Houston Plastic Surgery Clinic Cosmetic Surgeons of Houston Plastic Surgery Houston plastic surgery and Houston plastic surgeon in Texas providing liposuction breast augmentation enlargement and facelift or face-lift cosmetic surgery by Board Certified cosmetic surgeons. Houston Texas plastic surgeon providing liposuction breast augmentation enlargement and facelift cosmetic surgery Board Certified.

Technique
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I prefer to do this procedure under general anesthesia in the hospital or at an outpatient surgery center.

I do a subcutaneous face lift using a retrotragal, horizontal below the sideburn and sometimes a short temporal pre-hairline incision; in the retroauricular area, the incision extends posteriorly into the occipital area. In addition, an open submental lipectomy is performed when needed. The combined procedure of upward plication of the platysma laterally and midline plication of the platysma in the submental area usually takes me about 3.5 to 4 hours.

Having done several hundred cases of hair transplantation by using the micrograft and minigraft megasession technique previously described, (2-5) and having also done quite a few face lifts, I can safely determine how much occipital scalp I would excise during a face lift. Also, I know how much scalp I need or can harvest from the occipital area for a hair transplantation and still be able to close the donor site without undue tension.

With this in mind, I start the combined procedures by having the patient in the supine position and the head turned to the left. I first harvest a triangular piece of retroauricular and occipital scalp from one side and hand it to an experienced assistant who, under a 3.5X loupe using Personna Prep blades or no. 22 BardParker blades on a hard wood board, dissects it into micrografts and minigrafts as I do the face lift procedure. When I go to the second side of the face lift, I give the assistant another strip of occipital donor scalp; as the grafts are being dissected, I continue with the face lift.

When I am done with the face lift, which may or may not include an upper and lower blepharoplasty, my assistants have the micrografts and minigrafts lined up and ready for insertion Usually, we generate about 1000 micrografts and minigrafts from those strips that normally would have been discarded. If more grafts are desired, or if I need a larger piece of scalp to produce the required number of grafts, I would in a preliminary fashion harvest the donor strip of the appropriate size .

Once the grafts are lined up and ready for insertion, we are able to transplant about 1000 grafts per hour. So, combining the two procedures adds only about I hour to the surgical and anesthesia time.

The grafts are inserted into slits created with either a 65 Beaver miniblade or a Feather 11 Personna blade without the need for dilators.

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