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Facial Rejuvenation

Nose Aesthetics

What is Nose Aesthetics?

One of the structures that determine the facial features and draw attention because it is in the middle of our face is the nose. The nose is the most broken organ due to sports, accident or trauma due to its protruding structure on our face. For these reasons, rhinoplasty is one of the most applied aesthetic procedures. Curvatures or obstructions that cause breathing difficulties can also be corrected by performing septoplasty during rhinoplasty.

Rhinoplasty surgery can be performed to anyone whose expectations are realistic and reasonable, taking into account additional diseases, in the period after the age of 17, when facial bone development is completed. In the past, noses with a very raised tip, a very carved back and a very obvious design were aimed, but today the goal is to create a result that is in balance with other structures on the face, befits the face, is not very obvious and does not have difficulty in breathing (except for the patient group who wants to be aesthetically obvious). .

Since each person’s nose is unique to him, nose surgeries should be planned and performed individually. For this reason, it is important that you express to your doctor the features that you do not like about your nose and that you want to change during the pre-operative examination. People who think about having a nose surgery usually think a lot about this issue and when they look in the mirror, they only see their nose. The doctor you apply to can analyze your nose and other structures of your face (chin, cheekbones, forehead, eyebrows), their general harmony without focusing only on your nose, and can give you information about the procedures that need to be done in addition to the nose surgery. For example: filling these areas in a person with sunken cheekbones, advancing the tip of the jaw in a person with a chin that is too far back, or clarification with filling will provide a better aesthetic result. If you do not take these suggestions into account, the general facial expression will not give the result you want, even if you have a beautiful nose.

In rhinoplasty, two types of surgical methods called open and closed techniques are applied. Beyond the personal preference of the operating surgeon, both techniques have different advantages and disadvantages. Which of these techniques will be applied is decided after the examination. The duration of this operation, which is performed under General Anesthesia, is 2.5-3 hours. If only the cartilage at the tip of the nose will be intervened, local anesthesia may also be preferred. At the end of the surgery, silicone pads are placed in the nostrils if deemed necessary. These tampons are usually removed after 3-5 days. The plaster or splint placed on the back of the nose is removed after about 9-10 days. If only the tip of the nose has been intervened, it is not necessary to put a plaster cast, tapes will suffice. There is mild to moderate pain after the surgery and oral painkillers are sufficient for pain control. If you feel very well after rhinoplasty, you can be discharged on the same day, but patients usually stay in the hospital for 1 day.

Post-operative swelling and bruises may vary from person to person and the size of the surgery. Swelling and bruising may be more common in smokers due to cough and pressure increase after surgery. In order to limit and reduce this swelling and bruising, it is recommended to apply cold compresses around the nose and on the eyelids intermittently for 2 days. Keeping the head elevated also helps to limit the formation of edema. In the first days and weeks after nose surgery, your breathing may not be very comfortable due to edema and crusts in the nose. The use of some drops and creams during this period softens the crusts and makes them easier to clean.

The bruises and swellings around the eyes and nose generally go away after 2-4 weeks. After this period, the person who does not know him/her will not realize that he/she has had the surgery and will be able to go out into the community at the end of this period. Of course, the patient does not have to be on bed rest during this period, although he cannot do heavy sports, he can walk. One week after the operation, he can return to non-heavy working conditions such as desk jobs. It takes 1 year for the swelling to go down over time and the nose to take its final shape. During this time, your doctor may recommend various massages for you.

After rhinoplasty, as in any surgery, some undesirable situations may occur. There may be risks associated with general anesthesia, as well as bleeding, infection or wound healing problems. There may be numbness in the nose area for several months after rhinoplasty, especially in open technique procedures. After the operation, dryness can be seen in the nasal mucosa. This situation is more common in the winter months, in areas with low humidity or in houses with dry air heaters. It may be necessary to use sprays that moisturize the inside of the nose for a longer time. Sometimes there may be permanent or temporary changes in the sense of smell. This problem is more common in patients who are operated on the nasal septum. nose surgery

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist

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Facial Rejuvenation

Ear Aesthetics

What is Ear Aesthetics?

