Secretary

EILEEN ARNAL
Tel: 0161 804 8490
Please quote code BM001

Email

brian.musgrove@
consultantcare.com

Fax

0161 601 3566

Postal address

BT Musgrove Limited
PO Box 506
Manchester
M45 0FY

Information/FAQ

Consultations and treatment are carried out at one of the following private hospitals in Manchester : The Spire Hospital, Whalley Range, Manchester, The Alexandra Hospital (BMI), Cheadle, Cheshire,  and The Regency Hospital, Macclesfield. To arrange an appointment, please contact Eileen Arnal, Personal Assistant /Secretary on Telephone number: 0845 402 7401 The following is information on some of the more common procedures carried out, but it is by no means exhaustive.To understand how to deal with your concerns, I offer my patients a no obligation, full and frank consultation. This consultation will help you reach a fully informed decision for you as an individual. You will never feel under any pressure to proceed and your best interests are always a priority. The consultation should give you the confidence to make the best choice regarding the proposed surgery/treatment.

Facial Rejuvenation Treatment

Treatment of the ageing face can be divided into non surgical treatments such as Botox injections and surgical treatments such as facelift. There are specific indications for the various treatments and it is important that you choose the correct one. You need to consult an experienced surgeon who can advise you on the appropriate treatment.



Surgical Treatments

Facelift/necklift (Rhytidectomy)

There are many factors involved in the face ageing. Some of these are related to lifestyle, such as smoking, excessive exposure to sunlight and many are genetic.

We all age, the muscles and skin of the face lose their tone and elasticity and under the influence of gravity, the cheeks sag, the folds around the mouth become pronounced, jowls appear around the jawline and the neck ages. Facelift operations are designed to reposition these soft tissue structures by tightening the facial muscles and lifting the overlying skin to create a better shaped and more youthful appearance.

There have been many Facelift operations described over the years but one procedure which has stood the test of time is the SMAS facelift. The SMAS is the layer of muscle and connective tissue under the skin, which together with the underlying bones defines the shape of the face. Once this has been tightened, then the skin can be redraped over it to complete the reshaping of the face. Tensioning the muscle layer helps to support the skin and prevent unsightly scarring. The operation :
This is usually done under general anaesthetic and can take two to three hours. Incisions are placed in natural skin creases around the ears. All stitches are removed on the tenth day after the operation and it can take another week or so for any swelling and bruising to subside.

Preparing for a facelift: Many patients colour their hair on a regular basis and if this is the case, they are advised to have this done just before surgery, and then to avoid any type of colour treatment for 6 weeks following a facelift. It is not necessary to shave any hair for the operation and most people manage to hide the stitches with their hair.

You may experience a sensation of tightness for some weeks following the operation and this is quite normal.It may also take a few weeks for the swelling and bruising to go down, and even longer to completely disappear, though this will not be obvious to a casual observer. It helps to prop yourself up on pillows at night for the first few days after surgery to help the swelling subside.

Possible complications :
All surgical operations carry some risk, but facelift surgery is relatively safe. Infection and scarring are rare complications as is nerve damage. It is normal for the skin around the ear to become numb after the operation but this usually completely recovers within a few weeks.Sometimes there may be a little hair loss around the ears and temple area. This is not usually permanent but may be hard to disguise if your hair is short or you prefer to wear it tied up. A facelift may accentuate certain facial features. For instance, if one side of your face is slightly different than the other, it may be more noticeable after surgery. Scars usually fade over the course of a year, but will never completely disappear. As with any operation there is a small risk of bleeding post operatively, but this is not usually serious. If it causes the skin to swell and become painful, it is called a haematoma. Very rarely this may require a return to theatre for draining and to stop the bleeding.

Your surgeon should discuss these complications with you at your initial consultation as part of the patient consent, as well as any other possible risks for you personally depending on your age and medical history.

Blepharoplasty (Eyelid surgery)

Eyes can show the signs of ageing in several ways. They can become puffy because of the accumulation of fat and excess skin, or because of fluid retention. As well as ageing there are a number of medical conditions which can cause puffy eyelids such as underactive thyroid. It is important that you are seen by an experienced surgeon who can give you professional advice. Your surgeon will explain the procedures available to you and any risks associated with them.

Upper Eyelid Surgery (Upper Blepharoplasty): The main concern is heavy looking upper eyelids. The most common cause of this is the accumulation of fat in the upper eyelid and stretching of the skin. In middle age, it is common for the eyebrows to sag and contibute to "hooding" of the upper eyelid. An upper blepharoplasty usually involves removing some excess skin and muscle from the upper eyelid and any excess fat.THis creates a more youthful appearance with the eyes looking more open and alert. The skin incisions follow the fold of the upper eyelid and fade quickly following surgery. If there is some brow sagging then it may be beneficial to carry out a browlift at the same time as an upper blepharoplasty.

Lower Eyelid surgery (Lower Blepharoplasty): The commonest complaints are eyebags and skin wrinkles. This is caused by accumulating fat in the lower eyelids which stretches the skin. It is usually treated with a blepharoplasty operation to remove any excess fat and tighten the skin. Some older patients may have lax muscles under the eyes and it is important to consider this before carrying out surgery, in order to prevent a significant change in the shape of the eyelid following surgery. The muscle may need to be tightened as part of the operation. Lower eyelid incisions are hidden in the crease below the eyelashes. Occasionally in a younger patient who has no redundant skin, eyebags can be treated by making an incision inside the eyelid to avoid any scar which can be more visible in the younger individual.

Complications of blepharoplasty:

 

Irritable, dry eyes, sagging of the lower eyelid. These are usually temporary. Some medical conditions predispose to these complications, and it is important to tell your doctor if you suffer from dry eyes, excess tearing, thyroid disease and dermatitis.

