Surgery and Injectables for the Face, Montreal

If you avoid mirrors and being photographed because of some of your facial features, it is high time to regain your confidence and self-esteem. You are much more than the sum of your physical attributes; however, a good dose of self-confidence can fix a lot of problems.


Doctor Michel Alain Danino is available to suggest a solution that will meet your needs.

Face Lift

Love Your Skin

There are a number of lifting procedures available to you to help reduce the signs of aging of the skin on your face and neck. Cervico-facial lifting, which is a treatment designed to reduce wrinkles from the temples to the cheeks, is the most common type.

The objective of the surgery is to tighten the skin and muscles of the face (temples, eyebrows, cheeks) and neck, and to correct any lack or excess of fatty tissue. The goal of this treatment is not to change the look or shape of the face. Instead, the goal is to improve the anatomical structure of the face and neck in order to produce a younger appearance.

This type of treatment can be applied right from the earliest signs of aging, which include the weakening of the muscles in the cheeks and neck and facial wrinkles, generally occurring in the patient’s early forties. This treatment can also be combined with other types of cosmetic surgery, including blepharoplasty (eyelids), correcting the angle of the eyebrows and reducing wrinkles that appear at the corner of the eyes and on the forehead. The procedure can be performed by a medical-surgical therapy specialist (laserbrasion, dermabrasion, exfoliation, hyaluronic acid injections, Botox injections).

Rhinoplasty

Definition, Goals and Principles

Rhinoplasty involves changing the shape of the nose through surgery, which produces a cosmetic or functional improvement (e.g., correction of nasal respiratory problems). The goal of this surgery is to remodel the nose in order to enhance it, whether the imperfections are congenital, trauma related or due to aging.

Working from incisions inside the nostrils or beneath the upper lip, Dr. Alain Danino remodels the bone and cartilage that form the infrastructure of the nose, and gives it a more pleasing shape. The skin of the nose is realigned, usually with no visible scarring. Any nasal obstruction that hinders breathing, such as a deviated septum or a hypertrophy of the turbinate bones, can be treated at the same time. Rhinoplasty is performed on men and women alike, as long as the patient is over 16 years old.

Before Surgery
You will discuss your desires and needs with the surgeon. A careful study of the nasal pyramid and its relationship to the rest of the face will be performed, along with an endo-nasal examination. This process ensures that your surgery will produce the optimal results for your face, your medical requirements and your personality. The surgeon may recommend against rhinoplasty.

You cannot take any medication that contains aspirin within 10 days prior to the surgery. In addition, it is strongly recommended that you stop smoking before the surgery.

The Surgery
In general, there are no visible scars, but external incisions may be required along the column separating the two nostrils, primarily within the context of an operation involving the size of the nostrils. The incisions are closed using small sutures, which are generally made using very fine, soluble thread.

Rhinoplasty may be used to:


  • Reduce the size of an excessively large nose 
  • Remove a bump
  • Correct a deviation
  • Change the shape of the bridge
  • Shorten an excessively long nose 
  • Straighten the septum

The surgery can last from 45 minutes to 2 hours, depending on the surgeon, the complexity of the procedure and any additional procedures to be performed.

After Surgery: Post-Operative Monitoring
Rhinoplasty is relatively painless, but you cannot breathe through your nose for the first few days after surgery. Swelling (edema) or bruising may appear on the face or eyelids. It is recommended that you rest and avoid any significant physical effort in the days following the surgery. The dressings covering the nose are removed between 1 and 5 days after the surgery, and the splint is removed 5 to 8 days later.

At this stage, the nose still appears swollen, and breathing may still be difficult due to the swelling of the mucus membrane and the possible formation of crusty mucus within the nasal passages. The total healing period lasts between 10 and 20 days. Avoid any strenuous activities for the first 3 months.

Results
If all goes according to expectations, the results will give you a great deal of satisfaction. Less than satisfactory results may be due to a misunderstanding with respect to the goals to be attained, or to unusual scarring or unexpected tissue reactions. These imperfections may be subsequently corrected via surgical retouching a few months after the initial surgery.

