The Face book A Consumers Guide to Facial Plastic Surgery. american academy of facial plastic and reconstructive surgery

The Face book A Consumers Guide to Facial Plastic Surgery american academy of facial plastic and reconstructive surgery

2009 American Academy of Facial Plastic and Reconstructive Surgery Contents facial plastic surgery today 2 All rights reserved. No part of this book may be reproduced in any form or by any electronic means, including information storage and retrieval systems, without permission in writing from the publisher. The information in this book is believed to be accurate and to reflect the current state of medical science. However, new techniques are constantly being developed in facial plastic surgery. Moreover, each patient s care necessarily requires individual attention. Therefore, this book does not offer medical advice and is not a medical treatise. Patients contemplating facial plastic surgery should not rely on this book for advice but should consult a facial plastic surgeon. All surgery is serious and can involve complications. To the extent the facial plastic surgeon s advice differs from anything stated in this book, the patient should follow the surgeon s directions. Design: www.faustltd.com Library of Congress Catalogingin-Publication Data The Face Book, American Academy of Facial Plastic and Reconstructive Surgery. ISBN 978-0-578-03127-9 This book is available at quantity discounts with bulk purchase for educational, business, or sales promotional use. For information, contact: Publications Department American Academy of Facial Plastic and Reconstructive Surgery 310 S. Henry Street Alexandria, VA 22314 Phone: (703) 299-9291 Fax: (703) 299-8898 Online orders: The Face Book and other patient information materials can be ordered online at the AAFPRS Web site http://www.aafprs.org. Soft cover price: $15.95 (Discounts may be available from the publisher.) 1. Is facial plastic surgery for You? 8 2. Botulinum Toxin Type A (Botox) 26 3. Injectable Fillers 40 4. Office-based skin rejuvenation 54 5. Facelift Surgery 66 6. Plastic Surgery of the Nose and Chin 88 7. Plastic Surgery of the Eyelids 108 8. Plastic Surgery of the Forehead and Eyebrows 120 9. Plastic Surgery of the Cheeks and Midface 134 10. Plastic Surgery of the Ears 148 11. Hair Restoration Surgery 162 12. LASER SKIN RESURFACING 180 13. Scar Revision Surgery 192 14. Facial Reconstructive Surgery 204 15. Enhancing Postoperative Results 222

facial plastic surgery Today Objectives, Innovations, and Standards to Consider THE PSYCHOLOGY OF APPEARANCE NOT FOR EVERYONE The specialty of facial plastic surgery includes surgical and non-surgical solutions for improving the appearance of your face. Aesthetic (also called cosmetic) facial plastic surgery includes procedures and treatments to counter the effects of aging or just to change something that you do not like about your face. Reconstructive facial plastic surgery includes procedures to improve nasal breathing, to change or remove birth defects, and to fix defects caused by trauma, skin cancer, or more serious conditions. The practice of contemporary facial plastic surgery has changed dramatically since the last edition of The Face Book in 1998. For example, while there is still appropriate importance placed on surgical procedures that have stood the test of time because of their effectiveness and consistent results, today there is also an ever growing interest in less invasive procedures and treatments with less down time. Rapidly changing technology has transformed the specialty of facial plastic surgery dramatically. Few areas of medicine have seen so much change in so short a period of time, and the pace continues. Today, facial plastic surgeons, board-certified surgeons trained specifically in the treatment of facial aesthetic and reconstructive issues, can treat a wider variety of problems than ever before. The treatments are often more effective than even just five years ago, with more natural looking results. Some treatments are also less expensive. However, you should always keep in mind that just because something is new and exciting, it is not always better. A healthy skepticism has always been an important part of medicine. If something sounds too good to be true a quick, easy fix with one simple treatment or lotion it often is too good to be true. 2 www.aafprs.org 3

