Face Procedures

Surgical procedures designed to structure and reconstruct.

To choose a Plastic Surgeon, it is best to ask your family doctor for advice or to consult with friends or acquaintances. Remember that each case is unique and that your friend’s good results do not guarantee yours.

Blepharoplasty is a cosmetic surgery designed to remove excess and sagging skin from the upper and / or lower eyelids. As a person ages, the skin loses some of its fat and much of its elasticity, becoming saggy and wrinkled. This process, which can be accelerated by sudden weight loss, makes the eyelids protrude by herniating small pockets of fat that must be treated.

The removal of excess skin aims to improve the appearance of the individual. In upper blepharoplasty, a horizontal fold of skin is removed from the center of each upper eyelid so that the scar runs along a natural fold.

In the inferior blepharoplasty, the incision is made below the lashes, so that the scar is in the shadow area of the lashes and extends obliquely, to look like an expression wrinkle.


Anesthesia and Duration:
The intervention is performed with local anesthesia or general anesthesia under outpatient surgery and takes about 90 minutes.

After surgery, the patient will feel hot and will have bruises and swelling around the eyes. The eyes should be covered with an antibiotic cream to prevent infection. Ice is also applied to the eyes to reduce swelling and bruising. The first usually disappear after 3 days, and the bruises around two weeks. Suture points are removed 3 to 5 days after surgery and scarring becomes inapparable after 3 to 6 months in most cases.

The Cervico-Facial Lifting is intended to soften the signs of aging (wrinkles and expression marks) caused by the action of time. It is most suitable for those who have wrinkles, sagging or excess skin on the face.

Surgical procedure:
Anesthesia may be general or local with sedation and surgery lasts an average of 3 hours. The length of stay is about 24 hours and the patient should try to have a slightly elevated head when resting.

Compressive dressings should be made within the first 72 hours. Sun exposure should be avoided for the first thirty days, after this period with caution and the use of sunscreen.

Usually men and women over 40.

Improve the deep groove that goes from the nose to the corner of the mouth, the cheeks, the jaw line and the cheekbones. It also helps to improve sagging skin and puffiness by removing excess skin, correcting muscles and reshaping the skin. It can be done in conjunction with frontal lifting and blepharoplasty to correct excess eyebrows and puffiness of the eyebrows.


Incisions and technique:
There are different variations of face lifting. The incision is usually placed in front and behind the ear, hidden by the natural ridges. Behind the ear the incision enters the scalp, hidden by the hair. The earlobe should be loose and natural, avoiding the taut appearance. Sometimes a small incision under the chin can be used to help correct the neck muscles (platysma). Preferably the deep structures of the face and neck will also be repositioned. The skin is pulled up and back and the excess is removed. The appearance should look normal and not stretched. To correct the neck liposculpture can also be used, improving the contour. One of the most important aspects of facial surgery is the replacement of the lost volume. This can be achieved either by folding and suturing deep structures or by injecting fat from another region.

3 to 4 hours.

local with sedation or general.

Inpatient / Outpatient:
Most patients need 24 hours of hospitalization

Back to work: 10 to 14 days.

More strenuous physical activities: 3 weeks.

Bruises: 2 to 3 weeks. Avoid sun exposure for two months.

Myths and Realities
The unusual acceptance and expansion of cosmetic surgery in the last 2 decades has its genesis in social and individual motivations.

Among the social motivations: the aging of the population with the increase in life expectancy, the professional exclusion of the elderly, fashion and the media that impose biotypes and silhouettes depersonalizing the ego, the overvaluation of youth with their hedonistic cult, the delusional obsession with the politically cultivated image is the most relevant social factor contributing to this collective desire for eternal adolescence.

Secondly, individual motivations: the pace of biological degradation, usually faster than psychological deterioration, results in a lagged and aging real image of self-consciousness, the need to compete professionally and sexually in order to feel a new object of desire and finally the refusal of the idea of death.

We should focus only on those that we consider to be the most effective and lasting techniques to attenuate and counteract the marks of facial aging – cervico-facial rhytidoplasty and blepharoplasty showing clinical cases from our experience addressing the appropriate choice for each patient and each face. as well as the details to avoid iatrogenic sequelae and stigmas.

Attention should be given to unrealistic expectations with thorough clarification eliminating risks such as heavy smokers and psychiatric patients.

Finally, we must talk about the main complications and disappointments of these interventions from the point of view of the surgeon and the patient.

The longevity of our species has its genetically predetermined biological limit (Telomeres), but there is no consensus theory that explains aging that makes us all a being for death.

Until a factor or set of factors can act upon this relentless biological clock, Aesthetic Surgery is a legitimate transitional solution for living better with what we are becoming.

