The Procedures

Rhinoplasty
Blepharoplasty
Facelift/Browlift
Otoplasty
Chin Augmentation
Facial Fillers
BOTOX®
Skin Care

Rhinoplasty

Rhinoplasty is the most demanding facial plastic surgery operation. The variables and intricacies of human anatomy and genetics influence all levels of healing, which makes planning, preparation, surgery, and post-operative care for a rhinoplasty patient a universe unto itself. Minute change or major change, reduction or augmentation, primary or secondary, no rhinoplasty operation is preordained to be easy or simple. Each rhinoplasty requires the total immersion of every nuance of knowledge and experience to assure the best possible result. Dr. Pastorek must understand not just your external appearance, but also the internal nasal anatomic relationships.

Once he completes your examination, Dr. Pastorek presents you with a plan for the aesthetic correction you want. He likes to be absolutely certain of your goals before you leave the consultation. He wants you to know what is realistically possible with aesthetic nasal change before he starts any discussion about your preparation or post-op course. Various surgeons manage rhinoplasty in different ways. Dr. Pastorek performs his procedures through internal incisions (known as a Closed Rhinoplasty). You will usually leave the post-operative recovery room within one hour following the surgery. Cold compresses to your eyes are routine, so you can’t drive anywhere.

On the sixth day after the surgery, Dr.Pastorek removes the external silicone splint in the office. Because of surgical edema, the nasal appearance at this time never reflects the final result, but even after seven days, you can expect your nose to look better than the original. Most patients feel comfortable returning to work, school, or social situations immediately after the splint is removed. You will visit the office about 60 days after the splint is removed for a post-op follow-up, and Dr, Pastorek will meet with you after 6 months for a final visit. You can make other appointments as necessary. The doctor will provide in-depth information about post-operative care and activities when he removes your splint. Post-op photos are usually taken at the 6-month visit.

Dr. Pastorek feels that rapid recovery is one of the benefits of the internal incision approach to rhinoplasty and of his attention to detail before the surgery. The use of NASA technology, specifically lightwave frequency treatment, after the splint is removed quickens the reduction of post-operative swelling. With Dr. Pastorek’s technique, 25% of the post-op surgical swelling is usually down in 7 days, half of the swelling is down at 6–8 weeks, and almost all swelling is gone by 6–8 months. Final resolution is often related to your individual nasal skin thickness, so your results may vary.

Dr. Pastorek has performed over 6,400 rhinoplasty procedures.

Chin Augmentation

Dr. Pastorek may recommend chin augmentation as a procedure to enhance your rhinoplasty result or separately to balance the lower third of your face when the forward projection of your chin is not adequate. There are limitations to the amount of chin projection possible, however. Most patients require minimal augmentation, but even if you need maximum projection, the anatomic implants produce a remarkably natural appearance.

Occasionally, anatomic mandible configurations require orthographic surgery rather than augmentation. Chin augmentation is the only procedure where Dr. Pastorek feels that a non-natural material can be used without any cause for concern. He has personally used a solid silicone implant for over 30 years without problems. The implant itself has an even longer history of safety. The pliability of the implant and the thickness of the chin tissues contribute to an enhanced chin that feels natural to the touch. In the office, you can use non-surgical sizer implants to gauge which of the four standard dimensions would best create your desired appearance.

Blepharoplasty

Blepharoplasty—aesthetic surgery of the eyelids—improves the aging or baggy appearance of your eyelids. Often, the first sign of aging is looseness of the upper lid skin. While loose eyelid skin and lax eyelid muscles can be an effect of age, heredity, and/or sun damage, eyelid bagginess is usually a pure expression of heredity, especially in young patients. If it bothers you that your appearance shows signs of sleeplessness, tiredness, and exhaustion, it’s time to explore the option of an eyelid rejuvenation procedure with a qualified facial plastic surgeon like Dr. Pastorek. If you’re still young, but have inherited familial baggy eyes, you probably just want to look normal. Dark circles, fine skin wrinkles, and tiny eyelid skin lesions may also be a part of the baggy eyelid problem. Each of these symptoms require special attention and treatment. Moreover, Dr. Pastorek must evaluate any medical cause for your eyelid appearance.

