At our office, we fully embrace the individualized needs of each patient.
Each phase of the surgical process is vital. This personalized approach
is felt from the moment patients enter the office, through the consultation
phase, into the surgery itself, and throughout the period of recovery.
This concept allows a better connection between Dr. Gorin and his
patients in an effort to achieve the best surgical results possible
while avoiding a 'cookie cutter' methodology. Below is a brief introduction
to the various surgical procedures performed at our office surgical
suite. Of note, Dr. Gorin uses a team of highly trained anesthesia
personnel to manage that aspect of his procedures. This gives us the
capability to use a variety of anesthetic techniques, including general
anesthesia, 'twilight sleep', spinal and local anesthesia.
To Learn More about this amazing pain relief system, please visit the Ask Your Surgeon website, hosted by ON-Q.
Facial Rejuvenation Surgery:
There is a variety of techniques that have been developed
to surgically reverse the signs of aging and sun exposure. Gravity, over
time, can cause the various portions of the face to descend resulting
in a variety of changes. These include facial wrinkles, baggy eyelids,
ill-defined neck lines, and an overall 'tired' look. By using a multitude
of individualized techniques, including tightening of the skin and facial
muscles and removing or repositioning fat, facelifts can help reverse
these changes. If done correctly, this will result in a younger and more
'awake' look that is felt by patients and emanates to those around them.
The various elements of facial rejuvenation surgery include brow lifts,
eyelid surgery, cheek lifts, facelifts, and neck lifts. While it is common
to perform all of these procedures at the same sitting, there are many patients
that may only need (or request) to have one or more at the same time. Every
patient is unique, which is why it is vital to address each patient's needs
individually. While Dr. Gorin, in general, does not perform cosmetic surgery
on patients younger than 18 years old, more and more patients in their 40's
are presenting for facial rejuvenation surgery in an effort to 'start early'.
(However, we only perform surgery if there is a definite reason to do so).
A variety of techniques can be used in repositioning the eyebrows
to result in a more youthful and fresh appearance. Each method utilizes
incisions that are well hidden either in the hair-baring scalp or in the
hairline itself. The brows are then gently lifted and secured into their
new position. In selected patients, the 'frowning muscles' are partially
removed in order to alleviate the deep wrinkles between the eyebrows that
characteristically lead to an 'angry' look.
The eyes are typically the first area of the face that we
notice. They give clues as to how tired we are or how much stress we are
under. Over time, stress, gravity, skin changes, and the development of
dark circles under the eyes can all lead to a permanently 'tired' appearance.
Surgical correction of this area involves removing excess skin and removing
or repositioning of eyelid fat and muscle. Each patient's needs are unique;
therefore, the technique used must match that need. In the end, blepharoplasty,
or 'freshening up' of the eyelids, is one of the most important aspects
of surgical facial rejuvenation. It is commonly performed in conjunction
with a brow lift, or a cheek lift (see below).
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Cheek Lift:
A cheek lift, or 'midface lift', can be a vital addition for
many patients. Gravity and skin changes tend to allow the cheek skin and
fat to fall off the cheek bone. This results in deepening of the nasolabial
creases (this are the 'smile lines'). In addition, drooping of the cheek
can pull the skin and fat of the lower eyelid down thereby exacerbating
the tired and worn-out look. Dr. Gorin's cheek lift (or 'midface lift')
technique repositions the cheeks back up over the cheekbones using two small
incisions in the mouth (underneath the upper lip) and two equally small
incisions in the hair-baring scalp. Both incisions heal exceptionally well
and are easily hidden. This allows for smoother and less noticeable smile
lines, and can help (along with lower eyelid surgery) to decrease the lower
lid 'baggy' appearance.
Similar to the other facial rejuvenation procedures, a lower
facelift and neck lift involves incisions that are remarkably well hidden.
The approach is through an incision around the front and back of the ears
as well as a smaller incision under the chin. The skin and fat of the neck
are meticulously excised, then the muscles of the neck and face are tightened
and repositioned. Finally, the excess skin is carefully removed. This technique
allows for a natural, vibrant, more youthful appearance that is seen and
felt by the patient as well as all those around them.
This is a newer technique of face and neck lifting that has considerably less down time and shorter scars than the traditional methods. The scar typically starts just in front of the sideburn, continues down in front of the ear (but, hidden behind the ear cartilage, or 'tragus'), and stops at the bottom of the ear lobe. The scars are substantially shorter. However, for most patients, the results are just as impressive as the earlier techniques. This method also allows for a combination of cheek lifting along with lifting of the jowls and neck all in one relatively simple procedure. In addition, it is quite ideal for 're-do' face and neck lifts.
