Description of Clinical Program
The UCLA Facial Aesthetic Center is a place devoted to the care of your appearance with the latest treatments and procedures for facial refinement and rejuvenation. We offer a comprehensive approach to enhancing your natural beauty, individualized to your needs and desires. Our physicians have dedicated themselves to the cosmetic treatment of the face, eyes, and neck. Our goal is to give you the information and expertise to allow you to present your best face to the world.
Like all advanced societies, you live in an age where beauty in all aspects of life is elevated and exalted. You are a complex mixture of inner experience and outward appearance, and your face projects your inner world to others. Your face shows how much you smile and worry. It shows the time you have spent in your California sun, and the scars you have acquired. In addition to being a map of your personal past, your face is the product of the natural forces beyond our control: time, gravity, and the facial features that you have inherited. We can help overcome these forces to reveal all of the beauty inside you.
At the Facial Care Center we are full-time UCLA faculty physicians, nurses, and staff dedicated to improving and maintaining your facial appearance. We are trained in Facial Plastic and Reconstructive Surgery, and specialize in the latest technology and refinements for minimally invasive procedures, laser treatment, and surgery of the face. You can be assured of the quality and expertise that you have come to expect from UCLA Medical Center.
We have offices at the 200 Medical Center Plaza. Our surgical procedures can are performed at the UCLA Surgicenter in Westwood, so that you can be assured of the highest standard of medical care before, during and after your surgery.
How to Contact Us You may arrange a consultation with Dr. Rawnsley by calling the UCLA Head and Neck Surgery Consultation Suite at 310-570-0244.
Facelift
Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow’s feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jaw line softens into jowls, beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.
As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of rhytidectomy is crucial and psychological stability is vital. There is no ideal in a facelift. Rather, the goal is to improve the overall facial appearance. Skin type, ethnic background, degree of skin elasticity, individual healing, basic bone structure, as well as a realistic attitude are factors that should be discussed prior to surgery. This procedure is sometimes performed on patients in their thirties, and successful surgery has been performed on patients in their eighties. A facelift cannot stop aging, nor can it turn back the clock. What it can do is help your face look its best and give you a look of health and a more youthful appearance. A side benefit is that many patients experience increased self-confidence.
The surgeon begins the incision in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.
After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips, which permit surgery without shaving hair from the incision site. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia, the patient will experience little discomfort. Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.
Even though most patients experience very little pain after surgery, the surgeon will still prescribe medication. Some degree of swelling and bruising is unavoidable, and your surgeon may instruct you to use cold compresses to keep swelling to a minimum. The surgeon will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery. All sutures and staples are usually removed within five to 10 days following surgery. Recovery usually takes two to three weeks, though many patients go back to work in two weeks.
Forehead/Browlift
The brow and forehead areas are often the first to show signs of aging. Sun, wind and gravitational forces cause the skin to lose its elasticity leading to wrinkling and a perceived heaviness in this region of the face. A forehead or brow lift is one option for minimizing the effects of these changes on your appearance. A plastic surgeon performs this procedure by tightening the skin in the forehead region and removing excess skin, thus reducing the amount of wrinkling in the forehead region and minimizing the appearance of “drooping brows”. In some cases, the surgeon may remove a portion of the muscle that causes these vertical wrinkles. The goal of surgery is a smoother, more youthful appearance. While the average age range for this procedure is forty and sixty-five, it can occasionally be considered at an earlier age.
Because of advances in medical technology, endoscopic techniques are now available. These new techniques greatly minimize the length and number of incision as well as scar visibility. Using the technique, the surgeon makes a series of incision immediately behind the hairline. The endoscope is then utilized to remove the muscles that create the wrinkles in this region. The surgeon then lifts the eyebrows to reduce the sagging appearance of the eyebrows. A procedure of this type generally runs for one to two hours.
For approximately 10 days following endoscopic browlift surgery there will be some swelling and bruising in the forehead, cheek, and eye region. You will be instructed to use cold compresses and keep your head elevated to reduce swelling after surgery. With the healing process, you will most likely experience some numbness and itching. These conditions will improve gradually with time. Bandages are removed one to three days following surgery and suture removal occurs seven to ten days later. Most patients are fully recovered two weeks following surgery, however, it is generally wise to avoid strenuous activity for a slightly longer period.
This surgery is not medically necessary in most cases and will not be covered by insurance. An exception, however, is in the case where excessive sagging in the eyebrow region interferes significantly with vision.
