Surgical Procedures (Facial)
At the City Cosmetic Clinic we offer a variety of procedures and treatments to help you look your best. Let us know how we can improve your appearance and we can bring you the very best results with surprising comfort and convenience.
If you are considering cosmetic surgery or have any further questions, call for a consultation. We will be more than happy to answer any questions you may have. Our staff are dedicated to making sure that, as our client, you are as well informed as possible so you can make an educated decision before undergoing any of our procedures.
FACIAL
FACE LIFT & NECK LIFT
The natural process of ageing (gravity, sun exposure, and the stresses of daily life) can take its toll on our faces: deep creases appear beside the mouth, the jaw line slackens, and folds or fat deposits may appear on the neck.
Facelifts counteract these problems by removing fat and tightening skin and muscles. The desired outcome is to give your face a fresher, and more youthful look. This procedure targets folds and creases of laxity; it cannot single-handedly improve the appearance of wrinkles. To achieve the best result for your skin, we recommend a combination of procedures and treatments. These include eyelid surgery, facial implants, Restylane (also to enhance fullness), fat transfers, Botulinum Toxin injections, or laser skin resurfacing to erase wrinkles.
Surgical incisions are made in inconspicuous places such as behind the hairline and in the natural folds of the face and ears. This means that the effect of the surgery will be less visible, and surgical related scars gradually fade over time so that they are almost invisible.
A neck lift or chin liposuction is performed to remove excess fat beneath the chin and tighten the loose skin in the neck. This procedure is a less invasive alternative to a facelift and the procedure can produce dramatic results in the patient whose chin and/or neck has sagged with age or after weight loss.
How is it done?
Normally, facelifts are performed under local anaesthesia with intravenous "twilight sedation" in an Accredited clinic. It is also possible for the procedure to be performed under general anaesthesia in a Private Hospital.
The facelift procedure usually involves incisions in front of and behind the ear. The incisions may extend into the scalp. In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage. For ladies, we suggest that you grow your hair longer if it is currently very short as longer locks will hide incisions during healing. In men, the incision is aligned to accommodate the natural beard lines.
In some cases, excess skin is removed. Some fat may be removed as well using with liposuction. In other cases, the skin and muscle tissues are reshaped. The underlying muscle may be tightened with the skin, or separately. After the tightening or removal of excess skin, the skin is re-draped and sutured or stapled in place. Following the surgery, a dressing will be applied to protect the entire area where the incisions have been made.
How long does the surgery take?
The procedure can take anywhere from two to four hours, again depending upon the nature and extent of the face lift. Sometimes other procedures are added, and in that case, the time may increase.
Other procedures that are usually combined with the facelift are eyelid surgery, brow lift or liposuction under the chin.
What should I expect in recovery?
1. Your head will be wrapped in a special form of dressing for 3-5 days to ensure an optimum outcome for your treatment while the area is healing. It is possible that you will experience some discomfort in this time period. If the dressings are too tight and worrying you, call us and we can help you feel more comfortable.
2. Some minor pain or discomfort can be managed with either over-the-counter, or prescription pain medications.
3. You may also experience moderate swelling or bruising of the eyelids and other areas lasting for about one week while you recover from the procedure. We recommend that you stay at home and rest until the swelling has subsided, or do less strenuous activity including paperwork, or leisurely activity such as watching TV.
4. The period of recovery may take anywhere from four to six weeks; however, within two weeks the swelling should be reduced enough so you can engage in social activities and return to work. You will be able to conceal any bruises with makeup.
5. It is wise to wait for about six weeks before resuming any strenuous activity such as gym, yoga or aerobics on account of the internal stitches.
6. By seven weeks, your recovery is usually complete. It is recommended that if you are planning to undergo a facelift, you should allow a minimum of three months before attending major social events.
The technique employed by Dr Tiong's is very safe and effective. This is the product of years of experience - picking the best techniques of world leaders in facial surgery combined with his own research and understanding.
What are the costs involved?
Surgeon fees start from $5,500* including GST per area. Anaesthetic fee and hospital fees are extra.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.
