Procedures for the Face and Neck

Your facial appearance is one of your most obvious characteristics. In many ways, it provides others with a lasting impression of who you are, how you feel, and what you think. In many situations first impressions are important. Facial attractiveness is now recognized as being essential in situations as diverse as education, relationships and employment.

procedures for the face and neck

Certified by American Board of Otolaryngology Head and Neck Surgery and American Board of Facial Plastic Surgery, Dr. Aguilar is masterfully skilled and acclaimed for his craft in providing consistence in natural looking and impressive outcomes.

Facial surgical procedures include:

Facelift (Rhytidectomy)

Neck Rejuvenation & Neck Lift (Submental “neck & jowls” Liposuction & Platysmaplasty)

Nose Reshaping & Reduction (Rhinoplasty)

Deviated Septum Surgery (Septoplasty)

Turbinate Reduction (Turbinectomy)

Cosmetic Ear Surgery (Otoplasty)

Brow Lift (Temporal Brow Lift)

Eyelid Lift (Blepharoplasty)

Facial Liposuction

Facial Implants

Skin Resurfacing & Rejuvenation

Surgical Total Ear Reconstruction (Congenital Microtia & Atresia)

Facelift (Rhytidectomy)

The technical name for a face lift is “Rhydiodectomy.” In this surgical procedure, excess face and neck skin are removed and the tissues under the skin are tightened. Activities such as smoking, sunbathing, outdoor activities, and stress can alter the appearance of the face. Additionally, as we age deep creases may form between the nose and mouth, the jaw line may from slack and sag, and fold and fat deposits may appear around the neck. A face lift can reduce these signs of aging, resulting in firmer, fresher appearance.

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To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Neck Rejuvenation & Neck Lift (Submental Lipectomy)

Submental Lipectomy, also know as a neck lift, is a surgical procedure which removes localized fat deposits under the chin, corrects muscle laxity, or tightens sagging skin under the chin.

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To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Nose Reshaping & Reduction (Rhinoplasty)

Rhinoplasty is a surgical procedure done to correct a prominent, unusual asymmetric or irregular nose. It is one of the most commonly performed cosmetic procedures. Rhinoplasty can also be used to correct an undesirable nasal tip or to reshape the span of the nostrils. This surgery can help with your self-image if you are self-conscious about your nose.

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To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Deviated Septum Surgery (Septoplasty)

A Septoplasty (one form of rhinoplasty) is a corrective procedure that straightens the nasal septum (the partition between the two nasal cavities). A septoplasty can straighten a deviated, twisted, bent, or crooked septum to improve breathing, reduce the incidence of nasal and sinus infections, and increase comfort.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Turbinate Reduction (Turbinectomy)

Turbinectomy is a surgery used to correct a breathing obstruction or other afflictions by removing part of the turbinate structures (both bone and soft tissue) in the nasal cavity. Turbinates are bony structures that originate along the sides of the nasal passage and project into the nasal airway. They are covered by normal sinus lining and act as baffles to warm and humidify inhaled air. The turbinates can become enlarged as a result of trauma or infection and can clock sinus draining and breathing. A turbinectomy opens the nasal airway and improves breathing by removing some or all of the turbinates.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Cosmetic Ear Surgery (Otoplasty)

Also called “ear pinning” Otoplasty is a surgical procedure used to change the appearance of a person’s external ears by bringing the ears closer to the head, reducing the size of overly protruding ears, or reshaping various bends in the ear cartilage. Otoplasty should be performed to “fit” the patient’s needs. From childhood to older adults Dr. Aguilar is world renowned for his experience in Otolaryngology.

Dr. Aguilar’s first residency (of three) was Otolaryngology (Ear, Nose, & Throat, or “ENT”). He was certified by The American Board of Otolaryngology – Head & Neck Surgery, American Board of Facial Plastic Surgery, and American Board of Plastic Surgery in 1986.

