Eyelid Lift: Blepharoplasty

Blepharoplasty or Eyelid Rejuvenation is the surgical removal of fat, and usually excess skin and muscle, from upper and lower eyelids. It corrects droopy upper lids, which can make you look older and also impair vision, as well as puffy bags below the lower lids, which can cause a tired appearance. The results can be a refreshed, more youthful appearance with a younger looking, firmer eye area. Sometimes a canthopexy is needed; this is the lifting of the outer corners of the eyes, if they are droopy. A common misconception about this surgery is that it can remove the dark circles under the eyes. This unfortunately is not true, and cannot be corrected by surgery. The dark circles are vascular, and due to thin skin under the eyes.

Although blepharoplasty is performed in our clinic under a local anesthetic, it may also be performed under general anaesthetic if there is more than one procedure being done. Dr. Khanna may recommend other procedures, such as a brow lift to correct a drooping brow, in conjunction with blepharoplasty to achieve the best results to suit your individual needs and goals. The eyes are assessed and marked by Dr. Khanna and incisions are made in the creases of the upper lids to keep the scars as invisible as possible by concealing the scars along the natural fold of the eye. The incisions for the lower lid portion of the procedure are made as inconspicuously as possible along the lash line and in the smile creases of the lower eyelids again to conceal the scars as much as possible. After the excess tissue, fat and muscle are removed, the incisions are closed with very fine sutures. The result is a tightened eye area with no visible scars.

The blepharoplasty procedure takes approximately 1-2 hours. After surgery, patients will definitely need someone to take them home, as the eyes will be swollen and bandaged. Any sutures are generally removed approximately 5-6 days after surgery and bruising and swelling can last up to 2 weeks post surgery. Patients may also notice some tenderness during this time as well. The eyes may feel sticky, dry or itchy for a few days following the procedure and therefore ointment, cold compresses and keeping the head elevated is suggested to enhance healing and alleviate discomfort. Dr. Khanna may prescribe pain medication.

Face and Necklift: Rhytidectomy

A face lift is the answer to a sagging jowl area and deep smile creases.

In addition to tightening the skin, Dr. Khanna deals with the structural components underneath.

Dr. Khanna makes a series of incisions to help eliminate loose skin and re-drapes the remaining tissue into a more youthful position. Loose skin and muscle in the neck can also be addressed.

Incisions usually begin above the hairline at the temple and follow the natural line in front of the ear and curve behind the earlobe into the crease behind the hair and further into the scalp.

A face and neck lift takes only a few hours to perform, and leaves you looking like yourself - only years younger.

Chin and Cheek Contouring

Patients who have a small or receding chin may want to consider a chin implant. This surgery can help to correct a chin that looks too small in comparison with other facial features, and possibly makes the nose appear longer. This surgery will also help patients who simply desire a more prominent chin.

The intended result is to give the patient an improved profile. The surgery will give a more attractive jaw line that creates a better balance and harmony between the chin and other facial features.

The procedure is done as a day surgery in our clinic, under sedation and local or general anaesthesia. An incision is made inside the lower lip, which means no visible scarring, or under the chin where, when healed, the scar will be imperceptible. An implant suitable to the level of correction needed is then inserted and anchored into place. The implant is made of a synthetic material that feels much like the natural tissue found normally in the chin. The patient may have sub mental or under the chin liposuction to enhance the final outcome and contour of this facial reconstruction.

Patients will go home with a small pressure dressing over the chin. Initial discomfort is easily controlled with oral medication. Swelling, tenderness, and possible local numbness gradually subside after a month or two.

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Forehead/Brow Lift

Over time and with normal aging, the skin begins to lose its elasticity. This can become apparent when looking at the forehead area on some individuals. Sun damage, environmental effects and gravity can all affect the face, resulting in frown lines, wrinkling of the forehead and a heaviness or drooping appearance of the eyebrows. This can result in a person looking older than their years or project an expression of sadness, anger or fatigue that the individual is not feeling.

