Utah Facial Plastics

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MACS Facelift (Mini Facelift)

Many patients who consult with Dr. Thompson are interested in facial rejuvenating options that can achieve significant and long lasting results without the risks, down time, and additional cost of anesthesia and a hospital stay. Unfortunately, many of the procedures advertised as minimally invasive (weekend lift, thread lift, lifestyle lift, etc) and minimal recovery also achieve minimal results and are often performed by individuals who have minimal training in facial surgery. Because all surgical procedures are by definition invasive and require at least some recovery time, Dr. Thompson feels strongly that a significant and long lasting result should accompany this requirement. Any facelift that doesn’t address the deeper tissues beneath the skin (also known as the SMAS) is unlikely to achieve a long lasting result. Whether the SMAS is cut and removed, sutured together or extensively undermined, great results are achievable with a well performed and correctly chosen surgery. HOW IS THE MACS FACELIFT DIFFERENT THAN OTHER MINI FACELIFT PROCEDURES? Dr. Thompson has researched many minimally invasive facelift options, such as the Lifestyle Lift, and prefers the MACS facelift technique. This technique has been developed and refined over several decades and is performed not just by Dr. Thompson and a few other surgeons, but by hundreds of skilled and competent plastic surgeons. This means that the MACS facelift is accepted and endorsed by a huge body of plastic surgeons as an effective and safe procedure. The result of this collective experience is that the MACS facelift has been modified and improved as necessary and has proven itself as a reliable, consistent procedure with long-lasting results. Techniques that are developed and performed by only one or two surgeons by definition cannot benefit from the experience, improvements and refinements of multiple skilled plastic surgeons. WHO IS A GOOD CANDIDATE FOR A MACS FACELIFT OR MINI FACELIFT? Men and women with mildly loose skin on the neck and mild to moderate jowls are typically best suited for the MACS facelift procedure. It’s important that the patient is in good to excellent health and does not smoke. Individuals with good skin elasticity and strong bone structure will have the best possibility for an excellent surgical outcome. WHAT SHOULD I EXPECT AT MY CONSULTATION? Dr. Scott Thompson, a double board certified facial plastic surgeon in Utah, has extensive experience performing facelift surgery, including his MACS facelift procedure. During your consultation, he will discuss your concerns as well as your goals and motivations for surgery. An exam and review of your current and previous health history will also take place. He will then examine the structures of your face and neck, assess the quality of your skin tone and bone structure, and will make recommendations he feels will help you achieve your aesthetic goals. Dr. Thompson will discuss the procedure(s) he recommends and give information on where incisions will be placed, possible risks and complications, and make any non-surgical recommendations to enhance the overall surgical outcome. These options may include dermal fillers, botox, laser treatments, and/or professional skincare, some of which may be included in your surgical package. Dr. Thompson will advise you to avoid taking aspirin, ibuprofen products, Vitamin E and certain herbal medications before surgery, as these medications can cause increased bleeding and/or bruising. He will also insist that you discontinue smoking for at least one month prior to surgery to ensure proper healing, if applicable. Jessica, Dr. Thompson’s Patient Care Coordinator, will then provide you with all the financial details on any procedure discussed at your consultation and give financing options if applicable. She can also help facilitate the next step in the process and/or provide additional resources, such as before and after photos, articles, educational videos, etc.

MACS Facelift (Mini Facelift): Procedure and Results

HOW IS A MACS FACELIFT (MINI FACELIFT) PERFORMED? The MACS facelift is revolutionary because general anesthesia and more extensive surgery are not necessary to achieve significant facial rejuvenation. This procedure is done in the office under local anesthetic while the patient is awake and able to converse with Dr. Thompson. The patient does have the option of taking medication with sedative properties to help them relax and feel calm. Once the patient is thoroughly numb, liposuction of the neck and chin is performed through a tiny incision under the chin. Incisions are made in front of the ear and extend upwards inside the hairline slightly. No incisions are made behind the ear, as they are with a full facelift. A small area of skin is lifted off the cheek and the underlying SMAS (fibrous layer that sags with aging) is gathered upwards with two to three looped sutures that are firmly attached to strong tissue at the base of the temple. This helps tighten the neck, elevates the cheek to a more youthful positions, and redefines that jawline. The excess skin is then trimmed at the incision line and closed with fine sutures. WHAT SHOULD I EXPECT WITH RECOVERY FROM MACS FACELIFT (MINI-FACELIFT) SURGERY? Following surgery, a wrap around dressing is applied and left overnight. Pain is usually minimal but any discomfort is lessened with prescribed medication. Bruising varies but begins to disappear as early as 1 week or can last 2-3 weeks with some individuals. Some numbness is completely normal and will reside over time. Mild puckering of the skin in front of the ears may occur in some circumstances but resolves on its own in a short amount of time. You will be given post-operative instructions that include getting plenty of rest, avoiding strenuous activity, alcohol and sun exposure. Incisions will need to be cleaned twice a day and covered with antibiotic ointment until the sutures are removed. Your face may feel tight for a few day to a week, which is also completely normal. Patients are typically able to return to work within 1 week of surgery. Most sutures are removed within 1 week and any remaining sutures are removed 10 days following surgery. As for scarring, conspicuous scars are generally a result of poor technique and should never be a concern with any type of facelift if the incisions are closed properly. WHAT ARE TYPICAL MACS FACELIFT RESULTS? Expect to be extremely happy with your MACS facelift results and the youthful appearance you will regain. Patients report getting a lot of positive feedback from others who tell them they look great but are not sure what is different. They may think you changed your hairstyle or took a rejuvenating vacation. These comments are the sign of a great procedure that is not completely obvious to those around you. HOW MUCH DOES A MACS FACELIFT (MINI FACELIFT) COST? Surgical amounts vary between patients but price typically ranges between $5000 and $6500. That may or may not include any additional procedures Dr. Thompson may recommend, such as fat injections or eyelid surgery. It’s best to meet with Dr. Thompson at a free consultation where you’ll receive a quote on the procedure(s) recommended for you. WHAT DOES THE MACS FACELIFT COST INCLUDE? The total cost for macs facelift surgery includes all pre and post appointments and additional products designed to enhance your results and aide in the healing process. Arnica is given at the pre-operative appointment and is a homeopathic medication used to decrease bruising and swelling. Also included is an Obagi Surgical Kit (retail $380) to prepare the skin for surgery and resurface the skin overtime to enhance the overall result. Jane Iredale mineral loose or pressed powder is included to use as a safe, effective way to camouflage incisions once all sutures have been removed. Dr. Thompson feels a combination of treatments are often best for the overall result. ADVANTAGES OF MACS FACELIFT (MINI FACELIFT) SURGERY Advantages of this facelift (listed below as well) include significant and long-lasting results due to elevation of the deeper tissues, a shorter incision and scar, quicker recovery than a traditional facelift, and no requirement for general anesthesia -resulting in lower cost for surgery. Benefits: Shorter Scar Long Lasting Results (lifting of the SMAS layer) Less Bruising Quicker Recovery No General Anesthesia Can correct facial laxity as it begins to happen and restore youthful facial shape Lower Cost As a board certified facial plastic surgeon whose career is devoted exclusively to the face, Dr. Thompson has spent many years studying and perfecting the best facial rejuvenation techniques. We invite you to schedule a consultation with Dr. Thompson so that he can discuss your concerns, evaluate your specific facial features, and develop the best individualized plan for you.