Dr. Aguilar was recognized by the San Diego Tribune Feb. 13, 1990 as “Ear Reconstruction Master” and The Katy Times (July 8, 1990) “Ear surgery gives girl new lease on life”. Later, The Houston Chronicle (Nov. 19, 1990) posted “It’s Kind of Wonderful: Ear Rebuilding procedure Opens new World for Children”. The Houston Post (April 27, 1992) printed “Repairing birth defect affecting kids’ ears”. Lastly, The Houston Post (April 14, 1993) published “2 functioning ears like gifts from God for a 9 yr. old girl”.

 

“The greatest joy in my work is the finished product. I have had the tough 45 year old male patient cry before me after having 2 previous unsuccessful surgeries as well as children undergoing 4-5 surgical procedures to literally construct an ear from the cartilage removed from their very own rib.”

– Dr. Fred Aguilar

Other facial rejuvenation procedures for adults that may also be performed along with otoplasty surgery include temporal brow lift, facelift surgery, and/or eyelid surgery “blepharoplasty”.

 

Dr. Aguilar, a triple board certified plastic surgeon, has been practicing for more than 25 years. He has spoken and shared his techniques to surgeons across the United Sates and other countries.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Brow Lift (Temporal Brow Lift)

Dr Aguilar has performed hundreds of brow lifts, endoscopic brow lifts and related brow lift procedures. This page is currently under construction. Check back soon to see our new and improved brow lift page, as well as our new photo gallery showcasing Dr. Aguilar’s award winning work.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Eyelid Lift (Blepharoplasty)procedures for the face and neck

Your eyes are your most expressive facial feature. Your eyes tell the world when you are happy or sad, angry or tired. However, extra skin and fatty tissue around eyes can also age you & give others a false impression of who you really are and how you feel inside. Most Patients need either their top eyelids surgically improved or bottom lids; referred to as “bags”.

Blepharoplasty corrects this problem by removing excess skin and fat from both the upper and lower eyelids. As one of the most commonly performed plastic surgeries by Dr. Fred Aguilar, Blepharoplasty is often combined with other procedures such as facelifts, Temporal Brow Lift or injectables such as Botox or “fillers” (ie. Sculptra, Juvaderm, Restylane, etc). The result of an upper or lower blepharoplasty resuscitates a more refreshed look; which creates a very natural appearance and assists in maintaining a more youthful look without the “overdone” appearance.

The upper eyelid lift is achieved by first creating a slim incision inside the natural crease of the eyelid. The incision extends just past the outer edge of the eye into the natural laugh lines, making the tiny incision line practically invisible after surgery.

The lower eyelid lift is designed to eliminate puffiness and bulging fat under the eyes. For patients who have an excess of fat and skin under their eyes, the incision for the lower eyelid lift is made just below the eyelash line, where the resulting line will be nearly undetectable. For patients who do not have an excess of skin under their eyes, the surgeon may remove extra fat through an incision on the inside of the lower eyelid.

Occasionally patients need both upper & lower lids done; which would be discussed at your one-to-one consultation with Dr. Aguilar Blepharoplasty surgery is performed under general anesthesia or I.V. sedation, and usually takes one to two hours. As it is an outpatient procedure, patients are able to be driven home that same day. Patients usually return to work within one week depending on individual healing process.

Directly after an eyelid lift surgery, Dr. Aguilar will recommend that the patient keep their head elevated and use cold compresses regularly to diminish post-operative bruising and swelling. Sutures will need to be removed on the fourth or fifth day after an eyelid lift, and patients can expect most swelling to subside after one week. Some bruising may last for up to two weeks, but this can be easily hidden with make-up once the swelling is gone.

The results of an eyelid lift will be dramatically apparent after the first two weeks. Patients will continue to see improvement in the eyes as the scars soften and mature over the next several months.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Facial Liposuction

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Facial Implants

Facial implants are sculpted pieces of silicone or other substances that are placed in the chin cheeks or jaw to enhance the contour of the face. They may be used to help strengthen a jaw line or to balance the chin or cheekbones with the rest of the face.