Complications of Plastic Surgery of the face are not frequent. Hematoma (accumulation of blood under the skin), infection, bleeding and reactions to anesthesia. Some incisions may be visible due to variations in healing and may need to be retouched. Temporary injury to nerves controlling the muscles of the face or tenderness is rarely permanent. Asymmetry and change in the hair implantation line.

This intervention does not correct wrinkles around the mouth. The choice of technique depends on the thickness, texture and elasticity of the skin, the intensity of wrinkles and furrows. Overexposure to the sun will often produce more wrinkles and face lift will have to be combined with a laser resurfacing to eliminate them. The choice of incision site will depend on the hair implant line. Another procedure commonly associated with facial plastic surgery is nose rejuvenation (see Rhinoplasty). Smokers should decrease or even stop before surgery. You should avoid taking aspirin, which can cause bruising. Drains can be used to prevent fluid buildup. Recovery varies greatly. Sleeping with your head elevated helps decrease swelling and bruising and drains are removed in one to two days. Temporary asymmetry is normal and can be caused by swelling and bruising. Bruising should disappear within two to three weeks. Corrective makeup can be applied within a few days. Numbness can last for several weeks. Sun exposure is only allowed after the first month. It takes several weeks to evaluate the new look. Some men may have to shave behind their ears where shaved skin goes.

Duration of Results:
Usually 7 to 12 years.

Mentoplasty aims to increase the projection and / or contour of the chin by introducing an implant or reducing the projection of the chin. It is surgery often associated with plastic surgery of the nose, liposuction of the neck or surgery of the face, to harmonize the facial profile. The implants may be silicone, bone or synthetic material.

The surgery takes about 60 minutes. 

Local or general anesthesia and may be ambulatory. 

Facial edema may occur, lasting for 1 to 2 weeks and the first results occur in the first weeks and are permanent.

Otoplasty aims to correct aesthetic imperfections of the ears such as the so-called flappy ears.

This type of defect is quite common and has very negative psychological effects, especially in children. Because of this, the ideal age for an otoplasty is 5 to 7 years, when the ears are already formed and practically their final size.

Aspirin or any acetyl salicylic acid-based formula should not be used for at least 10 days before surgery. The ears and hair should be washed thoroughly on the eve of the surgery. If long, the hair should not be cut before the operation as it will help to disguise in the early days.

Surgical procedure
An incision is made behind the ear where excess skin is removed and cartilage is shaped or removed to correct any defective contours. The cartilage is then sutured to a position within normal standards.

Otoplasty is a technically simple surgery but requires a thorough work. The scars are almost invisible, located in the groove between the ear and the mastoid.

In general, local anesthesia associated with a mild sedative is used. General anesthesia may be recommended in some cases.


Postoperative pain may occur after otoplasty. If it occurs, a common painkiller solves the problem. A dressing held for a period of five to seven days is placed over the ears during which one should avoid lying on his side. After removing the dressing, the patient should wear a sleeping cap for at least one month. Stitches are removed on the 10th or 12th day after surgery. It is recommended to avoid prolonged sun exposure in the first month. Although the immediate effect is satisfactory, the definitive result of ear plastic surgery can only be seen around the sixth month.

Rhinoplasty is the name of plastic surgery on the nose. This surgery is performed on the nasal structure in order to improve the aesthetics or breathing of the individual. It serves to correct traumatic or natural deformities and also to correct dysfunctions. Often Nose Plastic Surgery is associated with a Mentoplasty, so that the result produces a greater harmony with the face shapes (Profileoplasty).

Plastic surgery on the nose usually takes 1-2 hours, although in more delicate procedures it may take a little longer

Maybe local or general.

In plastic surgery on the nose, the skin of the nose is separated from the bone and cartilage structure, which is then sculpted into the desired shape. The nature of the sculpture will depend on your problem and the surgeon’s preferred technique, sometimes we perform rhinoplasty inside the nose (closed), sometimes and increasingly often opt for an “open” procedure, especially in more complicated or complicated cases. secondary rhinoplasty.

Finally, the skin is readjusted over the new osteo-cartilaginous outline, and a splint is applied to help the nose maintain its new shape. Internal nasal plugs are also used. Plastic surgery in the nose is advised only to patients over 18 years old, except in case of respiratory complications or congenital malformations. Prior to this age Plastic nose surgery is not indicated because facial structures change with growth and it is advisable to wait for definitive development before undergoing corrective surgery.


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Medical Offices

Dr. António Gomes da Silva is available for consultation at various locations, contact us and check availability.

Europa Clinic
Rua de Catembe, 165
2775-561 Carcavelos, Portugal

Phone: 214 569 800
Consults: Friday from 15:00 to 19:00

Personal Derma
Av. António Augusto de Aguiar nº110 C
1050-019 Lisboa, Portugal

Phone: 211 633 439
Consults: Wendsday from 15:00 to 18:00


We believe that a well-informed patient with honest advice makes the best decisions. We provide each patient with individual attention, with beautiful and natural results.