COSMETIC SURGERY PROCEDURES

Body Contouring            Facial Cosmetic Surgery

Abdominoplasty           Blepharoplasty

Abdominoplasty                      Blepharoplasty

Breast Augmentation               Face/Neck Lift

Breast Lift                                Rhinoplasty

Breast Reduction   Buttock Implant

Liposuction – Liposculpture

Upper Arm Lift

The following descriptions are fromThe American Academy of Cosmetic SurgeryAbdominoplasty (Tummy Tuck)Abdominoplasty (tummy tuck) is an operation that is designed to reshape the abdomen . Often, through weight gain and loss, pregnancies and aging, the skin stretches beyond its elastic limit or ability to return to normal shape. An abdominoplasty removes excess skin and fat while the underlying muscles are tightened.The actual placement of incisions and design of the abdominal incisions vary depending on the looseness of the underlying tissues, the amount of fat to be removed, the condition of the overlying skin and prior scars.For those women where the sagging skin is mainly in the lower abdomen the mini-abdominoplasty is an additional option. This procedure is not as extensive due to a smaller incision that is easily hidden under a two piece bathing suit. This procedure offers a more rapid recovery and may be done on an outpatient basis.Who is a Candidate?

  • Women with loose or sagging abdominal wall skin.
  • Women with abnormal relaxation of the anterior (front) abdominal wall muscles due to weight gain or loss, pregnancies, or prior surgery.
  • Those who are unable to tighten the abdominal wall skin with exercise.

Intended Results

  • A smoother flatter abdomen.

Procedure Description

  • The procedure is usually performed at an accredited outpatient facility or hospital.
  • Anesthetic options include local anesthesia with oral sedation, conscious sedation and general anesthesia.
  • Mini-abdominoplasty can usually be performed under conscious sedation on an outpatient basis.
  • Standard abdominoplasty tightens all of the abdominal wall skin leaving a standard scar.
  • Mini-abdominoplasty tightens the lower abdominal wall skin only leaving a shorter scar.
  • Small suction drains may be inserted with both procedures.

Recuperation and Healing

  • Discomfort is usually controlled with oral medications or nasal spray.
  • Recovery may be at home with a responsible adult caregiver, at a supervised recovery facility or at the hospital with an overnight stay.
  • If placed, drains are removed in 2-7 days.
  • Sutures are usually removed in 2-3 weeks.
  • A compression garment with dressings over the incision sites is used.
  • Light activity may be resumed in 7-21 days. Sports will probably not be comfortable for about 6 weeks.
  • An abdominal binder (compression garment) is usually worn for 4-6 weeks.

Other Options

  • Liposuction-liposculpture of the area.

Note

  • The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Breast AugmentationBreast enlargement, known as augmentation mammoplasty, can enhance the body contour of a woman who is unhappy with her breast size. This procedure may also be used to improve the loss of breast volume following pregnancy and nursing. Additionally, the operation may help balance breast asymmetries. Saline filled or the newly FDA approved silicone gel implants may be surgically implanted by three standard routes with placement either above or below the chest muscle. The standard routes are periareolar (around the areola), inframammary (lower breast folds) and transaxillary (arm pits). Also, saline implants may be placed transumbilically (via the navel).The implant is composed of an outer flexible, silicone shell and filled with either saline or silicone gel. The outer surface may be smooth or textured. Implants also have various sizes, profiles and shapes to meet the individual needs of each woman.While breast augmentation will enlarge the breasts, the surgery will not alter underlying basic defects in breast shape and form. Major asymmetries may be improved but will not be completely corrected with breast enlargement alone. A noticeable difference in the size, shape or orientation of the two breasts is considered normal and is actually the rule. If breast size and/or nipple position asymmetries are severe, additional procedures to further improve symmetry may be necessary.Long term experience with breast enhancement surgery has demonstrated that this operation has a high patient satisfaction rate.Who is a Candidate?

  • Women who want larger breasts.
  • Women who want to improve their breast shape.
  • Healthy women without connective tissue diseases.
  • Healthy women without breast malignancy.

Intended Results

  • Larger and shapelier breasts.
  • Less asymmetry and size difference.

