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Dr. Denton's Plastic Surgery Blog for Vancouver BC

Choosing A Facial Plastic Surgeon For Your Facelift

The Prevalence of Facelift Surgery

Selecting to undergo a facelift procedure (rhytidectomy) has become more and more common over the past few decades. According to the 2017 statistics provided the International Society of Aesthetic Plastic Surgery, the demand for cosmetic surgery procedures around the world “continues to skyrocket”. This could be attributed to the combination of a general change in attitude regarding plastic surgery in general and the great improvements in cosmetic surgery techniques. A facelift is no longer a surgical procedure performed on the rich and famous. People from all walks of life are now choosing to reverse the undesirable changes that occur in their appearance and structure of their face associated with age. The goal of facelift surgery is to lift and restore the skin and underlying soft tissue of the face and neck to a more youthful position.

Caveat Emptor – Buyer Beware

The number of medical professionals or plastic surgeons offering surgical facelift procedures has also increased, which means today people have a wider choice and are able to select the professional who suits them best.

However, if you are considering a facelift, you need to keep in mind the term “caveat emptor” (buyer beware). Facial plastic surgery is especially powerful, and rewarding since it rejuvenates and increases self-confidence. Unfortunately, if it is not performed by accredited and experienced professionals, the results could be devastating. Therefore, before deciding to undergo such a potentially life-changing procedure you need to select a professional who is an experienced qualified specialist in facial plastic surgery. Dr. Andrew Denton always advises his clients that “the decision to have cosmetic surgery should be made with careful consideration.” The professional you choose should also be approachable and enjoy discussing and performing cosmetic facial surgery. You should be well informed about the different procedures and made to feel as if you are an equal member of the decision-making team.

My practice is built around the philosophy that every patient is an equal member of the decision-making team. Informed patients make good decisions. I encourage unhurried discussion between the patient, the other team members, and myself.

-Dr. Denton

Credentials Matter

Don’t rely on advertising or other people’s opinions when deciding on the best candidate to perform your facelift surgery. You need to have proof of his or her background, credentials, training and experience since it is less susceptible to being biased or misrepresented.

Like Dr. Denton, a plastic surgeon performing facelift procedures should be board certified by The American Board of Facial Plastic & Reconstructive Surgery and The American Board of Otolaryngology – Head and Neck Surgery. Professionals designated as “facial plastic surgeons” have undergone secondary specialized training and are certified by The American Board of Facial Plastic and Reconstructive Surgery. As a result, not all plastic surgeons can legitimately claim to be facial plastic surgeons. In order to be considered one, a surgeon must have completed years of specialized training in Otolaryngology/Head & Neck Surgery and passed the tests required to be certified by The American Board of Facial Plastic and Reconstructive Surgery. Facial plastic surgeons must also be affiliated by numerous professional medical organizations, especially ones relating to facial plastic surgery.

Why It’s Important to Choose a Facial Plastic Surgeon For Your Facelift

For most people, their face is a reflection of who they are. Our face is unlike any other part of our body. It is the most significant part of our identity. As a result, when you choose to undergo a facelift procedure, you need to make sure that your surgeon is a specialist in this area of your body.

Facial plastic surgeons understand better than anyone else the complexities of the face and how intricate the anatomy of the head and neck can be. These areas of our body contain more blood vessels, nerves and muscles than any other part. Only qualified and experienced professionals like Dr. Denton have the proper understanding of the physiology of the face, and how bone and muscular makeup affect the aesthetics of your face. In fact, you should be provided with a detailed description or image of what your face will look like after the procedure. At Dr. Denton’s state-of-the-art private operating facility in Vancouver, you will be able to see the expected results of your facelift through the use of computer imaging.

Schedule your facelift consultation here today and for a younger more rejuvenated and confident you.

Basic Facts About Rhinoplasty and Nose Reshaping Surgery

Rhinoplasty surgery (a nose job) is one of the most popular cosmetic procedures. It can correct, reconstruct, restore or improve your nose aesthetically. Surgeons can change the size, angle, and shape of the nose to make it more balanced with the other facial features.

