Procedures

PROCEDURES

Dr. Imber has long taught and written about the concepts of prevention and maintenance. With a dedication to performing the least invasive procedures at an earlier point in time, he has developed and popularized many of the procedures, which provide the framework for the work of the clinic.

Dr. Imber performs the full range of cosmetic surgery procedures. He has popularized the S-Lift, and developed the Limited Incision Facelift Technique, as well as popularizing the techniques of microsuction, and a large experience with fat transfer. His techniques for eyelid surgery incorporate fat transposition, and as with all procedures, strive for the most natural result.

To the right you will find an incomplete list of procedures performed at the Imber Clinic. Procedures requiring hospitalization are not included in the list.

Abdominoplasty

Abdominoplasty, or tummy tuck, is a procedure to tighten the abdominal skin and muscles. Pregnancy, and weight gain and loss are the primary culprits in the abnormal stretching and loosening of the abdominal skin and underlying rectus abdominus muscles. The operation is performed the office ambulatory surgical suite under general anesthesia.
An incision is made in the lowest portion of the abdomen, usually in the crease above the pubis. The horizontal length of the incision depends on the extent of skin laxity. The looser the skin, the longer the incision. After excess fat is removed by liposuction, skin and fat are lifted off the underlying muscles. The vertical borders of the restus abdominus muscles are tightened by suturing them together. In some circumstances there is so much skin laxity that the umbilicus (belly button) is removed. In these cases the umbilicus is replaced in its natural position in the newly tightened skin.

An abdominal binder is the usual dressing. Initial post operative days are uncomfortable, and there may be annoying complications associated with the procedure, such as fluid collection. In general, the procedure is easily tolerated and results are good.

Mini-Abdominoplasty is usually combined with liposuction and is designed to remove loose skin of the lower abdomen, between the pubis and the umbilicus. This is the most common area of concern after pregnancy, and the procedure deals directly with the loose skin, and stretched muscle. The incision is confined to the area above the pubis, like a caesarian section scar. There is no need to reposition the belly button. Recovery from mini-abdominoplasty is fast, and usually uncomplicated.

Ankle microsuction

Microsuction of ankles (cankle surgery)
“Cankles” is the commonly used term to describe a lack of transition in shape between the ankles and the lower portion of the calf.

The condition results in a relative shapeless ankle area, and can be due to many causes, the most common of which is a genetic predisposition. Sometimes weight gain concentrates in this area, causing “cankles, and it is sometimes caused by fluid retention.

Most healthy adults have the condition from youth, and it is purely an anatomic variation and does not signal illness.

Dr. Imber has pioneered the treatment of “Cankles” by microsuction, with generally excellent results. The procedure is performed under intravenous sedation, and local anesthetic. Patients are in twilight sleep and feel nothing. Incisions about a quarter of and inch in length are made on both sides of the ankle, and a small, sterile, steel cannula is inserted to remove all excess fat. This shapes the ankle from both inside and outside, and up toward the calf. The calf itself is not included in the procedure.

For most patients this results in a marked improvement in shape. For some, where the lower calf muscle is excessive the result is less dramatic. But, in virtually all cases there is significant, and often dramatic, improvement.

Complications are rare, and include the possibility of numbness in the area. Post operatively, dressings of gauze and ace bandage are applied. These are exchanged for compressive stockings after 48 hours.

There is little post operative discomfort, and the procedure is much appreciated for its aesthetic improvement.

Blepharoplasty

Blepharoplasty is the term for eyelid surgery, one of the most frequently performed cosmetic procedures. It comes from bleph, pertaining to the eyelids, and plasty, to mold. To mold the eyelids — a genteel way of describing the procedure. In reality, it amounts to surgically removing the excess skin on and about the lids and reducing fat pads, which cause baggy eyes.
As an antiaging surgical procedure, it is among the earliest performed, typically in one’s mid-to-late forties but increasingly earlier. That should come as no surprise, since the skin of the eyelids is the thinnest and most delicate of the face. The eyelids provide an actual mirror of the system and swell at the slightest provocation. Here one finds the first signs of allergy, illness, emotional distress, or the results of last night’s spicy food and alcohol. Repeated cycles of swelling — and the rubbing that unconsciously follows — take a toll on the elasticity of the eyelids. When the fine thin skin is subjected to regular abuse, there can be no surprise in its distortion and the breakdown of elasticity. Each smile helps etch lines on the outside corners of the eyes, as does each squint to block the sun or look off into the distance. We do squint, and we do like to smile and laugh, and the damage adds up.