Procedure Description

  • Breast Augmentation is usually performed in an accredited outpatient surgical facility under general anesthesia or conscious sedation with local anesthesia.
  • Surgical scar(s) are usually hidden as much as possible in skin folds.
  • Saline or silicone implants may be placed either above or below the chest muscle.

Recuperation and Healing

  • Discomfort is controlled with oral medications and long-acting local anesthesia.
  • A soft bra or compression garment is usually worn for several days postoperatively.
  • Patients are usually discharged to the care of a responsible adult and recover at home.
  • All sutures are usually removed in 1-2 weeks.
  • Light activity may be resumed in 7 days. Sports activities may be resumed in 3-6 weeks (depending on your surgeon).

Other Options

  • Breast lift — if sagging is an issue.
  • Areolar reduction.

Note

  • The specific risks and suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Breast LiftAs women age, the breasts lose shape and firmness. The skin gradually loses its elasticity and no longer holds the breasts in a youthful, upright position. Pregnancy, breast feeding, weight gain and loss also add to the tissue burden of loss of skin elasticity. Women who have sagging breasts (ptosis) my benefit from breast lift (mastopexy). If there are also problems of excess volume or size of the breasts, a reduction may also be done at the same time. Volume loss may be corrected by breast augmentation at the same time. Asymmetries may also be improved.Excess skin is removed, the nipple areolar (dark skin around the nipple) complex is lifted and the breasts are recontoured to create a more youthful appearance with firmer breasts. Depending on preoperative size, appearance and assymetries, the nipple areolar complexes may also be reduced. There are incisions made directly on the breasts which may extend around the nipple areolar complex, into the front of the breast and into the breast fold, depending on the degree of droop, asymmetry and volume considerations.Who is a Candidate?

  • Women who have sagging breasts.
  • Women who want to improve their breast shape.
  • Healthy women without underlying breast disease.
  • Women who will tolerate breast scars.

Intended Results

  • Higher breasts (lifted).
  • Tighter breast envelope (increased skin tightness).
  • Improved breast symmetry.
  • More pleasing breast shape.
  • More youthful appearance.

Procedure Description

  • Mastopexy operations are usually performed in an accredited outpatient surgical facility under general anesthesia or conscious sedation with local anesthesia.
  • There are several types of mastopexy procedures depending on the severity of ptosis (breast droop). In most cases incisions are made around the nipple areolar complex and in front of the breasts. Sometimes they may extend into the breast fold.
  • The nipple areolar complex is lifted to a more youthful position.

Recuperation and Healing

  • Postoperative discomfort is usually controlled with oral medications and long-acting local anesthesia.
  • A soft bra or compression garment is usually worn for at least several days postoperatively.
  • A postoperative care facility or closely monitored overnight home care is standard practice.
  • The patient may be seen the next day.
  • External sutures are usually removed between 2-3 weeks after surgery.
  • Light activity may be resumed in 7 to 10 days. Sports activities may be resumed in 6 weeks (depending on your cosmetic surgeon).

Other Options

  • Breast reduction or breast augmentation may be required with your mastopexy for the best results.
  • Breast contouring may be appropriate with mastopexy (speak to your cosmetic surgeon).

Note

  • The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation with your cosmetic surgeon. A standard mastopexy always requires the placement of surgical incisions on the breasts. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occasionally occur. Major complications are rare.

Breast ReductionBreast reduction is designed to reduce the size of a woman’s breasts. It may also improve the overall appearance or shape of the breast and help balance breast asymmetries. It helps in treatment of physical complaints such as neck, shoulder and back pain experienced by many women with large breasts.Skin, along with breast tissue and fat are removed to create smaller, shapelier breasts. An added benefit where ptosis (droop) exists is a simultaneous uplift of the nipple areolar complex to a more normal position. The areolae (darker skin which surrounds the nipple) may also be reduced in size and made more symmetric.Who is a Candidate?

  • Patients who want smaller breasts.
  • Patients with extensive breast asymmetry.
  • Healthy patients without breast cancer.
  • Patients who possess realistic expectations.
  • Patients who will tolerate breast scars.
  • Patients who complain of chronic neck, shoulder and back pain from excessive breast size.
  • Patients with large breasts who experience chronic skin irritation along their bra straps and under the breast folds.

Intended Results

  • Smaller breast size.
  • Improved breast contour.

