is a sagging brow or deep furrows between the eyes. A forehead or brow lift tightens loose skin and in some cases, removes the excess, and forehead wrinkling and drooping brows can be modified. When necessary, part of the muscle that causes vertical frown lines between the brows is also removed. There are two basic techniques that we use in browlifting; the more traditional coronal brow lift and the endoscopic forehead lift.

For a coronal brow lift, we make an incision slightly behind the natural hairline, running from ear to ear across the top of the head. We usually make this incision well behind the hairline so that the scar is not visible. If your hairline is high or receding, the incision may be placed just at the hairline, so as not to move the forehead back. In patients who are losing hair, a mid-scalp incision may be preferred. For a browlift in New York City contact a board certified plastic surgeon.

The endoscopic forehead lift offers the advantages of minimal incisions within the scalp, and a potentially shorter recovery period. Rather than making one long incision, we can use three to five scalp incisions of approximately one inch in length. An endoscope, a small wand with a camera on the end connected to a monitor, is inserted to allow the surgeon to have a clear view of the muscles and tissues beneath the skin. Another instrument is then inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or released. The eyebrows may also be lifted and secured into their higher position by sutures beneath the surface of the skin or by temporary fixation screws and other methods placed behind the hairline. Finally, the incisions are closed with stitches or staples.

A brow lift is often performed with eyelid surgery and facial rejuvenation for the best results.

New York plastic surgeon Eric Sadeh offers browlifts, facelift surgery, rhinoplasty, blepharoplasty and other facial plastic surgery procedures. Located in New York City serving Manhattan, Queens and Forest Hills.

Your eyes are the most revealing feature of your face. When engaged in conversation, our eyes are the center of attention. Puffiness, dark circles around the eyes, or droopy upper eyelids give the appearance of fatigue and aging. In some individuals, the excess skin of the upper eyelids can actually obstruct the field of vision, which can be dangerous when driving for instance. A surgical correction can remove the excess fat and drooping skin of the upper eyelids, minimize bags under the eyes and tighten the lower eyelid skin. The result is a fresh, youthful, and more rested appearance. Eyelid surgery is performed on men and women of all ages who want to improve their self-image. The following concerns are easily addressed with eyelid surgery, blepharoplasty:
* Upper eyelid:
o Excess skin that hides the natural fold of the upper eyelids
o Loose skin that hangs down from the upper eyelids
o Puffiness in the upper eyelids that creates a tired look
* Lower eyelid:
o Excess skin and fine wrinkles of the lower eyelids
o Puffy “bags” and dark circles

In many instances, excess droopy skin of the upper eyelids is due at least partially to a lowered eyebrow. As we age, gravitational pull along with decreased elasticity of the skin leads to a downward fall or ptosis of the eyebrows. Naturally low set eyebrows may be genetic in some, in which case an endoscopic forehead lift or browlift is necessary at an earlier age. In others, an endoscopic forehead lift may be performed simultaneous to blepharoplasty. It is imperative, however, to address the low eyebrows in addition to blepharoplasty in order to avoid excision of excess skin of the upper eyelid. Returning the eyebrow to its aesthetic position decreases the amount of skin necessary for excision in the blepharoplasty. For eyelid surgery in Beverly Hills by a board certified plastic surgeon contact us today.

As people age, effects of gravity to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth, the jaw line grows slack and jowly, folds and fat deposits appear around the neck. One should know that the face lift can’t stop the aging process. It can only “set back the clock”, improving the most visible signs of aging by removing excess fat, Tightening underlying muscles and re draping the skin of your face and neck. A face lift can also be done along with other procedures such as forehead lift, eyelid surgery or nose reshaping.

Suitable candidate for face lift:
* A man or a woman whose face and neck have began to sag but whose skin still has some elasticity.
* Whose patients bone structure is strong and well defined.
* Most patients are in their forties to sixties. But face lift can be done successfully on people in their seventies or eighties as well.
* A face lift can make you look younger and fresher may enhance your self confidence in the process. But it can’t give you a totally different look, nor can it restore the healthy and vitality of your youth.

Risks involved:
* When a facelift is performed by a qualified plastic surgeon, the complications and risks involved are minor. By following the doctors advise closely you can reduce your risks.
* Hematoma C a collection of blood under the skin that most be removed by the surgeon.
* Injury to the nerves that control facial muscles which are usually temporary.
* Infection and reactions to anesthesia.
* Smokers are usually affected by poor healing.

A forehead lift addresses the area of the upper face. It restores a more youthful, refreshed look to the area, making you look less tired, angry, or sad, by correcting drooping brows and improving the horizontal lines on your forehead. It is frequently performed with an upper lid blepharoplasty and can be performed with a face lift to provide facial balance and harmony.

