facial surgery
by Jenny Bryan
keyhole surgery
To avoid thin scars above the hairline, some people prefer keyhole cosmetic surgery. The operation most commonly carried out in this way is the forehead lift. Three or more stab incisions are put through the skin just behind the hairline of the forehead, instead of making an ear-to-ear incision. A tiny lighted telescope is inserted through one of the incisions and small instruments through the others. The surgeon then pulls up the muscles under the forehead to get rid of frown lines. The operation can be extended to tighten the skin around the eyes and reduce crow's feet.
baggy eyes
Folds in the upper eyelids and creases in the lower lids – both due to a loss of elasticity in the skin and slackening of muscles – can be trimmed out in an eyelid reduction operation called blepharoplasty. Incisions are made in the creases of the upper lids and just below the lashes in the lower lids, and excess skin and sagging muscle removed, together with any surplus fat.
The operation won't get rid of skin folds extending on to the cheeks or remove crow's feet, but it will make eyes look more alert and reduce morning swelling.
Typical price for blepharoplasty – about £3,000, significantly less if it's included in a facelift.
bat ears
Billy Walker put up with the teasing over his sticking-out ears throughout his adolescence. But, when he got an interview to be a TV presenter, he decided to splash out £2,000 on an operation to flatten out his bat ears. He watched a computerised before-and-after animation of how the surgery would change his face, and was convinced that it would put an end to the jug-ear jokes.
About 1-2% of the population think that one or both of their ears are too prominent. If parents notice their child's ear is prominent soon after it is born, the cartilage can be remoulded by splinting it. But, by the age of six months, the cartilage is too hard for splinting and, from then on, surgery is the only option.
The surgeon makes an incision behind the ear, adjusts the shape of the cartilage to create a fold in the outer ear, and then stitches it back so that it lies flatter against the head. Bandages and then smaller dressings protect the ears while they are healing and until the stitches are removed, 5-10 days after surgery.
When Billy's dressings first came off, he was devastated that one ear had been left more prominent than the other. But as the swelling went down and he got used to his new look, he decided that the operation had been a great success. Soon after, he got his first big break into television, as guest presenter on a shopping channel.
fuller lips
It used to be just celebrities who had their lips enhanced, but getting your lips injected to make them fuller or more pouty is becoming one of the most commonly performed cosmetic procedures. You can choose between a temporary substance, such as collagen or hyaluronic acid, or a permanent implant of your own tissue or a Teflon-type material.
Collagen and hyaluronic acid (a sugar molecule that is found naturally in most body tissues) make the lips look fuller but they gradually dissolve, so they need to be re-injected every three to six months. Anyone planning to have collagen injections should have an allergy test first, as the substance is bovine collagen and a small proportion of the population react badly to it.
A permanent implant can change the shape of the lips, not just make them look fuller. You can have a small piece of tissue taken from the lower layer of your skin or from muscle covering and threaded through your lip from one side to the other. The tissue won't be rejected because it's your own, but it may shrink as you get older.
Another option is to have a soft, tube-shaped polymer implant (SoftForm) put into your lips. The material has been used for many years in blood vessel and hernia surgery, and it is now being used to plump up lips and smooth out facial creases. Although the implant is designed to be permanent, it can be removed if it doesn't provide the desired effect.
Prices for lip enhancement range from about £300 for collagen fillers to about £2,000 for permanent implants.
(March 2003, resources updated January 2005)
