Secondary Facelifts Explained by a Facial Plastic Surgeon

If you underwent a facelift several years ago and were satisfied with the results but are now starting to notice some degradation, you are a likely candidate for a secondary facelift to restore your youthful appearance.

Secondary facelifts are sometimes referred to as ‘facelift revision surgery’ or ‘reverse facelifts’. They are performed either to restore the results achieved with the original facelift surgery, or to correct a faulty procedure. Even the best facelift can only provide temporary benefits because of the gradual reappearance of the signs of aging. A secondary facelift is a common procedure, performed to regain that natural well-rested youthful appearance.

Here is a link to Dr. Sharma's Official YouTube Channel. In the video below, Dr. Sharma discusses facelifts from his Coral Gables offices. 

Many people choose to do a secondary facelift because the results of their original facelift have faded. A facelift (rhytidectomy) have results that usually last on average for about ten years. Secondary facelifts usually become necessary around this time. Some people might even choose to have a less invasive means of rejuvenating the appearance of their face by the use of dermal fillers.  Dermal fillers can help with reducing the appearance of lines and wrinkles and also reduce the appearance of nasolabial folds (laugh lines). Rhytidectomy eventually becomes the best option for a more permanent treatment.

Second Facelift Procedure

The actual procedure of having a secondary face lift may involve the same area as the first or may even be expanded to improve the appearance of other areas of the face. More than likely there will be some amount of scar tissue in the face from the previous surgery. The scar tissue, if not too extensive, can actually help limit some of the bleeding and scarring. Dr. Sharma will discuss with you your options for treatment and review with you exactly what kind of facelift will be necessary to get the best results.

Risks of a Secondary Facelift

The risks of face lifts include:

• Bleeding

• Bruising

• Infection

• Nerve damage

• Facial asymmetry

• Anesthetic risks

In general, most people enjoy the aesthetic results for 10-15 years before they seek a secondary facelift. Facelifts are one of the most common plastic surgery procedures chosen to be redone because the face continues to highlight the signs of aging more visibly than any other body area and it features our most distinguishing and identifiable physical characteristics.

Most patients are extremely happy with their primary facelift and therefore, when the rejuvenating effect begins to fade they decide to have a secondary facelift to achieve that same level of rejuvenation they originally enjoyed. If you were pleased with the results from your first facelift, there are other considerations that will help you efficiently embark upon your revision facelift process with Dr. Sharma:

• Remind yourself about the specifics of your original facelift surgery. You will want to share the details about this previous procedure that yielded such favorable results for you.

• Know exactly what you're trying to improve with this facelift, and communicate this to Dr. Sharma. Even if you were pleased with your original facelift, you may have different wants or expectations now.

• During the consultation, bring in before and after photos of yourself from the first surgery that way Dr. Sharma can refer to these images while considering your current options to create a more personalized surgical plan for your second facelift.

If you're looking into revision facelift surgery to correct poor results from your first facelift, Dr. Sharma suggests that it is prudent to take certain steps the second time around. He has many years of facelift experience behind him and is able to make personalized suggestions and recommendations for your surgery, however, you should consider these questions and in preparation for your consultation with him:

• Identify what specifically displeased you about your original facelift results, and clearly communicate this during your consultation. 

• Be very specific idea of what you want and share all your thoughts with Dr. Sharma.

If you are interested in speaking with Dr. Sharma about a secondary facelift or facelift revision surgery, please contact his offices at (305) 456-5727 to schedule an appointment for a consultation.

About Dr. Vijay Sharma

Vijay M. Sharma MD, MPH is a Double Board Certified Facial Plastic Surgeon and a co-founding member of The Plastic Surgery Institute of Miami. He exclusively focuses on cosmetic procedures and surgery of the face. This specialization includes the face, neck, nose, eyes and ears. Born and raised in Maryland, Dr. Sharma attended college and medical school at The George Washington University in Washington, DC. He went on to a successful head and neck surgery residency at Tulane University in New Orleans. Dr. Sharma distinguished himself as the Chief Resident of Head and Neck Surgery at the world famous Charity Hospital of New Orleans. He then completed the prestigious Glasgold Fellowship in Facial Plastic and Reconstructive Surgery. Dr. Sharma moved his New York area private practice to Miami and Coral Gables in 2007.

