What is Abdominoplasty?

Also called a tummy tuck, abdominoplasty is a procedure that is used to
remove excess skin, fat and other tissue from the abdominal area,
eliminating “flab” and restoring underlying muscle tissue for a
firmer, more toned, sleeker appearance.

What causes belly flab?

The abdomen can become loose and “flabby” for many reasons, including significant weight loss, a cycle of repeated weight gains and losses, multiple pregnancies, and the natural effects of aging. That flabby appearance is caused not only by excess fat and skin but also by a weakness and separation in the wall of muscle that supports the belly area. These muscles frequently weaken and separate as a result of “holding in” a large belly, either as a result of pregnancy or significant weight gain. Also, skin becomes less elastic with age, contributing to laxity and sagging. In addition to pregnancy and weight gain, trauma and even prior surgery in the abdominal area can also cause muscles to become damaged and weak.

What happens during an abdominoplasty?

Before surgery, the belly area will be carefully evaluated to determine the best approach to use to achieve an optimal outcome. Two types of tummy tucks are available: a complete abdominoplasty, which uses a
larger horizontal incision hidden by the panty line, or a partial or “mini” abdominoplasty which uses a smaller incision to address
issues that are located primarily below the bellybutton. During both procedures, the underlying tissue will be remodeled and repositioned for a firmer, sleeker appearance.

What is breast reduction surgery?

Breast reduction surgery, or mammaplasty, is a procedure that removes excess fat, skin and glandular tissue from breasts that appear over large or out of proportion with the rest of the body, or which cause back pain or shoulder pain. Many people with heavy breasts also have deep troughs in the shoulder tissue where bra straps have exerted significant pressure.

How is breast reduction performed?

Breast reduction surgery uses an incision to access the tissue inside the breast so it can be removed. The incision is typically located on one of three areas:

1. Encircling the areola and nipple

2. Encircling the areola and nipple and then extending down in a single straight
line to the breast crease

3. An upside-down T-shaped incision extending from the areola down to and
along the breast crease

The placement and shape of the incision will depend on the amount of tissue being removed, the anatomy of the breast and other factors. Once the incision has been made, excess tissue will be removed from the breast and the remaining tissue will be carefully reshaped. The areola will be reduced in size if necessary, and the nipple will be repositioned. The incision will be closed in layers using very small sutures or stitches to help the area heal properly and to stabilize the tissue in its new shape. Surgical tape or glue may be used to close the upper layers of skin, and a compression bandage may also be
used to reduce swelling. Sometimes liposuction will be performed at the same time as a breast reduction to remove excessive amounts of fat. Either sedation or general anesthesia may be used for the
procedure, which can be performed on an outpatient basis.

What is eyelid surgery?

Eyelid surgery, or blepharoplasty, is a procedure used to reshape the upper or lower eyelids (or both) by removing excess skin and fatty tissue. Eyelid surgery can be used to eliminate the droopy or “hooded” appearance that often occurs with older age, and it can also eliminate under-eye “bags” and puffiness. Blepharoplasty can also be performed to correct lids that turn in (entropion) or out (ectropion), both of which can cause eye irritation and interfere with normal tear production and distribution.

How is blepharoplasty performed?

The approach will depend on which lid – upper or lower – are
being treated. Incisions may be made in the crease of the upper lid, so scars are hidden when the eyes are open, or along the lash line of the lower lid. Some types of lower lid surgery can be performed via an incision made on the inside of the lower lid, a technique called transconjunctival blepharoplasty. Once the incisions are made, fatty tissue and excess skin are carefully removed; then the incisions are closed using tiny sutures. Blepharoplasty is performed in an outpatient setting using sedation. Patients may choose to have just the upper or lower lids treated or both.

What will recovery be like?

Immediately following eyelid surgery, an ointment will be placed on the eye to protect the treatment area and prevent infection. Over-the-counter pain medication and compresses can be used to reduce discomfort and swelling, and contact lens wear may need to be suspended for a brief period to avoid irritation. Patients should also be sure to discuss any chronic eye conditions or diseases like dry eye syndrome or glaucoma before their procedures. Redness, irritation, and bruising typically resolve within about a week. Patients will receive complete care instructions, including guidance regarding the use of mascara and other eye cosmetics and products.

What is fat transfer?

