Six underrated cosmetic procedures that can make a big difference.

All can be done under local anesthesia, in the office.

1. Chin augmentation
2. Upper lip lift
3. Buccal fat removal
4. Fat injection
5. Chemical peeling
6. Upper or lower eyelid lift

Here are six, underrated procedures that can make a dramatic improvement to your appearance. All are routinely done in the office with little or no sedation.

Everyone knows about facelift, browlift and rhinoplasty surgeries. These six lesser-known procedures can really pack a punch when it comes to their aesthetic results.

1. Chin augmentation or chin implant

Chin augmentation or a chin implant, is frequently performed during a facelift or rhinoplasty but is also a great standalone procedure that can balance a large nose or create a more attractive profile. Aging and weight loss may result in loss of fat in the chin fat pad so that the chin loses projection, or a person can be born with a chin whose proportions don’t suit their face. A chin implant rejuvenates the chin by restoring or adding volume and projection.

Chin implants pull the neck muscles forward and extend the jawline, giving the appearance of a sharper more youthful neck. Wider chin implants which extend to the side of the chin can help to smooth out jowls. Square shaped implants in men give a stronger more masculine contour. Surgery takes about 45 minutes and down time is about a week. All stitches are absorbable.

2. Upper lip shortening

This procedure is often done with lip augmentation and skin peeling around the mouth. A long upper lip is a common sign of aging but can also be genetic. The upper lip is defined as the distance from the base of the nose to where the upper lip meets the lower lip. It is divided into the white skin and the red vermilion of the lip itself. With aging, the white skin of the lip often becomes longer in a vertical direction whilst losing projection in the profile view. The vermilion, in contrast, becomes thinner (shorter vertically) but also loses volume and projection in the side view. The junction between the red and white parts of the lip is known as the vermilion white-roll This also become flattened with age. The long upper lip and thin vermilion are also features that can occur in younger age groups. Upper lip shortening and lip augmentation are often done together. The lips can be plumped with filler or fat injections. Surgery takes about one hour; stitches are out in five days and down time is about one week.

3. Buccal Fat Removal

Many people with “chubby cheeks” dislike their appearance, but Buccal Fat or cheek fat pads are often ignored because people don’t know how easy it is to remedy this condition. The fat pad is the size of a large marble and is a globule of yellow fat which sits outside the buccinator muscle, which is the same muscle trumpeters use. The buccal fat can create a rounded cherubic shape to the lower face, even in men and women at their ideal weight. With aging, the buccal fat may become more prominent as surrounding skin and fat shrinks and sags. The result can be bulges around the angles of the mouth and the jowl area. Removing the cheek fat pad, through an incision inside the mouth, helps to create a more angular, contoured appearance with more definition of the cheek bones and in the older patient, bulges around the angle of the mouth can be reduced by removing the buccal fat pad. Surgery takes about 30 minutes and down time is less than a week. The stitches inside the mouth dissolve and do not need to be removed. A soft diet and mouth washes are recommended for a week after surgery.

4. Fat injection

Fat injection is the process of the removal of your own fat from some other part of your body, such as the tummy or inner thigh and then reinjecting the same fat using small syringes and cannulas, into the face. At least 50% of the fat survives and the procedure can be repeated if additional volume is desired. The result is permanent and not only improves contours but also improves the vitality and youthfulness of the overlying skin. Unlike fillers, fat injection does not have to be repeated once the ideal correction is achieved. So even though the initial cost is more than a syringe of Volumaä for example, the long-term cost is less because fillers only last for six to eighteen months. Fat is used to augment cheeks and chin, to fill in hollows around the eyes and to plump up and define the lips. Surgery takes about an hour and down time is about one week.

5. Chemical peeling

Lines around the mouth, under the eyes and in the cheeks and forehead are a result of smoking or sun damage plus aging. Treatment to improve these lines can vary depending on the skin type. Lighter-skinned patients are candidates for a TCA chemical peel. The treatment takes about 30 minutes. The skin peels over a period of 7-10 days and is red afterwards for up to several weeks.

6. Eyelid lift

Upper eyelid skin stretches with age and hangs down over the upper lid, giving a hooded look. This appearance can develop at an early age and may not be related to aging. Treatment is removal of extra skin and often fat in the upper lid. The benefits from a simple short surgery can be dramatic, opening up the eyes and restoring a youthful appearance. Mascara is easier to apply. Eyeliner can be winged again! The effects can last for decades and in many cases, one surgery literally lasts a lifetime! Surgery takes about an hour and the stitches are out in 5 days. Down time is about one week.

Lower lids often have bags which create shadows and the appearance of tiredness, even when you are well rested. They are often associated with excess wrinkled skin of the lower lid and hollowness in the tear-trough area below the inner part of the eye. Surgery can reposition the lower eyelid fat into the tear-trough area, to correct the hollow appearance. Excess skin in the lower lid can be removed at the same time. Surgery takes about one hour, and down time is about one week.

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