Possible Complications
Like any other surgical procedure, rhinoplasty involves some minimal risks related to the anesthesia or the surgery itself. In practice, the vast majority of surgeries are carried out with no problems, but the following complications are possible:

  • Very moderate bleeding
  • Hematomas that might necessitate draining if large or excessively painful
  • Infection
  • Unsightly scarring
  • Skin irritations that heal on their own, without leaving a trace


For more information on rhinoplasty, contact Dr. Michel Alain Danino.

Blepharoplasty

Blepharoplasty is intended to give tired eyelids a younger, more relaxed look.


Definition, Goals and Principles of Cosmetic Eye Surgery
Blepharoplasty is a surgical procedure that involves retouching eyelids, whether the defects are congenital (from birth) or acquired (primarily due to aging). The surgery may involve only the upper or lower eyelids, or both at the same time. Blepharoplasty may be combined with other types of facial surgery done at the same time. Consult your surgeon.

Most common reasons for undergoing blepharoplasty:

  • Sagging upper eyelids, resulting in a more or less defined fold
  • Limp lower eyelids resulting in small horizontal wrinkles
  • Bags under the eyes, resulting from the accumulation of fat and leading to a puffy look

Other conditions may result in some patients requiring surgical techniques other than blepharoplasty.

Before Surgery
You will be examined by your surgeon, who may ask you to undergo complementary ophtamological examinations and a full pre-surgical check-up, if necessary. The anaesthesiologist will meet with you prior to the operation and explain the pre-surgery fast. The anaesthesiologist and the surgeon will explain the procedures involved and the anesthesia that is best suited to you and to the upcoming procedure. You cannot take any medication that contains aspirin within 10 days prior to the surgery. In addition, you must stop smoking 1 month before and abstain for 1 month after the surgery. Smoking can severely hinder the healing process.

Hospitalisation
In most cases, the patient is discharged on the same day as the operation after being observed for several hours. However, depending on the anesthetic used and your recovery, you may require a short period of hospitalization.

The Surgery
The procedure used is left to the discretion of the surgeon, who will choose the approach that will yield the best results. The operation usually lasts between 30 minutes and 2 hours, depending on the complexity of the surgery.

Skin Incision and Sutures
Upper eyelids: The scarring zone is in the area between the movable eyelid and the fixed eyelid, in the crease.

Lower eyelids: The scar is located between 2 and 3 mm below the line of the lower eyelashes, and may extend slightly beyond the length of the eyelid. In some cases, the incision may be made transconjonctivally in order to avoid any surface scarring.

The stitches are very fine and not soluble. They will be removed 3 to 6 days after the surgery.

After Surgery
The post-operative monitoring period is painless, but you may experience some discomfort, visual impairment and tension on the skin. Avoid strenuous effort and continue to rest.

The main symptoms that you will observe are a temporary swelling of the eyelids (edema), bruising and lacrimation. Every patient reacts differently, and therefore, the severity and duration of these symptoms is variable. Sometimes, it is difficult to close the eyelids, or the outside corner of the eye sticks to the eyeball due to the swelling of the eyelids. Here again, it is important to be patient: these symptoms disappear in a few days in the majority of cases.

Depending on the scope of the operation, you can resume a normal social life within 6 to 20 days. You can put on make-up starting on the 7th day after the surgery. The scars, which will be pink at first, will gradually diminish. The areas operated may remain hard for several months, but only you will be able to tell, because they are not visible.

Results
You will be able to judge the results within 3 to 6 months after surgery. When it comes to cosmetic surgery, blepharoplasty is seen as the procedure providing both the most satisfaction and longest lasting results. The fatty pockets almost never reappear. However, as the skin continues to age, it gradually loses its tone, and wrinkles reappear on the eyelids over the long term, sometimes leading to another operation, which generally occurs on average approximately 12 years after the first.

