FaceliftOne of the most frequent questions i’m asked is how do i know if i’m ready for a facelift how we age has been genetically pre-programmed. This is out of our control. Some of the lifestyle choices we make play a dominant role influencing the aging process. The predominant factors include nutrition, diet, exercise, stress, smoking, and sun exposure. There is no set age when this procedure should be performed. Most commonly the patients are in the 40-60 age range. However, the procedure can produce excellent results for younger or older individuals as well.At the present time the loss of the elasticity of the skin is irreversible. There are many products and devices on the market which falsely claim to reverse this process. None have been proven scientifically. Currently, this is an area of extensive research. As technical advances progress, this problem will be solved. I feel we are still five to ten years away from an acceptable solution. At the present time your options include aging gracefully or undergoing a facelift.The facelift (rhytidectomy) is a surgical procedure used to smooth the loose skin on your face and neck and to reduce the most apparent signs of aging in the facial area, giving you a more youthful appearance. The procedure involves reducing the slacking jaw line and sagging jowls and fat deposits around the neck by removing excess fat and tightening underlying muscles, and redraping the skin on the face and neck. As a result, your face will appear firmer and fresher.There are many variations to the facelift procedure. Some of these include the mini, short scar, deep plane, smas, skin only, skin/muscle. A common denominator to all these procedures is the incision which is hidden in the hairline and follows the natural contour of the ear. Following the surgery the incisions are easily covered by makeup and concealed by the hair. Frequently, a small incision is made under the chin to remove fat in the neck or along the jaw line and to smooth the cord-like structures of the underlying muscle in the neck. Your options will be thoroughly discussed with you during your consultation.The surgery is performed under general anesthesia and can take anywhere from 2 ½ to 5 hours, depending on what needs to be done to obtain the best results. Frequently, additional procedures such as a blepharoplasty or browlift are performed at the same time. After the surgery you can return to the comfort of your home, under the care of a loved one. Generally, there is no need to stay in the hospital overnight.Surprisingly, there is very little pain associated with this surgery. Most patients describe a mild discomfort associated with a tight feeling in the cheeks and neck. The skin will feel numb to the touch for several months. Within a few days after the procedure the dressing covering the ears and neck is removed revealing some underlying swelling and bruising which for the most part subsides in 2-3 weeks. At that time one is able to return to work or full exercise.The surgery will make you look refreshed and rejuvenated. My goal is to achieve a natural appearance and not make you look wind blown. You will be pleased with the new you and the compliments you receive from loved ones.Options:
Younger, Older, Neck, Along, Blepharoplasty, Browlift
Eyelid Surgery BlepahroplastyAre you frustrated at being told you look tired and worn when you're not that tired expression is commonly caused by the appearance of your eyes. A blepharoplasty or eyelid surgery can alleviate that tired worn out appearance... this procedure removes the excess skin from the upper eyelids which hides the natural fold and puffiness which creates that tired look. In the lower eyelids the excess wrinkled skin is reduced and the "bags" or fatty protrusions are removed at times eliminating dark circles.Blepharoplasty can be performed on just the upper or lower eyelids but frequently all four eyelids are treated at the same time. This procedure is performed on an out-patient basis, allowing you to retire to the comfort of your own home. Generally, a local anesthetic is used after you have been gently sedated with some intravenous medication. The incisions are designed to be hidden in the natural upper eyelid crease or under the lower eyelashes. They heal nicely and become inconspicuous over time. Sometimes an incision is made inside the lower eyelid when only fat needs to be removed. The surgery is completed in around two hours when treating the upper and lower eyelids at the same time. Commonly, a blepharoplsaty is performed with other facial procedures such as a facelift.Surprisingly, little discomfort is associated with this process. Ice compresses are applied to the surgical area to help minimize bruising and swelling. In most cases this will resolve in 10-14 days. The bruising can be covered with makeup after the sutures are removed within the first week. It is not unusual for you to experience some mild blurry vision, sensitivity of your eyes to light and tightness when closing your eyes. Most people return to work within 2-3 weeks. Light exercise can be resumed after one week.You will be very pleased with your new refreshed and rested appearance. You will feel more confident in your appearance and this will carry over to business situations and social gatherings. Friends and love ones will notice you're more alert, rested and happier appearance, without realizing that you had surgery.Blepharoplasty or eyelid surgery, can remove the excess fat and drooping skin of the upper eyelids, minimize bags under the eyes and tighten the lower eyelid skin. The result is a more alert and rested appearance.Options:
Blepharoplasty, Eyelid surgery, Uper, Lower
