Forehead Lift -- PART 2

Operation

It is a relatively simple operation for the surgeon and for the patient as well. Forehead lift procedures may be completed under local anesthesia, with or without mild sedation, or under general anesthesia. The procedure may be performed in an out-patient facility, in the office, or hospital. Although the procedure is typically painless, you may have occasional mild discomfort during the procedure. If your surgeon elects for you to have general anesthesia, you will sleep through the procedure. The entire procedure may take from one to two hours, depending on the operation technique that will be used.

In conventional open approach, a coronal incision that is made slightly behind the natural hairline can be used. An alternative is the pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline. Your surgeon will then separate the skin and muscle from the underlying structures, depending upon the type of lift and desired results. Underlying structures are then suspended by permanent sutures or barbs. Your surgeon will then excise about 1 to 3 cm of excess skin; lift your skin to the desired level of lift; and lastly apply sutures or staples.

Another approach is endoscopic surgery. This commonly preferred technique is less invasive but it may require more surgery time. Several small incisions are placed just behind the hairline. An endoscope is placed under the skin in order to get a clear view of the muscles and tissues under the skin. Then the surgeon inserts another instrument through another incision to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is hold up in a higher position with temporary sutures. The skin will heal in this position.



Postop instructions

A hospital stay may or may not be needed following forehead lift surgery. The best environment for recovery will be determined by the preferences of both the patient and his doctor. Recovery varies from patient to patient and it is advisable to take it easy for the first week after surgery.

Your surgeon will apply a dressing to your face and head to protect your wounds, keep the tissue in the proper place during recovery and to help with swelling. The day after the surgery, the dressing will be replaced with elastic wrap to be kept in place at all times for a few days; then you will be asked to wear it at bedtime only for about a week. Initially after the procedure, patients can expect tenderness and swelling around the incision areas. The tenderness and swelling fade with time and usually subside after the first 10 days. 

After the operation you will be instructed to keep your head elevated and use cold compresses for several days. In case of excessive pain, redness, pus or other symptoms that do not appear normal, you will be advised to contact your surgeon immediately. Staples and sutures are usually removed after 2-7 days. Patients generally feel well enough to resume normal activities around the tenth day of recovery. Strenuous activities should be avoided for about three weeks.











Reference information: www.entific.com.hk, www.eafps.org/
The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Forehead Lift -- PART 1

Description

Forehead lift is the name of the surgical procedure that is performed to raise and rejuvenate the eyebrows.
Brief anatomy

The skin around the brow, forehead and temple areas loses its elasticity with age. Drooping of the eyebrows, horizontal wrinkles and vertical frown lines between the eyebrows are the earliest signs of aging. These give a tired, angry, or sad expression. A forehead lift can address these problems by surgically altering the muscles and tissues that cause wrinkling in the area above the eyes.


General information on the procedure

A forehead lift is often performed to treat conditions associated with aging. It may be done in conjunction with other facial plastic surgery procedures to achieve a more harmonious appearance. A forehead lift may be performed in several ways. The main difference among various methods for forehead lifting is the place of the incisions. Principally, a conventional open approach, or an endoscopic approach can be used.


Preop preparation

Your first step should be to contact a surgeon to schedule an initial consultation. During the consultation, your surgeon will work with you to establish realistic expectations about the results of your forehead lift procedure. 

The surgery will be explained in great detail so as not to leave any question or concern you have unaddressed. Depending on your needs and your surgeon's observations, additional facial procedures may be recommended. Your surgeon will also arrange to view your comprehensive medical history to decide if you are in satisfactory condition for forehead lift surgery. 

The surgeon must be made aware of conditions such as high blood pressure, heart disease, and bleeding disorders, as these can increase the risks associated with your operation. Previous surgeries are also crucial to know about, as they can affect the risk of complications. Your surgeon may also ask for medical clearance from your general physician and, depending on your health, request laboratory testing. In the weeks leading up to your forehead lift, it is important to cut down, if not eliminate, smoking and drinking alcohol.

 Aspirin, any medications containing aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs, gingko biloba, ginseng and vitamin E supplements should be avoided in the weeks leading up to the surgery. Lastly, daily medicines must be continued as long as they have been approved by your surgeon.

You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. Before the procedure, make sure to shower and shampoo your hair. Cosmetics should not be worn. False eyelashes, contact lenses, jewelry, and any other unnecessary accessories should be left at home.







Reference information: www.entific.com.hk, www.eafps.org/, 
The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Botox (Wrinkle Reduction Treatment)--PART 2

Botulinum toxin safety 

Botulinum toxin is a safe drug and when injected by an experienced facial plastic surgeon the incidence of side effects is extremely low. The most common side effects are temporary and localised bruising, slight redness of the skin and occasionally slight swelling at the injection site. The side effects of Botox are completely reversible and are temporary, lasting only a few hours and occasionally up to one or two days. Rarely unintended paralysis of muscles may result in troublesome cosmetic imperfections such as drooping of the eye brows. The incidence of such side effects is injector dependent and settles with time.