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To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Skin Resurfacing & Rejuvenation

I understand this topic may be confusing; especially with the Internet at your fingertips and many coupons and discounts to choose from.  Skin is complex and unless you are trained to evaluate and treat skin we do not expect you to have all the answers.  We want to take confusing out of the scenario and help you with your specific skin care needs.   Choosing a laser is a very personalized decision and depends on your individual skin condition, how much improvement you want and how much recovery time you can afford.  Dr. Aguilar’s office has the ability to recommend a skin care plan that benefits your specific skin and meets your desired expectations.

Laser resurfacing can improve the appearance of fine lines and wrinkles of the entire face, or those that develop in specific regions of the face, such as the upper lip and around the eyes. Laser and light treatments, or specially formulated chemical peels, resurface the skin to treat fine lines and wrinkles, acne scarring, and sun and age spots.

CO2 Laser Resurfacing

CO2 laser resurfacing has been used for years to treat various skin concerns including wrinkles, scars, warts, birthmarks, enlarged oil glands on the nose, skin cancer and other conditions.

CO2 laser resurfacing uses very short pulsed light energy or continuous light beams delivered in a scanning pattern to very precisely remove thin layers of skin with minimal heat damage to the surrounding structures.

Erbium Laser Resurfacing

Erbium laser resurfacing is designed to remove superficial and moderately deep lines and wrinkles on the face, hands, neck, or chest. One of the benefits of erbium laser resurfacing is minimal burning of surrounding tissue. This laser causes minimal side effects, such as swelling, bruising and redness, so recovery time is one week in most cases.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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Surgical Total Ear Reconstruction (Congenital Microtia & Atresia)

An Innovator, Dr. Aguilar Performs Groundbreaking Surgery For Children Born Without Ears

Dr. Aguilar has had the unique pleasure of learning to create ears on infants and children who were born without one or both ears. It requires consummate skill and art in plastic surgery.

“Sculpting rib cartilage into an ear requires a good three-dimensional eye. And the artistic ability to deliver that takes ongoing practice and maturity. I have performed over 300 ear reconstruction procedures for children with microtia since 1986.”

Ear surgery on children is “very satisfying,” says Dr. Aguilar, adding, “It allows these kids to go out in public with much better self-esteem. They feel like they have a better handle on life. This kind of ear surgery is painstaking and time-consuming. A child must undergo a series of four to five operations, depending on whether he is a candidate for having his hearing restored,” explains Dr. Aguilar.

Dr. Aguilar is one of the few facial plastic surgeons in the United States who specializes in reconstruction of the ear. The unique five-step procedure is predominantly performed on children with congenital microtia and congenital atresia. The term microtia indicates a small, abnormally shaped or absent external ear while the term atresia indicates the absence of the external ear. It can occur on one side only (called “unilateral”) or on both sides (called “bilateral”).

What is Microtia?

Microtia is an incompletely formed ear. The term “micro” means small and “otia” means ear. Hence, when translated literally, “microtia” means small ear. At times a bump of tissue is present in the location where an ear would normally be found. In other cases, the lobule, the lower part of the ear, and the concha, the hollow part of the ear, may be partially formed and the entire upper part of the ear is missing.

Why does microtia happen?

At the present, no one knows why microtia occurs. Further, there is no evidence that the mother’s actions or activities during her pregnancy contribute to this condition. It is most probable that the child received a normal set of genes from both parents. Yet something occurred early in the development stage to prevent the normal growth of the ear. Further research and discoveries in the understanding of human genes and fetal growth are necessary before many questions such as this may be answered.

Where should I go to seek treatment for my child?

The first Doctor you should consult with regarding the reconstruction of microtia is a Plastic Surgeon who also specializes in “ENT”, an otolaryngologist. Dr. Aguilar is Board Certified by American Board of Otolaryngology – Head and Neck Surgery. The plastic surgeon should begin Stages I and II at the age of 6 years. Atresia repair by the otologist is next. It is imperative that the plastic surgeon work closely with the otologist to assure that this comes after the Stage II repair. Download “The Role of The Plastic Surgeon” to learn more

Are both ears usually involved?