Fat Grafting

Fat grafting, also known as fat transfer or fat injections, is a procedure used in plastic surgery to enhance a specific area of the body using the patient’s own fat. As a facial plastic surgeon, Dr. Thompson uses this procedure, often in conjunction with a facelift and/or blepharoplasty, to restore lost facial volume utilizing fat tissues from the abdomen, thighs or back. In more recent years, we have learned that aging is not just skin deep. Overtime, volume is lost in the face resulting in a sunken or gaunt appearance. By adding volume to the face with fat grafting, fullness is restored leaving patients looking more youthful and refreshed. There is also some evidence to suggest that fat grafting may actually improve the quality of the overlying skin. It’s important to choose a plastic surgeon with extensive training and experience in fat grafting. As with any cosmetic procedure, fat grafting can be overdone resulting in an unnatural appearance. A good plastic surgeon understands the unique anatomy of the face and provides excellent aesthetic judgment about how and where fat is injected. WHO IS AN IDEAL CANDIDATE FOR FAT TRANSFER? A good candidate is any patient who suffers from facial volume loss and desires correction. It’s important the patient has good to excellent health and realistic expectations regarding their outcome. WHAT SHOULD I EXPECT AT MY CONSULTATION? Dr. Scott Thompson, a double board certified facial plastic surgeon in Utah, has extensive experience with fat grafting. During your consultation, he will discuss your concerns as well as your goals and motivations for surgery. An exam and review of your current and previous health history will also take place. He will then examine the structures of your face and eyes, and will make recommendations he feels will help you achieve your aesthetic goals. Dr. Thompson will discuss the procedure(s) he recommends and give information on where incisions will be placed, possible risks and complications, and make any non-surgical recommendations to enhance the overall surgical outcome. Dr. Thompson will advise you to avoid taking aspirin, ibuprofen products, Vitamin E and certain herbal medications before surgery, as these medications can cause increased bleeding and/or bruising. He will also insist that you discontinue smoking for at least one month prior to surgery to ensure proper healing, if applicable. Jessica, Dr. Thompson’s Patient Care Coordinator, will then provide you with all the financial details on any procedure discussed at your consultation and give financing options if applicable. She can also help facilitate the next step in the process and/or provide additional resources, such as before and after photos, articles, educational videos, etc. HOW IS FAT TRANSFER PERFORMED? Dr. Thompson will tailor your procedure to your specific needs since it does vary from patient to patient. Dr. Thompson often recommends a facelift to lift and tighten the facial skin in conjunction with fat injections to restore volume. See our facelift page for more information on the procedure and recovery. Sometimes fat injections are recommended for just a certain area of the face, such as under the eyes to fill in tear trough lines. This can be done in the office or a surgical center as well. If done in conjunction with a lower blepharoplasty, the entire procedure will likely be done in the surgical center. You can learn more on our tear trough rejuvenation page. Fat is taken from another are of the body, such as the thigh or abdomen, and remixed for optimal use. Dr. Thompson then injects the fat into areas of volume loss. This can be done in the office under local anesthetic in most cases or can be performed in the surgical center under general anesthesia. If a facelift or other surgical procedure is recommended, it will likely be performed at an out-patient surgical center. Common areas Dr. Thompson uses fat grafting include: Sunken cheeks Hollow temples Tear trouphs Nasolabial folds Marionette lines (frown lines) Skin depressions Facial creases and wrinkles WHAT SHOULD I EXPECT WITH RECOVERY FROM FAT TRANSFER? For fat injections, plan on 1- 2 weeks of recovery with some bruising and swelling. There will be a small incision on the thigh or abdomen where the fat was taken from and will be closed with 1-2 sutures. If surgical intervention is involved, refer to the facelift and blepharoplasty pages for further details on what to expect with surgery.

Eyelid Lift

With age, drooping of the eyebrows, looseness of the eyelid skin, and bulging fat cause loss of definition of the upper eyelids and bulging of the lower lids. Because the natural position of the brows and fullness of the eyelids varies among individuals, aging changes manifest themselves dramatically in some and much less so in others. The result in affected individuals is a tired, sad, or even angry appearance or an apparent decrease in the size of the eye. In an aesthetically pleasing face, the eyes are open and are the focal point of the face. Blepharoplasty (eyelid lift surgery) is designed to restore the eyes as the natural focal point of the face by reversing age associated changes. Before proceeding with blepharoplasty, it is essential to undergo a comprehensive evaluation by a facial plastic surgeon. Many patients present requesting eyelid surgery when in actuality a sagging brow or midface may be the source of their concern. Dr. Thompson or Dr. Henstrom will be able to assess what is needed at an initial consultation. WHO IS AN IDEAL CANDIDATE FOR BLEPHAROPLASTY SURGERY? An ideal candidate for blepharoplasty (eyelid) surgery is typically age 30 or older with a desire for eye rejuvenation. It’s important that the patient is in good to excellent health and does not smoke or stops temporarily before and after surgery. It’s also important that the patient doesn’t have serious eye conditions or a life-threatening illness with healthy facial tissue and muscles. WHAT SHOULD I EXPECT FROM A CONSULTATION? Dr. Scott Thompson and Dr. Henstrom, both double board certified facial plastic surgeons in Utah, have extensive experience performing eyelid lift (blepharoplasty) surgery. During your consultation, they will discuss your concerns as well as your goals and motivations for surgery. An exam and review of your current and previous health history will also take place. They will then examine the structures of your face and eyes, and will make recommendations he feels will help you achieve your aesthetic goals. Your surgeon will discuss the procedure(s) he recommends and give information on where incisions will be placed, possible risks and complications, and make any non-surgical recommendations to enhance the overall surgical outcome. These options may include dermal fillers and/or botox. It is advised that you avoid taking aspirin, ibuprofen products, Vitamin E and certain herbal medications before surgery, as these medications can cause increased bleeding and/or bruising. It is important to discontinue smoking for at least one month prior to surgery to ensure proper healing, if applicable. A Patient Care Coordinator will then provide you with all the financial details on any procedure discussed at your consultation and give financing options if applicable. They can also help facilitate the next step in the process and/or provide additional resources, such as before and after photos, articles, educational videos, etc.