EYELID SURGERY
As we age, excess skin forms around the eye area and the skin loses elasticity. Fatty tissue can also accumulate under the skin. These ageing processes combine to produce an appearance of tired, wrinkled and / or puffy eyes. Even with good skin care, wrinkles, puffiness and drooping eyelids will eventually catch up to you. Genetic factors and body chemistry can cause these ageing effects in younger people.
Cosmetic surgery may restore a youthful and refreshed appearance to your eyes. Blepharoplasty is a treatment for baggy skin under the eyes, sinking upper eyelids or drooping eyelashes that impair vision. This is often combined with other cosmetic surgery procedures such as a brow lift or facelift to improve droopy eyebrows, crow's feet and facial sagging.
Caucasian and Asian eyelids are anatomically different and must be dealt with care. Eyelid surgery is an exceptionally complex area of surgery which involves the interplay of many factors. It is not as simple as many doctors would lead you to believe, in that it is simply removal of excess skin.
How is it done?
Blepharoplasty is best performed under local anaesthesia with IV sedation. It is possible but rare for general anesthesia to be used. Please discuss with Dr Tiong if you think that this option will be necessary for you.
Briefly, surgical incisions are made along the line creases of the upper eyelid and possibly along the outer lower rim of the eye's skin. When removing fatty tissue, but not skin, an incision inside the lower rim of the eye's skin is made. These incisions often reach the outer corners of the eyes so that excess skin, fat or muscle can be removed.
How long does the surgery take?
Depending on the extent of the procedure, time in surgery may take between 1-3 hours. You may have only one pair of eyelids operated upon, or both the upper and the lower lids. Patients return home typically within hours of the surgery. You must be taken home by a carer and cannot drive home yourself.
What should I expect in recovery?
1. Following surgery an ointment is applied to lubricate your eyes and protect them from infection. Bandages may be applied to cover the eyes. You may experience tearing, itchy, burning eyes, dry eyes, light sensitivity and blurred or double vision, which can persist for several days. There will also be some swelling around the eyes.
2. Oral medications will help to minimize any pain and / or discomfort.
3. You will not be able to wear makeup, drink alcohol, watch television or wear contact lenses for several days following the procedure.
4. Bruising and swelling will continue to decrease after the stitches are removed. Sunglasses and protective sun block are required for several weeks.
5. We recommend that you take things easy for 2-3 days and simply rest. Any strenuous activities in the first 24 hours or even first few days can lead to bleeding and may potentially cause blindness. It is absolutely critical for you to follow the doctor's instructions.
6. After about 10 days, you may resume normal activities and return to work. It is still recommended that strenuous activities such as lifting, bending and intensive exercise are avoided until after three weeks.
What are the costs involved?
Surgeon fees start from $1,650* per eye including GST. Anaesthetic fee and hospital fees are extra should you wish it done in the hospital.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.
BROW LIFT
Brow lift is a cosmetic plastic surgery typically used for reducing creases that appear with age in the forehead. Most brow lift patients are between the ages of 40 and 70. The best candidates are healthy people seeking a solution to unwanted furrows and deep forehead lines. Other candidates may include younger people suffering from premature aging signs such as drooping eyebrows.
Brow lifts may be used in conjunction with fat transfers to create volume; or with eyelid surgery or facelift to achieve a fully satisfactory outcome.
There are many ways to approach Brow lift . Full coronal ear to ear incision brow lift is not necessary any more. Endoscopic brow is the best as in involved in minimally invasive surgery and rapid healing time.
This is a safe effective procedure in Dr Tiong's experience.
How is it done?
A forehead lift usually requires only local anaesthesia, though occasionally general anaesthesia is required.
Brow lifts are performed using and endoscope tool that acts as a visual guide, which requires a smaller incision. The advantages of an endoscopic method include a smaller incision, no general anaesthesia, reduced bruising, quicker recovery time, and less scarring.
For an endoscopic forehead lift, several tiny incisions are made within the scalp. The endoscopic instrument is inserted to produce a visual map of the inside of the forehead and eyebrows. . Expensive , dissolving surgical screws or sutures may be fastened to hold the position of the altered skin or muscle.
How long does the surgery take?
Time in surgery is about one to two hours, and you return home the same day.