With the natural loss of elasticity, the eyebrows drop a bit, adding excess tissue to the upper lids. The fat pads of the lower lids become more prominent, and bags develop. For some this is a congenital problem seen as early as the teen years; for most, it develops considerably later.
Incisions in the upper lids are made in a natural skin crease. Incisions in the lower lids, a wrinkle between the lashes. Sutures are removed in four days and patients return to work one week after surgery.

Clamping eyelid wrinkles

This simple procedure achieves a lot and is among the quickest fixes of all. It is directed at the patient with excess, wrinkled lower-eyelid skin and no bags under the eyes. Stand in front of the mirror and smile a few times. If the skin under your eyes doesn’t fall back in place but forms tiny folds and wrinkles, then you see the problem. This is primarily a condition of middle age, though young people with years of sun exposure also exhibit the signs. The small folds of skin are anesthetized and gently lifted away from the under-lying muscle. In proper candidates, this is easily done without distorting the eyelid. A fine clamp is then used to pinch the excess skin, which is then precisely excised. There is virtually no bleeding, and the incision is closed with skin glue, or fine sutures that are removed in four days. There is minimal postoperative swelling or discomfort, and by the end of the week there is little sign of surgery except for the absence of the excess skin.

Subconjunctival (transconjunctival) blepharoplasty

Another mouthful. This is an operation usually restricted to young adults. It treats puffy, baggy lower eyelids in people whose skin is still firm and elastic. That eliminates all but those in their twenties or thirties who have suffered through youth with people saying, “You look tired. Is anything wrong?” No, there’s nothing wrong. You look tired because you have inherited excess fat beneath the muscle of your lower lids. It’s a family trait. Have a look at the family album. It’s there — and it’s easy to get rid of.

The term subconjunctival, or transconjunctival, blepharoplasty means that the actual surgery is done through the inner lining of the eyelid and no visible skin incision is necessary. Under local anesthesia and sedation, the eyelid is held down and the cornea protected. An incision is made in the eyelid lining, or conjunctiva, in order to reach the fat pockets just deep to it, so the operation is sub, or deep to, the conjunctiva. After the fat is removed, some ointment may be put over the area, and the eye is allowed to close. No sutures are necessary, and healing is rapid.

Often some temporary bruising and discoloration result, but otherwise there are no scars and no sign of surgery.
The procedure is specifically designed for people with excess fatty bags but no loose skin or wrinkles. When the fat is removed, the skin becomes less tense, then contracts. If your skin is loose already or very inelastic, this may not be the procedure for you. In some cases laser resurfacing of the eyelid skin can be done at the same time. This tightens the lower-eyelid skin and removes blemishes and pigment.

Botox

Dr. Imber, and his nurses, have vast experience with Botox therapy, and have been using it successfully for more than a decade. Botox is the most effective method for temporary elimination of facial wrinkles and frown lines due to facial muscle activity. Botox is particularly useful to prevent wrinkling and skin breakdown in the younger patient. Botox requires 24-48 hours for full effect. The treatment is fast and causes minimal discomfort. Initially, a second visit may be necessary to establish proper dosage, and natural effect for new patients.

Brachioplasty

Brachioplasty is designed to tighten the skin of the upper arm. Depending on weight gain and loss, and heredity, most people will see a loosening of the skin of the upper arms. It is an unsightly reminder of aging, and has long been a target of innovative surgery.

It is simple enough to place an incision from the axilla to the elbow, and remove all excess skin and fat. Unfortunately, the price of this is a long, and often unsightly scar. Hence, the most dramatic version of this procedure is reserved for those whose skin laxity warrants accepting an unsightly scar.

For most people a compromise is available which significantly tightens the skin of the upper arm, and has little or no visible scar.

This is accomplished by suctioning out fat and removing a triangle of skin at the axilla (under arm).

Results are quite good, and significant complications are rare.

Breast Augmentation

Breast augmentation, involves the use of implants placed beneath the breast to increase breast size. The procedure, in very much its current form, has been performed successfully since the early 1970’s. Nearly 300,000 women undergo the procedure annually.

Breast implants are made of silicone envelopes filled with either saline solution or silicone gel, which some people may find worrisome. The fact is that silicone is everywhere, and silicone gel implants have been extensively studied by government groups and scientific panels, and are deemed fully safe for use. This is good news. In my practice I favor silicone gel filled implants over saline filled, as they provide a generally more natural result.