Eyelid Lift Procedure and Results

HOW IS BLEPHAROPLASTY PERFORMED? Upper eyelid surgery is performed under deep sedation if done in the surgical center or can be done under local anesthetic in the office. It depends on your surgeons recommendation as well as the patients personal level of comfort regarding location of surgery. Having the procedure done under local anesthetic in the office does significantly reduce total cost as there are no anesthesia & facility charges involved. A lower blepharoplasty or combination (upper & lower) would need to be done in the facility under deep sedation. With upper eyelid surgery, incisions are hidden in the natural eyelid crease and extend laterally so as to remove excess skin and to prevent an unnatural, “operated” appearance. Lower eyelid incisions are made either along the inner lining of the eye or just below the lower lashes. Excess skin and underlying fat are removed, and the incisions are closed with fine sutures. Early on, incisions are easily camouflaged with makeup and with time fade to the point of imperceptibility in most patients. The benefits of an eye lift include: Corrects droopiness, puffiness and bags Eliminates tired, angry, or sad look Restores the eyes as the focal point of the face Restores eyelid contour Safely and easily combined with other facial plastic surgical procedures FAT REPOSITIONING WITH LOWER BLEPHAROPLASTY SURGERY A traditional lower blepharoplasty typically involves the removal of fat and/or excess skin in the under-eye area. Fat repositioning is not so much a distinct operation as it is a different method of handling the bulging fat under the eye. During surgery, Dr. Thompson or Henstrom surgically distributes a layer of fat over the rim of the orbital bone and advances it into areas of depression or hollowing. By doing so, deep troughs and puffiness are addressed for a well-rested, rejuvenated appearance with no visible scarring. The approach your surgeon will take for under-eye rejuvenation depends not only on the evaluation of the lower lid but also of the cheek region. When patients have lower lid bulging and a pronounced lid/cheek junction (tear trough), simply removing fat will not correct the aged appearance. In such cases Dr. Thompson or Henstrom would perform fat repositioning to smooth the under-eye area for a more natural and aesthetic result. If skin also needs to be removed, this can be through the same fine incision under the lower eyelashes. In many cases, he will also recommend lifting the cheek upward simultaneously to meet the lower eyelid and achieve a more youthful lid/cheek junction. Under correction or over correction are not uncommon so it’s important to see an experienced facial plastic surgeon when it comes to any cosmetic eyelid procedure. LOWER LID SKIN PINCH PROCEDURE For patients concerned with mild to moderate excess skin and crepe-iness under the eyes, a lower lid skin pinch may be recommended by your surgeon as a stand-alone procedure or in conjunction with blepharoplasty and/or browlift surgery. This procedure is best for patients who need more than Botox to smooth under-eye wrinkles and whom skin resurfacing is not a good option for. Patients are typically younger and do not have excess fat under the eyes (eye-bags). A lower lid skin pinch is usually done in-office under local anesthesia and takes approximately 45 minutes from start to finish. Valium can be prescribed to take just prior to surgery to help patients feel more comfortable and relaxed. The skin is then “pinched” or elevated below the lower lashes where an incision is made to trim away the excess skin. It is then closed with fine sutures that are removed 3-4 days following surgery. Mild swelling is typical and resides within 3-7 days. WHAT SHOULD I EXPECT WITH RECOVERY FROM BLEPHAROPLASTY SURGERY OR EYELID LIFT? Ice packs are applied immediately following surgery to minimize swelling and bruising. Sleeping with the head of the bed elevated for several days helps as well. Pain is generally minimal with this procedure, and the sutures are removed three to four days following surgery to prevent suture marks. Although most patients feel ready to return to work within one week, bruising often remains into the second week.

Mid-Facelift

As middle age approaches, the effects of gravity start to become apparent as sagging in various areas of the face. In the region of the cheeks (referred to by physicians as “midface”), this sagging, combined with a gradual loss of facial volume, results in a hollow appearance below the eyes and deepening of the folds that extend upward from the corner of the mouth to the nose. When these changes are mild, significant improvement can be achieved by filling in the hollows and depressions with injectable fillers such as Voluma©. However, for more permanent and significant improvement, the mid-face lift is recommended. The endoscopic mid-face lift is considered to be one of the most significant advances in the field of facial plastic surgery in recent years. Prior to the development of this procedure, surgeons had no reliable or consistent method of managing mid-facial descent. The safe and effective performance of this operation requires an expert knowledge of facial anatomy and advanced surgical training. Dr. Thompson performs this procedure endoscopically (small incisions using a camera), and completed his training in facial plastic surgery with one of the pioneers of mid-facial surgery. HOW IS A MID-FACELIFT PERFORMED? The mid-facelift is performed under deep sedation, often in combination with a forehead lift since the incisions are the same. This procedure is performed endoscopically (with assistance of a camera), and the incisions are completely hidden behind the hairline. The mid-facial soft tissue is released from underlying attachments and restored to a more youthful position using dissolvable stitches. The benefits of the mid-facelift are as follows: Significantly improves deepening crease lines nasolabial folds) extending from the sides of the nose to the corners of the mouth Significantly improves hollowing below the eyes Restores sagging cheeks and early jowls to a more youthful position Offers more permanent correction than injectables or the “thread-lift” can provide Indicated for individuals in their 40s – 50s and older Safe and effective Endoscopic approach allows excellent results with smaller incisions hidden behind the hairline WHAT SHOULD I EXPECT WITH RECOVERY FROM A MID-FACELIFT? Upon completion of the procedure, facial dressings are applied to prevent excessive swelling and bruising. These are removed the following day. Patients are closely followed and sutures are removed in approximately 7 days. We recommend only light activity for the first week to ten days following surgery. Facial swelling is usually slightly more significant than with facelift surgery. Most patients return to work after 2-3 weeks with makeup easily covering any residual bruising.

Forehead Lift

As middle age approaches, age related changes begin to appear in the brow and forehead. Repeated movement of facial muscles causes furrows to develop between the brows and horizontal lines to form on the forehead. Additionally, the long-term effects of gravity manifest as drooping eyebrows and a heavy, tired, or angry appearance around the eyes. Botox® is an excellent treatment for the horizontal forehead and vertical frown lines. A more permanent solution to address both the lines as well as the drooping brow is a forehead lift (also called a brow lift). A forehead lift can restore the brows to a more youthful position, decrease excess upper lid skin slightly, and soften frown lines. Although many approaches to this procedure can be taken, Dr. Thompson uses the least invasive and most advanced technique available – the endoscopic forehead lift. This approach utilizes a camera and small incisions hidden within the hair. HOW IS A FOREHEAD LIFT PERFORMED? Endoscopic forehead lift is performed in the operating room under deep sedation. The incisions are hidden in the hairline, and a camera is used to assist in visualization of important structures. This procedure is often combined with a temporal lift or midface lift, as the same incisions are used for all of these procedures. In addition, blepharoplasty (eyelid surgery) is often performed with an endoscopic forehead lift. The brow is restored to a more youthful position and the frowning muscles are weakened. Restores youthful appearance and position of the brow Long-term or permanent correction of frown lines and creases Can improve eyelid appearance Endoscopic approach allows excellent results with smaller, well hidden incisions One of the most long-lasting surgical procedures Safe and effective WHAT SHOULD I EXPECT WITH RECOVERY FROM A FOREHEAD LIFT? Upon completion of the procedure, a drain and facial dressings are applied to prevent excessive swelling and bruising. These are removed the following day. Patients are closely followed and sutures are removed over the next several days. We recommend only light activity for the first week following surgery. Although severe pain is uncommon, some patients report mild pain shortly following surgery that is controlled by oral pain medications. Most patients return to work after 2 weeks with makeup easily covering any residual bruising.