Botox and Dysport Treatments for Men

According to the American Society of Plastic Surgeons www.plasticsurgery.org our society places a high value on looking young and fit. Men of all ages and all walks of life are looking into plastic surgery for cosmetic reasons. Several men have indicated to Dr. Sharma that their goals include a more balanced nose, a rejuvenated face and less lines and wrinkles. 

Billions of dollars are now being spent on cosmetic surgery – up to 90% of it by women. Basically, that means that the other 10% of cosmetic surgeries are performed on men – that’s $100,000,000 a year spent by men on improving unappealing characteristics of their appearance. In today’s world, people consider their looks as key to their self-image and it appears place a high value on their appearance.

More and more men are focusing on improving their looks and the importance of beauty today is far more pervasive than one might think. Consider this; all this spending on plastic surgery and cosmetic surgery procedures comes at a time when almost a fifth of Americans lack basic health care.

Since most literature concerning plastic surgery or cosmetic surgery focuses on women, Dr. Sharma wanted to offer men some valuable information for them to consider if they are contemplating improving their looks. In the diagram below, Dr. Sharma identifies ten (10) areas where men can enhance their facial features. Many of these areas are similar for women, however, usually men have more pronounced wrinkles or folds and thicker skin.

Many men are reluctant to undergo plastic surgery because they are afraid that they’ll no longer have that “distinguished” look. Dr. Sharma is careful to keep your appearance as natural as possible, however, his primary concern is to focus on areas that are a concern to you. As a result, we’re offering this schematic to help you properly identify the areas that are concerning you.

Men are good candidates to receive injectable dermal fillers as well as Botox or Dysport. You won’t often hear too many men discussing their procedures with other men or women but when you stop and think about it for a moment, there is no reason why men cannot use the same products as women to enhance their appearance. One way to start is by trying dermal fillers, otherwise known as a 'liquid facelift' and here are three (3) good reason why:

1. It's a good way to get started and test to see if plastic surgery or cosmetic surgery suits your lifestyle.
2. The effects of dermal injectables generally wear off after four (4) to six (6) months.
3. Dermal fillers are more economical than actual surgical procedures. 

Facial planning guide for men who are considering plastic surgery or cosmetic surgery with Dr. Sharma.

The facial planning chart above is a guide to help you begin identifying areas where you want to see improvement. Dr. Sharma has identified and provided the names of ten (10) areas for you to consider. Additionally, this chart will help you begin your discussion with Dr. Sharma when he asks you, “So, what do you want to improve?” during his consultation with you. 

Often times, plastic surgeons won’t come out and tell you what you should have done because they might mention something you’re not unhappy with and they don’t want to generate any further self-conscience insecurities. Therefore, by identifying these areas for yourself, it will help educate you and streamline your consultation.

If you’re a man and interested in learning more about your options for plastic or cosmetic surgery, please call Dr. Sharma’s Coral Gables offices at (305) 456-5727 and we’ll be glad to answer any questions you might have. 

About Dr. Sharma

Vijay M. Sharma MD, MPH is a Double Board Certified Facial Plastic Surgeon and a co-founding member of The Plastic Surgery Institute of Miami. He exclusively focuses on cosmetic procedures and surgery of the face. This specialization includes the face, neck, nose, eyes and ears. 

Born and raised in Maryland, Dr. Sharma attended college and medical school at The George Washington University in Washington, DC. He went on to a successful head and neck surgery residency at Tulane University in New Orleans. Dr. Sharma distinguished himself as the Chief Resident of Head and Neck Surgery at the world famous Charity Hospital of NewOrleans. He then completed the prestigious Glasgold Fellowship in Facial Plastic and Reconstructive Surgery. Dr. Sharma moved his New York area private practice to Miami and Coral Gables in 2007.