The implants push the natural breast forward and enlarge its projection and width. This can be achieved by placing the implant on top of the pectoralis muscles, in a natural plane just beneath the breast, or under the pectoralis muscles themselves. Why choose one over the other? The most common complication of breast augmentation is fibrous capsule formation. This happens when the body reacts excessively to the foreign body (the implant) and forms a thick internal scar around it. The result is a firm feeling breast. In order to mask this firmness, many surgeons place the implant beneath the pectoralis muscles. In effect, to hide the firmness with the muscle padding. To my way of thinking this placement is less anatomical, and too often results in a significant double hump deformity. I choose to place the implants above the muscle. If there is significant capsule formation it is usually easily dealt with, but the incidence of capsule formation requiring surgery is small. Neither method is perfect, but under the best of circumstances I find placing the implant under the breast and on top of the muscle to give undetectable, natural results…and that, after all, is our goal.

Incisions can be placed under the breast, near the inframammry fold, around the areola, or under the arm. Usually, the inframammary incision offers the best access, and is best tolerated.
After surgery a surgical bra is worn as a dressing. There is pain or discomfort for 24-48 hrs, and most patients return to work in a week.

Breast Reduction

This procedure reduces the size of overly large, pendulous breasts, to a size and shape in harmony with an individual’s body. There are many reasons to seek breast reduction, and a few variations on how it is performed.

Usually performed under general anesthesia, or sedation and local, the operation is fairly extensive due to the dense nature of breast tissue and volume being removed. Try to visualize the operation as taking a wedge out of a large pie, and the reforming the remainder into a smaller whole. There are many incision options, which depend on anatomy, surgeon preference, and patient preference.

The post operative dressing is usually a surgical bra, and post operative pain is surprisingly minimal.

Breast Lift is performed using the same incisions as breast reduction. Excess skin is removed, but not breast tissue. In essence, this operation creates a tighter, higher skin brassiere. When there is less dramatic sagging of the breasts, smaller incisions will often suffice, sometimes only around the areola, where scarring is minimal.

The level of patient satisfaction with both breast reduction and lift is very high. Scars fade with time, but never fully disappear. None-the-less, patients are delighted with the trade off.

Cheek Implants

Cheek implants are anatomically shaped to mimic the natural cheekbone, and are made of silicone. They are inserted through a facelift incision, when that is appropriate, or via a lower eyelid incision. It is also possible to insert them through the mouth. The implants are anchored with sutures. A tape dressing may be applied.

The procedure results in more prominent cheekbones, a hallmark of beauty, and also offers something of a lift to the cheek and jowl area.

Recently, I have most often been enhancing the cheek area with fat transfers. I have found this relative non-invasive procedure very successful, easy to perform, and long lasting.

Chin Enhancement

Chin enhancement, or mentoplasty, refers to building up a “weak” chin to balance facial structures. This is more important aesthetically than one assumes on first consideration. Chin and cheekbones are often the basics of a beautiful, or handsome face. A strong chin can balance a large nose, and often is suggested when doing nasal reduction surgery. I usually insert a small silicone implant from inside the lower lip. There are no visible scars and the result is instant. Post operatively there is a tape dressing for several days. Complications are few, and should be discussed fully prior to surgery.

I recent years I have been enhancing the chin with fat grafting, which is fast and elegant. The down side is not all the fat survives and the procedure usually has to be performed twice.

Fat Transfer

Autologous fat transfer is the medical term for fat grafting. The procedure utilizes your own fat as filler. This minimally invasive procedure fills in lines and folds, builds up cheekbones and chin, and eliminates facial depressions. A small amount of fat is harvested by needle from the belly, love handles, or thighs, treated to remove oils, and immediately injected into areas that need filling or augmentation. Usually performed under mild sedation, the procedure takes less than an hour, and recovery is overnight. There is no significant down time.

The objective is to inject fat in a manner that allows it to develop its own blood supply and be retained for permanent correction of defects. As a rule, a third to half of injected fat becomes a permanent graft.

Results are always natural and even minor complications are exceedingly rare. This is the most basic and easiest of cosmetic procedures and is an excellent tool correct skin folds and provide volume and lift.

Fillers

Fillers are sterile, injectable compounds used to fill in facial folds and wrinkles. Often the same substance can be used to enlarge and enhance cheekbones and other areas. Numerous brands are available depending on patient and physician choice. We are happy to discuss this with each patient. All modern injectables have very minimal risk of allergy. Results are visible immediately, with very little bruising or evidence of treatment.