Imperfect Results
In most cases, these are due to unattainable expectations on the part of the patient. For example, eyelid surgery can only correct the eyelids and the look of the eyes, while the sagging of the forehead and eyebrows requires wrinkle removal in the area around the temples, which is another type of surgery.

Imperfect results may also be caused by problems with healing or unexpected or unforeseeable tissue reactions, leading to the persistence of fine lines, overly sunken eyes (visible bone ridge) or the retraction of the lower eyelids, revealing too much of the eyeball, asymmetry or too visible scars. Some of these imperfections may require a second surgery or retouching, 6 months after the initial surgery.

Possible Complications
Although blepharoplasty has a cosmetic side, it is still a surgical procedure that requires anesthesia. Therefore, complications related to the surgery or the anesthesia are possible. We encourage you to discuss these complications openly with your surgeon and your anaesthesiologist.

We would like to remind you that by choosing a qualified and skilled plastic surgeon that is trained for this type of surgery, you minimize the associated risks, but they are not completely eliminated.

Thankfully, serious complications related to blepharoplasty are rare, and the majority of patients are satisfied with their results.

Do not hesitate to contact us to learn more.

Chin Surgery

Genioplasty, also called mentoplasty, is chin surgery performed under general anesthetic that aims to restore balance to your facial features. The intervention can be performed at the same time as a rhinoplasty or face lift.

Genioplasty is used to correct a receding chin using an implant or a prominent chin by filing down or removing jaw bones, depending on the case. Whatever the problem you wish to correct, consult Dr. Michel Alain Danino for all the information about the surgery, preparation and convalescence.

Injectables – Get a Lifting Effect Without Surgery

To treat:

  • Crow’s feet 
  • Wrinkles around the mouth
  • Wrinkles on the neck
  • Wrinkles on the forehead 
  • Wrinkles between the eyebrows
  • Wrinkles on the sides of the nose
  • Expression lines
  • Wrinkles on either side of the mouth
  • Wrinkles at the corners of the lips
  • and more…

Juvederm MD

This is a filler which is used as an anti-wrinkle treatment. Juvederm is made of hyaluronic acid, a sugar which is already and naturally present in the body, and its injection causes an instant smoothing out of the targeted areas of the face. The result is a younger and more relaxed appearance, and more elastic skin.

Botox®

Botox is the commercial name of an injectable product that has a bacterial origin, botulinic toxin. Approved by Health Canada, Botox® has been in use for more than 20 years. Thanks to its muscle relaxing effect, it provides an elastic, natural and smooth look that can last up to 6 months. Botox® injection is a non-invasive solution with a good reputation that does not require surgery, is nearly painless, and provides exceptional results. 


Botox® treatment can easily be combined with hyaluronic acid injections (Juvéderm MD).

Injections of Hylaform, Perlane and Restylane

These three products are made up of hyaluronic acid, an entirely biodegradable product which is already present in the human body. There is therefore no risk of allergic reaction.

Hylaform® Gel
Hylaform® is a viscoelastic gel that fills and smoothes wrinkles. The treatment is simple and quick, in addition to providing immediate results that last up to 12 weeks.

Perlane
Perlane is also made from hyaluronic acid. Perlane is used as a volumizing lip injection, and for the treatment of fine lines around the mouth, the eyebrows and the eyes. Results last 6 to 12 months, and are visible immediately after injection.

Restylane®
Restylane® injections are used to correct moderate to deep wrinkles on the face, as well as to add volume to the face. As with Perlane injections, the results you get with Restylane® last between 6 and 12 months.

Areas that can be corrected with HA injections are:

  • Lips
  • Cheekbones
  • Eye contour
  • Eyebrows (lion wrinkle)
  • Forehead 
  • Temples
  • Nose
  • The nasolabial lines (bunny lines)
  • Chin
  • Jaw

To discuss the various options that are available to you, make an appointment with Dr. Michel Alain Danino. In addition to counselling you as to the solution best suited to your needs and your budget, he can tell you about the pre- and post-surgical protocols for each treatment.

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