Botox
Are forehead wrinkles, crow’s feet, and frown lines causing you to look tired, angry and older than you feel? Botox is a quick and easy treatment, helping you to look rested and more youthful. Look as if you have just come home form a much needed vacation!
What is Botox?
Botox is a dilute, purified form of Botulinum toxin, which is an extremely effective muscle relaxant. Although Botox is a toxin, there have been no serious side effects.
How does Botox eliminate facial wrinkles?
When Botox is injected into the superficial muscles of the face, it relaxes these muscles and prevents the wrinkle lines caused by squinting, frowning, and raising our eyebrows. Botox is ideal for improving and smoothing the skin between the eyebrows, the lines of the forehead, and the crow’s feet area around the eyes.
Where is Botox used?
Botox is used on the face, only around the eyes and forehead so as not to affect a patient’s smile. It is important to understand that Botox only relaxes the overall facial muscles that cause wrinkles. Your skin will feel the same and you will have normal sensation in all treated areas. Muscles that are not treated and related to other expressions are not affected.
How is Botox used?
A small amount of Botox is injected into the muscle that creates a wrinkle. By injecting the Botox into a muscle, it blocks the nerve impulse from reaching that area and the muscles begin to weaken. As the muscle weakens, the treated areas begin to relax and the wrinkles in the skin soften and often disappear.
Does a Botox injection hurt?
Applying a topical anesthetic cream or ice compresses for several minutes prior to the treatment will effectively numb the area. When the Botox is injected, you may feel a slight stinging sensation that quickly subsides. Once the injection is complete, the nurse applies an ice compress and the discomfort disappears.
Is Botox safe?
Botox has an excellent safety profile. Neurologists and ophthalmologists have used it for over 15 years to correct facial tics and to relax the eye muscles responsible for lazy eye. These types of procedures require many times the amount of Botox that is used to treat wrinkles and have not resulted in any toxic effects to patients.
What are the advantages of Botox?
- Botox is a quick and effective way to remove wrinkles. A typical treatment takes 10 minutes.
- Results are seen within 4 to 7 days.
- Little discomfort and no ”down-time”. After the injection, you may resume normal activity or go back to work. There is no physical evidence that you had a cosmetic procedure done.
- The effect of Botox is reversible lasting between 3 and 9 months, depending on the number of previous treatments.
- A memory response may develop with repeated Botox injections if they are done every 3 months for approximately one year. So, although the effects are not permanent, there may be a gradual lengthening of the time interval between treatments. This will mean fewer treatments to obtain the same effect.
Eyelift
Eyelift surgery, or blepharoplasty, is performed to improve the appearance of drooping eyelids and/or puffiness or bags around the eyes. This procedure is not used to remove dark circles, fine lines or wrinkles around the eyes.
A blepharoplasty may be performed on the upper eyelids, the lower eyelids, or all four lids and serves to remove excess fat, muscle and skin resulting in a more youthful appearance. It is often performed in combination with other procedures such as browlift, facelift, or skin resurfacing. We will discuss in detail all of the possibilities so that you are able to make an informed decision.
Before beginning surgery of the upper eyelids, your surgeon will mark individual lines and natural creases of the lids and will plan incisions along these lines to minimize the visibility of any scarring. Once the incision has been made, excess skin, muscle and fat are removed and fine sutures are used to close the incisions. Lower eyelid surgery follows the same principles, in that the surgeon chooses an inconspicuous site to make the incision – usually along the lash line and smile crease of the lower lid. Again, skin, muscle and fat are removed and the incision is closed with fine sutures. A transconjunctival blepharoplasty is used primarily in cases where excess fat is causing eyelid puffiness. In this instance an incision is made inside the lower lid and the fat is removed. The suture line is completely invisible and self-dissolvable sutures are used, which leave no visible scar.
Following surgery, you will experience some degree of swelling and bruising. Cold compresses and elevation of the head are recommended to relieve any discomfort. In the seven to ten days following your surgery, you will clean the eye area. Eye drops may also be recommended. Stitches are removed three to five days following surgery.
This surgery is not medically necessary in most cases, and will not be covered by insurance. There are some exceptions: improvement of impaired vision, surgery as a result of injury, or surgery for an eye deformity.
Nasal Surgery
Surgery to correct the appearance of the nose, rhinoplasty, has been performed for many centuries. A consultation with one of the UCLA Facial Plastic and Reconstructive surgeons can help you to assess whether or not rhinoplasty is an option for you. The nose is the most defining characteristic of the face, and as such even a small change can drastically improve the appearance of one’s face. Rhinoplasties are often performed in conjunction with other facial plastic procedures. In a private consultation, we will discuss in detail all options so that you may make an informed decision.