 

Following blepharoplasty operations, the eyelids may feel a little tight, sometimes may be a little difficult to close completely and can be a little irritable and sore, until any swelling has subsided. It may help to prop yourself up on pillows and keep the head higher than the body for the first few days after surgery, to reduce swelling and bruising. Cold compresses, such as a bag of frozen peas wrapped in a towel, should also help. (Never apply ice directly to the skin). Your eyes may feel a bit sticky, dry or itchy for a few weeks and some people experience watery eyes. Others have blurred vision, or double vision and are sensitive to light for a few weeks. The eyes can be cleaned but it is important to follow the instructions given by the nursing staff. Avoid eye make-up until a couple of days after stitches are removed, or as advised by the nurses. Contact lens wearers will be unable to wear them for two weeks after surgery and they may feel a little uncomfortable for a while after that. Avoid driving until your vision returns to normal. Scars are pink and noticeable at first but become fine, fade quickly and rarely cause problems.

Browlift

This operation is designed to elevate the brow, open the eyes and make them look less heavy and tired.

There are two ways of performing a browlift. The conventional way has been to remove a strip of scalp behind the hairline. However a more modern method called endoscopic browlift employs "keyhole surgery". Small incisions are made within the hairline, through which, the surgeon performs the operation using an endoscope (small telecsope). No skin or scalp is removed with this technique which rarely causes any significant bruising or swelling.

The aim of the operation is to slide the scalp backwords in order to lift the brow off the upper eyelids, opening the eyes and creating a more youthful appearance.

Complications:

 

There are few complications associated with browlift. The forehead skin may feel numb for a few weeks after the operation. Scars fade quickly and rarely cause a problem.

Skin Resurfacing ( Laser, Chemical Peel, Dermabrasion )

As the skin deteriorates with age and loses its elasticity , thins, and develops blemishes it may be possible to improve its appearance with skin resurfaceing. This is carried out with a laser, dermabrasion or chemicals to remove a very thin layer of skin and allow new skin to grow. This can improve the wrinkles that develop around the mouth, help to clear pigment patches in the skin and make the skin look smoother. Skin resurfaceing is often used together with facelift operations.

Nose reshaping (Rhinoplasty)

Rhinoplasty is one of the most commonly performed cosmetic procedures. There are many different types of operation and choosing the most appropriate is critical to achieving the best result.

It can be combined with septal surgery to correct a crooked nose, particularly one which may be difficult to breath through.

Two surgical approaches are possible. One involves making incisions inside the nose and is called a closed rhinoplasty and the other uses a tiny incision under the nose and is called open rhinoplasty.

Your surgeon should have the expertise to apply the appropriate technique to your particular problem. Most commonly, the dorsal hump or bony part of the nose is too large, and/or the base of the nose may be too broad or the nose tip may droop. Many patients are unhappy with the appearance of their nose especially on profile.

Very occasionally it is necessary to augment the nose with a graft, usually cartilage which can be taken from the ear or from within the nose.

Following the operation it is usual to wear a small splint on the nose for seven days and you should expect some bruising around the eyes which may last seven to ten days. If the nose bleeds, do not pack your nostrils to stop it. Instead, apply a cold compress (a packet of frozen peas in a towel works well) across the bridge of your nose for 10 minutes. Try to keep your head up to prevent nose bleeds. You will feel "bunged up" and may have a headache which can be relieved with paracetamol. Drink plenty of water to avoid your mouth becoming too dry as during the first few days you will need to breathe through your mouth, and use petroleum jelly to avoid your lips becoming dry. Do not blow the nose for at least the first week and instead gently wipe it. Avoid any vigorous physical activities or sport and very crowded places for about 6 weeks, to prevent accidental knocks to your nose.

Complications :
Rarely scarring and sometimes breathing difficulties if the scarring occurs inside the nose. The tip of the nose may feel stiff and numb for a few months after surgery and swelling can take several months to completely subside. The true end result of a rhinoplasty may not be apparent for up to a year in some cases, but most patients are very happy with the outcome from as early as 3 months after surgery, when most swelling has subsided. Rhinoplasty surgery can bring about a dramatic aesthetic change when performed by an experienced surgeon who will make every effort to achieve a pleasing balance to the facial features when reducing or augmenting the nose.

Ear correction (otoplasty)

People are often embarrassed by their ears being prominent (bat ears).This can be corrected with an operation called otoplasty. This is often carried out with just local anaesthetic and sedation.

The surgery is relatively minor and can usually be carried out as a day-case without a need for an overnight stay.

It is necessary to wear a bandage over the ears for about five days after the operation.

Complications:
Scarring behind the ears.

Chin and Jaw surgery

The analysis of jaw deformity can be quite complicated and it is important that you consult a surgeon who has the appropriate skills. This needs to be someone with training in Maxillofacial Surgery.

Your chin deformity may be relatively straightforward and could respond to a simple procedure such as a chin implant, but very often more complicated treatment may be indicated, often combined with orthodontic treatment. Your surgeon may ask you to have some X-Rays of your jaw taken at your initial consultation.

Facial Surgery overview

Facial surgery is a fascinating area of medicine and draws on many skills. It is constantly evolving as new surgical and non-surgical techniques are discovered.

The prospective patient now has a vast choice of treatments to choose from. This can be bewildering to the average person. Moreover it is not suitable for every person who considers them self to have a problem.

For this reason it is iimportant that you consult the right professional who can give you the appropriate advice. This advice must be unbiased and with your best interests in mind.

Liposuction

It is quite common for the neck to thicken with age because of the accumulation of fat under the chin, the so called "double chin". It is common to carry out some liposuction with a facelift, if this is considered necessary to achieve the optimum result with a facelift.