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The treatment options for facial paralysis depend on the underlying cause and severity of the condition.
Here are some possible treatments for facial paralysis:

  • Physical Therapy: Physical therapy, including exercises and massage, can help improve muscle strength, coordination, and mobility in the face.
  • Medications: In some cases, medications like corticosteroids or antiviral drugs may be prescribed to reduce inflammation, manage infection, or control symptoms.
  • Botox Injections: Botulinum toxin injections, commonly known as Botox, can help relax overactive muscles and reduce facial asymmetry.
  • Electrical Stimulation: Devices like electrical muscle stimulators can be used to stimulate muscle activity and improve muscle tone.
  • Nerve Repair: For cases where facial paralysis is due to nerve damage, procedures like nerve grafting or nerve transfer surgery can help restore function.

Surgical options for facial paralysis are tailored to the underlying cause and the extent of the condition.
These procedures can encompass:

  • Nerve Decompression: This surgery aims to relieve pressure on the facial nerve, often due to inflammation or entrapment, by removing surrounding structures.
  • Nerve Transfer: Nerve transfer surgery involves taking a healthy nerve from another part of the body and connecting it to the damaged facial nerve to restore movement.
  • Muscle Transfer: In muscle transfer surgery, a muscle from another part of the body is transplanted to the face to replace or augment paralyzed facial muscles.
  • Selective Neurectomy: This procedure involves cutting specific nerves that may be causing abnormal muscle movements in the face.
  • Nerve Grafting: Nerve grafting involves the use of a piece of nerve from another part of the body to bridge a gap in the damaged facial nerve.

Apart from nerve surgeries, static suspensions can also be performed to restore facial symmetry when the face is at rest. These procedures aim to provide support to the paralyzed side of the face to improve its appearance and symmetry.

The choice of surgical technique depends on the individual's condition, the specific cause of facial paralysis, and the desired outcome. It's essential for individuals with facial paralysis to consult with a specialist who can recommend the most suitable surgical approach based on their unique situation.

A sagging neck and neck bands are typically addressed with a neck lift procedure. I usually incorporate a neck lift into a facelift for comprehensive facial rejuvenation. During this combined procedure, a separate incision is made under your chin to target the bands near the midline and, if necessary, remove excess fat beneath your neck muscles. Additionally, through this under-chin incision, certain deep neck structures like drooping muscles or enlarged salivary glands can be repositioned or removed. This approach becomes necessary when you're dealing with both tissue sagging and fullness in the neck area. Separately addressing only the face or the neck can be challenging because many interconnected structures exist, and the surgical techniques are closely related. Therefore, lifting the entire area is often the more logical approach for me.

A deep plane facelift is a surgical procedure used to rejuvenate the face by addressing sagging skin and tissue in a deeper layer compared to traditional facelift techniques. In a deep plane facelift, I work on the deeper structures of the face, such as the muscles and ligaments, to provide more significant and longer-lasting results. This approach allows for a more natural and less pulled appearance while also lifting and tightening the skin.

During the surgery, I separate and reposition the deeper layers of the face, including the musculoaponeurotic system (SMAS), which is a layer of tissue that lies beneath the skin. By lifting and repositioning these deeper structures, I can achieve a more comprehensive and effective facial rejuvenation without placing too much tension on your skin. This technique results in more subtle scarring, a more natural appearance, and longer-lasting outcomes.

Working in a deeper plane of the face brings a surgeon in proximity to the most crucial structures of the face, primarily the facial nerves. That is why deep plane facelifts are typically performed by experienced and skilled plastic surgeons. They are a preferred choice for individuals desiring more significant and enduring enhancements in facial aging. Nevertheless, it's important to note that this procedure is more intricate and may entail a lengthier recovery period when contrasted with other facelift techniques.

Sometimes it is hard to explain to a surgeon exactly what kind of change you want for your nose. Bringing some reference pictures definitely helps pointing out the likes and the dislikes. Make sure you select ones that have similar facial features and complexion to yours. (I can observe how realistic you are from the pictures you bring in.) I found the best reference pictures are your own pictures edited with any photo editing software, or even with hand-drawn lines. You may find how tricky it is to achieve the desirable result when editing your own nose on the screen. Same thing happens on the surgical table as well!

In addition to reference images, crucial information includes details about your breathing condition and your history of previous treatments. For those who have undergone previous nasal surgeries, treatment plans may differ significantly in order to achieve the desired outcome. If you can provide records from your previous surgeon, it would be immensely helpful in ensuring the best possible care and results.