Forehead Lift BrowliftA forehead lift or browlift is commonly performed to correct sagging or low position of the eyebrows creating a tired of sad appearance. It can help diminish deep horizontal creases across the forehead and frown lines or furrows between the eyebrows and sometimes across the top of the nose.There are many approaches to correcting these concerns. Botox offers temporary non-surgical correction which can last four to six months. Soft tissue fillers help to soften these lines by injecting a substance into the skin. Surgical options vary and depend upon specific problems and your desired results.If you are older with deep furrows, severe sagging of the eyebrows and poor skin quality the standard classic coronal browlift would be your best option. This requires an incision across the top of the scalp, beginning above the ears and concealed within the hairline. If you possess a high forehead the incision may be placed at the front of the hairline avoiding any further elevation. Working through this incision, i can modify the muscles that cause wrinkling and frown lines, remove excess skin and lift your eyebrows to a more pleasing position. This offers the best correction for severe brow ptosis with the most long lasting effects.An endoscopic approach is generally reserved for the younger patient with milder symptoms. This is a limited incision technique with several small incisions hidden in the scalp. The endoscope is a long, thin tube with a light on the end, which is attached to a video camera. This instrument allows me to work on the internal structures of the forehead. In most instances, there is no skin removed. The eyebrow is elevated and held in place with fixation to the underlying bone. In some cases, a combination of endoscopic and other techniques may be used.There are several other limited incision techniques available. What is the best approach for you all your options will be thoroughly reviewed with you during your consultation. This procedure is frequently combined with eyelid or facelift surgeries.The browlift surgery is performed in a fully accredited outpatient surgery center or the hospital. You can choice to have either general anesthesia or local anesthesia with intravenous sedation. Generally, the surgery takes about 90 minutes. After the surgery, you can return to the comfort of your own home.A dressing will be applied around your head for one to two days. It will be removed in my office. After the removal, you can begin to shower and shampoo your hair. Discomfort from the surgery is minimal. All the stitches and clips are removed by ten days. A relatively quick recovery is expected and in most cases, you can return to work in ten to fourteen days. Light exercise can be resumed at this time.With a browlift procedure, you can expect a more relaxed and refreshed appearance. You will no longer look sad or tired.Options:
Lift, Browlift, Lines, Furrows, Sagging, Low
Skin ResurfacingThis is a procedure that employs a carbon dioxide (co2) laser to remove areas of damaged or wrinkled skin. Resurfacing is often used to minimize the appearance of wrinkles around the mouth and eyes, but is also effective in treating age spots or areas of uneven pigmentation.Options:
Chemical PeelThis is a technique to help restore wrinkled or blemished facial skin. A special solution is applied to the skin to peel away the top layers of skin. During the healing process a fresh, new layer of healthy surface skin is formed. The new skin will appear smoother and finer with a more even pigmentation.There are several different types of chemicals available. These are categorized by the depth of penetration. The deeper the peel the more dramatic the affects but this is associated with a longer recuperative period or down time. A lunchtime peels is a superficial peel that refreshes the skin surface allowing you to return to work after the procedure with essentially no down time.After undergoing a thorough skin evaluation, what type of chemical peel most suitable for you will be discussed during your consultation. Say hello to a younger, fresher, healthier complexion.Options:
Lip AugmentationMany women are unhappy with the fullness of their lips.Many products are available to plump the lips and accentuate the contour. These products can be temporary or permanent. The temporary fillers come in many different varieties such as collagen, fat, hyaluronic acid, alloderm to name a few. New fillers are being released on a regular basis. There are many factors to consider before selecting the right filler for you. These include the longevity, ease of administration, results, cost, downtime etc. Permanent products are now available that are very soft and natural. These synthetic products are more involved to administer. They require a surgical incision to insert. Their popularity is increasing dramatically.During your consultation your options will be fully discussed. A review of the procedure, risks, benefits and limitations will be addressed.
Facial ImplantsFacial implants are designed to enhance structural bony deficiencies. They can restore facial symmetry and balance features to enhance proportion. They are performed for both cosmetic and reconstructive purposes.Facial implants come in various shapes, size and materials for augmentation of the chin, cheeks, jaw and nose. Most commonly they are made of soft silicone. Chin augmentation is by far the most common facial implant procedure. Frequently this is performed with a rhinoplasty to restore facial balance.Facial implant procedures can take from 30 minutes to 2 hours. They are performed under local or general anesthesia as an out patient. Most people require 1-2 weeks off work.As with any surgical procedure, there is a certain amount of risk. Some of these include: infection, bleeding, shifting and postoperative bruising and swelling.Most people will recognize you look better but they won't know why. Within 2 weeks friends and relatives will forget what you looked like before surgery. You will love looking in the mirror.