What is Lower Eyelid Blepharoplasty?

It’s a procedure that improves the appearance of the lower eyelids. It gives the surrounding area of your eyes a rejuvenated appearance, giving you a more rested and refreshed look. Lower eyelid blepharoplasty can remove the excess skin and fine wrinkles of the lower eyelid. Bags under the eyes can be corrected along with any droopiness of the lower eyelids. Loose or sagging skin that creates folds or interrupts the natural contour of the upper eyelid, sometimes impairing vision, can also be treated by eyelid lift surgery.

You may have noticed changes in your eyes that show your age. Do your eyes give you a worn-out or tired appearance? Some say the eyes are the windows to the soul. What feeling do your eyes convey? You may notice extra or wrinkled skin above or below the eyes or perhaps you have concerns about fat pockets below your eyes.

These issues are very common, and for some, may begin as early as their 20's. Eye-lift surgery is a very common cosmetic procedure to improve the appearance of the eyes. Recovery is usually very reasonable, with most patients return to work in less than a week. Blepharoplasty is frequently performed with other facial rejuvenation procedures such as a facelift, necklift, or Rhinoplasty. 

Lower Blepharoplasty is frequently performed to improve the appearance of fat pockets and/or extra skin under the eyes. This procedure maybe performed in the office, but frequently requires light sedation in an operating room. Although lower eyelid surgery can be more complex than upper eyelid surgery, Dr. Sharma’s patient satisfaction rate remains very high. Incisions are "invisible" or near-invisible and the results will give you a natural well-rested appearance.

Why choose Dr. Sharma to perform your Blepharoplasty procedure?

Vijay M. Sharma MD, MPH is a Double Board Certified Facial Plastic Surgeon and a co-founding member of The Plastic Surgery Institute of Miami. He exclusively focuses on cosmetic procedures and surgery of the face. This specialization includes the face, neck, nose, eyes, ears, etc. Dr. Sharma has devoted his entire professional career to the face only. Dr. Sharma has vast amounts of experience with eyelid surgery. Dr. Sharma, was quoted, "In performing over a 1,000 eyelid procedures, I've developed a further appreciation how important seemingly small details are in eyelid surgery. As an example, it is very important to remove only the necessary amount of tissue from the eyelids to give a nice natural appearance without over-hollowing the eyes. For the best results and safety, you should choose an experienced facial surgeon.”


Are you a good candidate for Lower Eyelid Blepharoplasty?

Blepharoplasty procedures are usually performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the lower eyelids and surrounding area. You should undergo blepharoplasty surgery for your own reasons, and not to fulfill or please anyone else.

Good candidates for blepharoplasty are:

• Non-smokers
• Individuals without serious eye conditions
• Individuals with a positive outlook and specific goals in mind for blepharoplasty
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing

You must tell your doctor if you have any of these medical conditions:

• Eye disease such as glaucoma, dry eye or a detached retina
• Thyroid disorders such as Graves’ disease and under or overactive thyroid
• Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

If you’d like to learn more about your options for lower eyelid blepharoplasty, please give Dr. Sharma’s offices a call at (305) 456-5727 and we’d be happy to continue this conversation with you.

Rhinoplasty Nasal Sculpting and the Nose Job

Your nose is the most prominent feature of your face. As a result, Rhinoplasty, also known as ‘nasal sculpting’ or more commonly known as a ‘nose job’ is one of the most common plastic surgery procedures performed today.

Perhaps you are considering Rhinoplasty for the following reasons:

1.    Maybe your nose does not tie in with your face. Perhaps it is too big or too broad or

2.    Maybe you have a hump on your nose that you’d like to have reduced or removed.

Below is a patient of Dr. Sharma’s that underwent Rhinoplasty to remove a hump on her nose.

This patient underwent Rhinoplasty to have a hump reduced on her nose. Notice how Dr. Sharma 's sculpting skills created a natural looking effect in the After photo.

If your nose does not fit your face, it can have a real impact on you psychologically. This issue can especially be a problem for teens and young adults. Be that as it may, we have seen patients seek Rhinoplasty in their 60's and beyond.

