Gentowa

Materials, as for example collagen, are used also by correction of eyes, but not always.

This way was offered to a single 28-year-old patient by a specialist. She wanted to eliminate the dark circles under her eyes. She said she looked like after making a night of it, even she has slept long enough. “And if I don´t sleep long enough, in the morning are my lids are swollen and I look like Derrick.“

She thought i tis enough to cut a little bit the lower eyelash, then to cut away a little bit of skin and then to saw it again. But it wasn´t so easy. She doesn´t have any wrinkles and it means she doesn´t have any abundant skin that could be cut away.

Her surgeon has prepared another way how to solve this problem:

Her skin is connected to a bone under the eyes by a bine. The bines may be smooth, but also strong and they fix skin to the bone. On the dividing line of the contour of bone and the hole after the eye a cut will be created. The cut creates the circles. To make these both surfaces equal it is enough to use a collagen or fat. But there is a risk, too. Skin is too thin in this place. If the fat is used – the biological material which may be changed by the time – there is a risk that an unequal relief may be created. The collagen and other materials are too expensive although the operation is short. The advantage of it is that, that you can inject some amount of collagen and if the patient is still not satisfied the process may be repeated. So i tis the operation without a scalpel.

A “sac“ under the eye may be created also by accumulated fat and a released muscle. The muscle is getting weaker year by year and the sacs are more marked. They make an impression as the hole was making bigger. It is an ilusion.

If there are wrinkles, too, it is necessary to make an combined operation. To shorten skin and to take out the fat. The cut is lead two millimetres under eyelash. By this cut you can make the way to the fat free and so it can be taken out. But this method is not used every time.

Before the operation it is necessary to estimate the given state individually. Has the patient many wrinkles? How weak is skin? Is there too much of skin?

In the case that skin is strong enough and “only“ full of wrinkles, there is another method: to use the laser, which makes skin smooth and make the collagen fibres stronger.

When the upper lid is slack, it creates the sad appearance of face and a human looks tired. Then skin, muscle and fat are taken out – in different combination and according to necessary extant.

It is provided by the local anaesthesia. The cuts are lead on the upper lids in a natural line. On the lower lid several milimetres under its border. The both ends several millimetres beyond the outer canthus. The abundant skin, muscle and fat are taken out according to necessary extant.

Stitches are removed on the fifth or sixth day after the operation.

A skin strap of a needed width is cut off closely above the red, the red is extended up on the place where the skin strap was cut off. Although the smoothest injection and stitches are used, the patient has to hope the scars will be invisible, or only less visible.

The marks of the intervention stay everytime, depends on individuality. Everyone has a visible white line etween the red and the lip which make the contrast. And after the intervention the contrast isn´t so visible anymore and a patient should know it.

A permanent make-up – the tattooed contour of lips by pigmented color – save the situation. It will last 3 – 5 years, according to the quality of skin. This is provided in tattoo saloons or in bigger comestic saloons. The price is 2 – 3 tousends crowns.

The correction of nose is in the plastic surgery considered as the most technical method, because nose is a threedimensional organ in the middle of face. By the intervention it is necessary to “play“ with small bones and gristles, what is too difficult and hard work. The millimetres play an important role. Some phases of the intervention are provided by assessment, intuitive and following the experiences.

The correction of nose belongs among the most frequent operations made on men, too.

The dicreasing of nose is the intervention that is provided by the local or whole anaesthesia.

According to the necessity the chondral or bone part of nose are operated.

The cuts are lead inside of nose, rarely outside on skin. In that case is their size minimal and placed on the less visible place.

After the intervention tampons are placed inside of nose for two days. From the outside it is fixed by a strap and a splint for 1 – 2 weeks.

Edema and bruise disappear within the next 10 days. The less sensitivity of nose, the fixation of skin, tangible small roughness and other showings are normal changes in the time after the operation and they disappear continuosly.

The final result will be visible mostly 4 – 6 months later, sometimes much later.

The size and form of nose should not be evaluate isolated, but complexy in comparison to whole face. The goal of the operation should be the achievement of balance between the length of nose, forehead and chin by the side-view. The difference between the width of back and tip of nose should not be big. There are many of such small details on nose.

The operation of nose is provided by the local anaesthesia. At first a pill for relaxation is given to the patient, then wadding tampons are put inside his or her nose. The tampons are sodden in special solution, which make mucous numb and then the nose will be made numb by injections. The already mentioned “special solution“ is 10 % cocaine.

Even if the nose is numb, a patient may feel touching, pressure or pull, but he or she shoud not feel the sharp pain.

The most of doctors say it is better to provide this operation only under the local anaesthesia. Because if there is a whole anaesthesia, as a patient wake up, he or she wants to breath through nose. There are tampons in nose and suddenly they can´t breath. It is a shock and within the first several seconds a patient doesn´t know or doesn´t realise it is enough only to open mouth. And to avoid this unpleasant shock it is better to use the local anaesthesia.

But some surgeons say the second way is better.

In the first day after the operation, skin must be covered by a steril vaseline, to keep it plint. Otherwise, as for example by burn, it would be dry. On the second day the burning will disappear, but skin is still dripping wet. Edema is the effect of this. In the places where the ray has reached the connection of skin and epidermis, may be small scars.

Three days later the dripping wet ends and the only sign that there was an operation is the light red color in face of different intesity – it depends on the type of skin, how big place have been operated and how deep was the ray.

There comes the critical period of time. If the red color doesn´t disappear, face can´t be exposed to the day light – neither if it is cloudy. Solarium is strictly forbidden. There is a tendency among people to go out after the operation. But the UV rays are still dangerous, although the sun isn´t shining. Each patient has to use a sun bathing lotion with an UV filter with the factor 20 or more all day long. It isn´t necessary inside of a flat or a house.

The color of face is fading until it disappears completely so the difference between the parts that were operated and the rest of face is invisible. It may takes weeks or months. Individualy it may takes four to six months. Then is the patient already out of dangerous and the sun light rays aren´t so dangerous anymore. The sun light rays may cause the different chromatosis and the creation of color stains.

If the patient follows the instructions there won´t stay any signs on skin. If it takes too long time, it can become boring. The patient may forget some rules or he doesn´t want to do it. He will go out, although the sun isn´t shining in the evening, but the sun light rays may still be there and they can cause many problems.

The most effectiv and the most modern is the laser method. The operated place is healing as the burn on skin – by small edema, dripping wet, sometimes small scars – lasting several days while the vaseline is beeing used. Then there is the red color in face tha may lead several weeks or several months.

By using one type of the laser only some types of „mistakes of beauty“ may be improved. If the patient want some hair on body beeing elliminated, it is necessary to use another type of laser. The laser isn´t a substitution of a classic facelift. The both methods may be used simultaneously, but it can be substituted. By using laser, not only wrinkles can be smoothed, but also the scars after acne. The instructions of a doctor must be fullfiled exactly.

A young passionate girl who likes going skiing had scars on her face caused by acne since she was a teenager. In November she was operated and in March she had to come on control. As she came she had unequal stains. She put a lotion on her face because a doctor told it to her. And she didn´t take part in any exotic holiday. She went „only“ skiing. But she protected her face by shawl…but the sun rays went through the shawl also wenn the sun wasn´t shining.

Several minutes of exposition of UV rays is enough, and not staying the whole days on an uphill. It wasn´t so bad for her but it was necessary to have next time for recovery. The stains may disappear spontaneously. If not, face may be operated by laser one more time, but the result isn´t sure.