Temporal Lift

For patients with early signs of midfacial and brow ptosis or sagging, a full endoscopic forehead and midface lift may not be necessary. For such patients, a moderate degree of lateral brow and midface elevation can be achieved with the temporal lift. To use popular jargon, the temporal lift could be aptly renamed “mini mid-face lift.” As with the forehead and midface lift, because a camera is used during the surgery, the incisions are small and hidden within the hair. Recovery is on the order of 7-10 days. Because of the many options available, navigating this decision process can be difficult. During the consultation, Dr. Thompson will perform a comprehensive analysis, and with the input of each patient, an appropriate recommendation will be made. Please visit the endoscopic forehead lift and mid-face lift pages to learn more about the surgical approach and treatable areas for these procedures. HOW IS A TEMPORAL LIFT PERFORMED? The mid-facelift is performed under deep sedation, often in combination with a forehead lift since the incisions are the same. This procedure is performed endoscopically (with assistance of a camera), and the incisions are completely hidden behind the hairline. The mid-facial soft tissue is released from underlying attachments and restored to a more youthful position using dissolvable stitches. Moderate improvement of brow and midfacial agin Endoscopic approach allows excellent results with smaller incisions hidden behind the hairline Offers more permanent correction than injectables or the “thread-lift” can provide Indicated for individuals in their 40s – 50s and older Safe and effective WHAT SHOULD I EXPECT WITH RECOVERY FROM A TEMPORAL LIFT? Upon completion of the procedure, facial dressings are applied to prevent excessive swelling and bruising. These are removed the following day. Patients are closely followed and sutures are removed in approximately 7 days. We recommend only light activity for the first week to ten days following surgery. Most patients are able return to work 7-10 days following surgery with makeup easily covering any residual bruising.

Chin Augmentation

Underlying skeletal structure, including a strong jaw line, contributes greatly to overall facial harmony and aesthetic balance. A receding chin can make a well proportioned nose seem overly large and can also blur the distinction between chin and neck. When a receding chin results from dental malocclusion, consultation with an oral surgeon may be necessary. However, generally speaking, a weak chin can be effectively and relatively simply augmented with an implant intended to give better definition to the chin and jaw line. Chin implants come in various sizes and shapes individually suited to each patient’s unique situation. For example, some are designed to be used as an adjunct to facelift surgery in order to achieve optimal correction of jowling. Others are recommended concurrently with rhinoplasty with the goal of achieving improved balance between the nose and face. Still others are placed in combination with submental liposuction to improve chin / neck distinction. During the consultation, these relationships will be discussed, and Dr. Thompson will make a recommendation based on these factors and each patient’s individual concerns and desires. HOW IS CHIN AUGMENTATION PERFORMED? Chin augmentation is performed in the operating room under deep sedation, often in combination with other procedures. A small incision is made below the chin hidden in the natural crease termed “submental crease.” A deep pocket is created and an appropriately sized and shaped implant is placed. The composition of the implants varies to some degree, but most often, a silastic implant is placed. Silastic is an inert, firm, rubber-like substance that has been used safely in various procedures for many decades. Infection and implant rejection can occur but are rare. Meticulous suturing improves healing and minimizes scarring. Improves facial harmony and aesthetic balance Improves jaw line contour and definition Improves face / neck contrast Ability to customize to each patient’s individual situation Safely performed in combination with almost any other facial plastic procedure WHAT SHOULD I EXPECT WITH RECOVERY FROM CHIN AUGMENTATION? Following surgery, chin tapes are placed and remain for 5 days, at which time sutures are also removed. Pain is generally minimal, but temporary numbness over the incision occurs in most patients. Light activity is permitted immediately following surgery, and all activities can be resumed at 3 weeks.

Rhinoplasty

Because it is the most defining feature of the face, the size and shape of the nose has a significant impact on a person’s appearance. Patients seek rhinoplasty surgery for many different reasons. Some people want a straighter nose while others may want their nostrils narrowed. A large dorsal bump is often of concern as well as the size in proportion to the rest of the face. Furthermore, the nasal tip has a tendency to lose support and droop as a result of the normal aging process. Rhinoplasty (nasal surgery) is performed most often to achieve aesthetic and also functional results. Aesthetically, Dr. Thompson and Dr. Henstrom in Salt Lake City, Utah work to reshape the nose to achieve a more harmonious relationship with the rest of the face. Functionally, cartilage and bone are repositioned or reshaped to improve nasal breathing. The term septorhinoplasty is used when both functional and cosmetic components exist. With dual certification in facial plastic surgery and ear, nose, and throat surgery, both Dr. Thompson and Dr. Henstrom have performed many septorhinoplasty surgeries for patients experiencing breathing difficulties that also desire a more harmonious look. WHO IS AN IDEAL CANDIDATE FOR RHINOPLASTY SURGERY? An ideal candidate for rhinoplasty or septorhinoplasty surgery is typically 16 years of age or older with good to excellent health and realistic expectations. Most candidates include those whom have a significant nasal deformity and/or cosmetic concerns that make them feel self-conscious or unhappy. Ideal candidates are well-adjusted and do not expect rhinoplasty surgery to transform them into someone else, but to correct concerns and restore facial balance. WHAT SHOULD I EXPECT FROM A RHINOPLASTY CONSULTATION AT UTAH FACIAL PLASTICS? Rhinoplasty is generally considered to be one of the more challenging of facial plastic procedures and is an area in which Dr. Thompson and Dr. Henstrom have particular expertise and training. The goals and approach to each individual are unique and depend on many factors discussed at length in a detailed consultation with either surgeon or their Patient Care Coordinator, who often see patients for the initial appointment at no charge. Imaging sessions our also offered at both offices in Layton and Draper, Utah. Dr. Thompson or Henstrom will be able to evaluate the nose as it relates to the rest of the face. A patient may request a reduction in the size of the nose when in reality, the chin makes the nose appear artificially large. In such a case, a chin implant may be recommended in addition to the nasal surgery. Some minor concerns can also be corrected with the use of non-surgical fillers to reshape the nose. Your surgeon will analyze the nose and face then make recommendations based on his knowledge and expertise in the aesthetics of the full face.