1. Is Facial Plastic surgery for You? SELECTING A facial plastic surgeon EVALUATING YOUR MOTIVES Preparing for the consultation visit The Aging Process VISUALIZING THE RESULTS FORMULATING A TREATMENT PLAN 8 The Face Book www.aafprs.org 9

deeper look: What constitutes attractiveness? Beauty despite the old adage is much more than skin deep. The appearance and health of your skin is an important part of your appearance, and often a starting point in evaluating your face. However, facial attractiveness is also largely determined by what lies beneath the skin the contours and dimensions of the underlying bone structure and cartilage and the health, tightness, and position of the deeper tissues between the skin and the bone. Facial plastic surgeons are trained to recognize the skeletal proportions that determine attractiveness. For this reason, your surgeon will analyze your bone structure and facial features carefully before discussing any possible improvements, perhaps using aesthetic principles similar to the following: 1A key principle of facial proportion is based on the golden proportion, a concept that has long been recognized in architecture and art. It states that a well proportioned face will be divided into equal thirds when horizontal lines are drawn through the forehead hairline, the brow, the base of the nose, and the edge of the chin. 2A proportionate face may also be divided vertically into fifths, each approximately the width of one eye. Aesthetic balance is considered ideal when the facial features fall within these parameters. 3Although an attractive face may have a high degree of symmetry (that is, similarity between one side of the face and the other), small differences in facial symmetry are very common and contribute to individuality. You probably already have noticed this on your own face. Our noses and ears are not necessarily symmetrical, and we do not necessarily age symmetrically. 4It was once widely believed that standards of beauty were largely cultural. Research suggests, however, that our views of what is attractive are remarkably consistent, regardless of race, nationality, or age. Although the preference for individual features may vary among cultures, the proportions of facial attractiveness are generally the same for most ethnic groups. 5Aesthetic principles are helpful, but they are only a guideline. People today appreciate individual uniqueness, and they know that true beauty starts from within. The surgeon will probe thoroughly into your attitudes regarding surgery; realistic expectations are crucial to success. Good candidates for surgical and nonsurgical cosmetic procedures understand how these procedures may improve their appearance, but they are not looking for perfection. They are strongly motivated and understand that even the shortest, least invasive procedure may involve a certain amount of discomfort and hours, days, weeks or even months of swelling or discoloration. Facial plastic surgeons are trained to recognize the skeletal proportions that determine attractiveness. Individuals with unrealistic expectations, on the other hand, are likely to be disappointed with even the best possible result. For this reason, surgeons are hesitant to operate on people with peculiar reasons for wanting surgery, those who are seeking more than surgery can do, and those who are being pressured into the surgery by someone else. Perhaps you may want to bring in pictures of faces you like, as well as ones you do not like, in order to communicate your desires more clearly to the surgeon. Remember, however, that pictures are only a tool. Facial plastic surgery is highly individualized, and no procedure gives an identical result in every patient. The goal of surgery is to improve and harmonize your own unique features, not to put someone else s features on your face. It is unrealistic to expect a surgeon to make your nose or any other part of your body look exactly like someone else s. 16 The Face Book www.aafprs.org 17

deeper look: The Effect Of Skin Type Since procedures aimed at improving the color, texture and overall health of your skin are so common today, your facial plastic surgeon will carefully assess your skin type. Even the outcome of procedures not aimed directly at the skin, however, may be affected by such factors as the thickness of your skin, the amount of oil it contains, the degree of pigmentation, and the quality of underlying cartilage. While a certain skin type will not necessarily disqualify you for facial plastic surgery, it may be necessary to modify, or even avoid, certain procedures to minimize the possibility of scarring or prevent undesirable changes in pigmentation. Facial plastic surgeons have identified six basic skin types, each associated with characteristic benefits and challenges related to facial plastic surgery: Type 1 Fair, dry, thin-skinned complexion (Anglo-Saxon) Type 3 White to Olive Skin, Darker Hair (Central European) Benefits Challenges Benefits Challenges Thin skin drapes easily and allows more refined results Scars tend to be thin and heal well. Postoperative swelling is minimal. Signs of aging appear early. Initial bruising is more obvious than in darker skinned individuals. Fine, deep wrinkles may be difficult to remove entirely. Thin skin makes bone and cartilage irregularities more obvious. Signs of aging appear later. Bone and cartilage structure usually is good. Scars usually are thin. Postoperative pigmentation problems may occur. Skin tends to bruise easily and postoperative swelling may last longer. Fine, white scar lines may contrast with peach skin tone. Skin cancers are most common in this group. Type 2 Fair, blue-eyed, blond complexion (Northern European) Type 4 Dark, oily brunette complexion (Southern European, Hispanic, Asian) Benefits Challenges Benefits Challenges Skin is relatively thin and handles easily. Scars tend to be narrow and nearly invisible. Signs of aging appear early. Fine, deep wrinkles may be difficult to remove entirely. Initial bruising is more obvious than in darker skinned individuals. Signs of aging appear later. Fine wrinkling over entire face is less common. Skin cancers are less common than in lighter toned skin types. Heavier skin tends to resist lifting. Postoperative swelling and bruising tend to last considerably longer. Scars may be thicker and darker. 22 The Face Book www.aafprs.org 23