Procedure Description

  • Breast reduction is performed in an accredited outpatient surgical facility or in the hospital under general anesthesia or conscious sedation with local anesthesia.
  • Depending on several factors, breast reductions are performed using surgical techniques that preserve breast tissue and maintain a healthy blood supply to the breasts.
  • Various external skin envelope closures are available which will determine the placement and size of your postoperative scars (talk to your cosmetic surgeon).
  • A drain may be inserted at the time of surgery.
  • Breast tissue is usually submitted for biopsy (pathologist examines).

Recuperation and Healing

  • Postoperative discomfort is controlled with oral medications or pain pump.
  • Surgical drains may be present after the surgery. Your cosmetic surgeon will determine when these are to be removed.
  • A special postoperative support bra may be worn after surgery for several weeks.
  • Postoperative care the first night may be at home with a responsible adult, an overnight care facility, or overnight at the hospital.
  • The patient may be seen the next day for evaluation.
  • Sutures will remain in place and are removed at an appropriate time as determined by your cosmetic surgeon (usually 2-3 weeks).
  • Light activity may usually resume in less than 10 days. Sports activities may be resumed in six weeks or longer (depending on your surgeon’s advice).

Other Options

  • Breast volume reduction by breast fat liposuction-liposculpture.
  • Breast contouring using breast skin resection with or without liposculpture .

Note

  • The specific risks and suitability of this procedure for a given individual can only be determined at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications that do no affect the outcome occur occasionally. Major complications are rare.

Buttock ImplantsThese procedures are for the individual who is unable to develop proportionate Gluteal muscles, lacks buttock fat, or simply desires more augmentation in the buttock area. The buttocks are augmented with the use of implants specifically designed for such a use or with your own fat, if applicable. Weightlifters sometimes request buttock implants to augment underdeveloped gluteus muscles to give a more balanced look as they have less actual body fat percentage to liposuction and re-inject. Buttock implants and buttock augmentation with fat grafting are for anyone who would like more curves where they have none.  Brachioplasty (Arm Lift)Loss of skin elasticity in the upper arm is a problem that can be seen with increasing age or after significant weight loss.The primary method to tighten the skin of the upper arm and remove excess fat is called a brachioplasty. The most common way this is done is by an incision that extends from the armpit to the elbow located on the inner arm or on the back of the arm. This technique allows for maximum skin and fat removal. Variants of this technique may use a less extensive incision where less skin and fat removal is necessary. Your cosmetic surgeon will review your situation and recommend the appropriate incision type for you.Who is a Candidate?

  • Men and women who are in good health
  • Men and women who have moderate to severe skin laxity of the upper arms
  • Patients after significant amount of weight loss from dieting and/or surgery such as lap band or Gastric Bypass

Intended Results

  • Improved contour of the upper arm.
  • Decreased size of the upper arm by removal of excess skin and fat
  • Decreased skin laxity of the upper arm by tightening the skin envelop

Procedure Description

  • Arm reduction is usually performed in an accredited office facility, outpatient surgical facility or in the hospital.
  • The surgery may be performed under general anesthesia or local anesthesia with conscious sedation.
  • Liposuction is performed on the arm if significant fat removal is required,
  • An incision is usually made in the armpit extending to the elbow on the inner arm.
  • Excess skin is removed and the incision is closed with sutures.
  • Drain use is variable.
  • The arms are usually wrapped with an elastic dressing.

Recuperation and Healing

  • Recovery may be at home with a responsible adult, in a recovery facility or overnight in the hospital.
  • A compression garment may be worn on the arms for approximately two weeks.
  • Bruising and swelling are normal and may take several weeks to resolve.
  • Stiffness of the arms, especially when bending is common and usually resolves within a few months.
  • Areas of numbness of the upper and lower arm are normal and usually resolve within a few months.
  • Sutures or staples are usually removed within two weeks.
  • Drains, if used are usually removed in less than 7 days after the procedure.
  • The incisions can be treated with scar creams and ointments.
  • The scar will take 8 -12 months to look its best.