Rhinoplasty

ANALYZING THE NOSE The desired nose should complement the other features of the face. The ideal shape comes from an aesthetic concept, which has its roots in the perception of beauty, for either male or female. On the other hand, plastics surgeons and artists have come up with particular proportions and guidelines based on their study of beauty and faces. These guidelines provide surgeons with a baseline for analyzing the face for the aesthetically ideal nose. These are the angles a surgeon needs to consider when assessing the right projection for the nose. Nasofacial Angle If the nasofacial angle is one way to analyze the nose. If the nasofacial angle looks big, this means that the nose is projected far from the face. If the angel is short, the opposite can be true. A skilled facial plastic surgeon can get a good impression on the projection by looking at the nose in profile. Nasomental Angle Often times, it’s a small chin that makes the nose appear larger than it actually is. Surgeons consider the nasomental angle along with others to determine what steps need to be taken for achieving facial harmony. The surgeon also determines whether the lips are properly aligned or linked to other facial parts. Nasolabial Angle An acute nasolabial angle is characterized by a droopy nose. If the nose is uplifted or too short, the nasolabial angle may be obtuse. Columellar Show Ideally, no more than 4 mm of the columella, the area between the nostrils, will be seen at profile. view. Dr. Thompson or Henstrom will also evaluate the nose from a front view, to assess whether the nose is straight or twisted, narrow, normal, or has excessive width. The tip will be evaluated to see if it’s asymmetric, bulbous, or abnormal. The thickness of the skin is also taken into consideration. From the side view, either surgeon can determine whether the nose is too short or long, has a hump or ski-slope, or if it has a pleasant profile in which case the nose fits the patient’s face. Projections are evaluated as well as how much nostril is shown. Considering all aspects and angles of the nose is crucial to the overall success of the rhinoplasty procedure. Most important to both surgeons is the patients desires and concerns when looking in the mirror. He can than provide the best course of action based on a thorough evaluation and discussion regarding the patients goals for rhinoplasty surgery. FORM & FUNCTION As noted above, many procedures are not purely aesthetic but have functional components as well. The patient’s nose should not only look great after the procedure but also has to work well. Your exam will include a thorough look inside to nose for any septal deviation and breathing issues that need to be addressed. Dr. Thompson or Henstrom can then ensure all steps are taken to ensure the nose will work properly and address the patient’s aesthetic concerns. At that time, your surgeons Patient Care Coordinator will provide financial information and take any steps necessary to approve surgery with your insurance carrier if there is a functional component involved. HOW IS RHINOPLASTY SURGERY PERFORMED? Rhinoplasty is performed in the operating room under deep sedation. Depending on the goals of surgery and the anatomic considerations of the individual patient, either an “open” or “closed” approach is taken. With the open approach, a small incision is made on the skin separating the nostrils. This incision heals very well and generally becomes imperceptible with time. With the closed approach, all incisions are made inside the nose. Whichever approach is used, cartilage, bone, and soft tissue are shifted and reshaped to achieve the desired result. Benefits of Rhinoplasty include: Improves harmonization of nose and facial features Improves nasal breathing Can restore nasal appearance and function following nasal trauma Results are usually permanent Safe and effective An in-office non-surgical rhinoplasty option is available for the right candidate. This can be done with the use of a dermal filler to even out the dorsum or add volume or shape to a certain area of the nose. These are typically performed by our Nurse Injectors (Alfie Symes & Beth Sheiner) in both Layton and Draper. If the goal is to decrease the size of any aspect of the nose, surgery would be required.

Rhinoplasty Results

WHAT SHOULD I EXPECT WITH RECOVERY FROM RHINOPLASTY SURGERY? Following rhinoplasty surgery head elevation and an ice pack to the forehead are recommended. If nasal packing has been placed, it will be removed the following day. A nasal cast will be in place and removed one week following surgery as well as any stitches and splints. Significant pain is uncommon, but prescription pain medication is provided for any discomfort that does arise. Patients typically report a general feeling of discomfort and pressure in the face. Most patients are ready to return to school or work after one week, but bruising often remains for about two weeks. Significant swelling is still present at one week when the cast is removed and resolves slowly over several weeks. Beyond this, subtle contour changes will continue to occur for up to one year as swelling continues to resolve. More pre-operative information is given, along with prescriptions, at a pre-operative appointment at least 2 weeks prior to surgery. WHAT ARE TYPICAL RHINOPLASTY RESULTS? Expect to be extremely happy with your rhinoplasty results and the harmonious balance restored to your face. Patients report getting a lot of positive feedback from others who tell them they look great but often are not sure what is different. If a septorhinoplasty was performed, expect to breathe normally again with a significant decrease in previous nasal concerns. It does take time for internal swelling to go down as well, but you will experience significant improvement once all packing and splints have been removed. HOW MUCH DOES A RHINOPLASTY COST? The surgical total greatly varies with each patient but is typically between $2,500 and $7,200. If insurance is involved, the cosmetic portion will likely be lower as it is more cost effective when performing cosmetic and functional nasal procedures at the same time. Jessica sends medical records and documents to your insurance provider after your initial consultation to gain authorization prior to surgery and will contact you regarding your final balance.

Revision Rhinoplasty

Because of its three dimensional nature, the nose is one of the most complex parts of the face. On the outside, it is framed by the mouth, the cheeks, the forehead, and the eyes and can significantly affect the appearance and balance of the rest of the face. In addition to this, the nose has a complex internal structure responsible for breathing, warming and moistening the air that we take in, our sense of smell, and allowing aeration of the sinuses among other things. Too often patients and sometimes physicians do not realize the complex nature of the nose when approaching it surgically. Any surgical approach on the nose that does not take into consideration all of the factors mentioned above increases the risk of developing some type of nasal problem postoperatively. Overly aggressive reduction of a large nose can result in inability to breath through the nose, a nose that doesn’t fit with the face, and a “surgical” look. Any patient considering rhinoplasty or septoplasty surgery should strongly consider choosing a surgeon such as Dr. Thompson whose training and experience reflect a thorough understanding of these principals, and whose practice manages surgical and non-surgical nasal problems on a regular basis. Revision rhinoplasty surgery presents more of a challenge than a traditional rhinoplasty as the presence of scar tissue and, sometimes, lack of cartilaginous support will demand the surgeon have a lot of experience with how to deal with the problems that may be encountered due to the past surgery. With cartilage having been removed in the original rhinoplasty, cartilage often needs to be taken from behind the ear to restore the nasal form. The ear incision is well hidden and there is no change in the shape of function of the ear. Although revision rhinoplasty has special considerations, it is a very rewarding procedures. Surgery time is typically longer for a revision rhinoplasty and typically takes about 5 hours. The mucus membranes revert to their normal size in 1-2 weeks after the surgery but the results continue to evolve over the course of a year, though noticeable improved post operatively.

Necklift

Dr. Thompson sees a considerable amount of patients regarding facial rejuvenation of the face and neck and the amount of facelift surgeries he performs each year is far above the national average. When patients visit him for their initial consultation, they often report deep frustration in the looseness of their jowls, lower face and neck. Aging is inevitable, and overtime the jawline softens into the jowls, the folds around the mouth deepen, and the neck loosens and begins to sag. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. Unfortunately, effects of these catalysts set in far before the inside feelings and symptoms of aging occur, which is why patients often report a deep desire to just look as young as they feel inside. Diet, exercise and healthy living keep us feeling good but it often requires surgery to restore outside features to reflect how one feels on the inside. Dr. Thompson’s facelift technique differs from a typical facelift technique in that it is more comprehensive. A traditional facelift works well for lifting loose jowls but is inadequate for treating significant neck laxity and completely overlooks the mid-face. Dr. Thompson’s preferred facelift is extensive in lifting and tightening the neck, jowls, and mid-face area for long-lasting results. With extensive training as a facial plastic surgeon and 10 plus years of experience performing numerous facelift surgeries, you can trust you’ll receive the best results possible following your facelift surgery in Utah. Additionally, Dr. Thompson’s background in the fine arts enhances his ability to balance the technical and creative aspects of his specialty and assists him in his goal of achieving natural surgical results that enhance each individual’s unique and attractive features. Patients also appreciate his genuine concern for their well-being and satisfaction. He is committed to ethical, caring, and honest treatment of his patients and works very hard to earn and maintain their trust. Although patient care is his primary focus, Dr. Thompson’s academic, research, and teaching abilities have been recognized throughout his career with numerous awards as well as several scholarly publications.