What should I expect in Recovery?
1. After surgery, a bandage is often wrapped around the head. You may experience temporary discomfort and numbness which can be managed with medication. Swelling can be controlled with head elevation and typically subsides within a few days. Other sensations, including itching or lack of sensation are usually a small side effect and will disappear after a short time.
2. Stitches and staples are removed in 1-2 weeks, and special dissolving screws will disappear by itself in are in about 4-6 months.
3.There may be some mild residual bruising, however most patients can return to work within 10 days with the help of a little make-up. If the bruising is minimal, the return to work can be even earlier.
4. you may get tension headache for a few weeks as your brow now been pull tighter . This can easily taking care of by Panadol or panadiene Tablets. Let Dr Tiong know if they are not strong enough and he can give you stronger tablets.
What are the costs involved?
Surgeon fees start from $4,400* including GST. Anaesthetic fee and hospital fee are extra if you wish to be done in Private Hospital.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.
RHINOPLASTY
Rhinoplasty reshapes the nose for aesthetic and corrective purposes. Whether the issue is birth defect, injury, or age-related changes, rhinoplasty can help provide balance and proportion to your nose and face.
Rhinoplasty can change many things about your nose, including your nose size (in relation to your face), nose width at the bridge, the size and position of the nostrils, and nose profile (by downsizing visible humps, bumps or depressions on the bridge).
Rhinoplasty can correct certain breathing difficulties such as those due to a deviated septum.
How is it done?
Rhinoplasty usually requires only local anaesthesia and is usually performed under twilight sedation. But it can be done in a private hospital with additional hospital fee. Before surgery, Computer imaging will be used to understand your wishes and expectations, and see it is an achievable goals.
Dr Tiong only do open procedure (where an incision is made across the columella) as he believes it helps him to gain assess to the various structures of the nose better when the soft tissues that cover the nose are raised through these incisions. This provides access to reshape the structure of the nose.
Nasal structures can be reduced or augmented with cartilage grafted from other areas of your body. These pieces of cartilage can come from the septum or occasionally from the ear or the rib cartilage. The projections inside the nose are reduced to improve breathing.
How long does the surgery take?
Most rhinoplasties normally require one to three hours in surgery, while a more complex rhinoplasty can take much longer. A filler rhinoplasty can take just 15 minutes.
What should I expect during Recovery?
You will probably be excited, if not anxious, to see your new nose, but patience is key after rhinoplasty. Complete results are not immediate and can take up to one year to be fully evident.
You will be unable to breathe through your nose for the first 24 hours, due to nasal packing, which is stuffed up your nose to help reduce swelling and bleeding. There will be some pain that can typically be controlled with pain medicine. Most people who undergo rhinoplasty can stop pain medication after 48 hours. Some people may feel nauseated after the surgery.
You may experience limited bleeding during the first few days. It is important to avoid any trauma to the nose during the first week after surgery. Blowing your nose is not permitted after rhinoplasty. This can be tough, as you may feel stuffy. Decongestants may help.
You will likely be asked to return in three days so the stitches can be removed. After seven days the cast is removed. Your nose will still be swollen, but after two weeks much of the swelling will have decreased. At this point, all nasal packing, splints and other post-surgical dressings should be removed. A splint may be placed over the outer part of your nose to protect your nose as well as help it hold its new shape during the healing process. A softer splint may also be placed inside your nose to prevent scarring inside the nose.
By one month, 85 percent of the swelling will have gone down. The remaining swelling may take up to one year. For these reasons, you should wait at least one year before undergoing revision rhinoplasty.
What are the costs involved?
Surgeon fees start from $4,400* including GST.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.
FACIAL IMPLANTS
Facial implant plastic surgery can help you balance disproportionate facial features, strengthen a weak jaw line, or accentuate your cheekbones to create a more youthful appearance. Facial implants are plates that are inserted in front of the bone of the cheek, chin, jaw, or other areas of the face.
The best facial implant candidates are patients whose skin has loosened around the face, with the surrounding skin retaining enough elasticity to be repositioned successfully. A weakened jaw line, or the appearance of reduced bone structure, can be improved with facial implants. Implants may also work in other areas of the face.