Forehead Lift

Forehead lift is performed to reduce horizontal forehead lines or lift the eyebrows. Sometimes, it is a means of lifting the upper lids as well. The procedure is most often performed from within the hairline, sometimes at the very border of the hairline. The procedure has in my practice, been largely been supplanted by Botox, which does a better job of smoothing out forehead lines. I usually reserve the procedure for lifting the eyebrows back to their youthful position.

Limited Incision Face-Lift Technique (L.I.F.T)

There is no such thing as a “one size fits all” face-lift. Surgical techniques should address specific problems, and the same procedure is not applicable to every problem and every person. A forty-nine year-old woman does not have the same aging issues as a sixty-seven year old, so why should she be offered the same operation? Men want to tidy up their necks and have their skin fit. Women are concerned with wrinkles, folds and blemishes. Why would I offer them the same single option? It doesn’t make sense. Different people in different stages of life have different requirements.

It has always been clear to me that if we are to provide a full range of maintenance and correction options, something must fill the void between simple, noninvasive skin treatments and a full face-lift. Loss of elasticity and signs of aging begin early and even if a road map of facial wrinkles has not yet appeared, relief is often welcome. Our goal is to stop the progress before the changes have pushed from youthful to matronly. Clean up the jawline, return the cheekbone prominence to what it used to be and undo those nasolabial folds along the cheeks and lines beside the mouth. While these changes are not terrible they are beyond the scope of injections, lasers and peels.

In the past, the most common advice was “Wait and do a full face-lift when you are ready.” Few plastic surgeons, myself included, thought very much of doing less. We were taught that anything less than a full face-lift wasn’t worth the trouble. We were wrong. Even as the nuances of the surgery and the sophistication of the profession advanced, we held to preconceived notions. But I was searching for a better solution. One that could be applied earlier, produce a natural result and make the early middle-aged patient look appealingly young again.
It was at that point, in the mid-1980s, that I first encountered the rudiments of the S-lift, so named for its lazy S incision. A few years later, I reduced the incision further, eliminating the component in the scalp and increasing effectiveness. The result was even more natural. It corrected the loss of elasticity and drooping from the eyes, to the Adam’s apple, and dramatically reduced the nasolabial fold. This was the limited incision facelift technique, or short scar face-lift. it seemed to be exactly what surgeons and patients were looking for and became enormously popular. As with everything in medicine, many people have simultaneous inspiration, and one cannot lay claim to “inventing” a procedure. “Success has many authors; failure is an orphan.”

This modern mini-lift has been adopted, renamed, and publicized by many surgeons. The June 4, 2009, New York Times published a long article about the marketing of specialized face-lifts, making reference to the seminal importance of my original S-lift and the procedures it had spawned. But be warned: A new name doesn’t make a new procedure. After the journal Aesthetic Surgery published the scientific paper on the first 1,000 limited incision facelifts I had performed, I smiled at advertisements for surgeons claiming credit for the new operation. I am happy to have had something to do with devising and popularizing an excellent procedure, but the real beneficiaries are my patients, who understood that the new procedure would help them achieve and maintain a natural, youthful appearance.

In order to understand how all this works, let’s consider the anatomy of the face, what we are trying to achieve, and the difference between face-lift procedures. The skin of the face lies on a bed of subcutaneous fat and wispy connective tissue. Only in areas of facial expression is it bound directly to the underlying muscles. That means that there are muscle-skin connections around the eyes, lips, mouth, nose and chin, but the entire cheek and neck area, from the ears to the nasolabial fold, is free of these attachments and not closely bound to the underlying tissues. Therefore, it is easily separated and lifted. It is because of this lack of firm anchors that these areas are liable to become lax and droop as soon as the skin begins to lose elasticity. Correcting that laxity, along with the tightening of the underlying tough muscle fascia, lends itself to successful repair, or lifting. This tough layer, called the subcutaneous muscular aponeurosis, or SMAS, is where much of the real pulling takes place. This tightening helps alleviate jowls and deep nasolabial folds and adds longevity to the result. The thin, flat platysma muscle, a continuation of the SMAS, which underlies the skin of the neck, is also tightened to correct the two loose bands under the chin.