There in no ideal nose, the most important consideration is creating harmony with the other features of the face. There are many important factors, which must be considered in the discussion preceding rhinoplasty: skin type, ethnic background, and age. We do not perform rhinoplasties on patients until they have reached full growth; in most cases this occurs around the age of fifteen or sixteen. The exception to this rule is if breathing is severely impaired.
In performing a rhinoplasty, the surgeon first makes incisions, the majority of which are placed inside the nose. The skin of the nose is then lifted from the underlying structural support. The surgeon then manipulates the underlying bone and cartilage, creating a new shape. The skin is then replaced over the frame and the incisions are closed. A splint will be applied to the outside of the nose to insure that the new shape will be maintained throughout the healing process. Soft, absorbent material is placed inside the nose to maintain the stability of the wall that separates the nostrils (this wall is called the septum).
The splint will be left in place for 5 to 8 days following surgery. The packing inside the nose is removed the day following surgery. You will experience swelling the day following surgery and some pain medication may be required. There may also be some swelling and bruising in the eye region. Cold compresses will help to keep this to a minimum. Sutures are usually absorbable and do not require removal.
This surgery is not medically necessary in many cases and will not be covered by insurance; however some exceptions are surgery to correct or improve nasal function for a major deformity or injury.
Laser Removal of Fine Line and Wrinkles
Sun, wind and gravitational forces cause the skin to lose its elasticity leading to wrinkling and a perceived heaviness in this region of the face. Premature wrinkling is more common than ever before. Laser techniques offer men and women an option for reducing the appearance of these wrinkles, improving the look of pitted acne scars and removal of pre-cancerous growths called keratoses. The procedures outlined here will not produce perfect skin, however you will find that the appearance of your skin is dramatically improved.
Your skin is made up of two layers: the epidermis and the dermis. The dermis contains two layers, the reticular layer and the papillary layer, both of which are composed of collagen. These are long fibers, which loosen and lose elasticity with age and exposure to the sun. Of these two layers, the reticular layer is the deepest. If this layer is damaged, scarring will result. The papillary layer has the ability to heal without scarring.
Laser surgery is used primarily to smooth facial skin that has wrinkled due to excessive exposure to the sun. High-energy, amplified light waves of carbon dioxide immediately vaporize the top layer of skin. There is no bleeding and minimal trauma to the surrounding skin.
Following laser resurfacing, a dressing will be applied to your skin. You will experience some swelling and “crusting” of the skin. Both are normal. Ointments will be applied regularly in the seven to ten days following surgery to keep the skin supple. Following the initial healing stage, you will notice some residual redness in your skin. This is normal and will fade with time.
It is absolutely essential that you follow the instructions your surgeon will give after your surgery. These instructions will generally include curtailing any activities that might stress the healing skin, avoiding extreme temperatures, and eating a soft diet. Two weeks following surgery, new skin will surface. This new skin will be pinkish in color and finer than your facial skin was previously. It will also have a greatly reduced number of wrinkles. Caring for your new skin is very important. It is essential to wear sun block for protection while the new pigment is being created.
Cheeklift
The cheek fat is situated high, near the cheekbones, when we are young. With time the fat and soft tissues beneath the facial skin gradually fall toward the folds by the nose and mouth (the nasolabial folds). This makes the cheeks appear flat and the folds by the nose and mouth deepen.
Beneath the skin, structural adjustments are needed. Repositioning the fat pads brings the cheeks back to their more youthful position. A cheeklift will correct this type of aging in the cheeks. Repositioning the facial fat restores the fullness and contours of the cheek. It gives the face a more youthful balance, and restores curves to the cheeks and an oval shape to the face. All of this is accomplished by working underneath the skin.
The technique for a cheeklift is minimally invasive. The facial skin is neither cut, nor tightened and the procedure takes only one hour under local anesthesia. It is a more conservative approach to restoring the facial shape than a conventional facelift and can give you a more refreshed look without a radical change in appearance.
The best candidates for a cheeklift are women and men who are bothered by these typical complaints:
- Deepening of the creases by the nose and mouth
- Flattening of the cheeks
- A sunken or fallen facial appearance
- A sad, angry or down turned appearance of the mouth
- Hollows beneath the eyes or indentations in the upper cheek
This procedure can be performed alone or in conjunction with other procedures of the face, such as a necklift, facelift, or browlift surgery.
