What is a facial plastic surgeon?
The majority of elective facial plastic surgery procedures in the United States are performed by facial plastic surgeons.

Facial plastic surgeons spend five to seven years in postgraduate surgical training, including one to two years of study in general surgery and at least four additional years of specialty training in head and neck surgery and facial plastic surgery. With a concentration on the complex physiology, anatomy, pathology, biochemistry, and bacteriology of the head and neck region, a facial plastic surgeon has a strong focus on the anatomy of the area being treated.

Typically, a facial plastic surgeon is board-certified in otolaryngology, the specialty addressing neck and head surgery. The world’s largest association of facial plastic and reconstructive surgeons is the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS - www.aafprs.org). The Academy’s bylaws require fellows to be board-certified surgeons with experience and training in facial plastic surgery.

Dr. Robert P. Hillstrom is board-certified by both the American Board of Otolaryngology (www.aboto.org) and the American Board of Facial Plastic and Reconstructive Surgery (www.abfprs.org).

How does reconstructive surgery differ from cosmetic plastic surgery?
When you choose to change your appearance for purely aesthetic reasons, your procedure is considered cosmetic. However, plastic surgery performed to repair damage from injury, cancer, or disease is classified as reconstructive. At Hillstrom Facial Plastic Surgery, Dr. Hillstrom performs procedures for both reconstructive and cosmetic reasons. Facial reconstructive surgery is often performed at Manatee Surgical Center to repair areas where cancer has been or needs to be removed or injury has occurred, while aesthetic procedures such as face lift, browlift, rhinoplasty etc.are typically performed for cosmetic reasons and can be performed in our Operating Room. Rhinoplasty (nasal surgery) can be performed for either cosmetic or functional reasons.

Am I a candidate for facial plastic surgery?
In general, most emotionally and physically healthy adults are good candidates for facial plastic surgery. Chances for a successful outcome are better if you have realistic expectations about the outcome and a well-defined reason for wanting the surgery. During your consultation with Dr. Hillstrom, he will examine your area of concern and assess your general health, medical history, and any concerns you may have about facial plastic surgery. He will use this information to determine the cosmetic procedures for which you are a good candidate and those that will best accomplish your goals of improving your appearance.

What is the best age to have facial plastic surgery?
The best age for facial plastic surgery is relative to each specific procedure and the health and goals of each patient. However, in general, there are no age requirements. For example, otoplasty (ear surgery) is often performed on children between the ages of four and 14, but adults also choose to have the surgery and are excellent candidates. Face Lift and brow lift surgery is often reserved for patients over the age of 40, but if droopy eyes or facial lines run in your family, you may need a face lift or eyelid surgery procedure at a younger age. In fact, it is best to have a face lift at the first signs of aging for optimal results.

During your consultation, Dr. Hillstrom will determine if any health issues exist that would make a certain procedure dangerous and which procedures will best fit your desired outcome.

What will recovery be like following my facial procedure?
Recovery time varies depending on the type of cosmetic procedure you choose. The majority of our medical spa treatments have little or no downtime, and patients are able to return to work and their regular routine almost immediately. However, our more extensive facial plastic surgery or reconstructive surgery procedures require more recovery time. During your initial consultation, Dr. Hillstrom will discuss with you the recovery procedure for the treatment you choose and how it may affect your routine and lifestyle.

Recovery Following Rhinoplasty
After rhinoplasty surgery a thin plastic and metal splint is placed over the bridge of the nose and left on for three to five days. Unlike other surgeons, Dr. Hillstrom leaves no packing in the nose during recovery, allowing you to breathe through your nose, creating a significantly more comfortable postoperative period.

Rhinoplasty patients at Hillstrom Facial Plastic Surgery, are typically able to return to their normal routine a short while after surgery. For the first day following rhinoplasty surgery, it is important to keep your head elevated to reduce any discomfort you may feel. Some bleeding is common, and you may experience a dull headache. A small amount of yellow-brown bruising may occur under the eyes, which usually subsides within a week or two. Sutures placed on the outside of the nose are removed within four to six days, while those on the inside of the nose dissolve.

Any swelling of the face typically subsides within a few days, but residual swelling in the nose may exist for up to six months, especially at the tip of the nose. For this reason, final results may not be visible for six months to a year. The improved appearance of the nose by rhinoplasty is permanent and scarring is generally minimal.

