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Rhinoplasty is a common intervention, is still quite delicate, nose surgery has evolved a lot in recent years, it seeks less today to reduce the size of the nose than to balance it, to put the nose in harmony with the face.

The most frequent anomalies are: the “bosses”, deviations of the nose, of the nasal septum with respiratory discomfort and the flattened nose, The intervention can be carried out as soon as the growth is finished at 15 years especially when there is a deformation with significant psychological impact.

It consists in acting on the bone and the cartilages of the nose which give it a particular shape. The evolution of techniques makes it possible to obtain natural noses with good respiratory function.

Before the intervention: The surgeon DR GHARBI NEDRA you ask to take medical photos and draw with you your new profile.

The procedure: It is most often performed under general anesthesia. The incisions are most often made inside the nose, sometimes under the nose. Through these incisions, the surgeon will reduce a bump, reshape the cartilage, correct a deviation of the nasal septum using the photographic project established with the patient. Rhinoplasty can be associated with a gesture on the chin, which consists of genioplasty . to have a harmonious profile At the end of the intervention, the surgeon encountered wicks in the nostrils and a plaster cast.

The postoperative procedure The intervention is not very painful. The exit is authorized after 1 to 2 days. The wicks are removed after one day most often. There is especially a respiratory discomfort the first days and the surgeon prescribes washes with physiological saline. You should not blow your nose or wear glasses for about 15 days. The plaster is removed around the 10th day. There are often bruises (bruises) on the eyelids and cheeks; they disappear in about 2 weeks.

You must avoid “fiddling” with your nose and any violent sport for 2 months; You start to see the result after 15 days but the nose remains a little swollen for about 2 months. The result was not really seen as final until after 1 year. Complications are rare.

This intervention gives a lot of satisfaction in terms of the profile of the face.


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Genioplasty is a cosmetic surgery of the chin, with the aim of changing chin position to recreate a harmonious face to face and profile.
Genioplasty is going to recreate a balance between the chin and the rest of the face, especially on the profile, under the profiloplasty.

Genioplasty chin implant by (chin prothesis)

The technique is based on several points

We define the progress of consultation desired by the patient chin.

The incision is usually hidden in the mouth (invisible scar) or very discreet under the chin.

Abox is performed in contact with the bone mandibulairte, avoiding detaching muscles chin tuft. This box corresponds to the exact dimensions of the prosthetic chin.

The interventiont is usually carried out under local anesthesia with a neuroleptic or general anesthesia if it is the wish of the patient.

The procedure takes 30 minutes to 1 hour depending on the type of implant.

The different types of prothesis chin

Following the appearance of the chin, and the correction to be made, several types of prosthesis exist: either small plants prothesis or dentures with side wings to expand too narrow chin.

Composition of prostheses used in genioplasty

artificial limbs are made mostly of hard silicone. They are very well tolerated.

The result of genioplasty by prothesis is immediate. However, the complete disappearance of edema takes between 2 and 3 months.

Hospitalization is an outpatient procedure.

A dressing of contention is stored for 5 days, to prevent movement of the prosthesis on the chin

If scar in the mouth; mixed feed for 48 hours, and antiseptic baths mouths for 5 days. Avoid hot foods first 48 hours.

This is a very satisfactory procedure that gives an almost immediate result

The patient can move his jaw safely right out of the operating room.


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The correction of prominent ears needs a surgical procedure called “otoplasty”, which the goal is to reshape the auricles, we think,

are excessively too visible.

The surgery is usually performed on the two auricles but could be done unilaterally.

Surgery, definitively, corrects abnormalities, by reshaping the ear cartilage, in order to obtain well-
positionned, symetrical ears also natural in size and aspect.

An otoplasty can be performed in an adult, in an teenager or, most of the time in a 6-7

years old child, as soon as the child starts suffering of his/her ear aspect.

• TYPE D’ANESTHESIE ET MODALITES D’INTERVENTION

• HOSPITAL STAY AND TYPE OF ANESTHESIA

Type of anesthesia

Three possible proceedings:

• simple local anaesthetic (an analpesic drug is injected locally to

insensibilize the ears)

• local anaesthesia completed by tranquillizing drugs, injected in veins (“vigil” anaesthetic)

• classical general anaesthesia, which puts you asleep

The choice between these different techniques must come after you have discussed it with the surgeon and the anaesthesiologist.

• THE PROCEDURE

Each surgeon is using his own technique, he may adapt to each case, in order to get the best result. But, common surgical steps

have to be used :

• THE PROCEDURE

Each surgeon is using his own technique, he may adapt to each case, in order to get the best result. But, common surgical steps

have to be used :

Skin incisions:

Usually, there are inside the natural retro-auricular fold. But sometimes, some small complementary

incisions may take place at the anteror side of the auricles, hidden inside natural folds.

bending the cartilage framework, which may necessitate deep fine stiches. Sometimes, cartilage cuting or

partial removing is indicated. Finally, the auricles are put back in a good position, in relation to the skull,

and anchored by deep stiches.