Fat transfer uses fat cells derived from a patient's body to plump up areas where volume has been lost and fill in lines and wrinkles throughout the face and in other areas of the body, including the buttocks and the breasts. Because it uses tissue from the patient's body, fat transfer is not associated with risks of rejection or other side effects that can occur with synthetic filler materials. Fat is absorbed by the body over time without any ill effects, making it a preferred option for some patients who cannot or do not wish to receive synthetic filler products.

Where can fat transfer be performed in the face?

Fat transfer can be performed on multiple areas of the face, including the cheeks, nasolabial folds (the lines that extend from the corners of the nose to the corners of the mouth) and the area under the eyes. Fat transfer helps restore volume and plumpness in areas that have begun to appear sunken or “hollowed out,” as well as helping to define areas like the cheeks. Fat transfer in the cheeks can also help wrinkling and skin laxity by gently lifting skin in the areas around and below the cheeks.

Can fat transfer be used in areas other than the face?

Yes, fat transfer can also be used in breast augmentation and in butt lift surgeries to provide a natural alternative to saline and silicone implants and other synthetic products.

What happens during the fat transfer procedures?

During the transfer procedure, fat is extracted from another area of the body, very often the belly region or the thigh area, then processed and reinjected into the treatment site.

How long do fat transfers last?

The body will reabsorb some amount of fat over time, but much of the fat that is injected will remain at the treatment zone where it will be incorporated into the natural structure of the skin. Some studies have shown fat transfers can persist for a year or more. Touch-up procedures can be used to help maintain the results.

How does BOTOX® work?

BOTOX® is a neuromuscular agent, which means it works on the nerve signaling between the muscles and the brain that control how and when those muscles contract. Facial muscles contract every time an expression is made, and as they contract, they tug on the skin that overlies them, creating lines and folds. Over time, these lines and folds become more permanent, becoming visible even when expressions are not being made. BOTOX® works by blocking the nerve transmissions between the facial muscles and the brain, so the muscles do not contract, and the skin is not pulled and creased. BOTOX® injections are typically repeated every six weeks or so. Over time, skin becomes softer, and lines and wrinkles become less noticeable, which means the time between injections may be extended.

Are cosmetic fillers the same as BOTOX®?

No, cosmetic fillers are used to treat wrinkles that form as a result of sun damage, pollution, gravity, age and other factors, not those that form as a result of facial movements. Fillers work by plumping up lines and wrinkles. Many fillers use hyaluronic acid, a naturally-occurring substance that helps the skin retain moisture, so it looks plumper naturally. Plus, the filler injections can help stimulate the production of collagen, so skin looks firmer and more resilient over time. Fillers typically last anywhere from six months to as long as two years, depending on the type of filler and the area which is being treated.

Can fillers and BOTOX® be used together?

Yes, many women and men opt to have both types of injections to treat both dynamic (“movement” wrinkles) and static (age-related wrinkles) at the same time to achieve all-over effects in multiple areas of the face.

Will the injections hurt?

Injections of BOTOX® and fillers can cause some minor discomfort and swelling, but these effects go away soon afterward. Patients should not rub the areas, which can wind up enabling the solutions to travel to other areas and diminish the result.

How does liposuction work?

Liposuction removes excess fat via suction, using a thin, flexible tube called a cannula which is inserted into areas of unwanted fat through very small incisions. The cannula also helps break fat deposits apart to make removal easier. Liposuction is not intended as a replacement for diet and exercise, but it is often used for people who have already lost weight and still have areas of fat that simply don't respond to diet and exercise routines. It can also be used in people who are not overweight to remove stubborn pockets of fat.

What areas can be treated with liposuction?

Liposuction can be used to treat many areas, including:

The bellyThe waistThe buttocksThe hipsThe backThe kneesThe chin and neck areas

Liposuction can help make all these areas appear slimmer, firmer and more toned. In the abdomen and other areas of the torso, liposuction also helps reveal the underlying muscles, so the effects of exercise are more visible.

What happens during the liposuction procedure?

Before liposuction is performed, a physical exam and medical assessment will be performed to determine the best approach as well as the best incision sites to provide access to the treatment areas. During the procedure, small incisions will be made through the skin and into the deeper layers where fat is located. Fluid will also be administered through the cannula into the treatment area to make it easier for the fat to be suctioned away and to help control bleeding. The cannula will be moved back and forth through the treatment area to ensure an adequate amount of fat is removed. Once fat removal is complete, the incisions will be closed, and a bandage will be placed on top of each incision site. Procedures are performed under general anesthesia, and in some cases, ultrasound may be used in conjunction with liposuction to liquefy the fat so it can be more easily extracted.