The limited incision facelift incision, or short-scar face-lift incision, begins in the bottom of the sideburn and follows a into the ear, behind the tragus, the little piece of cartilage that sticks out from the ear, and ends just behind the ear lobe. Incisions are hidden, and signs of surgery disappear quickly. One can confidently appear in public ten days after surgery. There is no scar in the hair or behind the ears or on the neck, and women can wear their hair up without worrying about the noticeable signs of traditional face-lifts. Because the top of the incision is in the sideburn there is no unsightly, telltale distortion of the hairline. The procedure reverses the loss of elasticity which has caused facial sagging, and results in a firm, straight jawline. Ancillary procedures include microsuction of the double-chin area and corners of the mouth and fat transfers to lip lines, lips, cheekbones and chin. Eyelid surgery is done at the same time, when indicated.

The procedure takes less than two hours to perform, usually under sedation and local anesthesia. It corrects loose jowls, reduces nasolabial folds, loose neck skin and reconstitutes the angularity of the cheekbone area. It does not correct the very lowest portion of the neck or the forehead. For these problems other variations of the face-lift may be employed.

Liposuction

Everyone knows something about liposuction, often sprinkled with misinformation. Liposuction, or suction assisted lipectomy (SAL) is performed under sedation and local, usually incorporated into the sterile saline solution injected to facilitate the removal of fat. Small, ¼ inch incisions, are made in relatively hidden areas close to the deposits of fat that are to be removed.
The procedure works by removing excess, enlarged fat cells, which make an area protuberant, or out of sync with the rest of the body. Examples are excess belly fat, love handles, saddle-bags of the thighs, fatty knees, or ankles.

In theory removal of fat cells from the area precludes return of the fat. Patients often ask if the fat then accumulates in other places. The answer is one will gain weight wherever the fat cells are. If fat cells are evenly distributed then one will gain weight throughout the body. The goal is not to gain weight, but liposuction in one area will not cause accumulation in other areas…gaining weight will.

After liposuction compressive garments are worn for variable periods of time, usually less than a week. Results of liposuction are not full visible for several weeks due to swelling. As with all surgery there are associated complications possible. These must be discussed prior to surgery. Liposuction is performed several hundred thousand times yearly, and has proven safe and reliable.

Microsuction

Microsuction is a very effective, minimally invasive technique. Fine, sterile cannulas are used for the removal of fat are the corners of the mouth, the jawline, neck, and the heavy folds that develop along the nasolabial line from the nose to the corners of the mouth.

Removing the fatty spots helps a lot, of course, and as a side benefit the microsuction irritates the undersurface of the skin and seems to stimulate it to tighten and look better. An area where this does wonders is the double chin.

Microsuction may eliminate the need for neck-lift in younger patients. What you can be assured of is visible improvement. This procedure is best for smaller areas and for individuals in their late thirties and forties whose skin retains a healthy elasticity. The least dramatic results are in those individuals with little excess fat but an anatomically obtuse angle between the neck and mandible (lower jaw). The sum of all this is that if the fatty accumulations along the jaw, and elsewhere, are dealt with early by microsuction, not only are they eliminated, but the skin over them tightens and adds to the result. Here, the sum is greater than its parts.

Microsuction of the jawline and the pouches alongside the mouth should be considered whenever a patient is undergoing eyelid or other facial surgery. It is a disservice not to think of it, for so much can be gained so easily. Microsuction alone is among the most popular options in fighting the early signs of aging. It is performed under local anesthesia and sedation. A tiny hole is made either under the chin or behind the earlobes, through which the cannula is introduced. These sites are chosen because they make for easy access to the trouble spots, and they are not readily visible.

The result of the procedure is immediate, though masked a bit by swelling over the first week or two. In general there is very little bruising. The actual result matures over six or eight weeks. At that point, all the swelling is long gone and the skin is as taut as it is going to be. The procedure is very, very low-risk. In general, this simple procedure takes about half an hour to perform, effectively eliminates some of the earmarks of early aging and refines the lower-face contours and tightens the skin. All this without traditional surgery, with minimal recovery time and little or no risk. Sounds too good to be true, but for the appropriate patients it buys years of good looks and pushes the need for actual surgery years down the road.

Dr. Gerald Imber and his staff will be happy to discuss your Microsuction procedure with you. Please call for a private consultation or schedule an appointment online at our Upper East Side office.

Mohs micrographic surgery

The reconstruction of facial defects resulting from Mohs surgery for cancer removal require experienced surgical planning and execution to achieve the most natural and least noticeable outcome. Dr. Imber has performed hundreds of these delicate facial reconstructions. Generally the reconstruction is scheduled for the morning following the Mohs procedure, to allow for proper planning and consultation with the Mohs surgeon.