Ears, which are originally hearing organs, are also aesthetically important organs that affect the perception of facial integrity due to the projections they form on both sides of the head. The fact that the angle of the ears with the head is higher than normal is called the prominent ear problem and it is seen quite frequently in one of twenty children, that is, in the society. Ear problems are not limited to prominent ears, problems such as the size of the ears, the size of the earlobes, the rupture or enlargement of the ear holes are also among the problems that can be treated with aesthetic intervention. The ear is a cartilage structure consisting of unique folds that are different from other cartilage structures in the body. Even thin folds are important for ear aesthetics.

Prominent ear deformity usually occurs due to genetic reasons, and since the folds in the upper half of the ear are also deleted, the ear appears open and flat outward. This appearance may result in ridicule by friends and psychological loss of self-confidence when the child comes to the age of play and socializes. This can even affect school success.

If prominent ear deformity is noticed at birth, it can be treated without surgery in the first few months with molding and taping methods, but these treatments fail because the cartilage hardens after the third month.

Ears are fast growing organs and reach 90% of their adult size by 5-6 years of age. In order to protect the child from psychological trauma at school, the ideal age for prominent ear surgery is considered to be 5-6 years old. Ear plastic surgery can be performed at any age. Interventions up to the age of 12 can be performed under general anesthesia and then with local anesthesia. General anesthesia can also be applied to people older than 12 years of age who are afraid of local anesthesia.

The surgery takes approximately 1-1.5 hours and generally does not require a stay in the hospital. Although different surgical techniques can be used depending on the condition of the patient’s ear problem, the most commonly used method is the process of laying the cartilages backwards with permanent sutures. The printed bandage around your ears after surgery is removed 2 days later. After that, tennis headbands or headbands should be worn for 2 weeks, neither too tight nor too loose to protect the ears. There may be swelling and bruising/redness for 1-2 weeks. It is not necessary to take stitches as dissolving stitches are used.

Although patients are afraid that their stitches will open and their ears will become prominent again, this possibility is very, very low.

Since the surgery is performed through an incision made behind the ear, there is no visible scar when viewed from the front. The scar can only be noticed if the back of your ear is opened and examined.

Tears or enlargement of the earlobe may occur due to heavy earring use and/or snagging. This situation can be easily corrected under local anesthesia. However, after this process, you should not use earrings for a few months to prevent reopening.

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist

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Facial Rejuvenation

Eyelid Aesthetic

What is Eyelid Aesthetics?

“You don’t get a second chance to make a first impression!” It is one of the introductory words that personal development experts like to use when starting their speech. When creating the first impression, your clothes, what your body language says; Of course it’s all important, but eye contact comes into play before engaging in social conversation and starting a conversation. We try to understand the feelings of the other person by looking into their eyes. For this reason, the eye area of the person in front of us is such an important body area that it can affect our thoughts about it.

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The face is not just eyes, lips, eyebrows or cheeks, it must be considered as a whole; but facial aging first begins to show itself around the eyes. Skin sagging, swelling, wrinkles and bags on the upper and lower eyelids; It causes an old, sleepy and tired appearance. Although the upper and lower lids are almost similar in structure, they may not deform at the same rate, so the lower and upper lids can be evaluated separately.

The downward displacement of the forehead and eyebrows due to the effect of gravity begins around the age of thirty-five. The sagging of the upper eyelid skin becomes more evident with the sagging of the outer eyebrows. Around the age of fifties, the muscles and skin on the upper eyelid become thinner, as well as the muscles and skin on the entire face, and sagging increases more. Due to the loosening of the connective tissue and fibers around the eye, the fat pads in the eye socket herniate outward and an image called under-eye bags occurs. Depending on genetic characteristics, sagging and/or bagging on the eyelids can sometimes be seen at an early age. Aesthetic eyelid surgery, that is, blepharoplasty, can give the person a younger and fitter appearance. Since the eye area has a very complex and sensitive anatomical structure, preoperative examination should be done very carefully and an intervention plan should be made for the problem.

Two problems are usually encountered in the upper eyelid, consisting of excess skin and herniation of fat pads. If there is excess skin, only the skin should be removed, and if excess skin is accompanied by excess oil, some oil may need to be removed. Sometimes the sagging skin on the upper eyelid is so great that it can even narrow your visual field and prevent you from seeing. Swelling on the outside of the upper eyelid may not be caused by excess fat, but by downward displacement of the lacrimal gland. Fixing the lacrimal gland towards the bone can solve this problem. In the lower eyelid, there is usually forward bagging of the adipose tissue in the lower part of the eyeball due to the loosening of the connective tissue. If this fat is more than necessary, it can be removed, or it can be shifted in the direction of the decreased adipose tissue to compensate for the tissue deficiency in the part such as the tear trough in the lower eyelid-cheek separation. The groove in the lower eyelid-cheek separation (tear trough) can also be temporarily corrected with fillers without surgery.

