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Laurence O’Halloran MD
Timothy Egan MD
Heinz Scheidemandel MD
Antonio Cachay MD
Sarah Blank MD

Chin Augmentation

20 Jan 2015 
Fairfax VA Chin Augmentation

Chin augmentation using surgical implants can alter the underlying structure of the face, providing better balance to the facial features. This operation is often, but not always, performed at the time of rhinoplasty to help balance the facial proportions. Chin augmentation may be achieved by manipulation of the jaw bone (mandible) and augmentation utilizing this technique usually provides a more dramatic correction than with the use of prosthetic implants.

Facelift

20 Jan 2015 

Facelift surgery, or a rhytidectomy, is designed to restore a more youthful appearance by removing major wrinkles and sagging skin. It involves tightening of the facial and neck muscles as well as the removal of any excess skin.

The skin begins to wrinkle and sag as a result of age, sun exposure and genetics. Children and young adults have smooth, round faces due to evenly distributed fatty tissues in facial contours. Over time, the skin sags and folds are the chin, jawline and neck become prominent. Not only does a facelift improve facial appearance but also has a dramatic effect on the neck, enhancing its contour and profile.

A facelift can make a patient look 5 to 10 years younger.

Dramatic as the end results are, this is not a simple procedure. It requires a week to 10 days of recovery.

Before Surgery

We will evaluate your medical history in order to determine your overall health.

Dr. Feinfield will discuss with you how your face can look and what you can expect from surgery. Our objective is to create a natural appearance that is pleasing to you. Before and After photographs will reveal what the surgery has accomplished.

Preoperative Instructions: Avoid drugs that contain aspirin several weeks prior to surgery to minimize excess bleeding. You may be required to take antibiotics to prevent infection. You may be instructed to shampoo your hair the night before surgery. A small amount of hair may be shaved around your ears and temples.

The Procedure

A facelift is frequently performed in conjunction with blepharoplasty (eyelid surgery), forehead lift, chin augmentation, and/or liposuction, to create an overall rejuvenation of the face. The procedure can be repeated as gravity continues its effects after the first surgery.

Facelifts are performed in outpatient surgical centers or in an accredited physician’s office. Local anesthesia with intravenous sedation is most commonly used, with premedication to help you relax. General anesthesia is generally not required but can be used if desired.

The surgeon will make incisions inside the hairline at the temple, in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. Excess skin is removed and sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck. Incisions are closed with small sutures.

The procedure may take up to 5 hours depending on whether any other procedures are performed at the same time.

Post Operative Care

It is necessary to have someone drive you home and stay with you for the first 24 hours. Initially you will have a large dressing wrapped around your head. You may have surgical drains attached to bulbs hanging at your neck. These will be removed in approximately 24 hours. Stitches around the ears will be loosened or removed in a few days. The scalp sutures will be removed in 7-10 days.

To minimize scarring, the doctor may remove the sutures in stages. Scarring fades quickly. Swelling and discoloration decrease within two weeks. Tightness in your face will be present for several weeks and there may be slight changes in your hair pattern around the incision.

We recommend that you avoid the sun for several weeks after surgery.

Complications following facelift are rare. These include bleeding, infection, loss of skin behind the ears, facial nerve injury, discoloration of the skin, numbness, asymmetry and scarring. Infection is rare due to the large blood supply to the face. As mentioned, the risk of bleeding is greater if you take aspirin or blood thinners within 2 weeks of the surgery. The risk of wound complications increases in diabetics, persons with a history of radiation, autoimmune and collagen disease as well as in smokers.

By following pre- and post-operative instructions, you will minimize potential problems.

Recovery: What to Expect

In the weeks following surgery, the facial skin and area around the ear may be numb. There may also be some temporary discoloration as healing begins, which may take a few months to disappear. Occasionally, the facial nerve is bruised during surgery, resulting in temporary loss of function or sensation. However, actual permanent damage to the facial nerve is rare.

The healing process is gradual, so you will not notice final results for up to 6 months. A single procedure often achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.

Endoscopic Browlift

20 Jan 2015 

Drs. O’Halloran and Egan perform brow and forehead lifts to raise eyebrows and reduce ridges and furrows on the forehead, thus creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries.

Newer techniques now allow us to perform Forehead Lifting through small incisions in the scalp by using an endoscope and specialized instruments. This accelerates the healing process ad avoids long open scalp incisions.

Post-Operative Information

Antibiotics may be prescribed for several days following surgery. Sutures are generally removed within one week. Swelling and some bruising may occur, which should subside within a few weeks. Women will be allowed to use eye cosmetics up to two weeks after surgery. You can proceed with your normal daily activities within 1-2 weeks. A final evaluation may occur within several months from the initial surgical procedure.

