Seattle Facial Plastic Surgeon - William Portuese MD

 

Seattle Facial Plastic Surgeon Dr William Portuese

As with many of the sciences, technical advances in surgery have greatly accelerated. Many aesthetic surgical techniques have relatively recent origins. The classic subcutaneous, or skin-only face lift, was virtually the only type performed until the 1970s. During the mid-70s, doctors developed techniques to reposition and tighten the deeper tissues of the face and neck, the SMAS (superficial musculoaponeurotic system) and the platysma muscle complex. The debate as to which of many face lift techniques achieves the best and most long-lasting results is There is no scientific evidence that proves any one technique is better than any other. In face lift surgery, it’s not how you play the game, but whether you win or lose that counts — that is, what technique works best in your hands. As plastic surgeons, our goal is to design the surgery so that it makes our patients look good but not strangely different. We also want operations that don’t cause distortion of the tissues and that allow patients to successfully undergo secondary procedures in the future, should they choose to do so. Contact Dr William Portuese located in Seattle Washington

To achieve the highest degree of patient satisfaction, the aesthetic surgeon must be comfortable with a variety of surgical and nonsurgical approaches to facial rejuvenation. Patients’ desires and expectations differ; therefore, matching the procedure or technique with each patient’s expectations for results and recovery is crucial for a successful outcome. During my career, I have witnessed the evolution in face lift surgery, starting with the simple skin lift to some highly complex and, in many cases, undesirable approaches and, finally, to an approach that involves a good understanding of the anatomy and restructuring of the underlying foundation. The addition of adjunctive nonsurgical procedures to enhance and maintain results has been important, but perhaps more important is the recognition by patients and physicians alike that a natural result is the best result. Today’s face lift techniques that deal more with the underlying structures are more complicated but allow us to achieve a very natural-looking result. Incisions are placed inconspicuously, overall result is a healthy, rested appearance that doesnot look like you’ve had surgery. Contact Dr William Portuese located in Seattle Washington

Additional techniques and types of face lift procedures according to Dr William Portuese in Seattle WA include the subperiosteal face lift, which may be performed using an endoscope, as well as the less extensive short scar technique, and the midface or cheek lift. The seemingly endless variety of approaches to correct a specific problem suggests the obvious: any number of techniques properly applied can yield satisfactory results. Whichever method is used, incisions must be placed so that they will heal well, and great attention to technique and detail will result in scars that will be almost imperceptible. No one technique is perfect for every patient. I do my assessment of each patient individually, carefully and thoroughly, to design a customized operation for them using tried and true techniques. The anatomy should be what determines the technique rather than the other way around. What we want is a natural, pleasing result without any stigma of surgery — that classic, freshened appearance that is everybody’s goal. There is no single type of face lift that is suitable for every person. Rather, I utilize a variety of techniques including mini-face lifts, full face lifts, and midface lifts. My technique for tightening the underlying structures of the face beneath the skin will also vary. Each face is unique, and Seattle plastic surgeons have a wide range of techniques and procedures from which to choose so that we can treat each patient on an individual basis. Contact Dr William Portuese located in Seattle Washington

A face lift by Dr William Portuese usually takes from two and a half to four hours to perform. If you are also having additional procedures, such as eyelid surgery or a forehead lift, the total time will, of course, be longer. The procedure can be performed under sedation (twilight) anesthesia, although general anesthesia is frequently used. Whether you are awake and unaware of what is going on, or you are unconscious, you will not feel any pain during the surgical procedure. Most patients are allowed to return home the same day, but an overnight stay may be recommended in some cases. It is important that your head be kept elevated, cold compresses be applied to your face, and someone stays with you the first night to help you and be alert to any possible problems. A temporary drain, a small, thin tube, may be inserted under the skin behind your ear to draw off any blood that might collect there. You will not feel this at all. Your head may be wrapped loosely in bandages, although not all surgeons like Dr William Portuese believe that this helps minimize bruising and swelling. Following a face lift, you should limit if not curtail most of your activities and prepare for a few days of pure relaxation. You should continue to elevate your head when you sleep to help minimize swelling and bruising. Most people suffer only mild discomfort. You can anticipate taking pain medication, according to your surgeon’s instructions, for about three days; acetaminophen (Tylenol) alone is usually sufficient. Aspirin and certain anti-inflammatory drugs that promote bleeding are to be strictly avoided, as is smoking or exposure to secondhand smoke.

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Dr William Portuese
William Portuese
William Portuese MD