Breast Augmentation

Many women are unhappy with the size of their breasts. They may feel that their clothes do not fit them properly due to the smaller size of their bust, or may be self-conscious wearing a swimsuit or form-fitting top. Some women have breasts that are very different in size, and desire correction.

Breast augmentation uses an implant, currently inflated with saline, to increase the size of the breast. Sometimes this may be combined with a breast lift to give the maximum improvement in breast size and shape. The implants can be placed beneath the breast tissue, or beneath the muscles of the chest wall. Implants are commonly placed through a small incision in the fold beneath the breast, or through an incision at the edge of the areola (colored part) of the breast. In some cases, the implant may be placed through an incision in the armpit.

When getting a mammogram, a patient with breast implants should always tell the technician she has implants.

Breast augmentation is a very successful and satisfying surgery.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Breast Reduction

Overly large breasts can cause a number of physical and psychological problems including: back, neck and shoulder pain, skin irritation beneath your breasts, grooving of the shoulders from your bra straps, and restriction of physical activity due to the size and weight of the breasts. It is important that we work together to choose the method most appropriate for your body.

The scars are not visible under clothing, including many low-cut tops and also many types of swimsuits. Breast-feeding may be possible using some surgical techniques, but can never be guaranteed. Very large breasts may require the nipple to be relocated as a skin graft, which leaves it without feeling. Most women are extremely satisfied after breast reduction surgery. Back pain that is caused by breast weight will often diminish or disappear.

I get the best results on most women using the limited scar vertical reduction technique. While this technique works for most women, it isn’t appropriate for all women. Limited scar breast reductions, also known as vertical reductions, or lollipop scar reductions, leave less than half the amount of skin scarring of a standard breast reduction. Breast projection remains good after this operation, so that you don’t appear flat as with standard techniques. After surgery your breasts will be very high, but will settle with time. The scar is initially gathered like the waistband of a skirt, but will become flat and straight with time. The lowest portion of the scar is usually the last to flatten out, and in some cases this area may require a small revision if it hasn’t settled after a year. We will probably use liposuction to smooth the surrounding areas, particularly the area underneath your armpit. This is often the most painful part of the procedure, but provides a much better end result.

I use all-absorbable sutures, so you won’t have to have any stitches removed. Sometimes your body will spit one of these sutures out instead of dissolving it. It will feel like a whisker, and is easily removed in the office.

I recommend that you not smoke for at least two weeks before surgery and refrain from smoking for one month after surgery. I do recommend exercise for my breast reduction patients. Some exercise before surgery will improve your body’s condition and can make your surgical experience a little easier. After your surgery, exercise will make you feel better and help you to have a better-looking body. After surgery, you should refrain from any activities that involve bouncing for four months. Many patients will lose weight after their surgery. I recommend that you avoid empty calorie items (candy, soda, and junk food) before surgery. You may lose a few pounds before surgery by watching your diet and getting some exercise. Wait 4-6 weeks after surgery, or until your wounds have healed before starting any serious dieting.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Breast Reconstruction

Breast cancer is, sadly, very common, affecting one out of every eight women. Many times, mastectomy, or removal of the breast is needed. Reconstruction of the breast may give a woman greater comfort and self-esteem in her body; also lessening the psychological impact of the loss of a breast.

Thankfully for cancer patients, recent legislation by the federal government now guarantees insurance coverage for reconstruction of the breast. Luckily, there are many options for the woman seeking breast reconstruction.

Implants are perhaps the simplest form of reconstruction and will fill the volume lost in the mastectomy of an average breast; however, it may not have the most natural look or feel.

For a much more natural feel, autologous tissue reconstruction uses tissue from another area of your body to recreate the breast mound. The tissue is usually taken from the abdomen or back.

You should discuss reconstruction with your breast surgeon before undergoing a mastectomy. Several factors need to be taken into consideration, including the severity of the cancer, the need for other therapies to treat the cancer, the condition of your body for reconstruction, and your expectations of reconstruction.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Mastopexy (Breast Lift Surgery)

Some women are pleased with the size of their breasts, but are very unhappy with the shape of their breasts. Time, gravity, and childbirth all affect the breast and my cause it to lose its youthful position and shape. The breasts will start to droop, with the nipple pointing downward.

There are numerous methods to lift the breast surgically, each designed for different stages of ptosis, or breast droop. Breast lift surgery will leave permanent scars on the breast, but these may fade with time. In cases where breast volume has also been lost, a woman may wish to combine breast lift surgery with breast augmentation (enlargement). The breasts can develop recurrent drooping as a woman continues to age. Large changes in weight can also cause recurrent breast drooping.

Breast lift surgery is not a substitute for a bra: the woman should still wear an appropriate, supportive bra.

The results can be long-lasting with simple, appropriate care, and what woman wouldn’t be pleased with the return of a more youthful breast.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Tummy Tuck (Abdominoplasty)

This procedure is designed for people who have stretched abdominal muscles and skin. It is best performed on people who are near their appropriate weight.