OtoplastyEar surgery or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. Most commonly, the procedure is performed on children between the ages of 4 and 14. ears are almost fully grown by age 4, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is not uncommon and can easily be performed under local anesthesia.The surgery is performed on an outpatient basis allowing you to return to the comfort of your own home. It generally takes around two hours. There are various techniques to accomplish the goals of the otoplasty. With one of the more common techniques, the surgeon makes an incision in the back of the ear to expose the ear cartilage. Then the cartilage of the ear is sculpted to allow it to bend back toward the head. Stitches are used to maintain the new shape. Sometimes cartilage is removed from the ear to help create a more natural-looking contour.Another technique involves making small incisions in the front of the ear. Permanent stitches are placed to fold the cartilage back on itself to reshape the ear without removing cartilage.Ear surgery leaves a faint scar that will fade with time. Sometimes surgery is performed on only one protruding ear to achieve a better balance.After the otoplasty surgery is completed the head will be wrapped in a bulky bandage to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by oral medication. Within a few days the bandage will be removed and replaced with a headband. At this point showering and shampooing of the hair is permitted. All the stitches will dissolve and do not require removal.Most adults can return to work in a week. Children can return to school in one to two weeks as long as they are careful about their activities.Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: lop ear, when the top of the ear folds down and forward; cupped ear, which is usually a very small ear; and, shell ear, when the curve in the outer rim, as will as the natural folds and creases, are missing. Earlobes may be too large or stretched requiring adjustment. Sometimes a new ear may need to be built in someone born without an ear or lost through injury.Most patients, young and old alike, are thrilled with the results of ear surgery. However, keep in mind, the goal is improvement, not perfection. Don’t expect both ears to match perfectly; perfect symmetry is both unlikely and unnatural in ears.Options:
RhinoplastySurgery of the nose is one of the most common of all plastic surgery procedures. The best candidates for a rhinoplasty are those people who are looking for an improvement in the way they look, not those searching for perfection. This surgery can reduce or increase the overall size of your nose, change the shape of the tip or bridge, narrow or widen the nostrils.Computer imaging is a wonderful tool which allows you the opportunity to preview your results prior to surgery. Right before your eyes on a computer monitor your nose will be transformed into its new shape and contour. This process will afford the opportunity to address your concerns and discuss the possibilities of improvement. Your active participation with the surgeon will allow for more realistic expectations. Unfortunately, this process is only a simulation and does not imply a specific result.Rhinoplasty usually takes an hour or two, though more complicated procedures may take longer. This is an outpatient procedure and you can retire to the comfort of your home to convalesce. The surgery starts with the skin of the nose being separated from its supporting framework of the bone and cartilage, which is then sculpted to the desired shape. The skin is then redraped over the new framework. After the surgery is complete, a splint is then applied to help the nose maintain its new shape. On occasion, a nasal pack or soft splint may be placed in the nostrils to stabilize the septum; this is the dividing wall between the air passages.After surgery, during the first twenty-four hours, the face will feel puffy, the nose may ache, and you may experience a dull headache. There is minimal pain, usually just a mild discomfort. For the first several days you will want to rest with your head elevated. There will be swelling and bruising around the eyes, reaching a peak in two to three days. Some drainage from the end of the nose is to be expected. By the end of one week all the splints, dressings, and packing is removed.One may resume light exercise and return to work after two weeks. No contact sports or rigorous exercise for five weeks. The overall appearance of the nose will improve gradually over the course of a year until final healing.It is common after some types of rhinoplasty for relatives or friends to remark that they do not see a major difference. Do not consider such a reaction an indication of failure. On the contrary, if it looks better and natural, it may go unnoticed. The intention, after all, is not to create a new nose that draws attention to itself, but rather one that blends subtly into the overall features of the face in the proper proportions. Minor revisions are sometimes desirable and may require additional surgery.
BotoxThe war against facial wrinkles has become more effective with the use of botox. When you smile, laugh or frown, the contraction of the facial muscles creates dynamic wrinkles. These wrinkles can be soften and in many cases eliminated with the use of botox. The fda approved the use of botox for the treatment of frown lines in 2002 but this product can be safely used in other areas such as the forehead, around the eyes and mouth. I have been using this safe and highly effective treatment in my practice since 1998.botox works by blocking the impulses from the nerve to the muscles. This causes the muscle to relax by blocking their contraction. The wrinkles in the overlying skin become smooth and wrinkle free. Botox will only affect the muscles where the injection is placed allowing untreated muscles to contract normally. This maintains normal facial expression.The treatment involves the use of a very fine needle to inject small quantities of botox in precise locations. There is a minimal amount of discomfort associated with the injections, often related to a tiny bee sting. This is a wonderful treatment that requires no downtime and allows you to resume normal daily activities immediately. You will start to see the affects within days and maximum response will occur within 1-2 weeks.The most common side effects are temporary bruising and swelling. Less common problems include temporary drooping of the eyebrow and asymmetry of facial expression. A touch up with a small amount of botox may help to correct these concerns. Rarely, one may see temporary drooping of the eyelid, but this can be reversed with special eye drops.The effects of the botox treatment will last 3-6 months. You may need to repeat the treatment 2-3 times a year. The dramatic improvement in facial wrinkles and the ease of application makes botox the most popular nonsurgical cosmetic procedure today.
Wrinkle Fillers and Collagen InjectionsThe trend today is toward more subtle facial enhancements. Many women and men are not interested in undergoing facial surgery. They don't want the cost, downtime or risks. With the increasing desire for people to achieve a more youthful appearance wrinkle reduction with collagen fillers is one of the most popular and fastest growing procedures. There is a great attraction for treatments that offer immediate results with little downtime the so called "lunch time procedures.Over time the skin loses its elasticity and the collagen support breakdowns. This results in the formation of fine lines, wrinkles and folds. Basically the skin is undergoing wear and tear. There are many contributing causes: sun exposure, facial muscle activity, environmental issues, stress, and our overall health to name a few. Restoration of the collagen in the skin with collagen injections or wrinkle fillers can restore the smoothness to the skin and that youthful appearance.The pharmaceutical community recognizing this need has responded with an abundance of products. The list of fillers is growing at a rapid pace with no end in sight. Some of products available at the present include: restylane, perlane, juvederm, hylaform, cosmoderm, cosmoplast, captique, puragen, prevelle silk, artefill, artecoll, sculptra, radiesse, evolence, hydrelle, elevess. My staff and i have evaluated many of these products and will be able to guide you in selecting the best product to correct your concerns.