To schedule a consultation with Dr. Hillstrom or for more information about rhinoplasty nose surgery, contact Hillstrom Facial Plastic Surgery

Will my insurance company cover the cost of facial plastic surgery or reconstructive surgery?
Typically, insurance companies do not cover plastic surgery that is performed for purely cosmetic reasons. Some insurance policies may partially or fully cover reconstructive surgery procedures or other medically necessary plastic surgery, such as rhinoplasty performed to correct a breathing problem. Please consult your insurance provider and policy for details on what is and is not covered.

What non-surgical alternatives to facial plastic surgery are available?
If you would like a procedure to bring back a healthy, more youthful look to your face but are not ready for a surgical procedure such as face lift, there are a variety of treatments available to you. BOTOX® Cosmetic is one of the most effective non-surgical treatments available to reduce the appearance of facial lines. Furthermore, volume replacement fillers such as Restylane®, Perlane®,  Juvéderm™ and Artefill can be used to fill in folds and wrinkles. These products can also be used to augment the cheeks, giving the appearance of a midface lift. They can even fill in the depressions in front of the jowls and fill the smile lines near the mouth to give the appearance of a non-surgical face lift. The eyebrows can also be filled, causing them to lift slightly and create the image of a non-surgical browlift. The results from wrinkle fillers typically last six to 6 months. At our Skincare Center, we offer microdermabrasion, skin resurfacing with peels, medical grade skin care products, and more to give your face a healthy, younger-looking appearance. In addition to these facial treatments, Hillstrom Facial Plastic Surgery also offer treatments for both the face and body including laser hair removal.

How do I find out more about facial plastic surgery and reconstructive surgery at Hillstrom Facial Plastic Surgery in Sarasota?
If you would like to learn more about facial plastic surgery and reconstructive surgery, or our skincare services, please contact Hillstrom Facial Plastic Surgery in Sarasota, Florida, or call our office at 1-941-355-FACE. Our staff will gladly answer any questions your may have, and can help you schedule your private consultation with Dr. Hillstrom.

Skincare FAQS

How does laser hair removal work?
Lasers target hair that is growing at the time of treatment. The laser eliminates hair by transforming light into heat and directing the heat down the hair shaft to the follicle bed so that no hair grows from it again. Candela lasers have a unique built- in cryogen cooling spray which reduces discomfort and protects the surface of your skin, leaving the surrounding skin unaffected by the treatment. Multiple treatments are always necessary. The exact number is dependent on the amount, density and growth rate of each person’s hair. The body area and age of the client are also important factors in determining the number of treatments necessary.

What causes skin damage?
Exposure to the sun and chronic low grade inflammation are the primary causes of skin damage. The sun’s damaging effects come from ultraviolet light and heat. Day to day sun exposure can cause skin cancer, wrinkles, dark spots, uneven skin tone, rough texture and broken blood vessels, among other things. In fact visible “aging” is largely due to sun damage. Chronic inflammation of the skin can be a secondary effect of acne, dermatitis, Rosacea, allergies, exposure to weather, bacteria or environmental toxins, smoking, drug or alcohol use.

How do we prevent skin damage?
Antioxidants protect the body and the skin from free radical damage. Regular application of skin products which contain active Vitamin C, Vitamin E, Green Tea and other potent antioxidants protect the skin by neutralizing free radicals. Of course sun protection with a full sunblock is the most important step to take. A diet rich in antioxidants may also benefit the skin. Other tips for skin health: quit smoking, it adds ten years to your face, exercise regularly to increase circulation and have a healthy glow, and most importantly, enjoy life, the radiance shines through.

What does microdermabrasion do?
Microdermabrasion is an exfoliating technique that helps repair facial skin from the effects of the sun and aging.   Microdermabrasion is performed using a device which gently sprays a jet of fine crystals across the skin’s surface, mixing gentle abrasion with suction to remove the outer layers of dead skin.  Relax and let your skin be restored to a more refined and silky appearance. Some of the benefits of Microdermabrasion are:

• Softer skin
• Improved skin texture
• Shrinking large pores
• Evening skin color
• Improving acne
• Unclogging congested skin
• No down time

What are Chemical Peels?
The professional peel process eliminates damage and rejuvenates the skin. Peel products exfoliate and stimulate the skin. Light peels work at the top layers of skin. These peels may be done by a skin care specialist such as an esthetician. Medium and deep peels can achieve dramatic results after one or two treatments and are done by medical aesthetic professionals.