Hair Restoration
A BRIEF HISTORY OF HAIR TRANSPLANT SURGERY
Throughout history, hair loss has been a prevalent issue for both men and women. Hair loss is a natural process that occurs in every 2 out of 3 men and 1 out of 5 women. In general, men are genetically programmed to lose hair while women lose hair due to hormonal changes. In the past people compensated for hair loss by using elaborate wigs, toupees, or other hair systems that were glued or woven into hair to hide the obvious loss. These methods were not permanent, and often times proved embarrassing to the person using these systems. About fifty years ago, the first hair transplant technique was discovered. The punch method moved the hairs from the back of the head, the safe hair that is genetically programmed to produce hair for a lifetime, to the areas that needed hair. However, the punch method resulted in poor survival of hair, painful damage to the nerves or arteries, obvious scarring, and a noticeable “pluggy” appearance.
HAIR TRANSPLANT SURGERY AT UCLA
The new concepts of hair transplantation take genetically programmed hair from the back or sides of the head and meticulously redistribute them into receptor sites utilizing only micrografts (grafts with one, two, or three hairs at a time). At our surgical center we believe that the transplantation of hair is more than a surgery, it is an art. In essence, the physician is painting a new, individually crafted hairline that is completely natural. We also use a feathering technique by placing the fine, single hair grafts at the front of the hairline and then place two or three hair grafts more towards the back of the hairline to add density and fullness. This feathering technique artfully softens the hairline to make it virtually impossible to detect. We also take precautions to monitor depth control by expanding limited anesthetized areas, which allow for a more dense appearance.
WHAT ABOUT CORRECTIVE SURGERY?
Actually, about 50% of the surgeries we perform are corrective in nature. We do corrective surgery for burn and trauma patients, and for poor hair transplants that were performed elsewhere. We also perform transplants for the eyebrows, eyelashes, and any other areas where hair growth is desired. Our dedication to accept challenging cases has given our center a whole new dimension to hair transplant surgeries.
IS HAIR TRANSPLANTATION PAINFUL?
During the surgery, the patient does not feel any pain. We minimize the pain by slowly injecting local anesthetic so that the patient only feels the first two pricks, which is likened to a small pinch. We maintain depth control with the incision by allowing no greater depth than 4-mm, so there is no possibility of damage to the nerves and arteries. Immediately after the surgery, the patient might need pain medication. The next day there is usually no pain.
WHO CAN BENEFIT FROM HAIR TRANSPLANT SURGERIES?
A hair transplant surgery can be performed on a man or woman of any hair type and any hair color. Anyone who desires more hair can benefit from hair transplant surgery, provided the individual has an adequate donor area. This can be evaluated and discussed during a private consultation.
HOW DOES THE PROCEDRUE WORK?
The first step is to meet with Dr. Rawnlsey for a free private consultation to discuss your personal needs and to set up an appointment for your surgery. The entire surgery can take anywhere from 4 to 6 hours. We start by injecting local anesthetic into the donor area at the back of the head. Dr. Rawnsley will carefully remove your donor hair in fine strips. This process takes about 10 minutes. Next, Dr. Rawnsley will artfully create the receptor sites while the experienced surgical staff prepares the grafts from the strips. Finally, the surgical staff will delicately place the grafts into the receptor sites. For almost the entire procedure, you will be able to eat lunch, fall asleep, talk with our surgical staff, or just relax.
HOW LONG IS THE RECOVERY?
On the day the surgery is performed, you will be able to resume your daily activities with only a few limitations. These limitations will last for 4 or 5 days and include restrictions on strenuous exercise and heavy lifting. In 10 days you will come back to our office to have the staples removed from the back of your head. At this time most of the tiny scabs from the grafted areas will have fallen off and your new hair transplant will be undetectable. You are welcome to wear a loose hat while your scabs are present. In approximately three months the new hair will start to grow and after six months, you can expect full growth from your transplanted hair. Most people will not realize that you are growing new hair, as new hair growth is gradual and very inconspicuous.
LIFE AFTER A HAIR TRANSPLANT
Many patients report positive results in their lives with the new hair growth gained from a transplant. Some enhancements include more confidence, regained self-esteem, pride in their new image, and the ability to look younger than their age. Many previous patients also say that the hair transplant is undetectable to their friends and family members.
THE NEXT STEP
If you are interested in learning more about hair transplants, contact (310) 570-0244. If you wish to set up a free private consultation with Dr. Jeffrey Rawnsley, please call the Head and Neck Surgery Division at (310) 570-0235.
|
to top 