The MACS lift is a relatively new facelift technique developed by Drs. Patric Tonnard and Alexis Verpaele at the Coupure Centre for Plastic Surgery in Belgium. They worked three years to establish this technique. The aim of the procedure is to obtain a harmonious and natural rejuvenation of the facial features. Disappointed by the often unnatural and radical changes of classical facelift results, both surgeons started to look for a way of, on the one hand reducing the impact of the operation and on the other hand to make the results look natural. Click here for an animated video of the procedure: See here for more information.
Patients with congenitally small chins are often candidates for a chin implant. These are placed either through an incision under the chin, or behind the lower lip. Chin implantation will often result in a more balanced appearance and can be a very important aspect of facial rejuvenation surgery.
There is a good reason why breast augmentation is one of the
most popular plastic surgery procedures performed today. It can allow for
a more natural, feminine, and proportioned appearance. It can also result
in a renewed sense of confidence and self esteem. There are a variety of
implant styles and techniques available. Dr. Gorin uses Mentor implants,
both silicone and saline. He most commonly places the implants under the
muscle using small incisions either underneath the areola or in the breast
fold. The procedure is usually performed under 'twilight anesthesia' allowing
for a faster recovery period immediately after surgery.
Breast lift, or 'mastopexy', involves repositioning the breast
and nipple/areola to a more natural, perky, and youthful position. Weight
gain or loss, pregnancy, breast feeding, the effects of gravity, and changes
in skin quality all can play a part in breast sagging or 'ptosis'. Mastopexy
involves an incision around the areola which, if needed, continues down
the breast with a possible short extension in the fold. Through this approach,
the amount of repositioning and recontouring needed is customized based
on the needs of each individual patient. Implants may also be placed which
can provide an even greater amount of fullness. There are patients in whom
implants alone will lift the breasts to an appropriate level. During your
consultation, Dr. Gorin will help guide you in a direction that will afford
the best result possible.
Breasts that are out of proportion can be a daily source of
physical pain and psychological stress. Breast reduction surgery involves
an approach similar to the breast lift procedure. This
technique allows for a reduction in the overall size of the breasts, as
well as a significant lifting of the nipple and areola. The end result is
a more proportioned and youthful appearance which can be a long lasting
solution to the daily struggles associated with excessively large breasts.
'Tummy tuck', or abdominoplasty, involves tightening of the
abdominal muscles and removing the excess fat and skin in an effort to obtain
a sleek, contoured, feminine core that is often so elusive despite diet
and exercise. The incision is kept low so as to be concealed by most clothing
(including bathing suits, jeans, etc). In general, many of the stretch marks
that may be present are also removed. Limited liposuction
is usually incorporated into the abdominoplasty to 'fine tune' the result
to each patient's needs.
Using strategically placed small incisions, liposuction (or,
'liposculputure') is a procedure used to remove fat, and thereby 'sculpt'
the body's problem areas. Many areas can be addressed, including neck, arms,
abdomen, hips, back, outer thighs, inner thighs, buttocks, and knees. Two
of the most common areas treated with this technique are the 'saddlebags'
in women and 'love handles' in men. In many cases, some of the fat removed
can be replaced in certain areas that may need more of an 'augmentation'.
An example of this is the 'divot' or 'hollow' that is commonly seen between
the hips and outer thighs in women. When there are isolated areas of fat
that diet and exercise cannot seem to treat, liposuction may be the answer.
Lifting of the lower body involves a variety of surgical procedures, each of which must be customized to fit the individual patient. Medial Thigh Lifts involve removing the excess skin and fat of the inner thighs, then elevating the remaining tissue through incisions in the groin crease (which often need to be extended down towards the knee). This procedure is necessary when liposuction alone will not accomplish the ideal result. Dr. Gorin will help guide you in this important decision making process.
Excess fat and skin of the upper arm can be a constant source
of stress and discontent. The inability to fit into clothes that would otherwise
fit perfectly except for the upper arms is the most common complaint. In
addition, patients feel uncomfortable wearing clothes that would otherwise
not cover the arms. Brachioplasty is a procedure that can address these
concerns. The technique utilizes incisions in the armpit that extend a variable
length on the inner aspect of the arm towards the elbow. This allows for
removal of the excess skin and fat and a recontouring of the arm to a more
natural, youthful appearance.