Light peels are made of alpha and beta hydroxy acids, such as, Lactic Acid, a by product of milk; Glycolic Acid, a by product of sugar; and Salicylic Acid, from the same source as aspirin. Enzyme peels are very mild made from fruit such as papaya, pumpkin, and grape.

The decision about what kind of peel or series of peels to have should be made in collaboration with a knowledgeable skin care professional. Together you can design an effective treatment plan that will give you the results you want – beautiful skin, at every age. For optimal results a series of treatments is recommended. A series of six peels yields amazing results!

Is water important for skin?
The human body is primarily composed of water, yet it’s easy to have dehydrated skin. Weather, sun, and indoor heating all contribute to dehydrated skin. As we age, our skin cells hold less water. Smoking, alcohol, sodium and preservatives all draw water out of the skin. It is possible to have very oily skin and still lack adequate moisture. We hydrate skin in two ways: by the daily application of quality skin products that add moisture to the skin and hold it in, and through the adequate intake of water and other healthy liquids.

How is Perlane different from Restylane?
Both Perlane and Restylane are composed of hyaluronic acid. The primary difference between Restylane and Perlane is that the hyaluronic acid gel particles in Perlane are larger than those found in Restylane. This gives Perlane additional ability to lift and fill the areas of injection that require a denser formulation. Perlane and Restylane are perfect complements to one another. 
Combination of Perlane and Restylane for Lip and Vermillion Border

How do Perlane and Restylane work?
Perlane® is injected into the skin to smooth away wrinkles and folds. Perlane®’s water-loving nature attracts and binds water molecules to help maintain volume.

Perlane® is composed of hyaluronic acid, a natural substance that already exists in the body. The hyaluronic acid in Perlane® is a crystal clear gel that is chemically cross-linked (the long chemical strands are tied together) to delay breakdown by skin enzymes. Perlane® is non-animal-based and free from animal protein. This quality prevents disease transmission. Allergy pre-testing is not necessary. Also distinct from other hyaluronic acid dermal fillers, Restylane and Perlane are minimally cross-linked, making them similar to the natural hyaluronic acid found in the body. Also view the Restylane-Perlane website.

Hyaluronic Acid Background
Physicians have been developing ways to restore volume and structure to aging skin using a variety of approaches for over 100 years. Past fillers included paraffin, silicone and collagen injections.

In the 1930s, researchers discovered a natural substance in the body that they named hyaluronic acid, and they found that it plays a key role in numerous areas of the body including the maintenance of skin volume and hydration, eye volume and shape and joint lubrication and cushioning.

In the decades since, numerous therapeutic and aesthetic uses have been developed for this versatile natural substance. In 2003, the U.S. Food and Drug Administration (FDA) approved the first hyaluronic acid dermal filler for the correction of facial wrinkles and folds, such as nasolabial folds (the folds running from the sides of the bottom of the nose to the outer corners of the mouth).

Today, hyaluronic acid-based dermal fillers are the fastest growing non-invasive aesthetic procedure in the United States, according to the American Society for Aesthetic Plastic Surgery.

What is hyaluronic acid?
Hyaluronic acid is a natural complex sugar found throughout all living organisms that retains water -- absorbing more than 1,000 times its weight -- and adds volume to the skin’s surface. In addition, hyaluronic acid binds with collagen and elastin and transports essential nutrients to these fibers. The triple combination of collagen, elastin and hyaluronic acid provides structure, elasticity and volume to the skin and contributes to its overall appearance.

As the skin ages and is exposed to environmental pollutants and ultraviolet rays, the cells lose the ability to produce hyaluronic acid. As a result, the skin begins to lose volume, often resulting in the formation of facial wrinkles and folds. Dermal fillers compromised of crossed-linked hyaluronic acid are used by physicians to help temporarily replace lost hyaluronic acid and to restore skin volume and a smooth, natural appearance.