Upper eyelid operations can mostly be performed with local anesthesia, since it works in deeper tissues in the lower eyelid, sedation should be added to local anesthesia. The operation of the upper eyelids alone ends in half an hour, but the operation of the lower eyelids takes about 1 hour. A full general anesthesia can also be applied to patients who wish. If the surgery was performed with local anesthesia or sedation, you can be discharged on the same day. Depending on personal characteristics, there may be bruises and swelling around the eyes that last for 7-10 days. It takes 1-2 months to get full results from the surgery. 

The eyelids age along with the other organs of the face. Performing eyelid surgery on a person with drooping eyebrows and crow’s feet will only partially benefit the tired or elderly expression of the patient, and the patient will not be happy enough. For this reason, detailed examination of the patient by a plastic surgeon; It should be analyzed whether it needs additional procedures such as eyebrow lifting, face lift, filling, botox.

As in any surgery, some undesirable conditions, called complications, may develop in eyelid surgeries. In the early period, there may be risks related to general anesthesia, bleeding, infection or wound healing problems that may be encountered in any surgery. Since it is worked around the eyes, eye irritation or dry eyes may be observed in the early period and you may need treatment for this. Swelling and bruises around the eyes after this surgery may last longer if you are exposed to sunlight for a long time. The amount of skin to be removed from the upper and lower eyelids is very important. If more skin is removed than necessary, it is possible for your eyes to remain open and dry and prepare the ground for keratitis. Since the removal of excess tissue is much more difficult to compensate, a good planning should be done before the surgery. Although the eyelid skin is the thinnest and most easily healed skin in the body, it should not be ignored that the wound healing process of each individual is different from each other.

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist

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Facial Rejuvenation

Brow Lift

What is Brow Lift?

People all over the world express their emotional state through facial expressions and often believe that emotions and facial expressions are directly related to each other. However, facial skin also begins to loosen and sag in parallel with age and genetic predisposition. This phenomenon is observed earliest and most prominently in the tissues around the eyes. The sagging of the eyebrows over time; even if the person is fit and cheerful, it gives him a tired, sad and old expression.

The sagging of the eyebrows generally starts after the age of 35, but genetically, there may be people who have low eyebrows and complain about this condition. If these people are looking for a permanent method rather than temporary methods such as eyebrow lifting with botox, they are suitable for eyebrow lifting surgery.

Brow lift surgery is a procedure that can be performed with eyebrow suspensions, endoscopic or open technique, under local or general anesthesia in 1-1.5 hours under operating room conditions. The eyebrows are hung on the bone periosteum with stitches by entering through two small incisions made through the scalp. The patient can be discharged after resting for a few hours. There is no loss of hair or sensation in the incision areas.

Since eyelids and eyebrows loosen and droop with the effect of gravity, performing brow lift surgeries together with eyelid surgeries generally provides better results. Again, botox and filler applications for wrinkles between the eyebrows, forehead and eye area will also help rejuvenate your face as a whole. Eyebrow procedures can also be combined with other aesthetic surgeries.

There may be swelling and/or bruising on the forehead and around the eyes after surgery. You can apply cold application around your eyes to reduce these bruises and swellings. You may feel numbness and tension in your forehead and as if your eyebrows are raised too high. These pass within 2-4 weeks as the edema decreases. The bandage on your head is removed after 2 days and you are allowed to take a bath. Stitches are removed after 7-9 days.

It may be difficult to return to social life due to swelling and bruises for 2-3 weeks. A trauma to the forehead area may cause breakage and loosening in the threads, causing unilateral or bilateral eyebrows to fall again. As it is said in every plastic surgery, the shape of the forehead and eyebrows may not be permanent as the aging process continues. However, depending on genetic factors, this procedure does not need to be repeated for 5-10 years.

The risks that may be encountered in the early period can be summarized as complications related to general anesthesia, bleeding, infection and wound dehiscence, which are the problems that may be encountered in any surgical procedure. Feelings such as numbness and difficulty in raising the eyebrows in the early period may very rarely be permanent. If an undesirable result such as asymmetry develops in the eyebrows, re-operation may be required.

