Practice Name

Specialty

City, State

Phone

PROCEDURES

Oral, Facial and Implant Surgery

Serving Northern Virginia McLean, Great Falls, Tysons Corner, Pimmit Hills, Fairfax, Falls Church, Arlington, Alexandria, Langley, Vienna, Reston, and Herndon

Michael Timothy Gocke, DDS, PC

Facial Cosmetic Surgery

We offer the following types of facial cosmetic surgery:

Blepharoplasty

We can perform blepharoplasty to correct sagging eyelids, bags or pouches beneath the eyes, as well as excess folds around the eyes. This surgical procedure involves the removal of excess skin and fat on upper and lower eyelids and is often performed in conjunction with other surgical procedures. Blepharoplasty can be done under general anesthesia (with you asleep) or under IV Sedation. Both are very comfortable options. Pre-medication is utilized prior to surgery to decrease swelling after the operation.

Dr. Gocke will trace the natural lines and creases of your face and make incredibly fine incisions from the inner to the outer edge of the eyelid. Surgery on the upper eyelid is performed first with the incision made in the fold of the lid. The incision is made below the eyelash on the lower eyelid. Any excess fat and skin are removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is applied to the area. Small sutures are used to close the incision and special ointments and dressings may be applied. The surgery can take up to 2 hours. In certain cases, lower eyelid incisions are made inside the lid.

Post-Operative Information

Initially, drying of the eyes can occur after blepharoplasty. It is important to use the V eye drops as prescribed by Dr. Gocke. The m-cision line must be cleaned 2 times per day with 50% Peroxide and water mixture. Then apply the prescribed ointment. Cold eye masks given to you at surgery should be used for 24 hours (30 mins on 30 mins off.)

Browlift

Dr. Gocke performs brow and forehead lifts to raise eyebrows and reduce ridges and furrows on the forehead, creating a smoother, more youthful appearance. This procedure can be performed in conjunction with other surgeries.

An incision is generally made across the top of the head from the front of one ear to the front of the other ear. The forehead and brows are elevated and excess skin is removed. The flap is then sutured. Newer techniques now allow us to perform forehead lifting through small incisions in the scalp by using an endoscope and specialized instruments. This accelerates the healing process.

Post-Operative Information

Antibiotics may be prescribed for several days following surgery. Sutures are generally removed within one week. Swelling and some bruising may occur which should subside within a few weeks. Our doctors will prescribe ice compresses and eye exercises to reduce swelling and regain mobility. Women will be allowed to use eye cosmetics up to two weeks after surgery. You can proceed with your normal daily activities within 1 to 2 weeks. A final evaluation may occur within several months from the initial surgical procedure.

Rhinoplasty / Septoplasty

Dr. Gocke performs Rhinoplasty in order to improve nasal breathing or to reshape the nose. Appearance can be improved for those people who are dissatisfied with the shape and size of their nose. Nasal reconstruction was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure in which deformities of the nose are corrected by removing, rearranging or reshaping bone or cartilage.

Before Surgery

A medical history along with a careful examination is conducted in order to evaluate your general health. We will discuss with you the way your nose can look in relation to your other facial features. Digital Photographs and computer imaging allow Dr. Gocke to evaluate the appropriate procedure to achieve the desired results. Pre-operative instructions may include eliminating certain drugs that contain aspirin to minimize the possibility of excess bleeding. Antibiotics may be prescribed before surgery to prevent infection.

Method of Surgery

Surgery is usually performed under IV sedation, which is both extremely comfortable and results in less swelling and bruising than general anesthesia. In most cases involving a reduction in shape or size of the nose, angle or removal of a hump, the skin of the nose is separated from the underlying skeleton of bone and cartilage. The bone and cartilage are then reshaped and the skin re-draped over the surface. Patients who have a deviated septum may benefit by correction of this problem. The incisions are placed inside the nose, unless the surgeon uses an open approach, in which case the incisions are made across the columella (the tissue between the nostrils). In cases where the nostrils flare, the surgeon may make an incision at the junction between the nose and the skin of the upper lip to narrow the flared appearance. It is not unusual to combine rhinoplasty with chin augmentation to improve the profile.

Post-Operative Information

The recovery takes one to two weeks. Most people resume their normal activities within a week or two. Following surgery, a lightweight splint is applied to maintain the new shape of the nose. The splint is removed within a week. Nasal splints may be inserted at the time of surgery to protect the septum. These are removed within a week. There is always some stuffiness of the nose, especially when work has been done on the nasal septum.

Pain is minimal and is controlled with medications. Bruising occurs around the eyes and begins to fade within a few days. Discoloration usually disappears in two weeks.

BOTOX® Cosmetic

BOTOX® Cosmetic treatment is a revolutionary approach to reversing the affects of facial wrinkles. Crows feet, worry lines and laugh lines can all be a thing of the past. These are referred to as dynamic wrinkle lines and all are treatable with this procedure. Cosmetic denervation is the process of injecting botox into the tiny facial muscles that create the wrinkles.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes is made in order to decide the most effective injection sites. All issues and concerns will be discussed.

The areas that will be treated are marked and digital photographs are taken in order to determine the amount of improvement after surgery.

The BOTOX® Cosmetic Procedure

BOTOX® Cosmetic injections are performed without anesthesia because they are virtually painless. Only a very small sting is felt when the injections are made. The effects are not permanent and may need to be repeated two to three times per year to retain the effects. Research has suggested, however, that long-term use of the injections leads to a longer duration of each treatment's effect. Patients over the age of 65 may not experience such dramatic results. BOTOX® Cosmetic is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

Post-Operative Information

After the operation patients may experience slight bruising around the area that quickly fades. Normal activities can be performed immediately. Possible side effects are temporary weakness of nearby muscles or in rare cases an eyelid may droop. BOTOX® Cosmetic is completely reversible so any side effect is only a temporary condition. The doctor will explain all risks associated at the time of your consultation.

Juvéderm® and Radiesse®

What Is Juvéderm® Injectable Gel?

As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But with Juvéderm® injectable gel, you don't have to just sit back and let it happen!

juvederm

Juvéderm® is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Dr. Gocke eases Juvéderm® injectable gel under the skin to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).

Juvéderm® provides a smooth, natural look and feel—so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm® compared to a collagen-based dermal filler.†

  • Almost 90% of all study volunteers who were treated with both Juvéderm® injectable gel and another dermal filler† preferred Juvéderm®!

  • Juvéderm® injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color.

Immediate Results

With Juvéderm® the injection process takes only about 15 minutes and results are immediate. Plus, there's minimal recovery or downtime. So you can step into your doctor's office for treatment and step right back into your life.

*Juvéderm® is indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabia folds).

Important Juvéderm® Treatment Considerations

Juvéderm® Ultra and Juvéderm® Ultra Plus are indicated for injection into the mid to deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). Side effects were usually mild to moderate lasting 7 days or less and included temporary injection site reactions like redness, pain, firmness, swelling and bumps. For more information, please click on the "About Safety" link, or call Allergan Product Support line at 1-877-345-5372.