In these scenarios, our surgeons frequently perform Rhinoplasty to achieve facial balance and facial harmony. Your nose will look great from the front and from the side profile. Dr. Sharma will achieve results that look great from any angle!

Dr. Sharma will give you a nose that you'll be comfortable with from any angle. He has performed over a thousand nasal procedures and is very skilled in the art of nasal sculpting.

Perhaps you suffered nasal trauma recently or even many years ago. This type of trauma can adversely affect the appearance and function of the nose. Dr. Sharma often deals with patients who have suffered nasal trauma and fixed their noses so now they look even better than before!

Whether or not you have had an injury, you may have difficulty breathing through your nose. Dr. Sharma has extensive experience in dealing with both the aesthetic (beauty) and functional (breathing) portions of Rhinoplasty.

Depending on your nose, a Rhinoplasty procedure generally takes 1-2 hours to complete. Dr. Sharma prefers using general anesthesia so your airway will be protected during surgery. You will wear a small nasal cast for a week and return to work or school within that same time frame.

For best facial balance, Rhinoplasty is frequently performed with other procedures such as chin implants, neck liposculpture, lip augmentation or an eyelid procedure. 

Why Choose Dr. Sharma for Rhinoplasty?

Dr. Sharma is a Double Board Certified Facial Plastic Surgeon and has performed thousands of nasal procedures. He is comfortable with both open and closed techniques for Rhinoplasty. Why not seek the best possible result for the most prominent facial feature? Come and discuss your wishes for your ideal nose with Dr. Sharma.

Special Note: Revision Rhinoplasty

Dr. Sharma has a well-known reputation for helping patients that have not been happy with nasal procedures performed at other institutions. Revision Rhinoplasty requires special attention and significant experience. Dr. Sharma consistently provides outstanding results for Revision Rhinoplasty and first-time Rhinoplasty patients alike.

Contact Dr. Sharma's Coral Gables offices at (305) 456-5727. His offices are located at:

475 Biltmore Way

Suite 308

Coral Gables, Florida 33134

Facelifts and Necklifts in Coral Gables by Dr Vijay Sharma

Are you in your 40's or beyond? Are you concerned about the looseness of your neck and/or loss of jawline definition due to jowling? Do you have concerns about the smile lines between your nose and mouth? Are you dissatisfied by the way you look in the mirror, from the side, or in photos? Have you ever considered a cosmetic procedure to look and feel better but want to stay looking natural? If you answered yes to these questions, then let Dr. Sharma help.

These common concerns may be addressed with a facelift. Dr. Sharma is comfortable with multiple types of facelift procedures and tailors each patient's procedure to their specific needs, concerns, anatomy, and physiology. "In performing over 2,000 facelifts, I have come to appreciate the artistry involved in making people look younger and better with a natural appearance. We have all seen patients that look over-stretched or pulled. My overwhelming experience is that patients prefer to look well-rested and natural. Not wind-swept and not weird! In my office, I'm pleased to say, we consistently achieve outstanding natural appearing results."

In the video below, Dr. Sharma discusses the basics about facelift procedures.

A facelift is also known as a 'rhytidectomy.' The overall principal behind this procedure is to tighten the tissues underlying the skin to improve the appearance of the neck, jawline, and in some cases, the smiles lines between the nose and mouth. There is also careful removal of redundant (extra) skin. There are a variety of facelift procedures available to patients today.

Less invasive procedures may generally be performed in the office under local anesthesia. Bigger, more extensive procedures tend to be performed under IV sedation or general anesthesia in an operating room. Any patient considering a facelift should discuss all the options available to them with their surgeon.

Here are a few Before and After pictures of some of Dr. Sharma's patients who underwent a faceleft and necklift procedure.

If you're interested in learning more about having a facelift and/or necklift procedure with Dr. Sharma, please contact our offices in Coral Gables at (305) 456-5727.