Whatever your reason is for considering rhinoplasty surgery, you should know that the results are permanent and it should only be performed on a fully developed nose. Consequently, we do not advise girls below the age of 16 or boys younger than 18 to undergo this procedure.

How Rhinoplasty  Surgery Can Help You

Open Rhinoplasty Before and After - Dr. Andrew Denton

Prominent hump with long and drooping tip reconfigured during open rhinoplasty surgery.

Rhinoplasty can be selected for aesthetic and/or functional reasons. It is a procedure which can significantly improve one’s appearance and quality of life.

One of the most desirable results of this procedure is an increase in confidence and self-esteem. A board-certified facial plastic surgeon, who has extensive experience in rhinoplasty surgery, like Dr. Denton and the use of computer imaging, can ensure that the result will be what you have been expecting. A well-performed rhinoplasty can greatly improve your appearance by enhancing other facial features such as your eyes and bone structure.

The Rhinoplasty Procedure

Basically, the surgeon makes incisions to access the cartilage and bones in the nose which may be removed. Fillers may also be added to acquire the desired shape. However, the procedure can be divided into “open” and “closed” techniques. In a closed rhinoplasty, all incisions are made on the inside of the nose whereas in an open, the incision is made on the skin between the nostrils. Closed rhinoplasty is often performed when dealing with cosmetic issues. The open technique is normally performed in cases where the nose is severely twisted or has been previously operated on.

Recovering From Rhinoplasty Surgery

After the procedure, a small plastic cast is placed on the nose to protect it and to maintain alignment during the initial healing period. This cast is removed in 7 days. If light dressing is placed inside the nostrils due to bleeding, it is painlessly removed either in the recovery area or in the office on the next day. Stitches placed inside the nose dissolve on their own, however, skin stitches, placed during an open rhinoplasty, are removed in 5 to 7 days.

During the healing process, it is expected that patients will feel puffiness around the nose and eye area, where they may also experience some swelling and bruising for several days. The swelling and bruising can be managed by applying cold compresses for the first 48 hours.

Normally, patients can shower and gently wash their hair 3 days after surgery but they must be careful not to wet the cast while bathing. Bending, heavy lifting and straining should be avoided during the first 48 hours since these activities can place excessive strain on the body. In two weeks, patients can perform light non-cardiac exercise which can be gradually increased over the ensuing seven days.

The majority of rhinoplasty patients are able to return to work 7 to 10 days following their surgery.

Additional Considerations For A Successful Result

If you are considering undergoing a rhinoplasty procedure you should consider who will be performing the surgery. You need to choose a board-certified facial plastic surgeon, who has extensive experience and expertise in rhinoplasty, as it is considered a challenging procedure. By selecting the proper surgeon you will increase the chance of achieving the result you want and which will satisfy you for the rest of your life.

Dr. Andrew Denton is a board certified facial plastic surgeon, who has extensive experience and expertise in rhinoplasty. He understands that each patient has a unique set of expectations, which is why he is always willing to discuss every step of the procedure. At Dr. Denton’s state of the art private operating facility in Vancouver, you will also be able to see the expected results of your rhinoplasty through the use of computer imaging. Dr. Denton truly believes that all his patients must be fully informed about the procedures they may be considering so that they can be an equal member of the decision-making team.

Schedule your rhinoplasty consultation here today and not only breathe easier but also look and feel more confident.

Eyelid Surgery for a Younger and Healthier Looking You

Eyelid surgery or blepharoplasty, with or without the use of the laser is one of the most common facial cosmetic procedures because it is a great way to refresh your appearance. With the passage of time, it is natural to experience some facial changes which may cause us to look older than we actually are. Excess skin, muscle and fat can form in the upper and lower eyelids which result in drooping eyelids or bulging fat around the eyes. Apart from making us look older and fatigued, this condition can also cause vision problems due to the overhanging eyelids.

Are You A Candidate For Eyelid Surgery?

Eyelid Surgery Before and After Image

Upper blepharoplasty performed in a male patient who had excess skin and fat in the upper eyelids. The result from this eyelid lift is an appearance that is more rested, youthful and approachable.