facial plastic surgery Today? Will we have this section? 2. Botulinum Toxin Type A (Botox and dysport ) What is Botulinum toxin Type A (BTX)? Is Btx Safe for You? Is Btx Painful? Why have Btx treatments? What About My Crow s Feet? What About Wrinkles Around My Mouth? Will I Look too stiff? Am I Too Young for Btx? I Had a Bad Experience with Btx, Should I Try Again? What else can Btx do? 26 The Face Book www.aafprs.org 27

Before After BTX Treatments and Injectable Fillers 34 The Face Book www.aafprs.com 35

3. Injectable fillers An Office Treatment for Facial Wrinkles, Facial Creases and Increasing Facial Volume Facial Wrinkles: A Sign of Aging Many Treatment options are available Where are Injectable Fillers Used in the Face? 40 The Face Book www.aafprs.org 41

4. office-based skin rejuvenation Office-Based Skin Rejuvenation Intense Pulsed Light (IPL) Skin Tightening Treating other types of skin problems Birthmark or blemish What is it? 54 The Face Book www.aafprs.org 55

Photo to come 3. 5. facelift Facelift Surgery surgery tightening Tightening the muscles neck in the neck managing TOO YOUNG fatty FOR deposits A FACELIFT? filling HOW depressions A FACELIFT IS DONE and dee ap wrinkles more AFTER than THE skin PROCEDURE deep 66 The Face Book www.aafprs.com/facelift 67

Before After Facelift 78 The Face Book www.aafprs.com 79

6. Plastic Surgery of the Nose and Chin YOUR EVALUATION A VERY IMPORTANT FIRST STEP THE BEST AGE FOR NASAL SURGERY HOW NASAL SURGERY IS DONE IMPROVING THE FUNCTION OF THE NOSE YOUR NASAL SEPTUM AND BEYOND AFTER THE SURGERY What to expect 88 The Face Book www.aafprs.org 89