Nasolabial Fold Injections in Coral Gables by Dr. Sharma

Where are your nasolabial folds? They are the two folds of skin that run from each side of the nose to the corners of your mouth. They separate the cheeks from the upper lip. The term nasolabial comes from "nasus" meaning nose and "labium" which means your lip.

The circled areas represent your nasolabial folds.

This is a Before & After of one of Dr. Sharma's patients who had dermal fillers in her nasolabial folds.

With aging, the folds become more pronounced and may become cosmetically undesirable. Some folks consider it a sign of maturity, age, or character. The most significant factors that contribute to the prominence of the fold are excess skin, skin thinning and excess cheek fat. Dr. Sharma frequently treats these lines with injectable fillers.

Nasolabial Folds are also referred to as:

·        parentheses

·        “smile lines”

·        “laugh lines”

If you would like to restore fullness to your face, or enjoy plump lips, enhance shallow contours or soften those facial creases and wrinkles, then Dr. Sharma’s dermal fillers may be the answer.

The dermal filler industry exploded in the last decade and propelled the cosmetic industry to a new level. Filler procedures are highly sought by:

• men and women
• baby boomers looking for a boost
• aging adults seeking a more refreshed, youthful look,
• and younger adults, who want to correct features

Dermal fillers have also been known  as "liquid facelifts" because they offer many of the benefits of a surgical facelift without the downtime.

 Fillers made it possible for people seeking anti-aging treatments to:

·        smooth lines

·        fill facial folds

·        temporarily remove wrinkles

·        plump lips and cheeks

·        add volume to sagging features

 If you decide you want to reduce facial wrinkles and lines, hyaluronic acid might be a good choice as a dermal filler because of its compatibility with the human body.  This substance is found in almost every single living thing. In humans, it acts as a network that transfers essential nutrients from the bloodstream to skin cells.

High concentrations are found in soft connective tissues and in the fluid surrounding your eyes. It is also found in some cartilage and joint fluids, as well as skin tissue. It is extracted and reformulated and has become one of the most popular kinds of injectable fillers. The term might sound familiar because it’s the same substance often injected into aching joints of people who suffer from arthritis to ease their pain and provide extra cushioning.

If you are interested in smoothing wrinkles, sculpting lips, and improving other facial features, Restylane injections are a growing favorite. In 2003, Restylane is approved by the FDA and can produce positive results on facial wrinkles, particularly around the mouth and nose. Another benefit is the long-lasting results, as the effects of Restylane treatments can be visible for six months or more. Restylane can be administered on its own or in combination with other treatments, such as with a lip enhancing procedure.

What to Expect during treatment with Dr. Sharma:

·        patients may experience some pain and discomfort from the needle during injection

·        discomfort is generally minimal and well tolerated

·        procedure can take a few minutes up to 30 minutes

·        patients can return home or back to work and other activities shortly after their procedure

Things to Consider:

• If you are under eighteen (18) years of age, you will need written and signed parental consent to have this cosmetic procedure.
• If you have any dermatological allergies, please advise Dr. Sharma before receiving your dermal filler treatment.
• If you are pregnant, Dr. Sharma advises you to avoid all dermal filler treatments during your pregnancy.

Coral Gables Facial Plastic Surgeon Shares Secrets to Fuller Sexier Lips

Do you want more full lips that look natural? As we age, our lips become attenuated or thinned. Come visit Dr. Vijay Sharma and no one will ever know your secret to the beautiful full lips of your dreams.

Dr. Sharma's goal with lip augmentation is more full, natural-appearing and attractive lips. Multiple options are available to you for lip augmentation. Some patients may require treatment of both lips, while others require treatment for either the upper or lower lip. Lip lines or "smoker's lines" may also be treated at the same time.

Temporary options last for months and include injectable fillers like Perlane or Juvederm for plumping up the lips. These procedures are comfortably performed in the office with local anesthesia. After the procedure, there may be a bit of swelling, but patients almost always easily return to work the next day.