Liposuction — LiposculptureLiposuction, commonly known as liposculpture, involves removing unwanted subcutaneous fat while simultaneously recontouring to create a more aesthetically appealing body.While not a treatment for obesity, liposuction- liposculpture selectively removes persistent and unwanted subcutaneous fat.Bothersome fatty deposits are found in areas that are resistant to diet and exercise, such as the face, neck, breast, abdomen, upper arm, hips, thighs, knees, and ankles. Liposuction-liposculpture can be performed on multiple areas at one time – your surgeon will follow accepted guidelines regarding safe volumes which may be removed in one session.While goals include size improvement, this procedure is not for weight loss. Final results may not be evident for 6 months following your procedure. During this time your body balances fluids and the skin and remodels underlying tissues. Final results also depend on proper nutrition, exercise and decreasing your caloric intake.Small incisions are made in hair bearing areas or natural skin folds. A special tumescent solution is next placed within the fatty areas to be removed. This solution provides anesthesia to the areas, while limiting the usual blood loss. Fat is then carefully removed from the areas of concern to the patient using a surgical instrument called a cannula, which is attached with tubing to a suction machine.The time for completion of the procedure depends upon the total amount of fatty tissue removed. At the end of the procedure, the skin openings may be sutured or left open to heal, depending on the size of the openings. The patient may be placed in a compression garment that is worn for certain amount of time afterwards.While recovery is easy, you should expect some initial drainage along with swelling, bruising and discomfort. Your compression garment will minimize the swelling, bruising, discomfort and assist in the retraction of any loose skin.While some results are noted immediately, your final shape and form will continue to improve as your swelling subsides. You will be encouraged to be up and about the night of your surgery and progressively increase your activities. Usually light work duties may be resumed within three to five days and vigorous exercise within two to four weeks.Who Is A Candidate?

  • Women and men desiring an improved facial, neck, breast, body or leg shape.
  • Patients of most ages who are healthy.
  • Patients who realize that this is not a weight loss procedure.

Procedure Description

  • Liposuction-liposculpture is usually performed under local or conscious sedation, in an approved outpatient facility.
  • The incisions are small and heal with minimal scars.
  • Patients may be placed in a special support (compression) garment at the end of the procedure.

Recuperation And Healing

  • You will be discharged home to the care of a responsible adult.
  • You are encouraged to be up and about the first night.
  • Some blood tinged drainage is expected for usually the first several days.
  • Light household duties may be resumed in several days.
  • Most patients resume standard pre-operative activities with 2 to 4 weeks after their surgery.

Other Options

  • Laser assisted liposcuction-liposculpture.
  • Vaser and ultrasonic assisted liposcuction-liposculpture.

Notes

  • The specific risks and suitability of this procedure for a given individual can only be fully determined at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications which do not affect the overall cosmetic results occur occasionally. Major complications are rare.

Eyelid Lift (Blepharoplasty)The eyelid lift or blepharoplasty is a procedure designed to remove excess fat and skin from the upper and lower eyelids. It improves droopy eyelids and puffy bags below the eyes, features that may make you look older and more tired than you feel. It may be combined with an eyebrow lift to correct drooping eyebrows.The incision for the upper eyelid is usually made along the eyelid crease. The incision for the lower eyelid may be made inside the lower eyelid, avoiding external scars (transconjunctival) or externally just below the eyelashes. Excess skin along the outside of the lower eyelid region may be “tightened” with a chemical peel or ablative laser.Who is a Candidate?

  • If you have excessive, sagging or wrinkled upper or lower eyelid skin.
  • If you have excess upper eyelid skin that interferes with vision.
  • If you have lost your natural upper eyelid crease.
  • If you have puffy pouches of fat in the upper or lower eyelids that create a tired or aged appearance.

Intended Result

  • A more youthful and rested appearance of the eyes.
  • Widening of visual fields if excessive upper eyelid skin has partially blocked vision.

Procedure Description

  • The operation is usually done on an outpatient basis under local anesthesia alone or conscious sedation.
  • Either a “Colorado” needle or scalpel is used for skin incisions to minimize scar and bleeding during the procedure.
  • The incisions are made where the natural crease should be in the upper eyelids. Excess fat and skin are removed.
  • The incision for the lower eyelids is usually inside the lower lids, avoiding external incisions and scar (transconjunctival).
  • If there is significant “laxity” of the lower eyelid, a canthopexy or tightening procedure may be done at the same time. The incision is along the outer portion of the lid just below the eyelash line.