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist

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Facial Rejuvenation

Botox Applications

What is Botox?

Contrary to popular belief, Botox is not a snake venom, but a toxin of a bacterium called Clostridium botulinum (Botulinum Toxin Type A). The toxin obtained from this bacterium in the laboratory environment is purified, diluted and bottled as a medicine.

In Turkey, 3 different brands of botulinum toxin originating from America and Europe are used, except for Chinese or Indian products. Although Botox is actually the market name of the botulinum toxin produced by the Allergan company, it has become the name used for all botulinum toxins in general, since it is the first product to come out. Other brand names are Dysport and Neurobloc.

After it was determined that the toxin of the microorganism C. botulinum caused temporary muscle paralysis, Botox was first used by orthopedists to relax spastic muscles and by ophthalmologists in the treatment of strabismus. It was envisaged that it could also be used to prevent the movements of the facial muscles that cause mimic lines over time, and for this purpose, FDA approval was obtained and it was put into aesthetic use. It is currently the most common non-surgical aesthetic application in the world.

Wrinkles on the facial skin are caused by the contraction of the muscles we use to make our facial expressions. Since not everyone does the same mimics at the same frequency, and the thickness and structure of the skin are not the same, the age and places where these wrinkles or lines begin to form are not exactly the same. Even at the age of 20, the lines between the eyebrows can become quite evident in people who tend to frown. People who smile by squinting or whose eyes are constantly squinted because their eyes are very sensitive to the sun may also develop lines called crow’s feet at a very early age. People who use their forehead muscles a lot while talking may have horizontal lines on their foreheads. Some people may have droopy eyebrows due to aging, while others may have genetic reasons. This lowness can be treated with surgery, as well as for those who do not have time for surgery or who are afraid of surgery, the edges of the eyebrows can be lifted with botox. Botulunium Toxin A is a treatment method applied especially for horizontal lines on the forehead, vertical lines between the eyebrows, wrinkles around the eyes called crow’s feet, and eyebrow lifting.

When botulinum toxin is injected into the muscle that causes the mimic we do not want, it temporarily reduces or stops the contractile function of the muscle, and thus the skin on the muscle becomes flat because it cannot be wrinkled. Botox application is an easy injection procedure that can be done in outpatient conditions. A slight swelling and redness may occur in the injection areas, which disappears within half an hour. The effect of the drug usually begins to appear after 2-3 days and fully settles in 7-10 days. After the first application, the effect usually lasts for 4 months, with repeated applications, this effect can last up to 8 months. The amount of dose administered, its location, and the number of times it is administered are also factors affecting the duration.

Botox should not be applied to those who have certain neurological diseases, pregnant and breastfeeding women, and those who use aspirin/blood thinners and have active infections in the areas where the injection will be made, botox should be applied after the anticoagulant drug is stopped and/or the infection at the injection site is treated.

Botulinum toxin does not spread to the body in cosmetic application doses. Allergic complaints are almost nonexistent all over the world. The side effects of botulinum toxin are drooping of the eyelid, depending on the application area. With some drops, this miscarriage can be treated in 2-3 weeks.

It is not possible for new wrinkles to form or to deepen existing wrinkles in areas under the influence of botulinum toxin.

Uncontrolled sweating is the last thing we need while trying to catch up with today’s busy work pace. Almost everyone uses deodorant products, also called “anti-perspirants”, to keep sweating under control during the day at the start of the day. However, for some, these products are not enough and the person realizes that they sweat excessively during the day and feel uncomfortable. There is now an easy solution for this condition called hyperhidrosis, which means excessive sweating. Botulinum toxin A, which is often applied to remove facial expression lines and wrinkles, is a product that has been FDA approved for use in the treatment of hyperhidrosis.

Botulinum toxin A is also commonly known commercially as Botox® or Dysport®. Botulinum toxin A is a neurotoxin and just as it weakens the mimic muscles by blocking the transmission from the nerves to the muscles, it also blocks the transmission of the stimulus from the nerves to the sweat glands. In this way, the person feels comfortable, relaxed and dry.

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist

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Facial Rejuvenation

Filling Applications

What is Fill?

