San Francisco Plastic Surgery Dr James Romano

126 Post Street, Suite 618, San Francisco, CA 94108 | 415.981.3911 

San Francisco Plastic Surgeon

About Dr Romano

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Before & After Images

Breast Surgery

Body Surgery

Facial Surgery

Brow Lift

Brow Lift Reversal

Buccal Fat Pad Excision

Canthoplasty

Cheek Implants

Cheek Bone Reduction-Malarplasty

Chin Implants

Corrugator Muscle Excision

Dermabrasion

Ear Reduction-Otoplasty

Eyelift-Blepharoplasty

Facelift-Minimal Incision

Facelift-Rhitidectomy

Facelift-Vertical

The Weekend Facelift

Facial Fat Grafting

Facial Wasting-Lipoatrophy

Lip Enhancement

Lip Lift

Lip Reduction

Lip Rejuvenation

Liposuction of the Face and Neck

Nasal Surgery-Ethnic Rhinoplasty

Nasal Surgery-Revision Rhinoplasty

Nasal Surgery-Rhinoplasty

Nasolabial Lines-Laugh Lines

Temporal Tuck

Male Plastic Surgery

Anti Aging

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Facial Wasting-Lipoatrophy

THE PREOPERATIVE FEATURES

  • Loss of underlying fat and support to the face, especially along and under the cheekbones most often seen in association with protease inhibitors prescribed for HIV affected patients.
  • Malnourished appearance.
  • Loose hanging skin especially in the middle part of the face.
  • Deep laugh lines on either side of a raised prominent fold.
  • Sunken cheek pads.
  • Noticeable and prominent outlines to the facial muscles and bones.

THE OPTIONS

  • Filler materials such as collagen, fat, and Sculptra.
  • Grafts placed under the skin surface (subcutanously) and either dissolve over time or have visible irregualr edges.
  • Grafts placed below the all the layers of the skin, muscle, just above the bone (subperiosteal) that are silicone or other materials and often custom designed to adapt and mold to the facial shape and mouth movements, yet substantial enough to fill in the crevices.

THE PROCEDURE FOR SUBPERIOSTEAL IMPLANTS

  • A general anesthesia is used and it takes about two hours.
  • A very small incision is made inside the mouth high up in the gums and a pocket is made of exact size and proportion to correspond to the area needed to be filled in and the size of the implant.
  • The implant is positioned in this space, deep under the skin, fat and muscle layers. The edges of the implant are therefore not visible on the skin surface and this appears very natural.
  • No drains are needed.
  • The sutures are all invisible and dissolve over time and do not need to be removed.
  • No dressings are required
  • The outcome is dramatic. In addition, the surgery disturbs very little tissue, has minimal risks, heals quickly, has only mild swelling, and provides a quick return to work. It can be safely and predictably revised later if you desire even larger or different implants.
  • This procedure does not interfere with other products or types of facial augmentation which may be performed in addition to or after this procedure.
  • This can be combined with the eyelift, forehead lift, cheek or chin implants, neck liposuction or any other plastic surgical procedure.

THE RECOVERY

  • You can go home after several hours.
  • You can shower the next day after surgery.
  • Usually almost no pain, or occasionally minimal pain that is mostly gone by the second or third day and easily controlled by medications.
  • Swelling which is mild and peaks at two to three days then disappears rapidly over the next three weeks.
  • Minimal if any bruising which is most at two days then disappears rapidly by three to five days.
  • Resume many activities within the first week, and most by at least three weeks.
  • Able to return toy work in 2-4 days.

THE RESULT

  • A DRAMATIC improvement that fills in the facial defects and wasting and looks natural.
  • 75-95% improvement in most cases.
  • Quick and comfortable recovery.
  • Very natural, rested and younger appearance.
  • Lasts the rest of your life and always looks better than if you did nothing at all.
  • Does not interfere with future, repeat or additional procedures later.
    Natural and presentable appearance in the first weeks that just gets better over the next six to nine months.

For before and after images of this procedure click here

 

Please call or contact the office for any further information or to schedule an appointment.

Copyright 2007 James J. Romano, M.D., 126 Post Street, Suite 618, San Francisco, CA 94108, 415 . 981 . 3911
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