Although microtia can involve one ear or both ears, 80% of the time only one is affected.

Can microtia be associated with other conditions or syndromes?

The most common condition in which microtia is seen is Hemifacial Microsomia. This is a condition which involves one ear. This is called unilateral microtia or one-sided. In this case, one half of the face does not grow in proportion to the other.

What if both ears are involved?

If both ears are involved the condition is considered to be bilateral or two-sided. A child with this condition could have Bifacial Microsomia, which is similar to Hemifacial Microsomia. However, in this case, both sides of the face are affected.

Are there other craniofacial conditions involving the ears?

Another condition to consider if both ears are microtic is Treacher Collins syndrome. In Treacher Collins syndrome the eyes are also affected and they appear to have a downward slant or “pulled down appearance.”

What are the chances of producing a child with microtia?

An estimate of the occurrence of microtia is one in 6,000 births. Adults with microtia are unlikely to pass the condition to their offspring. In fact, the probability of this happening is less than 6 percent.

How will my child’s hearing be affected?

It would seem that your child will be unable to hear from the microtic ear. However, in most cases, there is only an approximate 40% reduction in hearing. The effect might be similar to your sticking fingers in both of your ears. This is true because one can hear via “bony conduction.” This means that sound travels through the skin and the bones of the skull and into the inner ear.

Is the inner ear also abnormal?

Most children with microtia have a normally formed inner ear in the absence of an external ear opening. Therefore, there is still an ability to hear from the affected side. Children with unilateral microtia will have problems locating the direction from which a sound comes. Children with unilateral microtia usually do not require hearing aids.

Are ear infections a common problem?

They can be. It is very important to aggressively treat ear infections in the unaffected ear to preserve hearing in the normal ear.

Do children with bilateral microtia have the same problems?

Children with bilateral microtia will have more of a hearing problem. For these children, hearing is typically reduced by 40% on both sides. Due to this high degree of hearing loss, much of what is said is simply not heard. Children with bilateral microtia should be fitted with a special type of hearing aid before six months of age. The sounds that babies hear in the first year of life are very important for speech and language development. Future success in school also depends on one’s ability to hear adequately.

When is the best time to begin reconstruction?

Reconstruction of the outer ear requires approximately four separate operations which are spaced at least three to six months apart. In the first operation, rib cartilage is taken from the chest, carved to resemble the shape of an ear, placed in a pocket under the skin, and then allowed to heal. At the present, there is no adequate, artificial material which can substitute for the child’s rib without increasing the risk of complications. Nor is it possible for a donated rib from a parent to be used. The donated rib would eventually be rejected.

What is involved in the other operations?

The usual procedure involves making an incision around the ear to lift it slightly. A skin graft is then placed on the backside of the cartilage. This procedure helps to create the space normally found behind the ear, but it does not usually help the ear to stick out any further from the head. In the third and fourth stages of surgery, small amounts of tissue are moved around in order to improve the appearance of the ear. These stages are usually scheduled at least three months apart. Small parts of the opposite ear are used to rebuild the microtic ear. The normal ear is sometimes “set back a bit” in order to match the reconstructed ear.

How long will my child be hospitalized?

Children usually spend two nights in the hospital for the first stage of surgery. The remaining stages are done as day surgery and the child leaves the hospital the same day as surgery.

Is there surgery to improve the hearing?

There is a surgical procedure to improve hearing. It involves drilling out an ear opening and rebuilding an eardrum. This is done by an otolaryngologist (ENT). An otolaryngologist is specialized in working with ears, noses, and throats. The results of this operation depends on how much of the middle ear is present, as well as the experience and expertise of the surgeon. Most children with bilateral microtia are good candidates for this procedure. It is best to perform this surgery after the external ear has been rebuilt. If the surgery for impaired hearing is done first, it is sometimes impossible to later build the outer ear.

To schedule a private consultation and to see examples of Dr. Aguilar’s work, please call (713) 521-4777.

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