Nasal Surgery

Nasal surgery, or rhinoplasty, is a well known and very popular procedure. The object is to create a natural looking nose, in harmony with other facial features. The nasal bones and cartilage may be reduced or repositioned to make the profile finer, the angle different, or the width reduced. The important thing is to express your desires, study your photos at consultation and talk through the options. Virtually anything is possible, but common sense, and good taste should be the rule.

My policy is to alter professional photographs with the patient until we reach a “look” that satisfies the both of us, and is reproducible at surgery.

The operation is performed in the ambulatory suite under sedation of full anesthesia, and local. I virtually always perform a closed rhinoplasty, which means no visible scars. Afetr surgery a dressing of paper tape strips and a plastic cast are worn for a week. There is post operative pain for the first night, and adequate medication is prescribed. Vigorous activities must be curtailed for several weeks after surgery.

Neck Lift

Neck lift is a procedure that is directed at laxity of the skin of the neck. Most patients find that they are focusing on the neck without realizing that loss of elasticity starts at the top and works its way down. Gravity doesn’t pick just the neck. However, sometimes the loose, wrinkled neck skin is out of proportion with other changes. The neck lift involves an incision behind the ear and along the hairline. The skin is lifted up entirely from ear to ear and tightened. Microsuction is performed at the same time. Neck lift usually requires an incision under the chin as well, to tighten the platysma muscle bands. The downside of the procedure is that the scar is in the hairline, and that laxity above the jaw is not corrected. Still, under proper circumstances it is a very useful operation. Most often a neck lift is combined with a face lift, and thought of as a single operation.

Otoplasty

Otoplasty, also known as Ear Surgery will help to correct prominent or protruding ears by setting them back closer to the head or reducing their size. It can correct a defect in the ear structure that possibly was present at birth, which becomes apparent with development or it can treat misshapen ears caused by injury. The procedure improves the shape, size and position of the ears. Correction of even minor deformities can benefit appearance and self-esteem, as it will bring balance and proportion to the ears and face.
Congenitally prominent ears are a cosmetic deformity that can have a serious emotional effect on a child. The procedure is performed frequently for children beginning as early as six years of age, as the size of the ear is nearly that of adulthood by this age, and the sooner the prominence is corrected, the less “teasing” the child may be subjected to. Many teenagers feel self conscious and shy due to prominent ears, and wear their hair long to cover the ears. Adults may also benefit from this procedure, which improves self-confidence with relative ease. Often, adults choose this surgery in conjunction with other facial plastic surgical procedures. Not only is it possible to “pin back” ears, but ears can also be reshaped, reduced in size, or made more symmetrical.

Understanding The Surgery
Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. The surgeon will then remove the necessary amounts of cartilage and skin required to achieve the right effect. In some cases, the surgeon will trim the cartilage, shaping it into a more desirable form and then pin the cartilage back with permanent sutures to secure the cartilage.

In other instances, the surgeon will not remove any cartilage at all, using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, the surgeon will apply sutures to anchor the ear until healing occurs to hold the ear in the desired position.

What To Expect After The Surgery
Soft dressings applied to the ears will remain for a few days. Most patients experience some mild discomfort. If you are accustomed to sleeping on your side, your sleep patterns may be disrupted for a week or so because you cannot put any pressure on the ear areas. Headbands are sometimes recommended to hold the ears in the desired position for two weeks after the surgery.
The risks are minimal. There will be a thin white scar behind the ear after healing. Because this scar is in a natural crease behind the ear, the problem of visibility is inconsequential. Anything unusual should be reported to the surgeon immediately.

Facial plastic surgery makes it possible to correct many facial flaws that can often undermine one’s self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Surgery to correct or improve birth defects or traumatic injuries may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.

PLATELET RICH PLASMA (PRP) INJECTION THERAPY

PRP Therapy encourages collagen growth and is an effective treatment for hair regrowth, skin laxity, tone, texture, wrinkles, stretch marks, and more. Derived from your own blood, PRP contains highly concentrated growth factors essential for natural skin repair. When used within our cosmetic treatments, PRP helps to promote cell growth, tissue repair and collagen production within the skin.

Dr. Imber uses PRP Injections to treat a variety of aging issues, including:

Facial Aging: PRP is injected into skin to encourage collagen growth within the dermis. It is particularly effective in reducing acne scarring, wrinkles and lip lines.

Hair Restoration: A series of PRP injections in the scalp stimulates hair follicles and, in most cases, results in thicker, fuller hair growth in thinning areas.