This is done using a solid silicone chin implant placed through a small incision under the chin – I use those made by Implantech. The surgery is fairly simple and allows for a stronger chin in those with a weak chin. In rhinoplasty (nosejob) surgery, it may help balance the profile in those with a small or under-projected chin.
Those with prominent ears (also called” bat ears”) may opt to have the ears pinned back closer to the head. We often do this is children, but it can be done in adults under local anaesthetic. Access is via incisions on the back of the ear and the cartilage is then bent to give a better overall form.
Blepharoplasty is the medical term for this surgery, be it upper lids or lower lids – the former is usually due to skin excess (simply treated by skin excision under local anaesthetic) and the latter is more complex, with removal of eyelid (fat) bags and contouring of the eyelid cheek junction. Upper eyelid surgery is amongst the simplest of all aesthetic surgery.
For those with sagging of the facial tissues (jowls and neck laxity) as well as a degree of midface / cheek atrophy (loss of fat) the only real procedure that would comprehensively address these issues is a facelift. Here the facial tissues are elevated using long acting stitches in the SMAS layer to support the lift. It is a fairly major operation taking around 3 hours in the operating room. In my opinion, threads alone of various sorts do not work at all.
I use fillers from time to time to augment the central and lower third of the face is the right patient. I use Restylane products only as I find these most predictable in my hands. All are HA fillers and can be dissolved if need be – they are slowly absorbed over several months so are never permanent.
Most often I modestly augment lips with HA filler, like Restylane, using a small disposable cannula. I rarely use fat fills. If the lip is long (philtral height much longer than 12mm), I may suggest a lip lift surgery to shorten the upper lip and evert it slightly.
Rhinoplasty is a surgery designed to permanently change the form and often improve the function of the nose. I have a special interest in rhinoplasty surgery, and use preservation techniques whenever possible. The surgery may be done closed (scarless / no external incisions) or open, leaving a small scar across the columella and usually takes around 3 hours in the operating room for a primary. If there are bona fide breathing issues, some medical aids may contribute to the costs if motivated. Very few doctors in South Africa use closed preservation techniques regularly.