During the surgery, the excess skin is removed and the abdominal muscles are tightened. The procedure is particularly helpful to women who have lost contour of their abdomen after pregnancy, or have stretch marks on the lower abdomen. There will be a permanent scar that stretches from hip to hip, passing just above your pubic hair. There is also a small scar around your belly button. Some people require only minimal tightening and may be candidates for a mini-abdominoplasty, which leaves a smaller scar, but also less tightening of the abdomen.

This procedure is done as an outpatient surgery and you will go home with your family after the surgery. Most people prefer to sleep in a recliner for the first few nights, as the skin of your abdomen will be stretched tightly. Most people will require 2-4 weeks of recovery time.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Eyelid Surgery (Blepharoplasty)

Baggy, sagging eyelids can make a person seem older, or give them a tired appearance. Many people choose blepharoplasty to remove some of the excess fat and skin that accumulates around the eye. This can give the eyes a younger, fresher, more “awake” look. The scars are small and well hidden in most patients. The surgery is done as an outpatient procedure.

Patients are instructed to keep their heads elevated, and to apply ice packs to the eyes for the first 2 days after surgery. There is bruising and swelling after this surgery, which usually disappears in about 1-4 weeks, but most people are comfortable in public with cover-up makeup or glasses by 7-10 days. Current eye problems will affect the outcome of the surgery, and will be discussed during your consultation.

Many people will combine this procedure with a facelift.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Facelift (Rhytidectomy)

Time, gravity, and exposure to the sun and elements can cause the facial skin to loose its elasticity. There are several important areas of fat beneath the skin that help provide normal contour to the face. As the skin sags, these fat pads fall out of position which causes prominent folds and jowls to develop.

A facelift can reposition the skin and underlying tissues to restore a more youthful look. The scars are carefully positioned in the hair and around the ear. The procedure is done as an outpatient surgery and your family will take you home after surgery. You will be able to go out in public with covering make-up after about 10-14 days. The swelling may take up to 4-12 weeks to disappear depending on the technique used. We recommend that you keep your head elevated for the first few days after surgery. You must stop smoking for at least 3 weeks prior to and after the surgery. If you have any medical problems, these must be controlled prior to your surgery.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Midface or Cheek Lift

Some people don't require the correction of a full facelift, and can get excellent results from a midface lift. This procedure addresses the apples of the cheeks. With time, the cheeks start to fall. This creates grooves in the cheeks from the sides of the nose to the corners of the mouth. Your face begins to look sad, tired, and old.

The cheeks can be lifted through incisions either in the lower eyelid, or in the hair of the temples. This procedure is often combined with injections of your fat into the wrinkles to help restore a more youthful appearance. Swelling can last up to 3 months, or longer in some patients. The results are very satisfying, without the large scars of a full facelift.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Panniculectomy

This surgery is specifically designed for people who are heavier than their ideal body weight, and have an "apron" of skin that hangs down in front. The skin can collect moisture, causing painful rashes in the folds. Sometimes the skin and fat hang down so far that they can interfere with walking and other daily activities. Sometimes this procedure is covered by insurance.

A panniculectomy is similar to a tummy tuck. For those patients who are physically able to tolerate a larger operation, this procedure can be done with greater, more involved skin and muscle tightening than of a standard tummy tuck. In some cases, only the skin is removed.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Lower Body Lift (Circumferential Torsoplasty or Belt Lipectomy)

This procedure is often used for patients who have already lost a large amount of weight, either after dieting or after bariatric surgery, and have hanging skin. The abdomen is considerably improved, the sides are also contoured, and the buttocks will be lifted in this operation. The patient is actually turned over on the operating table, so that skin from around the entire torso may be removed. The scar goes around the entire body, at about the level of the waist in the back, and dipping just above the pubic hair in the front. It allows for a much greater skin reduction than a panniculectomy. There is a longer recovery, and usually you will stay overnight in the hospital.

This is a great operation for those in appropriate condition. This operation isn’t commonly performed by surgeons in this area, but is one of my preferred procedures.

For more information please see the American Society of Plastic Surgeons (ASPS) website.

Liposuction

People who have areas of fat that will not disappear with diet or exercise are good candidates for liposculpture.

Liposuction is done through small incisions, so scarring is minimal. The fat is first injected with a solution to decrease pain and bleeding. A tube, or cannula, is then inserted into the fat, and the fat is suctioned out of the body. Liposuction is designed to contour specific areas of fat. It is not useful for weight reduction, and it does not help sagging skin. We will discuss the appropriate procedures and options with you. It is commonly done under general anesthesia. You will be placed into a compressive garment after surgery to lessen the amount of swelling and to help contour the tissues. The swelling usually lasts up to 3-4 weeks. Massage is helpful to diminish swelling. Most people are comfortable after a few days. I strongly recommend herbal supplements to help decrease the swelling and pain with this procedure.

For more information please see the American Society of Plastic Surgeons (ASPS) website.