THE BEST AGE FOR NASAL SURGERY Many people wonder if there is a minimum age for nasal surgery, or if you can be too old for it. Surgery to refine the appearance of the nose is best done after a young person has finished growing. This usually means 16 for girls and after age 17 or 18 for boys. Sometimes, treatment is appropriate at an earlier age if an internal defect is causing serious breathing problems. In that case, however, additional surgery may be needed after the child matures. In general, it is best to wait until after puberty. At the other end of the age spectrum, nasal surgery can be done at any age as long as you are in good health. Older patients seek nasal surgery for cosmetic reasons and because it helps to maintain good breathing. As we age, nasal cartilage becomes thinner and loses its elasticity, causing the tip of the nose to lengthen and droop. Some people develop a hanging lobe between the nostrils, and the nose may appear more humped than previously. Internal breathing passages become narrower, and loose cartilage and tissue inside the nose may further obstruct the airway. Your surgeon should be familiar with these special conditions and may suggest some specific changes in your nose to prevent further adverse changes in your airway as you age. HOW NASAL SURGERY IS DONE Most cosmetic rhinoplasty performed until the early 1980s was undertaken through incisions made mostly inside the nose. Today, this is commonly referred to as closed rhinoplasty. Actually, a better term is endonasal rhinoplasty (endo means inside). In this approach, incisions are made just inside the rim of each nostril; the surgeon is able to lift the skin of the nose and see much of the bone and cartilage skeleton of the nose. Working through these incisions, the surgeon can shave away excess bone and cartilage to reduce a hump, reposition cartilage and bone to narrow the nose, and sculpt the nasal tip. Surgeons often deliver the cartilages with this technique. This means that the surgeon gently pulls the nasal tip cartilages through the incision for better visualization and replaces them to their original position once the work is done. Figure 1 Nasal surgery incisions for an external (open) rhinoplasty In an open or external rhinoplasty, a minimally noticeable incision is made between the nostrils (in the columella ) that extends inside the nose and enables the surgeon to lift the skin of the nose and visualize the entire bony and cartilage structure of the nasal skeleton from above (see Figure 1). Through this approach, more of the nasal architecture may be visualized in an untouched state. You should not be overly concerned about the use of an external incision. It is so small that it is often hardly visible after surgery and really only visible to you or your significant other. With either approach, incisions may also be made on each side of the nose where the nostril joins the face to reduce flaring nostrils or on the side of the nose for placement of fine chisels. These incisions too are usually undetectable when they heal. Which technique is better? While there are strong opinions on both sides of the discussion, the real answer is either. It is really a matter of your surgeon s level of comfort and experience with a particular technique for a particular set of circumstances. Many surgeons perform both techniques and have definite criteria and reasons for when to use which approach. Open rhinoplasties may tend to use more cartilage grafts (most commonly your own cartilage from your nasal septum) for added architectural structure. Some noses may require more structure, but not all. Some revision rhinoplasties are best done open, and some are best done endonasally. It is also not uncommon for a surgeon to start out doing a particular nose closed and then switch to an open technique because of particular anatomical characteristics found at the time of surgery. Does the surgeon have to break my nose? Whether open or closed, the nasal bones are carefully cut to straighten a crooked nose or narrow its width. I thought the doctor would break my nose, a young patient recalls, echoing a concern many patients have about nasal surgery. Instead, a fracture is made in a controlled way, so that the bones may be moved inward. It is not painful, nor does it typically increase bruising or swelling. At other times, additional support is needed to strengthen drooping tissues or replace cartilage destroyed by accident or disease. In this case, the surgeon may construct a graft or strut from your own cartilage and stitch it into place. This technique may be used to increase tip projection or correct a depression in the bridge of the nose. In some cases it may be easier to add these grafts and suture them in place with an open technique, but in other cases the grafts may be able to be placed very precisely into a small pocket created using a closed technique. Again, surgeon preference plays a bit role in the choice of approach. After correcting the framework of the nose, the skin is re-draped and the incisions are closed with sutures. A small splint may be applied to the outside of your nose to support it while it heals, and absorbent dressing material may be placed inside. 96 The Face Book www.aafprs.org 97

7. Plastic Surgery of the Eyelids WHY EYELIDS droop HOW BLEPHAROPLASTY IS DONE 108 The Face Book www.aafprs.org 109

8. Plastic Surgery of the Forehead and Eyebrows CHOOSING THE BEST TECHNIQUE HOW THE PROCEDURE IS DONE 120 The Face Book www.aafprs.org 121

Because the midforehead eyebrow lift relies on natural creases to hide the scars, it is often more acceptable to men. Women, on the other hand, may benefit from a coronal lift, which lifts and smoothes the entire forehead area. The incision for a coronal lift usually is made just behind the natural hairline, across the top of the head (see Figure 2). Connie H., a hairdresser, had a coronal lift at age 46. The procedure smoothed out the wrinkles in my forehead and restored a nice, natural arch to my eyebrows, she says. The coronal lift generally is not suitable for men who may later experience male pattern baldness because it may elevate the hairline somewhat. In women with high hairlines, the incision can be placed just within the hairline. The incision is made on an angle, which allows the hair to grow through the scar, effectively camouflaging it (see Figure 2). Since no hairbearing skin is removed, this procedure called a high forehead lift can actually lower the hairline a bit. A C B A C A direct eyebrow lift may be recommended for men who are likely to have hair loss, as well as for women who do not have loose skin or wrinkling in the forehead area. The incisions for a direct eyebrow lift are made just within or above each eyebrow (see Figure 1). The scar normally fades to a narrow line that may be camouflaged with makeup, if desired. C B Figure 1 A. Midforehead lift incision, B. Indirect browlift incision, C. Direct browlift incision. Figure 2 A. Coronal lift incision, B. High forehead lift incision, C. Endoscopic browlift incisions. deeper look: I m so glad I did this! Browlift surgery can be part of a more extensive procedure, as Ruth Yag, who is 61, learned when she consulted a facial plastic surgeon about a droopy eyebrow. My left eyebrow always had a tendency to droop slightly, she explains. It started getting worse a few years ago, and soon I could look up and see my eyebrow hanging down and pressing against my eyelid. Ruth thought an eyelid lift might solve her problem, until her surgeon pointed out the laxness in the muscles supporting her brow. Ruth accepted her surgeon s suggestion and opted for a coronal lift, an upper eyelid tuck, and a medium-depth chemical peel under her eyes. The procedures were done in the doctor s office surgery facility under twilight anesthesia. The entire process took about three hours, but Ruth was not aware of the details. I went into the operating room, and the next thing I remember is sitting in my recliner at home with my husband. I don t even remember how I got there. Afterwards, she says, there was very little swelling or bruising and hardly any pain. I expected it to be quite painful, but truthfully, it wasn t. I didn t even need the medication he prescribed. The staples in the long hairline incision pulled and itched a little as the skin healed, but I did exactly as he told me using ice and keeping it elevated and the incision healed quickly. In two weeks, Ruth was ready to resume her normal activities. The droop was gone and my eyes were more open. The best part was that I could see better. That was a nice surprise. Her facial plastic surgery experience was an unqualified success, Ruth concludes. My left eyebrow always had a tendency to droop slightly... I am so glad I did this. I would recommend it to anyone. 124 The Face Book www.aafprs.org 125