A forehead lift or a brow lift is a procedure that restores a more youthful appearance above the eyes. The muscles and tissues in this area are either removed or altered to smooth the forehead and help eliminate or decrease vertical frown lines between the eyebrows. In lifting the skin in these areas, horizontal lines are diminished and the eyebrows are lifted and an overall smoothed, rejuvenated appearance is achieved.

This surgery is done under a general anesthetic in our clinic. There are two types of procedures that can be done, one is the open brow lift, and the other is an endoscopic brow lift. An open brow lift tends to be done on a patient who may have a larger forehead or a receding hairline. One continual incision is made in the hairline, and the muscle and tissue are then released. The excess tissue is the removed or modified, and the incision is stitched back together. An endoscopic brow lift is done with the use of an endoscope. The endoscope has a camera attached to aid in the surgery. There are approximately 5 tiny incisions made in the scalp area, about ½-1 inch each. The slender scope is then inserted, and the tissue and muscle is released. Both techniques yield similar results, however the surgeon will determine which procedure would benefit the patient most.

Following the surgery, swelling and bruising are common and tend to last approximately 2 weeks following the procedure. This can extend into the cheek and eye area in some patients. Keeping the head elevated as well as using cold compresses is suggested to help reduce swelling and alleviate discomfort. As the incisions heal, numbness and/or itching can occur. This is normal and diminishes over time. The sutures are generally removed 6-10 days following the procedure and any dressings may be removed in approximately 1-3 days. The surgeon will advise you as to when you can resume normal activities, however strenuous exertion should be avoided for a longer period of time. Any residual bruising can be concealed using makeup.

The surgeon may recommend a brow lift in conjunction with another procedure, such as a blepharoplasty or eyelid lift, to achieve an optimum result to meet the individual needs and goals of each patient.

Lip Augmentation: Cheiloplasty

You can have fuller "Paris" lips easily through simple injection techniques performed by Dr. Sapra or the nurses at The Skin Spa.

Fat, collagen and other natural or synthetic materials, such as Restylane®, Perlane, Restylane® Fine Lines or Juvéderm™, are injected in the lip area to quickly and easily add volume for plumper, sexy lips. An added bonus to this fast and effective procedure is the incredibly brief down time.

Otoplasty

Otoplasty, also known as ear pinning, is generally performed to set prominent ears back closer to the head to prevent them from sticking out. It is also done to reduce the size of large ears. This procedure can be performed on children starting at the age of four or five when the ears are almost fully grown. It is also performed on both older children and adults, however it is preferable to do the surgery at a younger age when the ears are more soft and flexible. It will also decrease possible self-esteem or teasing issues that the child may endure as they grow. Be sure to listen to the child. They will give important clues as to whether their protruding ears are an issue to them. This can be a factor in deciding when is the best time to consider otoplasty surgery.

This procedure is done under general anaesthetic and takes approximately 1-3 hours to perform, depending on the degree of correction involved. During the surgery, a small incision is made in the back of the ear to expose the cartilage. The cartilage is then sculpted to bend it back toward the head. If necessary, a piece of cartilage will be removed to make sure the most natural appearance is achieved. Permanent stitches may be used to hold the new ear shape in place. When healed a faint scar will remain that is inconspicuous.

Following the surgery, walking and movement are encouraged to avoid possible complications of surgery and general anaesthetic such as blood clots or pneumonia. Though rare, all surgeries involve some risks and these will be discussed with you in great detail during your meeting with the surgeon.

There will be a bulky, snug bandage wrapped around the head and this will remain intact to promote proper healing and molding of the new ear shape. Throbbing or aching of the ears is common in the first few days following the surgery and can be alleviated by elevating the head when lying down and using pain medication that may be prescribed by the surgeon.

After approximately seven days, the bulky bandage is removed and replaced by a lighter dressing similar to a headband. Any stitches may be removed within 7-10 days following the surgery. The lighter headband dressing should continue to be worn over the next 6 weeks, including at night to protect the ear shape while it heals. Most patients are ready to return to work or school within one week, however any physical activity in which the ears could be bent, for example certain sports or playground activity, should be avoided for 4-6 weeks while the ears heal.

**Note: This procedure is covered by OHIP for patients up to and including the age of 16 years. Therefore a referral from your family doctor is required to see Dr. Khanna.