Insurance

Your insurance company may pay for part or all of the cost of surgery if the procedure is performed as a result of visual impairment. Because every insurance carrier is different, it is recommended that you check with your own insurance company to determine the level of coverage.

Eyelid Surgery / Blepharoplasty

20 Jan 2015 

Eyes are a prominent facial feature. It is the surrounding skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes.

The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and older than we really are. These changes in appearance can cause emotional distress and sometimes even visual impairment. An eyelid lift, or blepharoplasty, is designed to restore a more youthful appearance to your eyes. It may involve the upper lids, the lower lids, or both.

eyelid

New and Traditional Techniques

Traditional Blepharoplasty: An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed

The Transconjunctival Approach: This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated.

Laser resurfacing of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not affect the fat around the eyes and may even accentuate it.

Please ask your doctor if you have any questions about which procedure is right for you.

The Surgery

Local anesthesia is given around the eyes. An intravenous line is started so that sedation may also be given. During the procedure you will be awake but comfortable and relaxed. General anesthesia is rarely used.

This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours.

Complications are unlikely when performed by a surgeon with experience in blepharoplasty. These include: bleeding and swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, double vision and dry eyes.

Recovery: What to Expect

The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after the first day. Some vision blurring is normal.

The stitches will be removed in 4-5 days. Swelling and bruising will persist for about 10 days, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new look within approximately 10-14 days. It may take about 6 months for the scars to lose their redness.

Wrinkling will recur later in life; however it is unlikely that the “bags” will recur because the fat has been removed. Deeper wrinkles around the outer eye extended onto the temple are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing.

Nasal Surgery / Rhinoplasty

19 Jan 2015 

nasal-surgery

Drs. O’Halloran, Egan, and Scheidemandel performs rhinoplasty in order to reshape the nose. Appearance can be improved for those people who are dissatisfied with the shape and size of their nose. Nasal reconstruction was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone or cartilage.

Reasons for Surgery

Reasons include reducing the size of the nose, removal of bumps as well as improving the angle of a nose. Conditions may be natural or due to external trauma to the face. This operation will also help patients who have difficulty breathing. The operation can be performed on all age groups, including teens and the elderly.

Before Surgery

A medical history along with a careful examination is conducted in order to evaluate your general health. We will discuss with you the way your nose can look in relation to your other facial features. Digital photographs and computer imaging allow Drs. O’Halloran, Egan, and Scheidemandel to evaluate the appropriate procedure to achieve the desired results. Pre-operative instructions may include the elimination of certain drugs that contain aspirin in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed before surgery to prevent infection.

Method of Surgery

Surgery is usually performed under IV sedation, which is both extremely comfortable and results in less swelling and bruising than general anesthesia. In most cases involving a reduction in shape or size of the nose, angle or removal of a hump, the skin of the nose is separated from the underlying skeleton of bone and cartilage. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum may benefit by correction of this problem. The incisions are placed inside the nose, unless the surgeon uses an open approach, in which case the incisions are made across the tissue between the nostrils. In cases where the nostrils flare, the surgeon may make an incision at the junction between the nose and the skin of the upper lip to narrow the flared appearance. It is not unusual to combine rhinoplasty with chin augmentation to improve the profile.

Post-Operative Information

The recovery takes one to two weeks. Most people resume their normal activities within a week or two. Following surgery, a lightweight splint is applied to maintain the new shape of the nose. The splint is removed within a week. Nasal splints may be inserted at the time of surgery to protect the septum. These are removed within a week. There is always some stuffiness of the nose, especially when work has been done on the nasal septum.

Pain is minimal and is controlled with medications. Bruising occurs around the eyes, but begins to fade within a few days. Discoloration usually disappears in two weeks.

Insurance

Your insurance company may pay for all or part of the costs associated with your surgery if it is performed as a result of nasal obstruction. It is recommended that you check with your carrier to determine if there is coverage.

Cosmetic facial fillers

19 Jan 2015 

restylane-treatment

The simplest and least expensive method of facial contouring is by the use of a temporary, injectable filler. The injection of temporary fillers is performed in the office, with or without a topical anesthetic or nerve block, and the procedure takes about 5 to 15 minutes. Collagen is the old favorite, with Zyderm and Zyplast being the most commonly used brand of collagen. This product typically lasts from 2 to 4 months. A skin test is required prior to injection of collagen since about 4% of the population will have an allergic rection to the bovine (cow) collagen.