9. Plastic Surgery of the Cheeks and Midface with Special Section on Lip enhancement EVALUATING YOUR MIDFACE REGION PLACING THE IMPLANTS ANOTHER OPTION TO ADDRESS THE MIDFACE: FAT GRAFTING 134 The Face Book www.aafprs.org 135

To be rescanned by printer ANOTHER OPTION TO ADDRESS THE MIDFACE: FAT GRAFTING Cheek augmentation and blepharoplasty have given this patient a more youthful, less drawn appearance. Today, volume loss, principally fat loss, has become a vital component in many facial rejuvenative strategies. Although cheek and chin implants help to bring back the lost bone structure that can occur with aging, fat transfer taken from one s thighs or belly can be used by injection to restore the loss of soft tissue that can occur as well. Of all the places in the face for fat grafting, or fat transfer, the midface has become recognized as one of the most important areas to restore lost volume. Which option is the best for you to restore your aging cheek area depends on an in-depth consultation with your facial plastic surgeon. I wanted my eyes to look more awake and what I found was that the hollowness in my cheek areas was actually contributing a lot to my tired look. My surgeon put a little fat that I lost through aging back around my eyes and into my cheek area and I look so much more youthful and rested now. I have no regrets. Susan C., age 55 Trust your face to a facial plastic surgeon. deeper look: Techniques for enhancing the lips Just as soft, round, firm cheeks convey an aura of youth and good health, so do well-defined, shapely lips. Unfortunately, lips like cheeks are subject to sagging as we age. The problem is especially noticeable in women with thin lips. Even those born with perfect lips, however, will find that as time goes on, the colored portion of the lips thins out, and the arch of the upper lip called Cupid s bow flattens. Several facial plastic surgery techniques are available to enhance the fullness of lips and create and maintain a pleasing lip contour. One option is to augment the lip line with injections of a type of filler called hyaluronic acid (See Chapter 3 for more information). Hyaluronic acid and other types of injectable fillers plump up the border and body of the lips and can also raise the droopy corners of the mouth, but these fillers may last only several months. Fat taken from elsewhere in your body can be injected into the lips to provide volume. The fat usually is reabsorbed after about a month, although some doctors report that subsequent treatments produce more longlasting results. Surgical lip advancement offers a more permanent solution for some people. In this relatively simple procedure, an incision is made along the line where the colored part of the lip meets the skin what surgeons call the vermilion border. A tiny strip of white skin is removed and the red lip edge is advanced outward and stitched in place. The incisions heal quickly and scars are usually imperceptible. The procedure usually provides the most satisfactory results to patients who have experienced thinning of the lips due to age. If you have naturally thin lips, you may benefit from a lip implant procedure. Thin strips of an inert surgical synthetic material are threaded into the lips by means of a special needle. The implant adds bulk to naturally thin lips and restores fullness. The implant can be placed without sedation using a local anesthetic. There is usually no bruising, and most patients find that they are back to normal within a week. Because the implant material lasts indefinitely, the shape and fullness of your lips are enhanced permanently. 140 The Face Book www.aafprs.org 141