The excess fat and skin can develop because of aging but there are also individuals who are genetically disposed to this condition so it can occur even to people at a relatively young age. Consequently, there is no recommended age when you should have eyelid surgery. Therefore, if you have excess skin obscuring the natural fold of the upper eyelids and folds over the eyelashes and if your upper and lower eyelids appear puffy and tired, you should consider blepharoplasty.

How Is The Procedure Performed?

During the eyelid surgery, excess skin and fat are removed from the eyelids using the CO2 laser. Often, no skin incisions are required to treat the lower eyelids. If fine sutures are needed, they are removed after only 5 days. Blepharoplasty, like any surgical procedure, may produce some initial scarring, but it is minimal and almost nonexistent after several months of healing. It has also been our experience that most patients are able to return to normal activities within one week of having their eyelid surgery.

Are The Results Long-Lasting?

The results of the procedure should be long-lasting and, in most cases, it is only performed once. However, if the procedure is performed at a relatively young age, it is normal to expect the skin to droop with age. Therefore, in some cases, a patient may desire to have an additional procedure.

Combining Eyelid Surgery With Other Procedures

Eyelid surgery is usually performed as a single procedure but if you’d like to combine other procedures at the same time, we recommend a browlift. By combining the two procedures, you can improve the sagging of the eyelids along with an elevation of the eyebrows.

What Eyelid Surgery Won’t Remove

You should be aware that blepharoplasty is not a treatment for dark circles, fine lines and wrinkles around the eyes. If you would like to smooth out these wrinkles, you can include a Botox™ treatment to your eyelid surgery. By doing so, many of the lines and wrinkles around the eyes can be softened or eliminated.

Why Choose Dr. Denton For Your Eyelid Surgery?

Dr. Andrew Denton is a board certified facial plastic surgeon, who has extensive experience and expertise in blepharoplasty. He understands your need for a younger, fresher and healthier appearance. He is always willing to discuss a variety of treatment options to help you feel and look more confident. At Dr. Denton’s state of the art private operating facility in Vancouver, you will also be able to see the expected results of your blepharoplasty through the use of computer imaging. Dr. Denton truly believes that all his patients must be fully informed about the procedures they may be considering so that they can be an equal member of the decision-making team.

Schedule your blepharoplasty consultation here today for a younger and healthier looking you!

Chin Augmentation with Neck Liposuction and Rhinoplasty

In this patient, a chin implant/neck liposuction procedure was combined with a rhinoplasty.  These three procedure, when performed at the same time, result in a remarkable improvement in the balance and appearance.

The initial procedure performed is the liposuction or liposculpture.  Although there are many non-surgical options today for improving neck contour, when significant fat deposite are present, none of these will provide the superior result of surgical liposculpture.  I use very delicate 1 – 3 mm liposculpture cannulas attached to a gentle suction aspirator.  The small cannulas allow the utmost in precision when removed excess and unwanted fat.

My preference for chin augmention access is via a small skin incision underneath the chin.  This avoids an incision on the inside of the lip which is associated with a higher risk of implant infection during the healing period.  The incision under the chin heals to an essentially invisible fine line.  There are many diffent chin implant configurations.  I generally use silastic implants manufactured by the very highly respected medical device company Implantech.  Actual implant size and shape depend on patient preference, gender, height, ethnicity, facial anatomy, etc.

The rhinoplasty in this case lowered the nose as well as refined the tip.  The tip is now less projected and more rotated.  A gentle feminine curve has replaced the dorsal hump.  When viewed from the front, the sidewall shadow curves gently out onto the tip.  The columella has been raised.

Before and After Chin Augmentation and Neck Liposuction*

Before and After Chin Augmentation and Neck Liposuction*

Before and After Chin Augmentation and Neck Liposuction*

Before and After Chin Augmentation and Neck Liposuction*

Questions about Botox Treatments in Vancouver

Botox Treatments Q&A

What is Botox?

Botox, or Botulinum toxin, is a neurotoxic protein produced by the bacterium Clostridium botulinum. It is used commercially to paralyze muscles to remove and prevent the appearance of wrinkles.

How Does Botox Work?

Once injected into a muscle Botox blocks signals between the nerves and the muscles. This means the injected muscle can no longer contract, which causes the wrinkles to relax, soften, and flatten out.