When you enter a surgical theater, you will typically undergo a series of experiences and procedures. Here's what you can expect:
Pre-operative preparation:
Before entering the surgical theater, you will go through a pre-operative process. This includes changing into a surgical gown, removing jewelry or accessories, and wearing a surgical cap to maintain a sterile environment. You will have your vital signs checked, receive IV fluid or medications, and the anesthesiologist in charge will see you and may have a little chat with you about your previous surgery or recovery issues that you might have had. I like to use this time to mark or draw lines on your face to indicate the areas to be fixed.

Anesthesia administration:
Once inside the surgical theater, you will be transferred onto the operating table. Your vital signs, such as heart rate, blood pressure, oxygen saturation, and temperature, will be continuously monitored. Electrodes, blood pressure cuffs, and pulse oximeters will be hooked up to provide real-time data to the medical team. An anesthesiologist will give you the anesthesia which in most of our cases is general anesthesia. To keep it simple, you will be put to sleep safe and sound and the surgery will begin. 
During the surgery, you will remain unconscious, I guarantee. Throughout the surgery, your vital signs and the anesthesia level will be closely monitored. Our medical team will ensure your safety and well-being throughout the procedure.

Surgery completion: 
Once the procedure is completed, the surgical site, whether it is your face or body, will be dressed appropriately to protect the incision and promote healing.
You will then be transferred to a recovery area. The medical staff will provide necessary care, pain management, and instructions for further recovery.

Septoplasty is a surgical procedure performed to correct a deviated or crooked septum, which is the wall of bone and cartilage that separates the two of your nasal passages. When the septum is crooked, it can block your breathing, or cause congestion, snoring, and sinus infections.

During a septoplasty, the surgeon makes an incision inside the nose and lifts the mucous membrane covering the septum so the septum can be reshaped, trimmed or repositioned to improve airflow. Most of the time, the surgeon uses a surgical endoscope to get a better vision of the deeper structure of the nose. Septoplasty can be done under general or local anesthesia with sedation on an outpatient basis, meaning the patient can go home the same day. 

It's important to note that septoplasty is a functional procedure focused on improving nasal airflow and addressing breathing problems. It is different from rhinoplasty, which is a cosmetic procedure aimed at altering the shape or appearance of the nose. However, in many cases, both septoplasty and rhinoplasty have to be performed together if there are both functional and aesthetic concerns with the nose. The cartilage to be discarded from the septoplasty can be used for grafting in rhinoplasty. This combination is the most common procedure I do recently.

With the open rhinoplasty approach, I can see the deviated part from the top view and also deeper down as I open up the nose. Any mechanical blocking that is in the way can be fixed or repositioned as needed.

However, if you only have breathing difficulty and are not concerned about the appearance of the nose, you should see an ENT specialist, not a plastic surgeon because it is usually not necessary to reshape the nose while correcting the septum itself.

Surgery costs can differ from one hospital to another in Bangkok, where I currently collaborate with 4-5 medical facilities. Some of these hospitals offer comprehensive surgery packages that cover all expenses, such as hospital stays, medications, follow-up visits, and more. However, not all hospitals provide these packages.

To obtain an accurate price quote, you can reach out to either my assistant or your client manager. Typically, the final price can be determined following your initial consultation or after I've had the opportunity to review your photos and your surgical recommendation request form.

Additionally, my assistant will assist you in selecting a hospital that aligns with your preferences, taking into account factors like pricing, location, services, and safety.

Most of my cases are done under general anesthesia. In Bangkok, opening a clinic with general anesthesia facilities involves various regulatory licensing, permits, and accreditation. These requirements are complex and time-consuming, as well as require a significant financial investment. So to keep it simple, I use my trusted hospitals as my clinic. With the help of my assistants, you will not find it difficult to see me or schedule a consultation with me. Also I hope this will keep the cost of my surgery as low as possible considering the running cost of the clinic is eliminated. By the way, surgery in a hospital is safer. Plastic surgery is safe when performed properly. It does not get into your body cavity or vital organs. However, complications do exist. Such as bleeding, infection, or any aggravation of your baseline health conditions. Any surgical complications I can take care of but it is safer to have a full board of specialists in hand when an unexpected problem occurs. That is why I feel safer working in a hospital than a clinic. It is important to note that my decision is based on my current circumstances. I may eventually choose to open a private clinic later in my career. I will keep you posted.

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