We have all seen it when we visit various museums: earrings made of ivory, gold, silver, etc., necklaces, bracelets, combs, perfume bottles, containers for preparing mixtures… All this is proof that women have tried to look younger, more beautiful and attractive for centuries. For this purpose, they have benefited from various herbs, creams and mixtures.

Although we consider the person in front of us as a whole, the first area that draws our attention in a person when starting to communicate is the face. Scientific studies have revealed that the perception of the face as beautiful or ugly is largely independent of culture. The human brain detects and records extremely quickly whether a face is beautiful or not. In general, all women are aware of this, and they pay a lot of attention to their faces.

The need for the face to look young, fresh, bright and fit has led to the creation of companies producing facial creams, lotions and peeling products. However, tissue losses due to melting and thinning of the skin and subcutaneous adipose tissue during facial aging could not be prevented with these creams. Fillers have been produced to restore the volume and fullness lost due to aging or trauma, to reduce wrinkles, and to moisturize the skin from the inside. The fact that it can be done without surgery, easy to apply, getting immediate results, and having less side effects has increased the prevalence of these applications, and more reliable products have been put into use thanks to the R&D studies in this field.

Temporary, semi-permanent and permanent fillers are the most popular of the temporary fillers containing hyaluronic acid, because permanent fillers are more likely to have side effects. These fillings, which are generally in gel form, are used by injection and cannot be withdrawn from the area where they were injected.

Hyaluronic acid is a natural molecule that is already found in our body at a very high rate and can be obtained technologically from bacteria. Therefore, the possibility of allergic reaction is lower than those of animal origin. It has no carcinogenic effect. Although it is mainly used on the face, fillers can also be used in other parts of the body.

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Since the skin and subcutaneous tissue thickness is not the same in every part of the body, companies develop and produce products with different molecular sizes and cross-link ratios to be injected into different body parts. The place where these products will be used and the depth of injection are different from each other. While more fluid fillers with less cross-linking ratio are used for the under-eye area with a thin skin texture, products with high cross-linking ratio and high molecular weight are used to add volume to the chin or cheek area.

Since hyaluronic acid is a water-holding molecule, it adds volume to the area where it is injected in the body and can be applied practically in polyclinic conditions. As mentioned before, there are different products to apply to different areas, and only an expert can know which of these products will be used on which area, and different products can be applied for problems in different parts of the body in the same session.

Filling application areas; grooves descending from the corners of the nose to the corners of the mouth, lips, under eye, between the eyebrows, cheeks, chin, neck, hands and other places with tissue loss in the body. Sometimes, if the nasal ridge has become too curved or collapsed due to nose surgery or trauma, filling can be applied to give height to the ridge of the nose. Mild facial asymmetries, whether congenital or acquired, can be corrected with filler injections. The filling process can be applied to anyone, whether male or female, who has completed puberty (considering additional health problems).

Its effect lasts for 8-12 months depending on the applied area, product brand and type and the differences in the personal characteristics of the person applied. In this time, it is destroyed and destroyed in the body without harming the body. If the result obtained is not liked by the person who has been filled, permanent fillings are irreversible and getting rid of these materials may require some difficult surgical interventions. The advantage of fusible fillers is that there are some substances that will melt them, and if you have a little patience, it will melt itself.

Before starting the application, local numbing can be done with anesthetic creams or needles, as well as some brand products have pain relievers in their injectors. The application time is about 10-20 minutes.

After the filling is done, redness, swelling and bruising may occur depending on the sensitivity of the place where it is made. Side effects that may occur in filling processes; pain, swelling and discoloration at the injection site. Very rarely, granuloma and abscess may occur. Although the permanence of animal or silicone-containing fillers is higher; risk of allergic reaction, formation of cysts and granulomas is also higher. People who use aspirin should stop aspirin 1 week before the filling application and should not use it for 2-3 days after the application, otherwise intense bruises may occur in the application areas.

Applying ice after the filler injection prevents or reduces the development of bruising. Since hyaluronic acid acts by holding water, it is recommended to drink plenty of water for the first few days.

Recently, bioexpander has become popular in skin rejuvenation and wrinkle treatment. Bioexpander is also a type of hyaluronic acid. Since it is very thin, this filler can be used safely, especially around the eyes, like light filling. Since it contains pure hyaluronic acid, it also increases the vitality of the applied area.

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Kenan Selçuk TUNCAY
Kenan Selçuk TUNCAY
Otolaryngologist