The goal of the procedure is to raise the brow to a more aesthetically appealing position. It will also improve fullness over the outside corner of the lid, a scowling appearance of the eyes and horizontal frown lines of the forehead. It is not intended to create a look of surprise or what is commonly called the “deer in the headlights” look. Botox is not a substitute for a forehead lift, it can give you an idea of what to expect. Dr. Friedlander will show you potential areas of benefit during your consultation.

Several different approaches may be used, such as an endoscopic approach, a lateral brow and transblepharoplasy approach and rarely a coronal approach. Most often, only small incisions are required. The procedure is often performed with face lift and/or blepharoplasty. There may be some postoperative swelling or bruising, which resolves relatively quickly. You are able to return to work in a week if no other surgery is being performed.

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat–usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won’t remove crow’s feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.

If you’re considering eyelid surgery, this information will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don’t understand.

Your New Look
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they’ll fade to a thin, nearly invisible white line.

On the other hand, the positive results of your eyelid surgery-the more alert and youthful look-will last for years. For many people, these results are permanent.

Miami’s facelift expert, Dr. Sam Gershenbaum, brings state-of-the-art techniques and experience to every facial surgery procedure at our Miami, Florida center, including facelift, brow lift, rhinoplasty, ear reshaping, and more.

A facelift can improve the most visible signs of aging by sculpting and tightening the deeper structures and foundation of the face and neck. As we age, the effects of gravity, sun exposure, weight fluctuations, smoking, heredity, and the daily stresses of life begin to reveal themselves in our faces. Facelift surgery can bring youth back to a patient’s face. In youth, the face is firm and smooth due to good skin elasticity and proper positioning of normal facial fat. As we age, skin elasticity and muscle tone weaken, and facial fat descends, causing prominent skin folds, deep creases between the nose and corner of the mouth. Jowls become prominent along with fat deposits and loose skin in the neck.

A facelift won’t stop this process, but it can “turn back the hands of time.” A facelift (technically referred to as Rhytidectomy) is designed to reduce much of the looseness and many of the heavy wrinkles and folds in the face and neck. It will also improve the contour of the jaw and necklines. A facelift will not, however, completely remove every fold, line, and wrinkle. There is limited improvement around the eyes and with fine lines of the facial skin. A facelift alone will not improve “smoker’s” lines around the mouth, acne scars, or a poor complexion. Other options exist to treat these problems, including laser treatment, dermabrasion, and chemical peels.

At our Miami, Florida center, many facelift procedures are combined with a forehead and brow lift, upper and/or lower eyelid surgery, and “cheekbone” (malar) augmentation. Frequently, chin implants are placed to improve the profile proportions of the jaw line and increase the projection of the chin. These additional procedures may be performed at the same time and in combination with facelift and neck lift surgery or as independent procedures at a later date.

Background
Over time, your skin’s elastic collagen degrades leading to wrinkles and excess skin laxity. Along with this change in the quality of your skin, gravity pulls your forehead and facial skin downward leading to an aging face with low set eyebrows. Some men or women have naturally low set eyebrows which they have inherited from their parents. The “correct” position of the eyebrows varies between men and women. In women the eyebrow should have the shape of an asymmetric arc, with its peak 1 cm (3/8 inch) above the superior bony ridge of the eye socket. The eyebrow in an aesthetic male should be a similar arc with its maximal peak at the bony ridge of the eye socket. It is very important to maintain these differences between the female and male eyebrows when performing a browlift in order to not feminize men.

The descended eyebrows of the aging face have several effects. They crowd the upper eyelid and give the appearance of a “busy” and tired face. A browlift can return the eyebrows to their correct position and thereby opens the face producing a fresh and well rested appearance. To compensate for the pressure and crowding effects of the descended eyebrow, the upper eyelid signals your brain to raise the eyebrow by contracting the frontalis muscle at the forehead. For this reason, all patients with low set eyebrows have lines across the forehead corresponding to the constant effort by the frontalis muscle to correct the position of the brows. In such cases, your face becomes fatigued over the course of the day, as it constantly attempts to lift the eyebrows making mild headaches very common in late afternoons. A browlift returns the eyebrows to their correct position, opening up your eyes and face, and alleviating the constant need to contract the frontalis muscle. If desired, the frowning muscles can be weakened with this procedure correcting frown lines, making BOTOX injection into the forehead no longer necessary.

Dr. Sayah performs most of his browlifts endoscopically through small hidden incisions in the hair-bearing scalp. An entire facelift can in fact be performed through these same incisions if desired. Numerous advantages distinguish this modern technique for browlift from older ones. Standard browlifts are associated with long scars at the hair line or across the top of the head from one ear to the other. Hair loss and numbness of the scalp making you unable to feel a brush going through your hair are common complications of standard browlifts. The endoscopic technique preserves the nerves and blood vessels at your scalp, preventing numbness and hair loss. Other advantages of this new technique include faster recovery, and minimal “down time.”