How long does it last? 

The effects of Botox usually last for three to four months after the first treatment. The effects fade gradually, at which point wrinkling begins to reappear and you may return for re-treatment. Generally, with repeated injections, the effects last longer and the frequency of injections gets lesser. The duration of effect varies from patient to patient and may be less effective in older people.






Reference information: www.entific.com.hk, www.eafps.org/
The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Botox (Wrinkle Reduction Treatment)--PART 1

The gradual development of facial wrinkles is inevitable and generally represents the early sign of ageing. The most common areas of wrinkling include the forehead, the brows and the outer corner of the eyes (crow's feet). This is mainly related to muscle activity which can be effectively dampened by the use of botulinum toxin, which is a naturally occurring bacterial toxin. This type of treatment to paralyse muscles selectively and reduce wrinkles is commonly known as 'Botox' treatment. Botox is a trade name, and other similar preparations may also be used for this purpose. Botulinum toxin was initially used in the 1970s for treating patients with hyperactive muscles around the eyes. Currently, it is widely used for cosmetic reasons, such as wrinkle reduction and a wide variety of other medical conditions related to dysfunction of muscles.





Consultation and treatment 

During consultation a detailed medical history is obtained by your surgeon and assessment of the facial wrinkles is carried out to determine the exact areas of muscles that require the injection. An appropriate dose of botulinum toxin is then injected into the muscles using a tiny micro needle. Following the treatment with Botox, the skin over the muscles remains smooth and even. Injected muscles are paralysed in about 2-3 days while untreated areas continue to work as normal. As the needle used is very fine and small quantities are injected, the pain is minimal and therefore no anaesthetic is required. You may experience some discomfort over the treated area immediately after treatment. You may resume normal activities immediately however any strenuous activity and massaging the area should be avoided. You must follow the post injection instructions carefully to avoid any untoward effects. Some patients may experience mild headaches in the first week or so following the injection which resolve spontaneously, and the use of mild painkillers such as paracetamol is recommended to relieve the headaches.








Reference information: www.entific.com.hk, www.eafps.org/
The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Hearing loss treatment

The treatments vary depending on the type, site/s and severity of hearing loss. This is best assessed and diagnosed by an Ear, Nose & Throat Specialist. 

The appropriate treatment may be conservative observation, hearing aiding and /or ear surgery. For children with persisting “glue ear” especially when in both ears with notable signs of language and /or attention problems, a ventilation tube (grommet) can be placed into the eardrum by surgery. For patients with a perforated eardrum, this can be repaired by surgery.


For patients with bilateral complete deafness, a cochlear implant sound processor should be considered. This re-stimulates the deaf ear using an electrode array and some very clever speech software processing. The new sound that is heard will indeed be different. Speech and hearing rehabilitation exercises to re-learn these sounds would be required. Children do better than adults with these cochlear implants. Studies have shown that a child’s brain has a higher neuro-plasticity than an adult, and therefore a greater capacity to adapt to new sounds and learning development.

Reference information: www.entific.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above. 

胡亂「自療」致鼻敏感惡化

鼻敏感雖不是致命疾病，可是發作時引來的流鼻水、鼻子癢等問題卻是非常煩人，不少鼻敏感病人卻諱疾忌醫，自行購買成藥或利用針炙、按摩來「自療」。

其實，這些「自療」方法只能暫時消除病徵，根本沒有徹底根治鼻敏感帶來的炎症，長期使用，甚至會惡化成鼻膜炎，最終要動手術治療。

一些聲稱可以通鼻塞的噴鼻劑是鼻敏感患者最常使用的成藥。這些噴鼻劑只是利用藥物強力收縮鼻膜及血管，並沒有真正解決鼻敏感引致的發炎問題。長期使用，鼻塞問題不單會反彈，更會演變成慢性鼻炎。

其實，對於這個情況，醫生會向病人處方一些含輕量類固醇的噴鼻劑，病人只需連續噴一個星期左右就可以痊癒。現在含類固醇的藥物十分安全，被身體吸收的份量極微，不會影響身體功能。

參考資料: www.ent.cuhk.edu.hk , www.entific.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。

Implications of Chinese face reading on the aesthetic sense

Chinese face reading is an ancient art that has been developed over centuries, not only in China but over the wider area of Asia owing to China's cultural dominance in Asia during its imperial rule. Similar to feng shui, Chinese face reading is based on a philosophy held by Chinese people all over the world that expresses itself in contemporary daily life and practices by coloring people's choices, likes, and dislikes. It is inevitable that the aesthetic sense is also affected by face reading principles, especially among those who are most familiar with them. An understanding of these principles and beliefs would help surgeons better understand their Asian patients' requests and perhaps allow them to better communicate appropriate suggestions accordingly.