Crow's Feet Botox Vancouver BC

Patient before and after Botox™ injections to reduce appearance of “crow’s feet”, or wrinkles around the eyes.*

How Botox is Administered

Only a licensed board certified professional should administer Botox treatments. When looking for Botox treatments you need to do your research. See what other people’s experiences have been with that doctor, ask to see before and after photos, and have a discussion with the doctor. Any qualified professional should present all the facts, including the risks associated with the procedure, and talk you through the procedure.

How Long Does Botox Last?

The duration of Botox treatments can vary greatly from person to person. Some factors that effect the duration of the treatment include a persons metabolism rate, the number of units of Botox used, and the skill of the practitioner. The better the practitioner is at placing the product the better results will be achieved.

forehead botox treatments in Vancouver

A dramatic reduction in forehead and brow wrinkles is evident following treatment of these areas with Botox™.*

What is the Difference Between Botox and Dysport?

Dysport and Botox canadian pharmacy online both are a type of botulinum type A used to relax muscles and decrease wrinkles. Although Dysport was only approved in 2009 in the USA it has been going head to head with Botox for many years in Europe. Essentially both Dysport and Botox produce the same results – smoothing of wrinkles, however, there are some differences in how it is administered and how it works. Some differences between Botox and Dysport include:

  • Dysport does not last quite as long as Botox (although this is still being debated)
  • Dysport starts to take effect within 2-5 days vs 5-7 with Botox
  • Dysport spreads further than Botox
  • Dysport is less concentrated and therefore requires more to achieve the same results

Botox clinic Vancouver

Please Note

The biggest factor in the effectiveness of either Botox or Dysport is the person injecting the product. It is essential that you seek out a qualified medical professional to advise and administer the treatments. They will be able to inform you of the best options for your scenario. If you would like to book a consultation with Dr. Denton for Botox treatments please Contact Us or Book A Consultation.

For more information and pre-treatment research on Botox see Botox for Facial Wrinkles

As with all medical procedures make sure to consult a qualified physician who will be able to present all the information and options available to you. This is intended solely to provide high-level information for a basic understanding. See our full Disclaimer

Tip Refinement and Deprojection During Rhinoplasty

These three sets of photographs show before and after images of a patient that underwent open septorhinoplasty to address several concerns she had regarding the appearance of her nose.  Specifically, she was unhappy with the appearance of the tip from all angles (boxy, over projected and long) and the height and irregularity of the bridge.  Thin skin also added further challenges to this case.

During open septorhinoplasty the bridge of the nose was reduced to give the nose a more online pharmacy best feminine profile.  The tip was modified to make it more triangular and refined.  As is the case with any rhinoplasty I perform, as little cartilage and bone is removed as possible thereby maintaining the structural integrity of the nose.

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Before & After Tip Refinement & Deprojection of the nose - Front View

Before and After Rhinoplasty*

Revision Rhinoplasty to Remove and Repair Damage from Silastic Nasal Implant

Nasal augmentation – essentially making the nose larger – may be indicated if the bridge of the nose is too low or the tip of the nose too short.  Generally, this is more common during Asian and African American rhinoplasty.  In many parts of the world, the augmentation is achieved by using a silicone or silastic implant.  These implants are inexpensive and readily available in a wide range of shapes and sizes.  They can be inserted quickly with immediate and often pleasing results.  So what’s the downside?  There are several as it turns out, however, the main issues with these implants is that over time, the implant can shift and distort the nose.  Also, if the implant chosen was too large to begin top online pharmacy no prescription with, or the patient’s skin too fragile,  the implant can actually work its way through the skin of the tip of the nose.

When performing augmentation rhinoplasty, my preference is to use the patients own cartilage  where at all possible.   If a synthetic/man-made implant is required to augment the bridge of the nose, I prefer a custom carved ePTFE (Goretex) implant that is specifically designed for each individual patient.  At no time should the synthetic implant be allowed to contact directly the undersurface of the nasal tip skin.  The result is a long lasting and safe nasal augmentation.