Neck LiftWhen you look in the mirror are you concerned about the appearance of your neck is there too much loose skin, excess fat or a turkey wattle a neck lift can be performed to correct these concerns. It may be as simple as having liposuction or more involved. Frequently, a neck lift is performed in combination with other procedures such as a facelift.A complete physical exam will determine the contributing factors to your neck concerns. It is not uncommon that as we age bands will appear under the chin area. In many cases this is related to a separation of the neck muscle known as the platysma. The medial edges of this muscle will sag and become prominent. This can easily be corrected by performing a procedure known as a platysmaplasty. An incision is made under the chin and the muscle bands are sewn together creating a hammock effect supporting the neck region.A complete neck lift involves removal of excess fat in the neck region either by direct excision or liposuction. A platysmaplasty to correct the sagging separated neck muscles. Finally complete undermining of the neck skin to allow it to redrape over the underlying tissues. Generally, this is done through an incision behind the ear and under the chin. In many cases no skin is removed.After a neck lift when you encounter someone who has not seen you in awhile, they will think that you lost a significant amount of weight. No one will recognize that you have had surgery.
Latisse (Eyelash Enhancement)How would you like longer, fuller, darker eyelashes now there is latisse. This is a fda approved prescription treatment for inadequate eyelashes, medically referred to as hypotrichosis.The solution is applied to the upper eyelashes at bedtime after all the makeup has been removed. The latisse solution will transfer to the lower eyelashes upon eyelid closure while blinking or sleeping.Significant improvement will be seen in 6-8 weeks. The correction will peak around 6 months. If you stop the application, the eyelashes will revert to their original appearance within several weeks to a few months.If you have been diagnosed with glaucoma or are being treated for glaucoma or you are at risk for developing glaucoma you may not be a candidate for latisse and should speak with your ophthalmologist prior to instituting treatment.Latisse is a safe and effective treatment proven by clinical research. However, there are possible side effects you should be aware of. 4% of the patients developed eye redness and itching. This is probable related to applying too much solution. If the solution is applied to close to the skin you may experience skin darkening, irritation, dryness or redness.
Breast AugmentationIf you are unhappy with the size or shape of your breasts, breast augmentation may be the right choice for you. The insertion of a breast implant can increase the size of your breast and improve the shape. Childbirth, breast feeding, weight loss, aging can contribute to these changes. Your breasts may not have developed to a size that meets your expectations or your breasts may not be the same size. Breast augmentation is one of the most common cosmetic surgical procedures performed in the united states today.What is a breast implant breast implants are soft sacs, often referred to as a shell, filled with a saline (saltwater) solution or a synthetic silicone gel. The shell is made up of silicone, a rubber-like substance. Silicone gel implants has caused much controversy because of fears that it produces ill effects in women. At the present time there has been no scientific or medical evidence to support this premise. Research is on going to settle this issue.Silicone gel implants first became available in the early 1960’s. Early on it was not known how long they would last. It was hoped that maybe they would last a lifetime. Unfortunately, this was not the case. Over time it was discovered that the shell of the implant would breakdown. Some believed that this may be contributing to certain health problems. The fda began an extensive investigation into the safety of breast implants. In 1992, pending further investigation, limitations were placed on the use of silicone gel implants. The fda reserved the use of silicone implants for women; requiring breast reconstruction, with congenital birth deformities, requiring breast lifts and problems related to saline implants. Women who did not fulfill these criteria were only allowed to have breast augmentation with saline implants. On november 17, 2006 the fda lifted these restrictions and agreed to allow the use of silicone gel implants again.Saline breast implants were first developed in the late 1960’s; they never gained in popularity the way silicone gel implants did. Saline implants are not as natural as silicone gel implants. Saline implants are more round in appearance, firmer to the feel, more palpable, and more likely to develop rippling or folds that may become visible or palpable. Frequently, saline implants are placed under the chest muscle to add an extra layer of tissue to help camouflage the implants and make them more natural. Placing the implants under the muscle makes it easier to perform mammography and can decrease scar tissue formation.The breast augmentation surgery is performed as an out-patient procedure allowing you to retire to the comfort of your own home. The procedure takes less than one hour to perform. A general anesthetic is used in all my cases. The location of the incision varies but is most commonly placed around the areola or underneath the breast in the natural fold. Less common locations for the incisions include the axilla and umbilicus. The small size of these incisions will allow access for only a saline implant or a very small gel implant. After the incision is made a space is created to accommodate the implant. The implant can be placed in different locations: subglandular (under the breast tissue), subfascial (under the fascia), submuscular (under the muscle) or dual plane (partially under the muscle and under the breast tissue). The selection of the appropriate location is dependent on many factors such as soft tissue coverage, quality of the breast tissue and skin, breast sagging, physical activity and many other issues. At this point in the operation, i like to use a trial implant which i can inflate to all different volumes allowing me to select the most appropriate size. The final size is determined by taking into consideration many different factors: height, weight, elasticity of the skin, chest wall and breast dimensions, and each patient’s individual personal desires. My goal is to create as natural a result as possible. However, i am frequently making some compromises either on shape or volume to accommodate a patients wishes.After the breast implant has been placed the patient is evaluated to determine symmetry, positioning and overall cosmetic result. The incisions are closed and a sports bra is applied. There is a fair amount of discomfort associated with the surgery but this is controlled with a pain medication and at times muscle relaxant.When a foreign body such