Neck Liposuction

A strong jaw line and a sharp chin / neck contrast contribute to both a fit and a youthful appearance. Excessive deposits of fat under the chin can be congenital (genetically inherited), or the result of weight gain. In some, these deposits remain in spite of losing weight or being thin elsewhere. A “double chin” can detract greatly from an otherwise attractive face. Submental liposuction (removal of fat from under the chin) is performed to restore a more aesthetically pleasing contour to the neck and jaw line. This procedure is often combined with chin implant for those with a receding chin or facelift for those with sagging neck skin. HOW IS SUBMENTAL LIPOSUCTION PERFORMED? Submental liposuction is often performed in the operating room under deep sedation, often in combination with other procedures. It can also be done alone in the office under local anesthetic. Three small incisions – one under the chin, and one behind each ear, are made. A metal cannula under suction is placed into the incisions, and excessive fat is removed. Fine sutures are used to close the incisions. Improves jaw line contour and definition Improves chin / neck contrast Can correct a problem that may be impossible to address through lifestyle changes Safely performed in combination with any other facial plastic procedure WHAT SHOULD I EXPECT WITH RECOVERY FROM SUBMENTAL LIPOSUCTION? Following surgery, a cotton dressing is placed and removed the following day. Bruising is generally minimal and resolves within 1 to 2 weeks. Light activity may begin at 1 week with full activity resumed by 3 weeks.

Facial Nerve

The facial nerve, also known at the seventh cranial nerve, splits into five branches that combined, allow for facial expression and function. Facial paralysis occurs when one or more branches of the facial nerve become impaired. This often results in the loss of certain facial expressions and/or abilities, such as chewing, swallowing and even speaking. Facial paralysis is often caused by multiple factors and requires a specialized treatment plan for each individual patient. As Utah’s leader in facial nerve reconstruction, Dr. Henstrom provides a multidisciplinary treatment approach to prevent unwanted eye complications, restore facial movement, and improve the aesthetic appearance of the face. WHAT ARE THE CAUSES OF FACIAL PARALYSIS? Facial paralysis is caused by any condition that damages or inhibits the facial nerve in any way and can come on suddenly or happen gradually over a certain amount of months. Depending on the cause, symptoms can resolve rather quickly or may last for an extended period of time. Because the facial nerve is so intricate, there are variety of causes. The most common conditions leading to facial paralysis include: Bell’s palsy Bell’s palsy is considered the most common cause of facial paralysis, according to the National Institue of Neurological Disorders and Stroke. This condition involves inflammation of the inner ear that results in pressure to the facial nerve, thus causing facial paralysis. The cause for Bell’s palsy is unknown but may be related to a viral infection (including herpes, influenza and respiratory tract infections) of the facial nerve. The majority of Bell’s palsy patients (approximately 70 percent) recover within six months though others may experience symptoms long-term in cases where the nerve damage is more severe. Common symptoms of Bell’s palsy: Partical or complete paralysis of one side of the face (1% of cases experience full facial paralysis) Sensitivity to noise Pain in the inner ear at the onset Altered sense of taste Difficulty eating Difficulty speaking Dry eye and watering on the side experiencing paralysis if unable to fully close Stroke A stroke is a serious condition that occurs when the blood supply to the brain is suddenly cut off. If the blood supply is restricted for long enough, brain cells can become permanently damaged. There are a few ways facial paralysis can occur during a stroke. In the case of an ischaemic stroke, in which the the blood an oxygen supply to the brain has been reduced due of a blood clot, the lack of oxygen causes damage to the brain tissue and nerves. Seventy percent of people diagnosed with a stroke experience an ischaemic stroke. During a haemorrhagic stroke, a damaged or weakened artery may burst and bleed, which puts pressure on the nearby nerves, which can lead to facial paralysis. Common symptoms of a stroke: Facial paralysis Weakness of an arm, leg or possiblyl both Problems swallowing Problems with balance and coordination Problems with communication Headache and confusion Numbness in a part of the body Possible loss of consciousness Trauma Common head and neck trauma occurrences include car and bike accidents, falls, physical violence or assault, as well as home and occupational accidents. The facial nerve travels through the temporal bone. Skull fracture to the temporal bone often causes facial paralysis when the nerve is damaged or impaired from the pressure of swelling afterwards. Though rare, trauma can also occur during birth from the pressure of forceps or bone in the mother’s pelvis. Common symptoms of trauma related nerve damage: Dry eye and watering on the side experiencing paralysis if unable to fully close Difficulty eating and drinking Difficulty speaking Inability to carry out facial movements and expressions Tumors Tumors can lead to facial paralysis with malignant tumors invading the facial nerve or with benign tumors close to and compressing the facial nerve. The most common tumors leading to facial paralysis include acoustic neuroma, facial neuroma and tumors in the parotid gland region. Common symptoms of tumor related nerve damage: Progressive or recurrent facial weakness Hearing loss Neck mass Other Causes Iatrogenic injury, which occurs during surgical procedures of the face and neck in which the facial nerve is compromised. Guillain Barre Syndrome, an autoimmune disorder in which the body’s immune system attacks part of the peripheral nervous system. Lyme Disease is a bacterial infection transmitted to humans via infected ticks and can lead to facial paralysis. Ramsay Hunt Syndrome is a virus of the facial nerve and a more severe form of facial paralysis.

Facial Nerve Treatment and Repair

An extensive evaluation with Dr. Douglas Henstrom of Utah Facial Plastics is recommended initially to determine cause of facial nerve damage if previous diagnosis has not been made. Based on symptoms, he may recommend one or more of the following tests: Hearing Test A hearing test can help determine whether or not the nerve disorder has involved the hearing mechanism. Tear Test Testing the eye’s ability to tear is helpful in determining the location of facial nerve damage. X-Rays Scnas can help diagnosis infection, tumor or bone fractures, such as a CT scan or MRI. Balance Test Testing the balance system with an ENG (electronystagmography) can help determine location of nerve disorder. Electrical Tests Three electrical include a nerve excitability test (to determine extent of nerve fiber damage), electroneurography (measures muscle response to electrical stimulation) and electromyography (measures responses to determine if nerve and muscles are recovering). WHAT TREATMENTS ARE AVAILABLE FOR FACIAL NERVE REPAIR? As a double board-certified facial reconstructive surgeon and facial nerve specialist, Dr. Henstrom sees patients from all over the country for surgical and non-surgical treatment of facial paralysis. Dr. Henstrom is incredibly thorough during the consultation process and takes in to account both the aesthetic and functional components when determine the best course of action for treatment. There are a variety of non-surgical and surgical approaches Dr. Henstrom takes to provide a symmetrical and functional outcome and his innovative treatment plans often include a combination of both. Nerve repair or nerve grafts Direct microscopic repair is typically the best option in cases where the nerve has been cut or removed. Regeneration occurs at approximately the rate of one millimeter per day. Muscle Transposition Certain muscles can be transferred to other areas of the face to improve symmetry. Moving one of the jaw muscles to the corner of the mouth can even out the function and animation of the mouth. Eyelid, oral and facial procedures Weight placement in upper eyelid to help it close more fully Lower eyelid tightening surgery to reduce tearing and improve symmetry Nasal surgery to improve breathing Browlift to improve eyebrow symmetry Mid-face or facelift to lift drooping features and improve symmetry Lower lip wedge excision to improve symmetry of lips Botox to certain muscles in the face to improve symmetry REVIEWS “I was referred to Dr. Henstrom at the worst time of my life. I was 2 years into dealing with Ramsay Hunt Syndrome dealing with facial paralysis and severe pain. Doctor took the time to listen. He was heaven sent…he in turn helped me with the pain, paralysis, and he referred me to necessary specialists when I would talk to him about other issues.” AI “I met Dr. Henstrom several years ago, when I discovered he could use Botox to help with facial paralysis. Years ago, I had a procedure to remove lymph nodes due to melanoma. My smile was affected because of nerve damage. I’ve been getting Botox on my chin area to help straighten my lopsided smile, and it works. I didn’t know how much my self-esteem suffered because of my lop-sided smile, but now I feel so much better and have more confidence. I’ve never had a doctor as caring as Dr. Henstrom when it comes to really wanting his patients to feel good about themselves. He gets it.” EH SCHEDULE YOUR FACIAL NERVE CONSULTATION To learn more about the advanced treatment options for facial nerve repair, call (801)776-2220 or contact us HERE to schedule your consultation with Utah’ facial nerve specialist, Dr. Douglas Henstrom. Skype and FaceTime consultations are available for out-of-town patients.