Like rhinoplasty, blepharoplasty is aesthetic surgery of extreme accuracy and delicacy. The surgeon must be highly focused because of the required symmetry required of blepharoplasty. The anatomy and nature of the eyelids make secondary surgery problematic. Dr. Pastorek and his surgical team focus all their efforts to get the best possible results with the initial surgery. Years ago, Dr. Pastorek developed a suspension suture technique to permanently support the lower eyelid. It allows him to tighten the lid, move a small amount of upper cheek laxity upward, and prevent a displacement of the eyelid, assuring that the position and appearance of the lower lid remains normal.

The ease of local anesthesia required for totally pain-free surgery of the eyelids and the small surface area involved make the office or the Manhattan Eye, Ear, and Throat Institute outpatient surgery ideal for blepharoplasty procedures. Most patients recover within 60 minutes following the procedure. Before your discharge, you are instructed to rest for the remainder of the day, use cold compresses, and enjoy a quiet day of music or books on tape. Discomfort is minimal. Sutures are removed on the fourth post-op day. Make-up can be applied directly to the incisions on the 6th post-op day. Most patients return to business on the seventh day. Activities and cautions are discussed at the time of your consultation and when your sutures are removal. You will realize the final result of your blepharoplasty about one month after the operation.

Dr. Pastorek has performed over 4,900 blepharoplasty procedures.

Facelift/Neck Lift/Brow Lift

Facial rejuvenation surgery often includes a facelift, neck lift, brow lift, and blepharoplasty. When you come in for a facial rejuvenation consultation, Dr. Pastorek will evaluate you for your particular needs. Some patients will require several procedures to achieve their optimal appearance, while others will require just one. No matter what plan is necessary, the goals are always the same: the most normal appearance, the most long-lasting result, the safest surgery, the finest scars, and a rapid recovery and return to your life’s routine.

Dr. Pastorek has kept these goals as the centerpiece of his personal evolution of facial rejuvenation surgery. In his modification of the deep-plane facelift, he has found the perfect procedure for a totally natural look, a normal hairline, a youthful repositioning of mid-face anatomy, and the most minimal bruising and swelling. Tisseal fibrin glue sealant—which provides instant, firm redraping of the skin—eliminates the need for drains. NASA-specific lightwave treatments are used to enhance healing; Dr. Pastorek has found that this treatment improves upon already exceptionally consistent good results. You will enjoy a quick return to business as usual and experience years of continued aesthetic benefit.

If you think you can benefit from a brow elevation or a procedure to gain symmetry of your brows, the doctor will evaluate the best approach for your individual need during your consultation. Many brow lifts can be performed through a blepharoplasty (eye lid) incision, avoiding hairline incisions. Dr. Pastorek believes in a conservative and realistic brow appearance. Effectiveness and longevity of a brow lift are paramount when he plans the brow lift procedure that’s right for you.

As a teacher and lecturer, Dr. Pastorek studies and considers the latest developments in this field. He feels that the parade of new and inventive facial plastic surgery procedures offering shortcut, minimal-effort, and quick-fix pathways to rejuvenation must be evaluated over an extended period to test their worthiness and long-term effect. The goal of any surgical facial rejuvenation procedure is years, not months, of benefit.

Dr. Pastorek usually performs facial rejuvenation surgery in the outpatient operating room while you are under intravenous analgesia. A moderate pressure bandage is removed the day following surgery during an office visit. The operative area is inspected, the wounds dressed, lightwave treatment is administered, a “preview” of the result is presented, and smaller pressure bandage applied. The bandages and sutures on your face and lids are removed on the fourth post-op day. Any sutures at the hairline are removed on the seventh day. Staples are removed on the tenth or eleventh day. Make-up can be applied at any time after the bandages are removed.

Dr Pastorek has performed over 2,500 facial rejuvenation procedures.

Otoplasty

Otoplasty is a common procedure designed to bring protruding ears into a normal position near your head. The goal of otoplasty is create normal-appearing ears. The problem of “lop ear” deformity may occur on one or both sides, and it usually occurs at birth. The ears become normal in size at around age 5 or 6. Otoplasty can be performed on children once they reach that age. Many parents wait until the child asks about a possible change in appearance rather than introducing the subject to the child. Many patients reach young adulthood before requesting otoplasty.

The procedure is done under a local anesthesia with intravenous sedation for most adults. General anesthesia is required for children. Incisions are hidden in the natural crease behind the ears. The newly formed ear is held in place by internal sutures. The incision is closed with absorbable sutures. A bandage holds and protects the repositioned ears for four or five days. Swelling and bruising is usually minimal. You have to take care, however, not to tug on your ears for two weeks. Once healing is complete, there are no restrictions to activities.