Sutures :

Usually, the skin after surgery.

• THE SURGICAL FOLLOW-UP

Pains are usually moderate and if necessary, they can be treated using pain killers or anti-inflammatory

A maintaining and protecting head-band wil be use day and nights for 15 days and then for another few weeks, during night, only.

It will be appreciated within 1 to 2 months after surgery. It is the time needed for the edema to disappear, allowing the ear reliefs

to be clearly seen. After this period of time, only the scar will be red and harden for another few month before toning down.

• POSSIBLE COMPLICATIONS
Even if it is done for aesthetical purpose, an otoplasty remains a true surgical procedure, what means, it can induce the same risks

as any surgery as little it is.

We must distinguish the complications from anaesthesia and the one from surgery.

All things considered, the risks must not be overestimated, but you must be conscious that an operation, even a minor one, always

has some degree of unforeseeable unknown factors.

You can be assured that if you are operated on by a qualified Plastic Surgeon, he will have the experience and skill required to

avoid these complications, or to treat them successfully if necessary


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‘Blepharoplasties’ means aesthetic surgical procedures of the eyelids aiming to correct unsightly aspects, whether due to heredity or age. They can be performed on the upper or lower eyelids alone, or all four at the same time.

This technique may be carried out alone or in association with other cosmetic facial surgery (brow-lift, forehead-lift, face- and neck-lift) or with techniques such as laser resurfacin,

The goal of a blepharoplasty is to correct signs of aging and remove the tired look due to the heavy eyelids by a more rested, relaxed appearance.
Drooping heavy upper eyelids, with a more or less marked skin-fold.
Lower eyelids which have drooped and shrunk, leading to horizontal wrinkles due to distended skin.
Bulging fat, responsible for ‘bags under the eyes’ at the lower eyelid level, or sagging upper eyelids

The procedure aims to correct these problems durably by surgical removal of excess skin, fat and muscle, without of course affecting the normal functions of the eyelids.
It should be noted that other age-related problems may be present but their treatment necessitates techniques more complex than standard blepharoplasty, or requires supplementary surgery.
This procedure, for both men and women, is often carried out around the age of forty.
It can however be done much earlier where the problem is congenital rather than age-related, for example in the case of bags under the eyes.

• BEFORE THE OPERATION

Prior to the operation a thorough examination of the eyes and eyelids will have been carried out in order to detect any anomalies which could complicate the procedure or indeed show that it is not recommended in this specific case.
A specialised ophthalmologic examination will often be prescribed to rule out any ocular pathology.
A preoperative check up will be carried out as prescribed.
An anesthesiologist will see you in consultation at the latest 48 hours before the operation.
No aspirin-based medication should be taken during the 10 days preceding the operation.
For certain types of anesthesia you may be required to fast (neither eat nor drink) for six hours before the operation.

• HOSPITAL STAY AND TYPE OF ANESTHESIA

Type of anesthesia
Three possibilities exist :

Local anesthesia alone, in this case the eyelids are numbed by an injection given locally.

Local anesthesia with sedation given by intravenous drip.(‘twilight’ anesthesia)

Standard general anesthesia, you sleep throughout the procedure.
The type of anesthesia will be chosen after discussion between yourself, the surgeon and the anesthesiologist.

Hospital stay
The procedure may be carried out on an out-patient basis, in an ambulatory facility, the patient leaves on the same day after a few hours under observation.
However, in some cases a short hospital stay can be preferable. The patient arrives in the morning (or sometimes the previous evening) and is discharged the following morning.

• THE PROCEDURE

Each surgeon has adopted his or her own specific technique which he or she adapts in order to obtain the best results in each case.
We can however give some basic points.

a
Incisions :
-Upper eyelids : They are concealed in the fold situated at the mid-point of the eyelid, between the mobile and fixed parts.

-Lower eyelids : They are 1 to 2mm below the eyelashes, and can go slightly beyond them.

Note : For the lower eyelids, in the case of isolated “bags” (without excess skin to be removed), a blepharoplasty can be carried out by the transconjunctival approach, that is by using incisions placed inside the eyelids, thus leaving no visible scar.

Resection : Once the incision made, unsightly excess fat is removed, as are redundant muscle and sagging skin. At this stage, numerous appropriate adjustments can be made in order to tailor the procedure to the specific needs of the patient.

Sutures : Stitches are made using very fine absorbable thread .

The operation can take between 30 minutes and 2 hours depending on the specific requirements and complexity of the case.

• AFTER THE OPERATION

There is no actual pain, but possibly some discomfort with a sensation of tension in the eyelids, slight irritation of the eyes and perhaps some blurring of vision.
During the first few days rest is advised, with no physical strain, no lifting heavy weights for example.
During the recovery period there will be edema (swelling), and bruising, to a variable degree for each individual patient.
For the first few days it may be impossible to close the eyes completely, a slight detachment of the external angle of the eye may also be observed, but in both cases these signs are rapidly reversible.