Facial implant surgery is one of the many cosmetic-surgery remedies to improve faces affected by aging or genetic issues. Temporary, less invasive alternatives include Botox, fat transfers, and Restylane.
Facial implant surgery can enhance the results of a facelift and may also be performed at the same time as a brow lift or eyelid surgery.
How is it done?
Facial implants are most often performed under local anaesthesia or general anaesthesia for more complex cases.
The facial implant procedure varies depending on the type of implant. The most common facial implants are chin, cheek, or jaw implants. You may need more than one type of implant to achieve the results you're looking for.
Cheek Implant
During a cheek implant, an incision will be made under the lower eyelid or on either side of the upper lip. A pocket will be created for the implant to fit into; the implant is then inserted through the incision. A bandage will be applied to reduce swelling and discomfort.
Chin Implant
During a chin implant, an incision will be made under the chin or along the lower lip on the inside of the mouth. A pocket will be formed for the implant to fit into; the implant is then inserted through the incision. Tape across the chin will be applied to reduce swelling and discomfort.
Jaw Implant
During a jaw implant, an incision will be made on either side of the lower lip. A pocket will be formed for the implant to fit into; the implant is then inserted into the lower jaw through the incision. Tape across the chin will be applied to reduce swelling and discomfort.
How long does the surgery take?
Time in surgery is about 1-2 hours. Typically, you can return home the same day.
What should I expect during recovery?
Swelling and bruising often occur after the procedure and will subside within several days.
Cheek Implant Recovery
Moving your mouth, eyes, and lips may be difficult during recovery.
Chin Implant Recovery
Moving your mouth may be difficult for up to a week. Your chin and neck may be black and blue. Your activity should be kept to a minimal during this period.
Jaw Implant Recovery
After surgery, the jaw will continue to swell for up to 48 hours. There may be a low level of swelling for several months after the procedure. Moving your mouth may be difficult for about seven days. Movement will improve during the next few months. Your jaw may be black and blue. Your activity should be kept to a minimal.
The results of facial implant plastic surgery may not be fully evident for several months.
What are the costs involved?
Surgeon fees start from $3,300* including GST. Anaesthetic ,hospital fees and implants cost are additional and chargeable.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.
OTOPLASTY
Ear surgery can correct protruding ears (excessive ear cartilage), large or otherwise deformed earlobes, "lop ear" (where the ear tip bends down and forward), and "cupped" or "shell ear" (which could be a very tiny ear or an ear without natural creases).
How is it done?
A general anaesthesia is typically used for young patients and a local anaesthetic combined with a mild sedative for adults.
Techniques vary depending on the general anatomy of the ears, the extent of the ear cartilage, excessive skin in the surrounding area, or level of deformity in other areas of the ears.
Dr Tiong will employ many surgical otoplasty techniques to correct the pathologies of your ears to give you a natural look. He does not simply pin the ears back giving you an obvious pinning back look.
How long does the surgery take?
The procedure may take from 1-2 hours, again depending upon the nature and extent of the deformity.
What should I expect during recovery?
After the procedure, the head is wrapped in a thick bandage. Fitting of the bandage helps to maintain the new position of the ears and enhances the healing process. Patients usually return to the clinic within the first few days to exchange the bandage for a lighter one.
Otoplasty patients may experience temporary discomfort, headaches and numbness which can be managed with oral medications. Any swelling or unusual sensations will disappear over a short period of time.
Young patients are often required to refrain from normal activity for at least seven days after surgery. Special care must be given to children throughout the first three weeks of recovery to restrict them from playful activities that may disrupt the ears. Adult patients usually return to normal activity within three days after surgery. More complicated procedures may require a longer recovery time. In all cases, the ears should not be bent for at least a month or more.
What are the costs involved?
Surgeon fees start from $4,400* including GST.
*The cost of cosmetic surgery can vary (higher or lower), depending on the complexity of the procedure, the required results, cost of implants, aftercare treatment and the area of the body where the surgery is being performed. Further costs may be incurred for anaesthetist and hospital fees if applicable. For specific pricing information, please arrange a consultation with Dr. Tiong.