as an implant is placed in the human body a membrane of scar tissue will form around it. This is referred to as a capsule. Since a breast implant is soft, the wall of scar tissue sometimes can shrink compressing the implant making it immobile and feel firm. This is called capsular contracture. In most cases this occurs to a mild degree, but in some cases the contracture can become severe distorting the shape of the breast, making the breast feel hard and limiting the mobility of the implant. If a person develops a severe contracture, pain may develop limiting function and physical activity. Sometimes medication can help but additional surgery may become necessary. I’m a firm believer in postoperative breast implant displacement exercises. When these exercises are performed appropriately they can minimize the formation of any significant contracture.Most women are able to return to work in few days and full physical activity within two weeks. As with any surgical procedure there are risks to consider such as bleeding, infection, scarring, numbness, shifting of the implant, palpability, deflation, rupture, capsular contracture, limitations in performing a mammogram, problems with breast feeding, and the need for future surgery to replace the implant if it leaks or ruptures. All breast implants will require replacement at some time.Women who undergo breast augmentation surgery feel more confident about their appearance. Discover how easy it is to find clothes that fit and compliment their new figure. They look and feel better in a swim suit or low cut dress.
Breast LiftAs time passes, pregnancy, nursing, excessive weight loss and gravity have adverse effects on women's breasts causing them to lose their elasticity, firmness, and shape and begin to sag. A breast lift is a procedure that corrects this condition using a combination of removing excess breast skin, tightening the skin. If desired, implants may be used to restore breasts to their natural shape and size.
Correction of Tubular BreastsPlease check back soon for more information do your breasts have a "snoopy nose" appearance if so, you may be suffering from a condition known as tubular breasts. This is also known as constricted or tuberous breasts. Generally, low self esteem and poor body image are the main concerns women have for this treatable condition.This abnormality of shape and size can be present in varying degrees. Generally, the characteristics include
Asymmetry of the Breasts
A High Breast Fold
A Short Distance From the Nipple to the Breast Fold
Lack of Lower Breast Fullness
A Narrow Breast Width
Large Areola Diameter with Bulging of the Areola From Herniation of the Underlying Breast Tissue
Correction of Inverted NipplesA flat or inverted nipple has been reported to occur in 10-20 % of the female population and rarely in males. This is a congenital problem that results from fibrosis and shortening of the milk ducts. It can occur in disease states such as breast cancer but this is much less common.Nipple inversion can be constant but on many occasions nipples may evert during pregnancy, breastfeeding, cold or sexual arousal. Many women option for surgical correction if the nipple fails to protrude at all.Surgical correction of the inverted nipple can be performed under local anesthesia on an out patient basis. The basic principles of the procedure involve the severing of the ducts that prevent the nipple from protruding. There are many surgical approaches to correction depending on the severity of the condition.Prior to considering surgery a woman should be aware that if the milk ducts are severed she will not be able to breast feed. Also there is a remote possibility that there may be some loss of sensation in the nipple.
GynecomastiaGynecomastia is an abnormal benign enlargement of the male breast. It may be classified as either physiologic or pathologic, and although its origin is multi factorial, in most cases an identifiable cause is never found.The physiologic type occurs during puberty. This type is often self-limiting and regresses spontaneously, with most cases resolving within three years. If this condition persists into adolescence further, hormonal evaluation is warranted.The pathologic type involves an imbalance in the ratio of the female hormone, estrogen, and the male hormone, androgen, or a defect in the tissue receptors of androgens.In adults, gynecomastia is associated with increasing age and in particular testicular hypofunction, an increase in body fat, and an increase in the estrogen/androgen ratio. This may be associated with medications, tumors, chronic disease, and a host of other conditions. In many cases there is a genetic predisposition. If your father suffered with this condition, it may be passed on to his sons. In most cases the etiology is unknown.For males who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a more pleasing contour of the chest.In many cases, a more pleasing contour can be achieved with liposuction alone. In more involved situations the excess glandular tissue may require direct excision with a scalpel. This may be performed alone or in conjunction liposuction. In some extreme cases the surrounding skin envelope may need adjusting. When additional skin is removed, this will lead to more scarring.The surgery is performed on an out patient basis, allowing the patient to return to the comfort of their own home. Usually, general anesthesia is used. The procedure takes around two hours depending on the extent of the deformity. Surprisedly, after the surgery there is minimal discomfort.With the liposuction technique, ultrasonic liposuction is particularly advantageous. This approach is more effective in removing the excess tissue and in contouring the breast shape. The ultrasonic technique uses a solid metal probe to emulsify the fat. It is always performed in conjunction with standard liposuction technique. A narrow, hollow, metal straw-like tube called a cannula, attached to a vacuum pump, is inserted through a small incision. The cannula is moved back and forth under the skin with deliberate strokes breaking up the fat and suctioning it out.The incisions are closed with dissolvable sutures and covered with a dressing. Then a compressive garment is applied. After the surgery, there will be a fair amount of bruising and swelling. The bruising will dissipate in several weeks but the swelling can last several months. Most patients return to work within several days and regular exercise in two to three weeks.As with any surgical procedure there are risks. These include infection, excessive bleeding, skin injury, adverse reaction to anesthesia, temporary loss of breast sensation and fluid accumulation. The procedure may also result in noticeable scars, permanent pigment changes in the skin, asymmetry in the breast contour or size or contour irregularity.Generally, gynecomastia surgery is very rewarding. It can enhance your appearance and self-confidence. The results are permanent and significant. If your expectations are realistic, chances are good that you’ll be very satisfied with your new look.