Recuperation and Healing

  • All sutures are usually removed within 7 days.
  • Initial discomfort is usually mild and controlled with oral medication.
  • Bruising and sensitivity to light usually subside within 1-2 weeks.
  • Swelling usually disappears within 2 weeks.
  • Eye makeup may be used following suture removal and healing of the incisions. Old makeup should be discarded as it may promote bacterial growth and postoperative infection.
  • Contact lenses can be worn when comfortable and sutures have been removed-usually 7-10 days.

Other Options

  • Additional procedures that may enhance the result are: forehead lift (endo eyebrow lift), facelift, carbon dioxide laser resurfacing, chemical peel, and Botox.

Notes

  • The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Face/Neck LiftSkin of the face and neck lose elasticity as one ages. Underlying muscles also lose tone. This is magnified through sun exposure, weight gain or loss, gravity and stress. These factors may act together and accentuate the appearance of wrinkles, creating a tired look.A facelift-necklift helps improve the most visible signs of aging through removal and redistributing excess fatty deposits, tightening underlying muscles and removing sagging skin. The standard facelift addresses the lower 1/3 of the face and the upper neck.Variants include the mini and extended facelift-necklift procedures. Procedure choice depends on your needs and must be discussed with your surgeon. Surgeons have recognized the three dimensional nature of the facial structures and often complemented this procedure with others to restore volume and address cosmetic issues throughout the facial-neck structures.Often other facial procedures are performed at the same time including forehead lift, eyelid lift (blepharoplasty), chin and cheek implants, nose reshaping (rhinoplasty), liposculpture, chemical peel, laser resurfacing and lipotransfer.Who is a Candidate?

  • Men and women with jowl formation (the lower cheeks and jaw line are saggy).
  • Men and women with a poorly defined jaw line.
  • Men and women with wrinkled saggy and fatty neck.

Intended Results

  • A sharper and better defined jaw line.
  • Improved neck and chin angle.
  • Less tired look with more youthful appearance.
  • This does not treat the lines around the mouth and will not improve skin surface defects and discoloration.

Procedure Description

  • Face Lifts are usually performed in an accredited office facility, outpatient surgical facility or in the hospital.
  • They may be performed under local anesthesia with or without oral sedation, conscious sedation, and general anesthesia.
  • The surgeon usually makes incisions in front and behind the ear. This should be discussed with your surgeon.
  • Sutures and/or staples are used for closure followed by placement of an elastic dressing around the face and neck.

Recuperation and Healing

  • Recovery may be at home with a responsible adult, in a recovery facility or overnight in the hospital.
  • A compression garment may be worn around the lower face and neck for approximately one week.
  • Bruising and swelling are normal and may take several weeks to resolve.
  • Stiffness in the neck and some soreness with swallowing and eating is common.
  • Sutures and staples are removed within two weeks.
  • Drains, if used are usually removed 1-3 days after the procedure.
  • Make-up can be applied over the skin immediately but not over the incisions for 2-3 weeks.

Other Options

  • Chemical peels, laser resurfacing and microdermabrasion to improve the skin appearance and texture.
  • Botulinum toxin and fillers.
  • Lipotransfer and implant insertion to restore lost volume.
  • Eyelid and forehead rejuvenation.
  • Rhinoplasty.

Note

  • The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

RhinoplastyRhinoplasty (nose) is an operation to improve the shape and size of the nose so that it is in harmony with the rest of the face. Rhinoplasty is essentially a surgical sculpting of the nose and is accomplished by careful contouring of the bone and cartilage giving the nose its shape. At the same time deformities that cause breathing problems and some sinus disorders can be corrected. Most incisions (seamless rhinoplasty) are placed inside the nose where they are least visible.Rhinoplasty is performed under sedation with local anesthesia. The surgery takes approximately one and one-half to two hours. The use of “seamless” nose surgery allows for no visible external scars and with this type of seamless nose surgery discomfort is minimized because no plates, tubes or painful packaging are used.Rhinoplasty is often an enhancement to facial rejuvenation, particularly in the correction of the aging nose (drooping of the tip). A significant “combo” effect is seen with facial augmentation in conjunction with cosmetic nasal surgery.In most instances, change in appearance can be seen immediately.