Before & After Revision Rhinoplasty Nasal Augmentation - Front View

Before and After Revision Rhinoplasty*

Before & After Revision Rhinoplasty Nasal Augmentation - Side View

Before and After Revision Rhinoplasty*

Before & After Revision Rhinoplasty Nasal Augmentation - Underneath View

Before and After Revision Rhinoplasty*

Before and After Rhinoplasty – 5 year follow up

Before & After | 5 year follow up | Closed Rhinoplasty | Side View Before & After | 5 year follow up | Closed Rhinoplasty | Front View Before & After | 5 year follow up | Closed Rhinoplasty | Lateral View

Above are three sets of before and after photographs of a patient who underwent closed septorhinoplasty surgery 5 years ago*. Even though the closed rhinoplasty technique is not commonly used in my practice (mainly because the open approach provides superior access and control to the various nasal structures that require modification during complex rhinoplasty cases) this is an example of a great and long lasting result from a closed rhinoplasty.

In this case the objectives were to straighten the nose, narrow the tip, deproject the tip and rotate the tip – all of which canadian online pharmacy no rx were met nicely in this case. The one main advantage of closed rhinoplasty over the open approach is that the closed approach avoids the transcolumellar incision at the bottom of the nose. However, in my experience this is rarely if ever an issue.

Healing time generally is comparable between the two. Most patients will require 7-10 days off of work or school and two weeks off of the gym or other significant exercise.

Synergistic rhinoplasty with chin augmentation

Cosmetic nasal surgery – otherwise known as rhinoplasty – is the most popular procedure in my practice. Although the nose is a central feature of the face, it should not be a focal point of the face. Rather, it should lead the observers into the individual’s eyes, lips and smile. In other words, after a successfully performed rhinoplasty, the nose should actually draw less attention to itself than it did prior to the procedure. The key to this is balance among all of the facial features. When considering changes to the appearance of the nose it is critical to consider all of the other features of the face so that an optimal balance is achieved. In rhinoplasty, one of the most important related areas to consider is the chin. In this pharmacy online usa case, the patient had a prominent nose with an over projected and under rotated tip. The tip was full and asymmetric. Open rhinoplasty was performed to adjust these features. However, during the consultation, other features were recognized to be out of the balance. As a result a chin augmentation was performed concurrently. These procedures are considered synergistic – in other words they are together greater than the sum of the parts. The importance of chin augmentation combined with reduction rhinoplasty will be discussed in the next post.

For questions or to book a consultation, please contact us.

rhinoplasty with balancing chin augmentation

Left view of patient’s before and after profile*

rhinoplasty with balancing chin augmentation

Front view of patient before and after surgery*

Before and After Open Rhinoplasty

The following is a series of three before and after photos of an open rhinoplasty procedure completed for a patient in our Vancouver plastic surgery clinic. The “after” photos were taken one year following the open rhinoplasty plastic surgery.

The goal of the rhinoplasty was to make the nose more feminine and balanced with the other facial features. Specifically, we lowered the bridge (profile), providing a subtle curve that was designed to complement the other facial curves – note in particular the curve of the forehead.  Changes were made to the tip of the nose as well.  The angle between the nose and the lip was increased (“rotation” of the nose) and the tip of the nose was shortened (“projection” of the nose).  Following these changes, the bridge flows gently into the tip with a slight change in angulation between the bridge and the tip known as a “supratip pharmacy online no prescription break”.  On frontal view, the bridge of the nose was narrowed and the tip was refined and given more definition.  Finally, the nostrils were found to be excessively wide – one more than the other – and changes were made to narrow the base of the nose.

There is a saying in rhinoplasty surgery that “the results of a good rhinoplasty are seen in the eyes”.  The nose will no longer detract from, but rather add to, the other facial features.  Eyes become brighter, lips become fuller and a smile becomes more engaging.

right oblique view of before and after open rhinoplasty in vancouver

Right oblique view of open rhinoplasty patient*. The goal of the surgery was to refine, deproject and narrow the tip and also to feminize and refine the dorsal contour.

frontal view of before and after photos of open rhinoplasty patient

Frontal view of an open rhinoplasty patient.*

right lateral view of before and after open rhinoplasty surgery by Dr. Andrew Denton

Right lateral view of and open rhinoplasty patient.*