Restylane and its thicker counterpart, Perlane are both made from hyaluronic acid, a substance that naturally creates volume in the skin. Since this product does not involve the use of foreign substances, allergies are extremely rare and a skin test is not required. Additionally, the results last about twice as long as collagen, and in some instances, Restylane and Perlane can last for up to 12 months. As an alternative to injecting a substance that your body will eventually absorb, another class of fillers involves injection of a permanent substance. Once this foreign substance is injected, your body will naturally form scar tissue around it to protect it from entering other areas of the body. This scar is made of collagen, which as we know is a filler all by itself. However, since the foreign substance is not biodegradable, it will stay in your body presumably forever. Although this may seem like an ideal permanent solution to facial contouring, your body’s reaction to the foreign material is unpredictable and some of these products can be toxic. While many people will do fine with injection of a foreign, non-biodegradable filler, some people will form excessive scars, creating firmness, lumpiness, inflammation, and migration of the substance. And since it is permanent, it is very difficult to remove if problems do arise. There are nearly 20 types of permanent injectable fillers, but the most commonly used are Silicone and Artecoll (made from the same chemical as plexiglas), neither one of which is legal in the United States.

Botox® Cosmetic

19 Jan 2015 
Botox in Fairfax VA

botox-injection

BOTOX® Cosmetic treatment is a revolutionary approach to reversing the affects facial wrinkles. Crow’s feet, worry lines and laugh lines can all be a thing of the past. These are referred to as dynamic wrinkle lines and all are treatable with this procedure. Cosmetic denervation is the process of injecting BOTOX® Cosmetic into the tiny facial muscles that create the wrinkles.

Before Treatment

To better understand your overall health, we will evaluate your medical history prior to treatment. In addition, a complete examination of your eyes is made in order to decide the most effective injection sites. All issues and concerns will be discussed.

The areas that will be treated are marked and digital photographs are taken in order to determine the amount of improvement after treatment.

The BOTOX® Cosmetic Procedure

BOTOX® Cosmetic injections are performed without anesthesia because it is virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long term use of the injections leads to a longer duration of each treatment’s effect. Patients over the age of 65 may not experience as dramatic of results. BOTOX® Cosmetic is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

Post-Treatment Information

After the treatment patients may experience slight bruising around the area that quickly fades. Normal activities can be performed immediately. Possible side effects are temporary weakness of nearby muscles or in rare cases an eyelid may droop. BOTOX® Cosmetic is completely reversible so any side effect is only a temporary condition. The doctor will explain all risks associated at the time of your consultation.

Balloon Sinuplasty

19 Jan 2015 
Fairfax BALLOON-SINUPLAST

Fairfax ENT is proud to offer in office Balloon Sinuplasty.

A clinically proven, minimally invasive technology for treating chronic sinus inflammation without the need for surgery or anesthesia. The Balloon Sinuplasty™ system by Acclarent™ uses a small catheter and balloon to quickly open and expand blocked sinuses.

Sinusitis is one of the most common chronic health problems in the U.S., afflicting 37 million Americans each year. Patients suffer headaches, congestion, fatigue and other symptoms. This condition significantly impacts an individual’s physical, functional, and emotional quality of life.

Historically, sinusitis patients were limited to two treatment options: medical therapy such as antibiotics and topical nasal steroids, or conventional sinus surgery such as Functional Endoscopic Sinus Surgery (FESS). Medical therapy can help alleviate symptoms as many as 80% of patients but is inadequate for the rest. For them, sinus surgery is often the best option. However, FESS is a conventional surgery that requires bone and tissue removal in order to open up blocked sinus passageways. In lieu of a desired treatment, approximately 900,000 patients each year elect to live with painful sinus conditions.

Northern VA Balloon Sinuplasty

Balloon Sinuplasty of the Frontal Sinus

 

There is an alternative solution in endoscopic sinus surgery with the Balloon Sinuplasty™ technology by Acclarent. A small, flexible balloon catheter is placed through a nostril into the blocked sinus passageway. The balloon is then inflated to gently restructure and open the sinus passageway, restoring normal sinus drainage and function.
Drs O’Halloran and Egan have been performing Ballon Sinuplasty for over 5 years and are now offering the same procedure in the convenience of an office setting. This new technology offers a fast, safe and effective alternative to surgery or medication. Studies have shown that Balloon Sinuplasty is:

  • 91.6% functional patency rate at one-year
  • No serious adverse events at two-years
  • Symptom improvement for 85% of patients across the two-year-postsurgery period
  • 95% of patients who have had Balloon Sinuplasty say they would have it again.