The scars may remain as pinkish lines for the first few weeks, but can be hidden by makeup from the 7th day onward.

• THE RESULT

The final aspect will not be visible before 3 to 6 months. This is the time lapse necessary for the tissues to regain their softness and for the scars to heal and practically disappear.

• POSSIBLE COMPLICATIONS

A blepharoplasty, although essentially an aesthetic procedure, is nevertheless an operation, and this implies that the risks inherent to any surgery apply here.

We must distinguish here between risks related to the anesthesia and those related to the surgery.


Concerning surgery : by choosing a competent, qualified Plastic Surgeon, used to performing this procedure, you limit the risks, without however eliminating them completely.

Fortunately, real complications are rare following a blepharoplasty which has been carried out correctly. In fact practically all the operations go well and patients are completely satisfied with the result.


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The face- and neck-lift is the most frequent procedure; this means surgical correction of aging of the neck and also the face from the forehead to the jowls.

The aim of the operation is to remedy the sagging and laxity of the skin and muscles of the face (forehead, eyebrows, cheeks, jowls, and the oval facial outline) and the neck.
The aim here is not only to transform the form and aspect of the face. On the contrary, restoring the different anatomical structures of the face and neck (the skin, the muscles and the fat) enables the patient to look as he or she did some years earlier.

The muscles are tightened, to correct slackness. The skin is then draped as required over the new curves, without excessive stretching. This dual action gives a natural appearance (as the skin is not over-stretched), which lasts (since the muscular base is strong). The healing process is generally uneventful (the skin is less bruised because it is less traumatized, because the tension and separation are limited.) Excess fat, if present can be treated by liposuction.
On the other hand, if the face appears emaciated, this can be corrected at the same time by re-injection of autologous fat. (liposculpture).
In this way the face and the neck are ‘rebuilt’ or ‘restructured’.
The incisions necessary for the procedure are hidden almost entirely in the hair (at the temples and the nape of the neck) and around the ears. The scar is thus almost entirely concealed.

• BEFORE THE OPERATION

Prior to the operation a thorough examination will be carried out as prescribed.
You will see an anesthesiologist in consultation at the latest 48 hours before the procedure.
No aspirin-based medication should be taken over the 10 days preceding the operation.
You must wash your hair the day before the operation and make-up must be thoroughly removed.
You must fast (neither eat nor drink) for 6 hours before the operation.

• HOSPITAL STAY AND TYPE OF ANESTHESIA

Type of anesthesia
A face-lift can be carried out under general anesthesia or local anesthesia with sedation (‘twilight’ anesthesia).
The type of anesthesia will be chosen after discussion between yourself, the surgeon and the anesthesiologist.
Hospital stay
A 24-48 hour hospital stay is usual.
• THE PROCEDURE

Each surgeon has adopted his or her own specific technique which he or she adapts in order to obtain the best results in each case.
We can however give some basic points:

The incision is almost completely hidden in the hair, or around the ears.

Once these incisions are made, the skin is detached ; to a greater or lesser extent in each case, according to the degree of sagging of the skin.
The muscle layer is then carefully and precisely tightened to correct laxity, without affecting the normal expression of the face.
If there are localized fat deposits, which can form on the neck, the chin, the jowls or the cheeks, lipoaspiration is performed during the operation.
The skin is then re-draped in a natural manner, excess skin removed, and stitches placed without excess tension.
Finally a dressing is placed around the head, framing the face.
The procedure lasts from two to three hours depending on the surgeon and the individual corrections required.

• AFTER THE OPERATION

You will be able to go home on the first or second day after the operation.
For the first few days you are advised to rest and avoid physical strain.
During this period you should not be surprised by, or worried by, the following :

edema (swelling) which can be worse on the second day than the first.

bruising around the neck and chin

a sensation of painful tightness especially behind the ears, and around the neck.
This bruising and swelling generally disappears in the two weeks following surgery.
After one month all signs of swelling have usually practically disappeared. The zones from which the skin was detached may feel slightly hardened, this is perceptible to the touch, but not visible. The ears will not regain normal sensitivity for one or two months.
The scars are hidden by the hair both in front and at the back of the head. The only zone where they are visible, in front of the ears, can be temporarily masked by make-up or concealed by the hair.

• THE RESULT

After two or three months one can have a good idea of the final result. The scars, however will still be slightly pink and hard to the touch, and will not fade until the sixth month after the operation.
Through progress over the years and techniques of great precision we usually achieve a result giving an impression of considerable rejuvenation which nevertheless looks quite natural. The face does not have a ‘surgical’ appearance and has regained the features which it had eight to twelve years .

• POSSIBLE COMPLICATIONS

A face lift, although essentially an aesthetic procedure, is nevertheless an operation, and this implies that the risks inherent to any surgery apply here.

We must distinguish here between risks related to the anesthesia and those related to the surgery.

Fortunately, real complications are rare following a face- and neck-lift which has been carried out correctly. In fact practically all the operations go well and patients are completely satisfied with the result.