While all people are different, none of us can completely escape the effects of aging, sun exposure, and gravity on our faces and skin. As a person ages, the fullness and elasticity of the skin diminish and facial tissues droop, often in cosmetically unappealing ways. Because an aged face can camouflage someone who is truly young at heart, many otherwise healthy people appear “fatigued” and say that they look older than they feel. Fortunately, there are a number of procedures that can help restore youth and vitality to the face. Among these are face lift (rhytidectomy), eyelid lift (blepharoplasty), nose reshaping (rhinoplasty), and lip augmentation

Gummy Smiles

I often have patients ask me “What can I do about my smile? I see too much of my upper gums when I smile and can’t seem to fix it!” For those who don’t suffer from this problem I know it may seem like a minor issue, but being self-conscious about one’s appearance when that person is supposedly at their happiest can cause numerous self-esteem issues.

Before/After Surgery

premouth 2 post1 mouth 2

What causes Excessive Upper Gingival Show, AKA a “gummy smile”? There are several factors that can cause this appearance. An abnormal eruption of your teeth, wherein the teeth push through the gums in an unusual manner, is one cause. Your teeth can also be covered by excessive gum tissue, which makes them appear short, regardless of their actual size. For many patients, however, the muscles controlling your upper lip are hyperactive thus forcing your upper lip to rise further than normal with an attempted smile. This hyperactivity causes your gums to become exposed more than the normal amount.

Fortunately, for this latter group there is now a relatively simple and straightforward way to deal with the problem of excessive upper gingival show. This treatment involves no surgery, only 2-4 Botox injections that take about 5 minutes to perform and can be safely done over your lunch break. The treatment effects typically last several months and can be repeated as necessary. The Botox works by relaxing some of the hyperactive smile muscles thus allowing your lip to rise more naturally and producing a result that you can be happy with. It will really give you something to smile about!


faceliftThere are very few surgical procedures that compare to the rejuvenating effects of a facelift. Incisions are usually made within the hairline or along the hair margin above the ear and extend around the earlobe to the hairline behind the ear. The tissue layers beneath the skin, including the neck muscles are tightened, excess fat can be trimmed or repositioned, and the excess skin and soft tissue removed. The final result is usually evident within 4-6 weeks,but can be seen sooner and patients often see continued improvement for several months thereafter. While the results of facelift surgery can be quite dramatic, Dr. Peled, makes every effort to ensure that the final outcome is a more youthful, natural-looking face.

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Eyelid surgery (blepharoplasty)

GreenSagging eyelids or puffiness below the eyes can cause many people to looked tired and appear older than they feel. Eyelid rejuvenation surgery (blepharoplasty) is a relatively straightforward procedure that can have a remarkable effect on aging eyes for both men and women. The procedure is usually performed on an outpatient basis under either local anesthesia or IV sedation. Incisions are placed below the lash lines (lower eyelid) and in the skin crease of the eyelid (upper eyelid) so as to “hide” them. During eyelid rejuvenation surgery, the excess skin and fat that cause the "tired" look of the eyes are removed and the tissues are tightened as necessary to produce a more youthful, vibrant appearance. Swelling and bruising can be obvious initially, but usually resolve over a period of 1-2 weeks. Post operative pain is usually minimal. During this time, the swelling and bruising can easily be camouflaged with makeup. Patients can usually return to work in about one week and begin exercising two weeks after the procedure. As with any aesthetic surgical procedure, Dr. Peled strives for a result that appears natural leaving the patient with a “refreshed” look.

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Nasal Reshaping (rhinoplasty)

Male1The nose has often been referred to as the dominant feature of the face. This characterization likely comes not only because of it’s location at the center of the face, but also because it is the feature that projects the most from the facial planes. As a result, when a nose is out of proportion with the other facial features, it can distract from an otherwise beautiful face. Nasal reshaping or rhinoplasty can address many aspects of the nose such as wide nostrils, a bumpy nasal bridge, an overly “long” nose, and an unusual-looking tip. In doing so, the goal is always to re-establish the facial proportions and deemphasize a prominent nose. Rhinoplasty is performed in an outpatient setting using a general anesthetic. A temporary splint (plastic cover) is placed on the nose for approximately one week after the operation and packing of the nose is usually not required. A small amount of pain is common, but the swelling and bruising can sometimes be significant for up to two weeks depending on the degree of nasal re-shaping performed. Blowing of the nose or strenuous activity is prohibited for 14 days, but easy exercise is permitted at two weeks. More strenuous activity is not permitted until 4-6 weeks after the procedure. Final results are evaluated 6-12 months from the time of surgery.

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Ear Reshaping (otoplasty)

Ear01Prominent ears can often make people feel self-conscious about their appearance. In particular, younger children are often teased during school as a result of their ears “sticking out too much”. Setting back the ears or (setback otoplasty) is a safe and effective procedure that addresses this problem. It too is performed as an outpatient procedure under general anesthesia. The incisions are placed behind the ears and hence are relatively “invisible”, even when the hair is worn up. A bandage is worn for about one week after the procedure. Younger patients may not engage in sports, any contact activities or swimming for two months. Adults may exercise as early as 14 days after their surgery.

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For additional information about the surgical procedures discussed on this page, please contact our office."


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