Facial Surgery FAQs in Savannah, GA

Laser Resurfacing

Question: If you have laser resurfacing of the whole face - how deep do you go and also if you have to have it repeated how soon can this be done and how much does it cost for the first time and then the repeat procedure.

Answer: If the CO2 laser is used, the laser beam penetrates 50 microns with each pass (each application). For acne scars & deep wrinkles, we usually do 2-3 passes for a total depth of 1-1.5 mm. It should not be repeated any sooner than 6-12 months, and at that time either less power or fewer passes would be used. Healing time is 10-12 days. Other lasers (Erbium, Fraxel) penetrate only 20 microns per pass & have little or no down time (healing time). Yet they do not achieve the same degree of smoothing & tightening. Currently we do not use these 2 but we are investigating the Fraxel laser for selected uses. Cost for a full face CO2 laser resurfacing is $3150 including surgeon, operating room, and anesthesia fees assuming a 1.5 hour operation time.

Lawrence E. Ruf, M.D.

Fat Pads Under the Eyes

Question: I am a happy pt.of Dr. Davies with a new question. I recently saw a program where the fat pads under the eyes is removed by injecting a needle into the skin and pulling out the fat. Is this something you do? I am very interested in this procedure.

Answer: The only procedure I know of that resembles what you're talking about is mesotherapy. This is where fluid is injected into the fat pads of the eyes (usually lower lids) and slowly dissolves away the fat-we think. The problem with this is that no one is totally sure of the recipe for the material and no one actually knows what is happening to the fat. When it works, it works beautifully, but it's also not predictable as to who will have success with the procedure. I am under the impression that it's actually been banned in Europe and South America until it can be more quantified and regulated. So, no, I don't do this! Anything this uncertain around the eye area sounds very dangerous to me, so, even if the procedure gets cleared by the FDA someday, I will wait at least six months to see what the studies show and what results other surgeons are achieving. While it's a surgery, I can do a transconjunctival blepharoplasty that won't leave a scar on the outside of your lid. This is where the fat pads of the lower lids are removed through an incision on the inside of the eyelid. There's no incision on the outside, and, if there's loose skin, we can tighten it with laser. I've had this done myself, along with a standard upper lid blepharoplasty. 

Barbara L. Davies, M.D.

Double Chin Solutions

Question: I am 30 years old and overall, I have an average body. Just looking at my face, I look overweight because of my double chin. I need to know what you suggest and price ranges, along with payment options. Also, how much time would I need to take off work.

Answer: It is possible you would need some fat removal, tightening of the muscles in the front part of the neck, and perhaps a stitch sling to create the improvement you desire. However, because these changes are so specific, and each person is looking for something a little different, a detailed consultation would be necessary to determine what you really need. Overall prices range from about $3000-$10,000 (including operating room and anesthesia charges).

Lawrence E. Ruf, M.D.

Lower Eyelid Surgery

Question: My mother's family (for as far back as I can recall) all have sagging bags underneath our eyes. I've had them all my life as I look at pictures growing up. I'm now 32 but I'm afraid that when I turn 40 I'll look like I'm 50. The bags aren't dark yet but as I look at my mother, sister, aunts, and uncles it will only get worse. What is the cost of this surgery?

Answer: Price for a lower lid blepharoplasty (removal of the "bags" underneath your eyes) is going to be around $2800-$3200. This is a ballpark figure, but includes the surgeon's fee, operating room, anesthesia, and all of your post operative visits. To get a true price quote, you should come in for a consultation. 

Birthmark Removal

Question: I have a portwine birthmark on my cheek. Is there a new procedure that has shown good success with removing dark portwines? Over the years, I've had treatment with several different types of lasers as each one was newly released, but none of the procedures available as of 2001 were successful in removing or lightening mine.

Answer: Complete removal of a portwine birthmark may be an unrealistic goal as some are deeper than others. Most, however, will respond very well to the yellow and/or green light lasers. As the lasers have evolved over the years, more refinements have occurred but none have achieved the ability to penetrate as deeply as needed to eliminate deeper vessels (deeper than about 2 mm). We can say that with a treatment every 3-5 years, we can keep most portwine birthmarks under good control. If there are deeper components (large vessels down in the fat & muscle) more complex techniques such as embolization (done by specially trained radiologists) would be needed. I hope this is of some help to you. 

Lawrence E. Ruf, M.D.

Pin Back Ears

Question: Hello my 27 year old son is very interested in getting his ears pinned back. Do you do this type of surgery? What would be the approximate cost? Thank you

Answer: Yes, we do the ear pinning surgery (otoplasty). Approximate cost varies, depending on the individual patient's needs. Ballpark price would be around $4400, which includes the fee for surgeon, operating room, anesthesia, and post-op visits.

The procedure is 2-3 hours and is day surgery, not overnight. Stitches come out in about 10 days and final healing is approximately 6 weeks. The surgery is done through an incision behind the ear with the cartilage being reshaped and set back. The risks are the same as all operations and include bleeding, infection, scarring, etc. It is hard to fully explain a procedure and risks without seeing you and talking in detail. There is no waiting list, you can call and make an appointment at any time. The fee for a cosmetic consultation is $60.00. While this is day surgery, someone will need to drive you home because of the anesthesia. You should be up and around the next day. 

Scott W. Vann, M.D.

Chin Reduction Surgery

Question: I would like a chin reduction. I have a long face and my chin comes out looking a lot like a half moon from my profile. I just want a smaller chin that is softer looking. I realize that you can't tell me what you could do for me without looking at my face but I was wondering if this could be fixed and at how much.

Answer: A chin reduction involves trimming off some of the bone of the chin while preserving the skin, fat, and muscle. In more severe cases, is may require a more sophisticated reduction of both sides of the mandible (lower jaw). We do the chin reduction through an incision behind the lower lip. We refer patients needing jaw reduction to the oral surgeons. I hope this is of some help and if you think the chin is all you need, I'd be happy to see you.

Lawrence E. Ruf, M.D.

Nasoplasty Quote

Question: I'm 28 years old, I've wanted my nose done since I was 15. When I was young I had a nice straight nose, when I hit my teenage years my nose began to get a so-called "hump" on it. Which runs in my family. Everyone of course says I look beautiful the way I am, and I don't think I'm "ugly", but I hate my nose, and would like to have the hump straightened out and the wide tip narrowed. I just wanted to know how much money I need to do this type of procedure, since I'll probably be paying out pocket. A ball-park figure to get started.

Answer: A ballpark fee for nasoplasty can be anywhere from $5000-$8000, depending on how much needs to be done. It is too hard to give quotes over the internet; I really need to examine your nose so we can discuss exactly what needs to be done. I can then give you a realistic quote for your surgery. 

Lawrence E. Ruf, M.D.

Acne Scars

Question: I have pitted acne scars. Went to see a dermatologist about this matter. He told me that there was not much I could have done.Is there any hope.

Answer: Yes there is hope. Soft tissue fillers like Restylane or Collagen can help fill in depressed areas. Laser surgery can improve the scars as well as help with pigment changes. A consult would help determine which is best for you. 

E. Daniel Deloach, M.D.