10. Plastic Surgery of the Ears ABOUT EAR ABNORMALITIES NO NEED TO WAIT HOW EAR SURGERY IS DONE AFTER THE SURGERY 148 The Face Book www.aafprs.org 149

11. Hair Restoration Surgery PATTERNS OF MALE BALDNESS TODAY S HAIR GRAFTS SCALP REDUCTION AND TISSUE EXPANDERS WHICH HAIR RESTORATION PROCEDURE IS FOR YOU? 162 The Face Book www.aafprs.org 163

For Germaine, the solution was a series of hair transplant procedures one of several permanent solutions available for hair loss. I tried a drug treatment, but it didn t work for me, he says. I didn t want a wig. Now I have my own hair, growing naturally. It s unbelievable how great it looks. Facial plastic surgery offers several effective techniques for treating hair loss, including hair grafts and scalp reduction. One of these options or a combination of methods may be right for you. Figure 1 Figure 2 For many men, growing older means growing balder a bare spot at the crown and excessive hair loss over the front and top of the head. Figure 3 Figure 4 PATTERNS OF MALE BALDNESS Before selecting an appropriate treatment for male pattern baldness, your surgeon will consider the extent of your hair loss, how your remaining hair is distributed, and your ultimate balding pattern. The most important thing to remember about male pattern baldness is that it is progressive. Therefore, treatment must take into account what is going to happen in the future. Whatever procedure is selected, the goal of hair replacement surgery is to give you a natural appearance that will look good for the rest of your life. It is important to identify your final balding pattern so that donor hair is not taken from any area that is programmed for future hair loss. Subsequent thinning of treated areas also must be considered. Keep in mind, however, that the precise extent of future hair loss cannot always be predicted accurately. To help predict future hair loss, facial plastic surgeons have identified four types of male balding patterns (see Figures 1-7). Male pattern baldness usually begins at the front of the head with a receding hairline. It typically continues across the top of the scalp, and a bald spot may appear on the crown. In many men, these areas eventually meet, producing the classic horseshoe-shaped rim of hair around the edge of the scalp. In other cases, the hairline recedes to the middle of the scalp, with little or no thinning at the crown. Rarely, a man will develop crown baldness only, with normal thickness in all other areas. In general, women can exhibit three types of hair loss patterns. They can lose hair that resembles any male pattern loss, sometimes with preservation of their hairline. They can lose hair in a diffuse pattern over the central scalp at times to include loss in the sides and back of the head as well. Alternatively, a Christmas tree pattern can be observed when the hair is parted and the hair loss is observed with the individual looking down to the floor. Figure 5 Figure 7 Figure 6 The Norwood Classification depicts the seven stages of male pattern baldness from a non-balding scalp of a Norwood 1 shown in Figure 1 to the most advanced stage of hair loss represented as a Norwood 7 in Figure 7. 166 The Face Book www.aafprs.org 167

Before After Hair Transplant 176 The Face Book www.aafprs.com 177

13. Scar Revision Surgery HOW SCARS FORM SCAR REVISiON TECHNIQUES 192 The Face Book www.aafprs.org 193

14. Facial Reconstructive Surgery Special Section on our Face to Face Program REPAIRING SOFT TISSUES CORRECTING STRUCTURAL ABNORMALITIES 204 The Face Book www.aafprs.org 205