Procedure
Small hidden incisions are made at the hair-bearing scalp. The endoscope (camera) is then introduced under your skin. Using special endoscopic instruments, Dr. Sayah performs the procedure in layers. The deepest portion of the scalp is released. The next most superficial layer of your forehead scalp is then incised to provide greater upward mobility to your eyebrows. If desired, the frowning muscles between your eyebrows are next weakened such that you no longer require BOTOX® to prevent frown lines. The next layer of your forehead is released last, and the forehead is elevated to its aesthetically correct position. The eyebrows are shaped at their correct position, taking into account your preference, particular needs, and sex. This position is different in every person, and is determined in detail prior to the procedure. At the end of the procedure, the incisions are closed with plastic surgery techniques to minimize scarring, and bandages are placed.

A facelift is a surgical procedure used to improve those visible signs of aging on the face and neck, primarily due to sagging. As individuals age, the skin and muscles of the face begin to lose tone and begin to sag. The facelift cannot stop the process of aging. It can improve the most visible signs of aging by tightening and lifting the deeper structures, re-draping the skin of the face and neck, and removing selected areas of fat. A facelift can be performed alone, or in conjunction with other procedures, such as a browlift, liposuction, eyelid surgery, or nasal surgery.

Facial Rejuvenation
A facelift cannot correct conditions such as sagging eyebrows, excess skin and fatty deposits in the upper and lower eyelids, or wrinkles around the mouth. Remember, if wrinkles are the problem…a resurfacing procedure will likely be required… In some cases, resurfacing can be accomplished along with a facelift or at a later time. At your consultation, we will be happy to counsel you as to which procedures may be required to complete your total rejuvenation.

Any one or combinations of the following conditions may indicate that you are a good candidate for facelift surgery:
* A deep line, or fold, running from the corner of your nose to the corner of your mouth.
* Jowls, or loss of a well-defined jawline associated with youthfulness.
* Deep wrinkles in the cheeks and sagging of the skin in the areas of the cheekbones.
* Loose skin, wrinkles, vertical cords or excess fatty tissue in the neck.

In our practice, facelift surgery is individualized for each patient. The best candidates for facelift surgery have a face and neck line that has begun to sag, but whose skin has elasticity and whose bony structure is well defined. A facelift begins with carefully placed incisions. In general, incisions are made just inside the hairline at the temple and extend along the natural curve of the ear, back behind the ear and horizontally into the posterior hairline. Another incision is placed beneath the chin to allow the removal of the vertical bands in the neck and to recreate a natural and smooth contour in this area. These well-placed incisions are made in natural creases and become largely invisible after they heal. Facelift incisions allow us to visualize the underlying facial structures and fat before sculpting the face by repositioning muscle, skin and fat to a more youthful location. A facelift surgery can reshape your face and return structures to where they were found in youth.

Cosmetic eyelid surgery or Pasadena Blepharoplasty, is a procedure that improves the appearance of the upper eyelids, lower eyelids or both. Blepharoplasty corrects the effects of aging and heredity which cause the appearance of bags or puffiness under the eyes, excess sagging skin, droopiness of the lower eyelids and fine wrinkles on the lower lids. The surgery results in a more youthful and energetic appearance.

A facelift, neck lift, browlift or skin resurfacing technique may also be performed at the same time as eyelid surgery.

Procedure
The procedure in done on an outpatient basis under general anesthesia or sedation and local anesthesia and lasts from 1½ to 2 hours for either upper or lower lids and 2 to 3 hours for both.

Droopiness of the upper eyelids is corrected through an incision within the natural crease of the upper eyelid, through which fat deposits are repositioned, the muscles are tightened and if necessary, excess skin is removed.

Conditions of the lower eyelid may be corrected through an incision hidden inside the lower eyelid. Through this incision, fat is redistributed and/or removed. An incision underneath the lower lash line can be used to remove excess skin if necessary, and/or to tighten the lower lid.

The incision lines from both upper and lower lid surgery are well concealed within the natural structures of the eye and are often unnoticeable. A mid-facelift may be performed through the same incisions as eyelid surgery.

Recovery
Initial healing may include some swelling, bruising, or dry eye.. Healing of incisions takes 5 to 10 days at which time sutures will be removed and the patient can return to work. However, it may take several weeks for swelling and bruising to disappear, which can be camouflaged with makeup.

Results
The surgery removes excess skin, eliminates bags and restores firmness to the area surrounding the eyes, resulting in a more rested, alert and youthful appearance.

Risks
Risks associated with eyelid surgery include poor healing or infection of the incisions, temporary blurred vision and dry eye. Carefully following your surgeon’s instructions before and after the surgery can help minimize these risks.