LiposuctionExercise and diet will make you healthy, muscular and lean. It does not always remove those stubborn localized fat deposits. Liposuction removes fat sculpting the body and doing what diet and exercise alone cannot accomplish. Liposuction does not replace or serve as a substitute for good diet and exercise. The best candidates for liposuction are men and women near normal weight whom mainly want to improve their body shape and contours. This is one of the most popular cosmetic surgical procedures performed in the united states today.Both men and women of all ages may undergo liposuction; however, patients with good skin elasticity will achieve the smoothest contour after the fat is removed. Almost any area of the body can be treated using this technique. Several areas of the body can be addressed at the same time. There are limits on how much fat can be removed safely during a single session.In most situations the liposuction can be performed as an out-patient allowing you to retire to comfort of your own home. Prior to the surgery, the areas to be treated will be outlined with a marking pen giving the patient an opportunity to discuss the plan. A general anesthetic is always administered when treating large or multiple areas. The small incisions are designed to be placed in natural creases or contour lines of the skin so that they are less conspicuous. A special solution called tumescent is infiltrated into the proposed treatment areas. This solution facilitates the removal of fat, narrows blood vessels to help minimize blood loss and contains a local anesthetic to provide some postoperative pain relief.A surgical instrument called a cannula is then inserted under the skin. This is a metal straw-like instrument with holes at the end. The cannula is attached to a clear flexible tubing which flows into a receptacle. The receptacle has suction applied to it, facilitating the removal of the fat. There are measurements on the receptacle allowing for monitoring of the volume removed from an area. The cannula is moved back and forth many times removing the fat and contouring the body. As the contouring proceeds the surgeon monitors the progress by comparing the result from one side to another, rolling the skin between his fingers to check the thickness and evenness and watches what is traveling through the tubing.Once the goals have been reached the incisions are closed, dressed and a compressive garment applied. Pain medication and an antibiotic are prescribed. The garment is removed 48 hours after surgery for showering but is generally worn from one to two weeks. The speed of recovery is dependent upon the extent of your surgery. Most patients can return to work within the first week after surgery. Normal physical activity can be resumed in one to two weeks. Significant bruising and swelling accompanies this procedure. Most bruising is gone in three to four weeks. The swelling gradually subsides. Your final result normally takes several months.As with any surgical procedure there are risks involved. Some of these include: bleeding, infection, scarring, asymmetry, contour irregularities, indentations, discoloration of the skin, sensory changes of the skin, emboli, fluid collections, injury to the overlying skin, secondary skin tightening may be required. These concerns will be discussed in greater detail during your consultation.Most patients are extremely pleased with their new slimmer shape and how they appear in clothes. Many will require a new wardrobe. You will feel more confident about your new sculptured appearance.
Body LiftA lower body lift also known as a belt lipectomy is a procedure designed to shape, tone, tighten and lift the abdomen, back, thighs and buttock during one operation. The lower body lift can be broken down into 3 components: abdominoplasty, buttock lift and lateral thigh lift. The procedure can be performed in one or several stages depending on the patients needs. The total lower body lift is a major surgical procedure that can take 3 to 5 hours to complete.The most common candidates for this procedure are patients who have undergone bariatric surgery and lost a significant amount of weight. After pregnancy, many women have excess loose hanging skin that they cannot improve with diet and exercise. They may benefit from the "mommy makeover" which may include a lower body lift.In the total lower body lift a circumferential incision is made around the body from above the pubic area around the sides to the top of the buttock crease. General anesthesia is required. During the surgery the patient will be repositioned on the operating table to allow access to all these sites. Liposuction may be needed to remove some residual fatty deposits in adjacent areas. The loose skin is elevated in the buttock, back, thighs, and abdomen and the excess is removed. In many cases the stomach muscles are tightened. After the incisions are closed, the patient in placed in a compressive velcro binder. Generally, drainage tubes are used to help prevent fluid collections (seromas). If the procedure is very involved admission to the hospital is recommended for 1-3 days.Recovery from this procedure can take 2-4 weeks. You will be out of work for a minimum of 2 weeks depending on your type of work. Some of the problems that can arise include: infection, bleeding, healing problems, fluid collections, blood clots, and emboli.The lower body lift is a very rewarding procedure that can make dramatic improvements in a person's appearance. You will love your new look.
