JOIN US FOR A FREE SEMINAR! Click to hear more about seminar series Upcoming Seminars Canfield Ohio Tuesday October 5th 7:00 PM Akron Ohio Tuesday October 12th 7:00 PM Leos's Ristorante Niles Ohio Thursday October 14th 7:00 PM Cleveland Racquet Club Pepper Pike Ohio Tuesday October 19th 7:00 PM Dr. Gentile Speaking Engagements 33rd Annual Meeting of the European Academy of Facial Plastic Surgery September 1-5, 2010. Antalya/Turkey American Academy of Facial Plastic & Reconstructive Surgery Annual Meeting September 23-25, 2010 Boston, MA, USA The 1st World Congress on Controversies in Plastic Surgery & Dermatology (CoPLASDy) November 4-7, 2010 Barcelona, Spain Rejuvenation of the Aging Face January 19-23, 2011 San Diego, California Munich Facial Plastic Surgery 2011 February 14-18, 2011 Munich Germany

Smartlifting

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Forehead and Eyes

Normal brow position with excess upper eyelid skin. Eyelid enhancements included both upper and lower blepharoplasty with laser tightening under eyelid skin. Patient pleased to not look tired anymore.

When lower eyelid fat is excessive or bulges beneath the lower lids, hidden incisions can be made inside the eyelid. This conjunctival approach lessens the chance that eyelids will look operated.

Excessive eyelid skin can sometimes obstruct vision as well as make us look older. The removal of excessive upper eyelid skin and or fat or muscle is know as Blepharoplasty and opens the eyes making them look more youthful.

In some patients the skin is just slightly excessive so in planning the Blepharoplasty we would plan to remove a much smaller amount of tissue. Cheek lifts or filler injections can also improve sunken areas under the lower lid.

In some patients the forehead and eyebrow has descended and gives rise to the excess upper eyelid skin. These patients respond well to endoscopic or classical brow and forehead lifts.

In patient with low brows and forehead concerns we will usually combine the brow and forehead lift with upper blepharoplasty. Conservative fat removal is accomplished to give patients aesthetically pleasing eyelids.

Facial Rejuvenation
Mid and Lower Face and Neck

Mid-face and lower neck improvement is most dramatic with Dr. Gentile's Subperiosteal Deep Plane facelift which he pioneered and presented at the 2001 International Facial Plastic Surgery Seminar in New York City.

Mid- face improvement also involves improving the depressions under the eyes. Neck Lifting can produce dramatic results with the Subperiosteal Deep Plane Rhyidectomy.

In most patients neck improvement also involves liposuction and lifting of the neck anatomy. Dr. Gentile pioneered the Purse-String Platysmaplasty which enhances the ability to get great results in neck lifting. This was first presented in Newport Beach California in 2002 and is now being utilized by other Plastic Surgeons around the country.

The combination of skin Rejuvenation and facelift surgery was fist described to Facial Plastic Surgeons by Dr. Gentile in 1999 in Palm Springs California. It dramatically improves sagging skin and muscles as well as enhancing the overall quality of the skin.

The more youthful appearance after comprehensive facial rejuvenation is apparent in this patient.
Who underwent composite forehead lift with upper blepharoplasty and Smartlifting™ of the face and neck. Better position of her eyebrows is evident and they are not over-elevated in a “surprised look”

The more youthful appearance is in part due to the more open eye aperture and more volume in the cheek and areas adjacent to the cheek and lower eyelid.

The lateral view demonstrates a marked improvement in the jaw line and the laxity in the skin adjacent to the jowl and chin. More fullness is evident in the midface.

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Rhinoplasty

Multiple procedures or Natural Makeovers are now common place at the center. Patients are interested in Looking Their Best and sometimes this involves have multiple facial procedures. This patient had facial and Rhinoplasty surgery as well as skin revitalization.

Many teens decide to undergo Rhinoplasty surgery because they would prefer noses with more refined features. Often times this involves lowering the bridge and shaping the tip. Often times breathing passages require surgical correction.

Patients with noses that appear to project too much may have an elongated bone in their nose know as the nasal spine. Reducing the size of the nasal spine can reduce the projection of the nose.

Teen Rhinoplasty can help in reducing some undesired characteristics of the nose but the biggest improvements are not in appearance, they are in improved self-esteem which leads to a better quality of life.

Some patients require Rhinoplasty because of accidents or injury. When a nose is injured it may be treated by closed reduction of the fracture. If problems with the appearance of the nose persist a Rhinoplasty may be necessary to restore the nasal appearance.

Nose with large bony bridges need to be carefully reduced so as to not reduce the ability to breath through the nose. In some patients chin implants balance the profile of the nose.

