A Facelift is a surgical procedure that improves the visible signs of aging in
the face and neck. It specifically targets the lower third of the face and neck
where it can: improve jowls and tighten the jawline, remove loose skin and
excess fat in the neck (“turkey neck”), improve vertical lines that extend from
the outer corners of the mouth (“marionette lines”), and also improve the
nasolabial folds that run from each side of the nose to the corners of the
mouth (“smile lines” or “laugh lines”) in most patients.
Dr. Koch performs the state-of-the-art “Vertical SMAS Facelift” to fully
address the aging lower face and neck. He believes that there is no better
treatment available for these aging issues. He also performs a “Mini-Facelift”
in select patients which has less downtime. In either case, Dr. Koch performs
these in the office setting with local anesthetic and oral sedation, and uses
inconspicuous incisions while preserving the hair. He also has significant
experience doing male and revision facelifts. It should be noted that Dr. Koch
has trained the most physicians in the in-office facelift in the country
A Necklift, also performed in the office setting, is a surgical procedure that
improves the visible signs of aging in the neck. Depending upon the patient’s
condition and desires, it may include neck fat removal (liposuction), removal
of loose skin (submentoplasty), or reducing the appearance of neck cords aka
platysmal bands (platysmaplasty).
A Browlift is a surgical procedure that improves the visible signs of aging in
the forehead and eyebrow. It can: raise sagging brows that are hooding the
upper eyelids, reduce the wrinkle lines that develop horizontally across the
forehead and the vertical creases that develop between the eyebrows (“the
elevens”), and places the eyebrows in a more alert and youthful position. Dr.
Koch performs all conventional browlift techniques including,
Lateral/Temporal, Direct, Mid-Forehead, Coronal, and Endoscopic Browlift.
Some of the browlift techniques are performed in-office, and the one used
depends upon the patient’s condition and desires.
Blepharoplasty or eyelift, also performed in the office setting, is a surgical
procedure to improve the appearance of the eyelids. Surgery can be
performed on the upper lids, lower lids, or both where it can: remove loose or
sagging eyelid skin which can lead to a tired appearance, remove fat deposits
or lower eyelid bags, and improve fine wrinkles of the lower eyelid. Dr. Koch
uses his vast experience to perform the appropriate technique for each
patient. This includes “transconjunctival blepharoplasty” which removes fat
pads from the lower eyelids without any external incisions.
A Rhinoplasty or “nose reshaping” is a surgical procedure to improve the
appearance of the nose. It can treat: size to achieve facial balance, profile with
visible humps or depressions on the bridge, a tip that is enlarged or bulbous,
drooping, upturned or hooked, and nostril position. It can also correct
impaired breathing caused by structural defects in the nose such as a deviated
septum (Septoplasty, Turbinate Reduction). Dr. Koch performs both primary
and revision rhinoplasties, and uses endonasal (all in the nose) and open
techniques depending upon the patient’s conditions and desires. Rhinoplasty
and septoplasty are usually performed at the ambulatory surgery center
where patients go home after the procedure.
Skin resurfacing and rejuvenation is a non-invasive procedure that utilizes
various lasers and radiofrequency devices to achieve improvement in skin
texture irregularities like wrinkles and acne scars, pigmentation changes like
freckles and sunspots, or visible blood vessels. Also, as skin loses tone and
becomes less firm with the aging process, these devices can stimulate new
collagen, elastin, and hyaluronic acid production. Dr. Koch also performs
Fractional Radiofrequency Microneedling which is a device with fine pins
which creates tiny, painless punctures in the top layer of the skin. This
stimulates the body to create new collagen and elastin. Results include
improved texture and firmness, as well as a smoother skin surface.
These non-invasive procedures are performed in the office and are frequently
done in conjunction with surgical procedures such as facelift and
blepharoplasty. Different treatment modalities are available to treat different
aspects of skin damage, so the specific type of treatment is best determined
after an in-person consultation. Dr. Koch is a recognized expert in skin
resurfacing and rejuvenation, and recently published the medical textbook
“Non-Invasive Cosmetic Procedures.” He also performs BOTOX ® and Wrinkle
filler injections (such as JUVÉDERM ® ) as part of his non-invasive procedures.
Dr. Koch also performs other facial cosmetic and reconstructive procedures,
most of them in the office setting, and these include: Facial Scar Revision,
Otoplasty (“Ear Pinning”), Facial Lesion Removal such as moles, Facial Skin
Cancer Reconstruction, Facial Fat Grafting, and Earlobe Repair.