Tummy TuckAn abdominoplasty or tummy tuck is a surgical procedure designed to remove loose abdominal skin and the underlying fat. This procedure is particularly helpful to women who through multiple pregnancies have stretched their abdomen so far that it does not return to its normal shape and individuals who have lost significant amounts of weight through diet and exercise or gastric bypass surgery.The abdominoplasty surgery is most commonly performed on an out-patient basis allowing you to retire to the comfort of your own home. A general anesthetic is required. The morning of the surgery a horizontal incision is designed just above the pubic region extending laterally. The length of the incision depends on the amount of skin to be removed but generally extends from one hip to the other. If there is loose skin above the navel a second incision is needed around the navel to permit tightening of this skin. I try to keep the incision hidden in the swimsuit line. Working through this incision the underlying muscles are tightened by pulling them together with sutures. The redundant skin and fat is pulled downward and the excess is trimmed. The stretch marks included in this excess will be permanently removed. A new opening for the navel will made at the same location but the shape will be altered.A rubber suction drainage tube is placed and sutured to the skin where it exits. All the incisions are closed and covered with a dressing. An adjustable velcro binder is applied for compression, comfort and support. After surgery, you should position yourself in bed or recliner so that there is no tension on the incision. 48 hours after surgery the binder and underlying dressings can be removed so that you can shower.The first postoperative visit in my office is scheduled when the drain is ready to be removed. This is when there is less than 25cc of drainage for a full 24 hour period. After the abdominoplasty the skin and abdominal wall will feel tight.. initially, ambulation will be in a bent over position until the tissues relax usually around one to two weeks. Most patients can return to work after two weeks if there is no heavy lifting required. No strenuous exercise is allowed for five weeks.As with any surgical procedure there are risks involved. Some of these risks include; bleeding, infection, scarring, loss of sensation of the skin, unevenness, contour irregularities, loss or delayed healing of the skin near the pubic incision, fluid collections, emboli, and secondary liposuction to improve contouring. These concerns will be discussed in greater detail during your consultation.The shape of your body will be more pleasing, allowing you to wear clothing with greater confidence and comfort. Your self-esteem will brighten building your confidence.A tummy tuck is a major surgical procedure in which excess skin and fat are removed from the lower abdomen and the muscles of the abdominal wall are tightened. This procedure is particularly helpful to women tummy tucks are often performed in conjunction with liposuction.The best candidates for an abdominoplasty are men or women in good health and relatively good shape, but are bothered by a large fat deposit or loose abdominal skin that won’t respond to exercise.
Mommy MakeoverChildbirth, pregnancy and breast feeding can play havoc with the female figure. The physical trauma from these changes can be devastating. If you want to regain your natural curves cosmetic surgery may be the right approach for you. These physical changes can affect your breasts, abdomen and you may develop excess fat in places you never knew existed.There has been a boom in mommy makeover procedures. In part this is due to women having careers and starting families later in life. Many career women have undergone extensive education and have worked hard climbing the career ladder to be successful. Now, after having achieved this great success they are ready to start a family. When you go through a pregnancy and breast feeding at an older age your body is less able to bounce back. After juggling a family and career, you have less time for yourself. You have spent hours exercising but are not getting the results. Cosmetic surgery offers the solution to many of these concerns.Take for example S.G. of orchard park, new york. She is a 40 year old woman who worked her way through law school as a waitress. She is a partner in a very successful law firm in buffalo. At 35 she gave birth to twins. She continued to work from home while caring for the twins. By the time she was 39, she had tried most nutritional, exercise and weight loss programs and decided the 25 extra pounds she gained after having the twins would not come off her 5 foot 6 inch frame through diet and exercise alone. After researching her concerns on the internet, she found my practice. She liked the results she found on the website and underwent a consultation. She decided to have a tummy tuck and liposuction. She is thrilled with her results. She has dropped several dress sizes and loves how she looks.Several procedures are helpful with regaining that youthful shape. These include: breast augmentation, breast reshaping (mastopexy or reduction), abdominoplasty (tummy tuck) and liposuction. Often a combination of these procedures may be needed and can be performed at the same time.You have spent 9 months with your pregnancy, years raising and caring for your children and family now is the time to start thinking about taking care of you. Consider the benefits of a mommy makeover and the new and improved you.
