Dr. Denton – Asian Plastic Surgery in Vancouver
Plastic Surgery for Asian patients is a unique field. While many of the surgical techniques developed in North America were designed specifically for Caucasians, unique features and anatomy of the Asian patient necessitate a different approach, in particular when considering the nose, upper eyelid and chin.
Dr. Andrew B. Denton is as a board certified facial plastic surgeon with fellowship training from the University of California San Francisco who practices in Vancouver, British Columbia. Because both of these locales boast vibrant and large Asian communities, Dr. Denton has extensive experience and expertise in the field of Asian cosmetic surgery.
During your consultation, you will have the opportunity to discuss your treatment options with Dr. Denton in a confidential and unhurried setting. Computer imaging will be performed to demonstrate to you the expected result following your procedure. Surgery is performed in Dr. Denton’s fully accredited private plastic surgery operating facility in Vancouver, British Columbia.
Asian rhinoplasty (nose reshaping)
Research has shown that Asians have relatively fewer growth centers in the nose and mid facial areas than their Caucasian counterparts. This helps to explain the position of the nose and upper lip. Often the bridge of the nose is low and the tip is wide and can be poorly defined. As a result, during Asian rhinoplasty plastic surgery, the goal is usually to raise and narrow the bridge and to add definition to the tip with or without narrowing the nostrils. This is in contrast to the typical Caucasian rhinoplasty which usually involves making the nose smaller. As with all surgery performed on Asian patients, success is measured by a result that is consistent with the individual’s ethnic identity.
Asian blepharoplasty (eyelid surgery)
The differences between the upper eyelids of Asian and Caucasian patients are threefold. The Asian eyelid is characterized by a poorly defined or absent crease, an excess of fat and an epicanthal fold (the skin that covers the inner corner of the eye) of varying size and configuration. The goals of Asian blepharoplasty are to create a natural appearing upper lid crease that complements and is in balance with the other facial features, to remove excess fat and, if necessary, to make changes to the epicanthal fold. Two plastic surgery techniques are used to create the eyelid crease during blepharoplasty, each with its own advantages and disadvantages. The “suture method” limits the size of the incision but may be less permanent than the “incisional method” in which excess skin is also removed at the same time as the crease is being created or changed. The suture method does not address excess fat or the epicanthal fold, both of which require skin incisions.
When considering plastic surgery of the lower eyelid, fewer differences exist between the techniques used in Asian and Caucasian patients. In both ethnic groups, the goals are to reduce eyelid puffiness and skin wrinkles.
Learn more about Blepharoplasty (for Asian patients)
Upper eyelid surgery begins with a skin incision hidden within the upper eyelid crease. Incisions are made with either the CO2 laser or a scalpel. Excess skin, muscle and fat are then carefully removed to leave a more youthful and well-contoured eyelid. Finally, the incision is closed with a fine line of stitches.
Lower eyelid surgery techniques are more variable. If excess skin is not present, all incisions are made on the inside of the eyelid to avoid any external scars. The bulging fat that gives lower eyelids their puffy and tired appearance is then meticulously removed. If excess or wrinkled skin is present, it can be removed at the same time or smoothed with the CO2 laser.
Droopy, heavy upper eyelids and puffy lower eyelids with or without baggy wrinkled skin are effectively treated with modern blepharoplasty techniques. In both men and women, a forehead lift should be carefully considered with upper eyelid surgery if the eyebrows have dropped significantly with age.
On the night before your surgery we ask that you not have anything to eat or drink (including coffee, tea and juice) after 12:00 am. This allows your stomach to empty thereby minimizing any postoperative nausea.
Two weeks prior to your surgery all blood thinning medications and supplements (e.g. aspirin, ibuprofen, ginko, ginseng and vitamin E) must be stopped. This reduces the amount of swelling experienced postoperatively. A prescription for antibiotics and pain medication will be supplied to you. It is important to take the antibiotics as directed until finished.
A simple blood test to measure your hemoglobin level is performed prior to surgery and, if you are over 50 years of age, a cardiogram is required for your safety. A preoperative visit with your ophthalmologist may be necessary with any history of eye problems.
Surgery is performed in our fully accredited operating room under twilight anesthesia. You will be asked to arrive 30 to 45 minutes prior to the onset of surgery. After surgery, patients are taken to our specially equipped recovery area. Once recovered all patients proceed home accompanied by a responsible adult or to an after care facility.
Moderate swelling and some bruising are normal in the early postoperative period. Stitches used to close any skin incisions are removed in 5 days. Stitches placed inside the lower lid dissolve on their own within several days.
Following surgery, you should rest quietly for the first 24 hours. Sleeping with two pillows under your head for the first 2 nights helps minimize swelling and bruising. Cold compresses placed over the eyes are soothing and will also help with swelling.
Patients are permitted to shower and wash their hair 3 days after surgery.
Bending, lifting and straining are prohibited during the first 48 hours. Light non-cardiac exercise can be resumed two weeks following surgery and slowly increased over the ensuing seven days.
Make-up can be applied to the upper eyelids as soon as the skin incision has healed and to the lower eyelids within 7 days. Most patients are back at work within 7 days of surgery.
Following your consultation, a quote is given which is guaranteed for one year. Our quotes include all costs: pre-operative tests, anesthesia, facility charges, the services of our staff, and applicable taxes. You are encouraged to make cost comparisons. In comparing, be sure you determine the total of all costs related to the surgery.
A deposit is required at the time the surgery is scheduled in order to hold a specific date for you. The balance is due two weeks prior to your surgery. For your convenience, we accept MasterCard, VISA and debit cards.
We have arranged a financing plan for our patients with an outside financial institution. Ask our patient care coordinators for details about how to qualify.
Occasionally, provincial health care plans and insurance companies will pay for upper eyelid surgery in cases where vision is restricted by excess skin. If this is a consideration, a visit to your ophthalmologist to test for vision restriction will be required by the insurers prior to your surgery.
Not infrequently a heavy brow contributes to drooping upper eyelid skin and, in these individuals, a browlift procedure should be considered at the same time as eyelid surgery.
In the absence of excess fat in the lower eyelids, a simple resurfacing procedure may be all that is necessary.
Laugh lines or “crow’s feet” are not corrected by blepharoplasty, but do respond well to treatment with Botox™.