Permanent options for lip augmentation are available. Permanent options may include the use of state-of-the-art lip implants. This procedure may be performed in the office under local anesthesia. There may be a bit more swelling with the permanent option as compared to injectable fillers. However, Dr. Sharma's patient satisfaction rates are high with both types of procedures.

Lip augmentation may be done by itself or in combination with almost any type of procedure: Botox, facelift, breast augmentation, and more. Lip augmentation can be that added boost to make another procedure really outstanding!

Why Choose Dr. Sharma For Lip Augmentation?
He is a Double Board Certified Surgeon with a tremendous amount of knowledge and experience with lip augmentation. You could go to the local spa and have almost anyone inject medication into your lips, but should you? Probably not! 

Dr. Sharma's fees are competitively priced, however, when it comes to something as important and intimate as your lips, patients are better served by Dr. Sharma's extensive experience and artistry as a facial plastic surgeon.

Ear Pinning In Coral Gables An Otoplasty Resource

Often, people with large, protruding or disfigured ears find them to be bothersome and are a major source for their self-consciousness. Otoplasty, which is plastic surgery for the ears, can enhance the appearance of your ears by improving the following aspects:

• the shape
• the position
• the proportion of the ear

It can correct a defect in the ear structure that is present at birth and becomes more apparent as you get older or it can treat misshapen ears caused by injury. The corrective goal of otoplasty is to set back the ears so that they appear naturally proportionate and contoured, because they are harmoniously set back, without evidence or indication of any surgical correction.

The Procedure

Otoplasty is one of the most common plastic surgery procedures that is performed to correct developmental abnormalities from birth and should be considered on ears which stick out more than 4/5 of an inch (2 cm) from the back of the head. It can be performed at any age after the ears have reached full size, usually around five or six years of age. Having the surgery at a young age has two benefits:

• the cartilage is more pliable, making it easier to reshape
• children experience increased self-esteem after the cosmetic improvement

As long as you are in good health, there is no upper age limit for this surgery. Ear surgery creates a natural shape, while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to your appearance and self-esteem.

This is a side view of a before and after of one of Dr. Sharma's patients who underwent otoplasty.

What to Expect:

• Typically, otoplasty surgery can take approximately two hours.
• The soft dressings over the ears will be used for a few weeks as protection, and the patient usually experiences only mild discomfort.
• Headbands are sometimes prescribed for nighttime wear to hold the ears in place following surgery.

Medications are administered for your comfort during the surgical procedure. Your choices include:

• local, intravenous sedation
• or general anesthesia

During your consultation, Dr. Sharma will discuss what the best option is for you.

Correction of protruding ears uses surgical techniques to create or increase the antihelical fold – the area just inside the rim of the ear - and to reduce enlarged conchal cartilage which is the largest and deepest concavity of your external ear. Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within the ear folds to hide them.

 The procedure begins with an incision behind the ear, in the fold where the ear joins the head. Dr. Sharma may remove skin and cartilage and/or trim and reshape the cartilage. Your ears may also be reshaped, reduced in size, or made more symmetrical. Dr. Sharma then secures the cartilage in the new position with permanent stitches which will anchor the ear while healing occurs. Dr. Sharma makes sure your ears won’t look “pinned back’ but rather that he provides a natural appearance so your ears will be more symmetrical with your face.

Dr. Sharma’s ear surgery offers near immediate results in cases of protruding ears, visible once the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, Dr. Sharma is able to hide surgical scars behind the ear or they are well-hidden in the natural creases of your ear.

A frontal view of a patient before and after Dr. Sharma's otoplasty procedure.

A frontal view of a patient before and after Dr. Sharma's otoplasty procedure.

During recovery, otoplasty patients may experience:

• temporary discomfort and numbness — managed with oral medications
• headaches — relieved through use of a long-acting local anesthetic
• swelling, which can be managed with head elevation - decreases within a week
• unusual sensations — may include itching or the lack of sensation at the incision line, which can disappear over the course of six months

If you'd like to have a consultation with Dr. Sharma, please call his office at
(305) 456-5727.

We are located at:
475 Biltmore Way
Coral Gables, FL 33134