Mohs Reconstruction (Skin Cancer)

A particularly common problem here in the mountain west is skin cancer. With so many sunny days each year as well as so many opportunities for outdoor enjoyment, it seems that almost everyone has either personal or indirect experience with some form of skin cancer. Reconstruction of facial defects following removal of skin cancers can be a challenging problem, but is something that Dr. Thompson specializes in and greatly enjoys. The pictures on this page are examples of various defects before and following reconstructive procedures. We provide these partly for your education, but also hopefully, as a strong motivator for appropriate skin care and protection. Mohs Reconstruction is the term used to describe a reconstructive procedure of the face following a Mohs surgery to remove certain types of skin cancer on the face- where skin cancer most commonly occurs. Mohs surgery has an impressively high cure rate and through a Mohs reconstruction, the final esthetic outcome can be greatly improved. Dr. Thompson sees hundreds of cases each year with referrals from many dermatologists along the Wasatch front who have performed a Mohs surgery and seek repair for complex situations. If you have a sore or lesion that is painful and/or itchy and isn’t healing, consider visiting one of the following dermatologists for evaluation: Dr. Payam Tristani-Firouzi Swinyer-Woseth Dermatology Dr. Bradley Summers Dr. John Robison Dr. Joseph Jensen If mohs surgery is required, Dr. Thompson would see the patient the same day following the cancer excision to discuss options and schedule the repair for as soon as possible. Our medical staff then contacts the insurance provider, if patient is insured, to verify benefits and obtain authorization if needed. If the repair is simple, the dermatologist may close at the same time unless the patient requests Dr. Thompson for the repair due to his specialty in the aesthetics of face. Mohs reconstruction can be done in the office under local anesthetics in some cases and others must be done in a surgical center under general anesthesia. Some cases are optional and up to the preference of the patient. Repairs of facial cancer defects that have been created using the Mohs technique often utilize healthy adjacent skin flaps or skin grafts. Large areas occasional need to be repaired using free tissue transfer, ie skin, muscle, and/or bone from a different part of the body to fill the defect. The process can be emotional, as well as physically, difficult as areas larger than expected are sometimes removed from the face. When patients, especially younger patients, come in for an initial exam following the cancer excision, there is often great concern that their facial features will ever be restored back to how they were prior to skin cancer. Through various Mohs techniques, Dr. Thompson is able to reconstruct large areas that overtime, show little to no sign of previous trauma. Sometimes multiple procedures are beneficial to obtain maximum results and speed the healing process. Steroid injections are sometimes used to bring swelling down, areas can be smoothed with dermabrasion, and occasionally a scar revision procedure is done, if needed, to repair previous scarring. Dr. Thompson also sees many patients with previous Mohs surgery specifically for scar revision as they were not happy with the aesthetics of the original scar. Dr. Thompson stresses the importance of proper daily skincare to all patients, especially those with a history of skin cancer. Sunscreen with an spf of atleast 30 or higher with the ingredients zinc and titanium oxide (physical blockers) is important to apply daily, especially to areas of concern, and may need reapplication on days patients are getting multiple hours of sun exposure. With any incision, patients need to be vigilant about daily sunscreen use for at least one year for minimum scarring. Please see our skin care section for more details.

Facial Trauma

Nasal fractures are particularly common and an injury that Dr. Thompson is often called upon to manage. Ideally, facial fractures are treated within one to two weeks, but sometimes more involved surgical procedures are required when displaced bones have been allowed to heal. Facial fractures and/or facial lacerations are commonly suffered during motor vehicle accidents, fights, domestic violence, athletic events, animal bites, etc. Facial trauma frequently involves the jawbone, cheekbone, eye socket, and/or brow and requires realignment of the bone segments and fixation for proper healing. Facial lacerations can cause scarring, facial nerve damage, salivary duct transection, tear duct injury, or even loss of a particular body part. It’s important to seek immediate medical care in any of these situations. If surgery is necessary, a detailed plan and patient instructions will be established with Dr. Thompson in the office prior to surgery and scheduled in an appropriate time for optimal repair.

Scar Revision

Any time there is an incision or cut in the skin, there will be a scar. But many variables can affect the severity of scarring, including the size and depth of the wound, the thickness and color of ones skin, the direction of the scar, location, and the blood supply of the area. While early care and closure in the emergency room is highly important, permanent scarring that results can be difficult to live with and leave one feeling self conscious about their facial appearance. Patients typically seek revision when a scar is wide, red, raised, sunken, or is distorting certain parts of their face, such as the eyes or lips. Such scars typically result from accidents, burns and injuries but can also come from acne or certain surgical procedures. As a dual board-certified facial plastic surgeon, Dr. Scott Thompson is highly experienced with scar revision in all skin types. By employing an individualized approach to treatment, Dr. Thompson can dramatically improve the appearance of scarring and provide you with an increased level of self-confidence. IS SCAR REVISION TREATMENT RIGHT FOR YOU? It’s important to visit at one of our several Utah locations with Dr. Thompson during a complimentary consultation to discuss your concerns and determine whether or not you are a good candidate for scar revision treatment. Dr Thompson will perform a thorough examination and review your medical history at that time as well. He will then discuss possible treatment options for scar revision that will best help you achieve the best outcome possible. It’s important to remember that it’s typically best to wait at least one year from the date of injury to allow the body enough time to heal. That is when Dr. Thompson can best determine treatment options for revision and provide realistic expectations. WHAT TREATMENTS ARE AVAILABLE FOR SCAR REVISION? Different types of scars respond to different treatments. Keloid scars result from the overproduction of collagen and tend to grow beyond the edges of the wound or incision. Hypertrophic scars, on the other hand, do not grow beyond the edges of the would but are thick, raised, and may also restrict certain facial expressions. Both hypertrophic and keloid scars can often be treated with steroid injections alone. The process may take up to a year with a series of injections during that time frame. If they do not heal on their own through steroid injections, Dr. Thompson will often remove the excess scar tissue surgically and may reposition the incision so it heals in a less noticeable pattern. This is typically done in-office under local anesthetic and is considered a minor outpatient procedure. You may also receive steroid injections during surgery and post surgery in certain intervals for up to two years following initial treatment. This will help prevent the scar from reforming, though keloids have a tendency to recur and may even come back larger in size. There are many other techniques Dr. Thompson employs for various facial scars. including z-plasty, which is essentially moving the scar from one area to another, usually in a natural fold or crease, to make it less visible. Skin graft or flap surgery involves taking healthy skin adjacent to the wound, or from an entirely different part of the body, and covering the injured area. Surgery is successful when new blood vessels and scar tissue form in the injured area. Dermabrasion, micro-needling, and/or our fractional CO2 laser are all ablative techniques that work to reduce the visibility of scars by resurfacing the area and make “rough or elevated” scars less prominent. Such techniques work very well for acne scarring among other types of scars. Also beneficial for acne scars is Bellafill, an injectable that adds volume under the skin to lift and smooth out pitted acne scars to the level of the surrounding skin. Other hyaluronic acid fillers, such as Restylane, may be used to fill facial scars as well. Because scars are highly individualistic, more than one procedure and/or technique may be employed to provide maximum improvement. Recovery time will vary depending on your treatment plan and can be further discussed at your initial consultation with Dr. Thompson.