Frontal view of patient requesting tip and minor “bump removal” shown before and after a “finesse” rhinoplasty. In a finesse rhinoplasty it is very important to not over do the rhinoplasty. With a few minor changes the patient will achieve the desired result. The nose will continue to refine itself for many years after rhinoplasty so excessive changes are not called for.

The lateral view shows a natural slope for the bridge and one that is not overdone or underdone.

Another example of a finesse rhinoplasty with only minor tip work and some minor bridge work done.The tip is done with small cartilage grafts placed in the tip called batten grafts.
The results of the rhinoplasty are naturally looking.

The lateral view demonstrate a very elegant transition from the bridge to the tip. Again the slope should not be exaggerated into a ski slope and if it does not have some slope to it the patient may feel that it is not enough of a “result”. Very straight bridges are kind of the norm in many rhinoplasty practices but we continue to favor a subtle slope which is more feminine.

Certain ethnic noses need to be reduced in size by advance techniques involving the tip cartilages. The nasal tip is like a tripod and in some large noses we plan to shorten equally the legs of the tripod as was done in this patient.

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During planning of your rhinoplasty a computer imaging session will be conducted to determine how high you wish the bridge to be. Today's rhinoplasty surgeons tend to want a straight dorsum with little slope but we prefer to have a bit of slope to the bridge (called retrousse). Most of our patients prefer a slight slope except male patients who should maintain a straight slope.

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Revision Rhinoplasty

Trauma or previous Rhinoplasty can leave the nose with some unnatural shapes or depressions. One third of Dr. Gentile's rhinoplasty surgeries are revisions and he utilizes all current techniques to give patients the best possible result.

At times the correction of undesirable appearances requires specialized procedures such as columellar grafting. This patient had a T-Strut inserted to stabilize and elevate the nasal tip. Dr. Gentile first presented this Innovation in 2002.

When the bridge is narrowed after rhinoplasty it may compromise the breathing passages. When this occurs it is a nasal valve blockage and it can be corrected by spreader grafts.

The correction of many asymmetries after rhinoplasty may require extensive cartilage grafting. In these patients ear cartilage or rib cartilage may be required to rebuild the nose.

In some patients unnatural depressions of the tip or fullness or nodularity can be addressed with a revision. The revision rhinoplasty is usually done through the open approach so that irregularities can be corrected.

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Skin Rejuvenation and Acne Care

The Center specializes in non ablative laser skin care which requires little or no down time and utilizes Intense Pulsed Light and lasers to correct pigmentary problems rosacea, and age spots.

Lip creases are treated by both ablative and non ablative methods. The correction of deep lip creases is also accomplished by filler injections, and Botox® Cosmetic to relax muscles in the upper lip.

Dark pigmented lesions are treated by three different lasers but raised ones respond best to the 532 Diode laser. In these patients a short laser treatment can clear most if not all the lesions.

Extremely deep creases will usually require treatment with the Carbon Dioxide laser. In these patient healing may take up to one week.

Patients with dark flat spots or Age Spots’ respond well to treatment with our short pulsed 532 laser the Medlite. It will remove most age spots in a single treatment and is virtually pain free. It is also used for tattoo removal.

Some patient may require a MiniLaserPeel that utilizes the Ultra fine ERBIUM laser. In this procedure the skin is lightly treated so the sun damage is erased and recovery time is shortened. Peeling may go on for up to 6 days in this procedure but down time is much less than Carbon Dioxide laser. Radiofrequency tightening may also be performed.

Rhinophyma can be a devastating problem for patients and it is ususally seen in male patients. It is a form of advanced acne and can be associated with basal cell carcinoma in the affected areas. Advanced laser and radiofrequency techniques can effect life changing transformations in these patients and are comfortably done under just minor sedation at the center.

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For Men Only

Men with active lifestyles may wish to eliminate excess upper eyelid skin and lower eyelid puffiness. This is easily accomplished with upper and lower lid blepharoplasty.

Men more often than women may have droopy eyebrows and making the eyes look refreshed may require brow and forehead lifting. This patient had eyebrow, eyelid and forehead lift done endoscopically through tiny incisions.

Patient suffering from acne want solutions that work. The center specializes in high tech options for reducing or eliminating acne including laser, light and photodynamic options including blue light therapy.

Comprehensive facial rejuvenation in males includes deep plane face lifting, as well as forehead and eyelid surgery for a refreshed and revitalized look Patients treated at the center look rejuvenated and revitalized but do not have the operated look.

Lower eyelid bags or puffiness can be erased by an invisible incision under the eyelid known as Transconjunctival Blepharoplasty this approach minimizes the chance that lower eyelids will look operated.

In patients with large under eye "bags" the bulges usually have a corresponding depression under them. In these patients we remove the fat with an internal (transconjunctival) incision followed by laser skin tightening of the lower eyelid skin and MicroFat Grafting to the under eye depressions. All manuevers must be done to obtain natural looking results as shown here.