Arm LiftTired of those loose flabby upper arms want to be able to go sleeveless then an arm lift may be just the help you need. An arm lift or brachioplasty is a cosmetic surgical procedure designed to reduce, reshape and contour the upper arm from the elbow to the underarm area. This procedure has become more popular since the advent of weight loss procedures such as gastric bypass.Frequently, this procedure is accompanied with liposuction. Liposuction is used to reduce the volume of excess fat then the resulting excess loose hanging skin is removed and reshaped. There are 2 general approaches. The standard technique or brachioplasty uses an incision from the armpit to the elbow. The more limited approach referred to as a medial brachioplasty uses an incision in the underarm area only. This approach is reserved for individuals who have only a minimal amount of excess hanging skin. The results with this approach are less dramatic and are not for everyone.This is an outpatient procedure that can be performed with general or local anesthesia with sedation. Generally, an arm lift takes 2 ½ to 3 ½ hours to perform depending on what needs to be done. Most patients are off work for 1-2 weeks. You are unable to resume strenuous physical activity for 2-4 weeks.The biggest concern with a standard brachioplasty is the scarring from the incision. This incision notoriously heals poorly meaning the scar stretches in width, can become raised and remain permanently discolored. Standard scar treatments are not very effective in improving the overall appearance. The same is true for a medial brachioplasty but the incision is more hidden in the underarm area.
Laser Hair RemovalLaser hair removal is one of the most popular cosmetic procedures performed worldwide. Both men and women seek this treatment to remove unwanted and unsightly hair from anywhere on their body. The most common areas treated include: lips, chin, bikini, armpits, legs, arms, chest, and back.The laser beam targets the pigment in the hair follicle. The hair follicle acts as a conduit, conducting the laser energy (heat) to the hair bulb. The blood vessels located in the hair bulb are destroyed. Without the blood supply there is no nutrients supplied to the hair follicle and hair growth is no longer possible. The best results are obtained in fair skinned individuals with dark hairs. People with tanned skin either from the sun or self tanners are advised to wait until a more suitable time.Because of the nature of the hair growth cycle, series of laser hair removal treatments are needed.
Three Stages of Hair Growth
Anagen Phase Is the Active Hair Growth Phase. During This Phase, the Hair Follicle Is Directly Connected to the Blood Vessels. It Is Only During This Stage That We Can Permanently Destroy the Hair Follicle.
Catagen Phase Is the Dormant Phase. The Hair Is No Longer in Contact with Its Blood Supply. The Hair Can Be Destroyed During This Phase but Not Permanently. The Hair Will Grow Back in Time.
Telogen Phase Is the Shedding Phase. During This Stage the Hair Is Totally Dormant. The Hair Is Falling Out but Can't Be Destroyed. Within an Area Not All Hair Follicles Are in the Same Hair Growth Cycle at the Same Time. Therefore Only the Hairs in the Anagen Phase of the Growth Cycle Are Destroyed.
Laser ResurfacingLaser resurfacing is a treatment for reducing fine lines, wrinkles and skin irregularities such as blemishes, age spots or acne scars. This treatment will help restore the skin to a more youthful appearance. Other names associated with technique include: lasabrasion, laser peel or laser vaporization.There are two types of lasers most commonly used in laser resurfacing carbon dioxide (co2) and erbium. Each laser vaporizes superficial, damaged skin cells.Co2 laser resurfacing uses continuous or pulsed light energy in a scanning pattern to precisely remove layers of skin. Fractionation of the laser beam leaves intact untouched skin allowing for faster healing and a quicker return to normal activities. In most cases this is an in office procedure, performed on an outpatient basis using oral sedation in combination with topical and local anesthesia. Healing generally takes anywhere from 3-7 days depending on the aggressiveness of the treatment.
Intense Pulse Light (Ipl) TreatmentIntense pulse light skin treatments or ipl treatments are used to help reduce the signs of sun damage, skin aging and improve skin imperfections. Photorejuvenation with an ipl system will create skin with a healthier, smoother and more youthful appearance.The skin is cooled with a cold gel. Sometimes an anesthetic cream or gel is used. A handpiece is gently touched to the skin and pulses of light are applied. You will feel a slight stinging sensation like the snapping of a rubber band. The treatment generally takes about 20 minutes.You are able to return to work and resume normal daily activities immediately without any downtime or signs of treatment. A series of 4-6 treatment sessions are usually required to achieve the optimal results. The procedure provides gradual improvement with very low risk.Conditions that are improved with this type of treatment include: age spots, sun spots, sun damage, mottled pigmentation, a ruddy complexion, brown spots, rosacea and fine facial veins.
Wrinkle ReductionThe cosmetic surgeon has many tools in his armentarium to fight the battle against wrinkles. There are many nonsurgical and surgical facial treatments that can reduce fine lines and wrinkles.Botox cosmetic and collagen fillers offer excellent temporary correction of forehead furrows, frown lines, crowsfeet, lip lines, laugh lines, marionette lines and more. These treatments offer more subtle results with minimal downtime and risks. Everyone will know you look better but they will be scratching their head trying to figure out why.Surgery offers more dramatic permanent results but at a cost. There will be more downtime, healing, scars, risks and cost. From facelifts to eye lifts the options are endless.Chemical peels are another modality to improve facial wrinkles. The concentration of the peel solution and the individual product selected will determine the magnitude of the results. Peels are graded by their depth of penetration into the skin: superficial, intermediate and deep. The stronger the product the deeper the penetration the better more long lasting the results will be. A chemical peel to the lower eyelid area is particularly beneficial and can postpone the need for a lower blepharoplasty.During your consultation, a thorough evaluation of all your concerns will be addressed. An explanation of the different options available to you will be discussed. You will then be able to make an educated decision about the best approach to meet your needs.
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