Mole Removal

Moles come in various sizes, shapes, and colors. While most are benign, certain types are at increased risk for malignant transformation – meaning development of skin cancers such as melanoma. Any significant change in any feature of a mole warrants further investigation and sometimes removal of the mole. If you have a mole that has changed significantly or is exceptionally large, evaluation by Dr. Thompson or a dermatologist can be helpful in determining whether or not a biopsy is warranted. These types of evaluations and procedures are typically covered by insurance.

Congenital Deformities

Dr. Thompson also specializes in reconstruction of the face and sees patients with many congenital deformities, such as cleft lip repair and microtia. Cleft lip repair is the surgical correction of the cleft lip birth deformity. This procedure is typically performed around 3-6 months of age and commonly involves repairing nostril asymmetry (tip rhinoplasty) as well. Repairs can be done at any age but the it’s typically best to perform the repair while still small and prior to age of awareness. One particular area of interest for Dr. Thompson is microtia reconstruction. Microtia, or congenital malformation of the ear, is a relatively uncommon problem in the United States, but much more common in several South American countries. Since these patients are born without an ear, or only a small remnant, reconstruction is a multi-stage endeavor that requires patience and dedication by both the surgeon and the patient. A few pictures are included below. For more information about our HUGS foundation please visit helpusgivesmiles.org or visit Dr. Thompson’s Medical Mission page. Our organization is dedicated to improving the lives of children, and we invite you to consider making a donation to this worthy cause with the assurance that all funds are used to directly benefit underserved children.

Otoplasty

Otoplasty, or ear pinning surgery, is the surgical reshaping of the outer ear to correct deformities or improve the aesthetic appearance. Otoplasty surgery is most commonly performed to correct overly prominent or protruding ears. Ear pinning surgery is an outpatient surgery that can be done under light sedation in the surgical center or under local anesthetic in our office. Dr. Thompson and Henstrom see many children, adolescents and adults concerned about their protruding ears. Many report years of bullying with cruel nicknames like “Dumbo” & “Mickey Mouse” or have parents looking to correct the problem before the bullying begins. Even if only mildly distorted, the impact can be quite harmful. Our surgeons take great interest in helping young children and adolescents to feel more confident and self-assured through otoplasty surgery. On top of 10 plus years of experience with otoplasty surgery in private practice, both surgeons have also traveled to South America frequently to perform ear surgery for children born with Microtia, a congenital deformity where one or both ears are underdeveloped. Many of these children and adolescents have experienced ostracization in their community and/or within their family units. Without the work that our surgeons and team provide, they would otherwise have no options. You can learn more on Dr. Thompson’s Medical Mission page. WHO IS AN IDEAL CANDIDATE FOR OTOPLASTY SURGERY? An ideal otoplasty candidate is at least 5 years old with ears that have reached full size. It is often desirable to consider this surgery before children start Kindergarten or first grade. By this age, the child has a personal interest in improving his/her appearance and is more motivated to comply with pre and post-operative instructions and actually look forward to the procedure. An idea candidate also has good to excellent health and is desiring this procedure to improve their quality of life. WHAT SHOULD I EXPECT FROM A CONSULTATION? Dr. Scott Thompson and Dr. Douglas Henstrom, both double board certified facial plastic surgeons in Utah, have extensive experience performing otoplasty surgery. You and/or your child’s concerns will be discussed as well as the goals and motivations for surgery. Your surgeon will make sure this is something the potential patient is desiring will strive to make this process as comfortable as possible, especially for young children. And exam and health history review will also take place at this time as well. Your surgeon will then examine the structure of the ears relative to the head and determine candidacy for otoplasty surgery. The procedure will be discussed in detail with all risks and benefits evaluated at that time for you to make an well informed decision. Both surgeons advise no aspirin, ibuprofen products, Vitamin E and certain herbal medications before surgery, as these medications can cause increased bleeding and/or bruising. More information is given at a pre-operative appointment 2 weeks prior to surgery. The Patient Care Coordinator will then provide a detailed quote for the surgical cost as well as anesthesia and facility if applicable. They can also help facilitate the next step in the process and/or provide additional resources, such as before and after photos, articles, educations videos, etc. HOW IS OTOPLASTY SURGERY PERFORMED? Under light sedation or local anesthesia, incisions are made along the back of each ear, in the natural fold where the ear is joined to the head. The skin is loosened and the cartilage is reshaped with sutures positioning the ears in a natural position, closer to the head. When a satisfactory result has been achieved, a dressing is placed over both ears and any necessary prescriptions can be started. WHAT ARE THE BENEFITS OF OTOPLASTY SURGERY? Effectively and permanently improves position of the ears Can be performed under local anesthesia or light sedation (in-office or surgical center) Highly effective with low complication rate Typically offers a real emotional boost, in addition to its cosmetic benefits HOW LONG IS RECOVERY FROM OTOPLASTY SURGERY? Soft dressings are placed over both ears following surgery and removed the following day. Most patients report mild discomfort and may experience slight disruption in sleep patterns if accustomed to sleeping on their side. It is important not to put any pressure on the ear areas for approximately one week following surgery. Headbands are given in the office for patients to wear continually for five days and then just at bedtime for an additional 7 days. This helps hold the ears in place and protect them during the recovery process. The sutures are removed one week after surgery and steri-strips are applied for an additional 3-4 days.

Split Earlobe Repair

Split ear lobe is exactly what it sounds like and is the separation of the skin from the point of piercing down through the base of the ear lobe. It most commonly occurs due to the trauma of heavy or dangling earrings that create a slit in the ear lobe that overtime, extends to the base of the lobe. Catching a hoop earring in a comb when combing the hair or having a small child grab it are two common causes along with heavy pendulant earrings and infection. Although most common in women, Dr. Thompson see’s a considerable amount of males for gauged earlobe repair as well. PROCEDURE The procedure is minimally invasive and typically performed under local anesthetic in any of our three locations. Dr. Thompson makes incisions to “freshen” the wound edges and the closure is performed in a zig-zag fashion to strengthen the area from splitting again. Patients return 3-4 days post procedure for suture removal. RECOVERY Patients report minimal pain with split lobe repair but pain medication is typically given in case of discomfort. Antibiotics are also prescribed to prevent infection. Aerobic activities should be avoided for one week following surgery and it’s important to avoid bending, lifting or straining during that time as well. Once sutures are removed, a steri-strip dressing is added to reinforce the closure while healing takes place. Six weeks following the procedure when the incision is fully healed, Dr. Thompson than pierces the ear again if the patient desires. This is also done under local anesthetic so there’s little to no pain involved.