Guest on Lisa Linder's Our Community Radio Program / MileHiRadio Denver

This week I had the pleasure of being a guest on Lisa Linder's Our Community Radio Program. I had a great time with Lisa and her daughter Noel. 

We spent an hour talking about facial plastic surgery and all of the cosmetic and reconstructive surgery that I perform in my practice in Lone Tree, Colorado.

We also discussed my past and future humanitarian mission work. We spent alot of time discussing our recent surgical mission with Outreach Africa. We traveled this year to Tanzania and operated on 59 people and saw over 300 in the clinic over a two week period. You can also find photos of the trip on my Facebook page.

I hope you'll take a listen to the interview!

Your Anesthesia Options

I am often asked what type of anesthesia will be required for Facial Plastic Surgery.

The most appropriate option depends upon the surgery being performed and the underlying health of the patient. I've listed below the options that I frequently employ and a discussion of their pros and cons.

Local Anesthesia

Local anesthesia involves the infiltration of a numbing solution (Lidocaine and Marcaine) that includes some epinephrine (adrenaline) to constrict blood vessels and minimize bleeding. The area is numbed nearly instantaneously. You do feel a "pinch" or "bee sting" but the area that is infiltrated will remain numb during surgery and for three to five hours afterward. Local anesthesia can be combined with oral sedation (Xanax, Ativan, Valium) to provide relief for anxious patients.

This option is most appropriate for small soft tissue procedures:

• Upper Blepharoplasty
• Mole Removal
• Scar Revision
• Skin Cancer Reconstruction
• Earlobe Repair
• Laceration Repair

IV Sedation (Twilight Anesthesia, Monitored Anesthesia Care, MAC)

IV sedation uses safe doses of common intravenous medications to provide procedural sedation. Medications used include Versed and Fentanyl among others. This is often combined with local anesthesia to provide local relief of discomfort and minimize bleeding during the procedure. IV sedation allows a patient to "sleep" through the procedure without the need for a breathing tube in their airway. 

IV sedation is effective for nearly all facial plastic surgery procedures including:

• Facelift
• Necklift
• Browlift
• Upper and Lower Blepharoplasty
• Rhinoplasty
• Cheek Implants
• Chin Implant
• Liposuction
• Otoplasty
• Deep Laser Resurfacing

General Anesthesia

General anesthesia is what most people think of when they refer to "being under" or "being asleep." General anesthesia results in loss of consciousness that requires a breathing tube to be placed to assist the patient in breathing. When performing face or neck surgery, general anesthesia is only required for cases such as reconstruction of severe nasal defects where it is expected that some blood might enter the airway. In these cases, we need a breathing tube in place to protect the airway and maintain breathing. 

While many facilities will perform general anesthesia for Facial Plastic Surgery, this is not required as IV sedation is safe and effective in most cases. 

For further information about your options, call (303) 788-6632 or email info@lonetreefacial.com .

What's the difference between a browlift and a blepharoplasty? Which do you need?

This is a very frequent question in my practice. Maybe my patient saw something on TV or spoke with a friend but they're convinced that they need a specific procedure to rejuvenate their face. This is incredibly common when talking about the eyes and upper face and there is alot of confusion out there.

What is a browlift?

Women tend to have refined, arched eyebrows which sit above the bony rim of the eye socket. Men, on the other hand, tend to have flat eyebrows with minimal arch and their brows tend to sit right on top of the framework of the eye socket. The browlift procedure is designed to lift and reshape the eyebrows. 

Does the browlift procedure differ in women vs. men?

The procedure is technically the same. However, I aim for a refined, arched brow in women and a flatter, less elevated brow in men to maintain the natural cues of a feminine or masculine face. One major mistake for men seeking brow or eyelid surgery is undergoing a procedure with a plastic surgeon who does not frequently operate on men. The result is often a feminized appearance that clashes with the rest of the man's masculine appearance.

What is a blepharoplasty?

Both upper and lower blepharoplasty are frequently performed. This is the most common procedure performed in my practice for women and men. 

An upper blepharoplasty is performed to remove extra skin from the upper eyelid, a small strip of muscle and occasionally a pocket of fat near the nose. This recreates the natural eyelid crease and "opens" the eyes making a person look more rested and more youthful.

Lower blepharoplasty most often involves removing fat that forms a "bag" or a bulge in the lower eyelid. This is typically performed with an incision hidden on the back of the eyelid. In patients with extra skin in the lower eyelid, a small incision is placed below the eyelashes to remove the extra skin.

So which do I need?

Drooping eyebrows AND extra upper eyelid
skin require both a blepharoplasty and browlift.

• If your eyebrows are drooping AND there is extra skin in the upper eyelid when the brow is lifted to its natural position, you need a browlift AND a blepharoplasty.

Drooping eyebrows but NO extra upper eyelid
skin require a browlift only. 

• If your eyebrows droop but there is no extra skin in the upper eyelid when the brow is lifted to its natural position, you need a browlift only. 

Eyebrows in good position but extra upper
eyelid skin require a blepharoplasty. 

• If your eyebrows are in good position but your upper eyelids are full, you need an upper blepharoplasty.

How can I learn more?

Setup a complimentary consultation with me to discuss browlift, blepharoplasty or any aspect of facial rejuvenation surgery. You can reach my office at (303) 788-6632. For your convenience, I have office hours on Wednesday evenings and Saturdays available.