deeper look: Face to Face Face To Face is a humanitarian program conducted under the auspices of the Educational and Research Foundation for the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS Foundation). In both the United States and abroad AAFPRS members assist those who suffer from facial deformities which may be secondary to trauma, birth disorders, tumors, or other causes. FACING A GLOBAL NEED Unlike some other programs, FACE TO FACE: International makes the educational exchange among facial plastic and reconstructive surgeons all over the world an integral part of its program. The surgeons are men and women who believe that a more lasting impact is made on communities when the FACE TO FACE teams work together with local medical personnel to manage an individual s care. Mutual respect grows as different surgical approaches are discussed and demonstrated. The volunteer surgeons and the hosts verbally exchange case analysis and share published information. This exchange of information, knowledge, and techniques is encouraged and contributes to the long-term success of the program. FACES IN OUR MIDST The AAFPRS Foundation is the first surgical group to take a firm stand and become involved in assisting individuals who are victims of domestic violence break the cycle of violence, enhance their self-esteem, and rebuild their lives. Many victims of domestic violence receive facial injuries and are not financially able to have these injuries adequately repaired. The AAFPRS offers pro bono consultation and surgery to eligible individuals through FACE TO FACE: The National Domestic Violence Project. FACE TO FACE realizes that the surgery will not alleviate the emotional scars that these individuals carry at all times. That is why they have partnered with shelters across the United States. Healing must occur within before surgery attempts to erase the physical scars. The newest program, FACES of Honor, offers medical and reconstructive surgical services of volunteer surgeons of the AAFPRS to military members and veterans with face, head, and neck injuries as a result of deployment to the Operations Iraqi Freedom (Iraq) and Enduring Freedom (Afghanistan). The Academy s mission is the same wherever AAFPRS surgeons are: treat one face at a time, one person at a time. This woman was shot in the face by her domestic partner. Through the FACE TO FACE: The National Domestic Violence Project, she received numerous surgeries, free-of-charge, that allowed her facial senses to function normally and gave her the strength to face the world again. 212 The Face Book www.aafprs.org 213

15. Enhancing Postoperative Results PLAN AHEAD TO BEAT THE POST-OP BLUES CHECK YOUR DIET BEFORE AND AFTER SURGERY GIVE YOURSELF TIME TO HEAL USING COSMETICS AFTER SURGERY 222 The Face Book www.aafprs.org 223

More Patient Information form the AAFPRS The AAFPRS Patient Brochure Series Single copies of the following brochures are available via the AAFPRS Web site: www.aafprs.org. The brochures contain information about the most common facial plastic and reconstructive procedures in use today: Rhinoplasty (nasal surgery)* Blepharoplasty (eyelid surgery)* Skin Resurfacing and Peels Rhytidectomy (facelift surgery)* Otoplasty (ear surgery) Forehead and Brow Lift Facial Scar Revision Mentoplasty (chin surgery) Laser Surgery Treatment of Facial Wrinkles Lip Enhancement Cleft Lip and Palate Hair Replacement What Is a facial plastic surgeon? *Also available in Spanish facial plastic surgery Today The AAFPRS produces a quarterly patient education newsletter that will provide you with up-to-date information about facial plastic surgery. Facial Plastic Surgery Today is on-line at the AAFPRS Web site: www. aafprs.org. The AAFPRS Web Site Visit the AAFPRS Web site and you will find the latest information about the major facial plastic surgery procedures in use today, including new techniques such as laser resurfacing, an introduction to the AAFPRS and its programs and patient publications, and the names and phone numbers of facial plastic surgeons in other cities. The Academy s Web address is www.aafprs.org. About the American Academy of Facial Plastic and Reconstructive Surgery Founded in 1964, the American Academy of Facial Plastic and Reconstructive Surgery with 2,700 members is the world s largest association of facial plastic surgeons and the only organization dedicated solely to the advancement of the highest quality of facial plastic and reconstructive surgery. To achieve its mission, the AAFPRS: Ascribes to rigorous professional standards; Offers a widely recognized program of post-residency education; Disseminates information that assures recognition of specialty standards among professional medical organizations, healthcare providers, legislative and regulatory bodies, and the public; Long recognized by the American Medical Association as a national medical specialty society representing facial plastic surgery, the AAFPRS holds an official seat in the AMA House of Delegates and on the American College of Surgeons Board of Governors. The majority of AAFPRS members and fellows are certified by the American Board of Otolaryngology, which includes examination in facial plastic and reconstructive surgery. Other AAFPRS members are surgeons certified in ophthalmology, plastic surgery, and dermatology. Most members are diplomates of the American Board of Facial Plastic and Reconstructive Surgery. The Face Book: A Consumer s Guide to facial plastic surgery Additional copies of The Face Book can be ordered by calling (703) 299-9291 or by visiting www.aafprs.org. Supports the concept that facial plastic surgery requires intensive training and competence, embodies high ethical standards, artistic ideals, commitment to humanitarian service, and a desire to enhance the quality of human life; and Assists members with practice management, to assure the delivery of high quality, cost-effective medicine and surgery. 232 The Face Book www.aafprs.com 233