Reference information: www.entific.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

鼻敏感或是鼻塞的手術

包括下鼻甲減容術及鼻中隔成型術。下鼻甲減容術是適用於因為下鼻甲肥大引致鼻塞的病人，而鼻中隔成型術是適用於因為鼻中隔偏曲而引致鼻塞的病人。有一些病人是兩種情況也有，而耳鼻喉專科醫生就會同時為他們做這兩種手術。

通常先試藥物治療     例如  :  類固醇噴劑或抗組織胺

術前注意       
全身麻醉或局部麻醉

血液或鼻分泌倒流

全身麻醉

術後注意       
填塞方法   (例如海棉或紗布1-2天)

流眼淚，面腫，面痛，頭痛等等

藥物: 去減少這些不舒服

避免過熱的食物

                                                                               

出院以後       
鹽水洗鼻

輕微流血  →   冰敷

嚴重 → 回去急診室

休息兩至三天，視符工作性質

長期問題       
仍然需要藥物，尤其是鼻水，噴嚏等問題

復發(鼻塞)

併發症注意   鼻中隔穿孔

參考資料: www.entific.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。

矯鼻手術介紹

鼻矯形及隆鼻手術 面部整形日漸普及，大眾對整形的接受程度也越來越高。改善鼻形手術是其中最普遍和受歡迎的整形項目。除了外觀上的改善外，有鼻塞的人仕更可藉手術治療。 鼻矯形可分為手術性及非手術性兩種。 非手術性鼻矯形 主要是透過注射來達至矯形效果。常用物質包括透明質酸(Hyaluronic Acid, 又稱玻尿酸), 微晶瓷(Calcium Hydroxyapatite) 等。

 透明質酸是人體本身物質，常用於注射面部，下巴，鼻部等。好處是簡單而需時短，一般二十分鐘左右可完成。但是，由於注射透明質酸只可輕微改善鼻形，所以不 是所有人也適合。例如，鼻翼左右不平衡，鼻子過大或比較嚴重之鼻部畸形，就需要選擇手術性修復。

透明質酸隆鼻通常能維持半年至九個月，需要重覆注射，方可 維持效果。 但是，注射性矯鼻並非完全沒有風險，如注射位置紅腫，瘀傷，甚至發炎等。此外，注射性矯鼻只能改善外觀，並不能幫助有鼻塞問題的人仕。 手術性鼻矯形 手術性鼻矯形，適合比較嚴重之鼻部畸形，鼻子過大，或有功能上問題如鼻塞之人仕。

手術之植入物，可分為自體移植和異物植入兩種類型。自體移植的植入物是來 自患者身體的其他部份：例如，鼻中隔軟骨，耳朵軟骨或肋骨等。好處是副作用如排斥或發炎等，較異物植入為低。 異物植入手術的植入物，一般是人工物質，例如矽膠或合成的聚合物，如Goretex等。異物植入的好處是手術時間較短，而亦不需在病者其他部份造成傷口。 一般來說，單純隆鼻的手術時間較短，大約三十分鐘左右。

鼻矯形(或鼻雕)手術則需時兩至三小時。 每一個患者的需要和狀況也不同，在決定手術前，請先諮詢專科醫生平衡手術的風險。

黃德彰  耳鼻喉專科醫生

參考資料: prochats.she.com/, www.entific.com.hk/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。

胡亂「自療」致鼻敏感惡化

鼻敏感雖不是致命疾病，可是發作時引來的流鼻水、鼻子癢等問題卻是非常煩人，不少鼻敏感病人卻諱疾忌醫，自行購買成藥或利用針炙、按摩來「自療」。其實，這些「自療」方法只能暫時消除病徵，根本沒有徹底根治鼻敏感帶來的炎症，長期使用，甚至會惡化成鼻膜炎，最終要動手術治療。

一些聲稱可以通鼻塞的噴鼻劑是鼻敏感患者最常使用的成藥。這些噴鼻劑只是利用藥物強力收縮鼻膜及血管，並沒有真正解決鼻敏感引致的發炎問題。長期使用，鼻塞問題不單會反彈，更會演變成慢性鼻炎。

其實，對於這個情況，醫生會向病人處方一些含輕量類固醇的噴鼻劑，病人只需連續噴一個星期左右就可以痊癒。現在含類固醇的藥物十分安全，被身體吸收的份量極微，不會影響身體功能。

參考資料: www.ent.cuhk.edu.hk , www.entific.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。