Breast augmentation includes surgical techniques designed to increase the size of the bustline through the use of saline or silicone implants, or sometimes, fat grafting. The reasons for undergoing breast enlargement surgery are very personal. Some women decide to undergo surgery after losing breast volume following significant weight loss, pregnancy or breastfeeding while others may have surgery to “even out” breasts of uneven sizes. Still others have very small natural breasts and want to feel more confident in the way they appear, and some women simply want to achieve their aesthetic ideal.

How is breast augmentation performed?

Breast augmentation can be performed in different ways, depending on the type of implant that is being used, the anatomy of the patient and other factors. Surgery begins with an incision which is usually made around the nipple, in the crease or fold beneath the breast or in the underarm. A pocket is created in the underlying tissue to help hold the implant in place. The implant will be placed into this pocket and secured. Silicone implants are inserted into the pocket “whole,” while saline implants can be inserted “empty” and then filled with saline solution once in place. The implants will be carefully positioned and centered under the nipple before the incisions are closed using small sutures. A compression bandage will be placed over the surgical site to aid in healing.

How will I feel after breast enlargement?

Following breast augmentation surgery, there will be some bruising and discomfort as the tissues adjust to the implants. Soreness and swelling will dissipate within a couple of weeks, and wearing a compression garment during this time will help reduce swelling and promote faster healing. There will be activity restrictions during this time, including avoiding heavy lifting and strenuous activity, to prevent placing strain on the chest muscles and tissues. Final results of the surgery will be visible once the swelling resolves.

What are PRP injections?

Blood is composed of several elements, including red and white blood cells, plasma (the liquid portion) and platelets. Platelets play an important role in clotting and healing, stimulating the production of growth factors as well as collagen. PRP, or platelet-rich plasma, is a concentrated form of plasma that contains a much higher number of platelets. PRP is derived from a blood sample taken from the patient. The sample is processed using a special device to separate the platelets and concentrate them. Then the platelets are mixed with the remaining blood and injected back into the patient in the specific areas in which a healing response is desired.

How are PRP injections used?

PRP is used in cosmetic treatments and also to facilitate healing following injury or surgery. In cosmetic surgery, PRP therapy is commonly referred to as a “vampire” facelift, thanks to its use of blood products. PRP is used to correct cosmetic issues like wrinkles and loose, lax skin by stimulating the healing response at the cellular level, promoting the formation of new, healthy tissue to replace tissue damaged by the sun and other factors and restoring a healthier tone and texture to the skin. PRP is also used to replace volume in the eye areas and other locations where the skin appears thinner and less resilient.

What is the procedure like?

First, the skin will be numbed with a topical gel or cream to reduce any discomfort caused by injections of PRP. A small sample of blood is drawn and processed to concentrate the platelets. The blood product is mixed with Juvederm®, a hyaluronic acid-based cosmetic filler, and then reinjected into the skin to promote both immediate and long-term results.

What is the recovery process like?

Many patients may experience swelling for the first few days after treatment, but any discomfort can be relieved with over-the-counter pain medications. No activity restrictions are imposed following treatment. Initial results are visible once swelling resolves, with continued improvements as the skin remodels itself.

What is a breast lift?

Also called a mastopexy, a breast lift improves the appearance of sagging, pendulous breasts by removing excess fat and skin and repositioning the breasts in a more natural, uplifted position for a younger-looking profile. Plus, by removing sagging tissue, breasts can look and feel firmer and more toned, and nipples can resume a natural, upright position. Breast lift surgery can be an especially good option for women whose breasts are sagging as a result of older age or following childbirth or breastfeeding.

How is a breast lift procedure performed?

Breast lift surgery is performed as an outpatient procedure using general anesthesia or sedation. During the procedure, an incision will be made encircling the nipple and extending down the bottom of the breast to the crease beneath the breast so the underlying tissues can be accessed. The excess tissue will be removed, and the nipples may be resized and reshaped before being restored to a more uplifted position on the breast. Once the breasts have been repositioned, the incisions will be carefully closed with tiny sutures and surgical adhesives in some cases. Most procedures take about two to three hours to complete.

How can I tell if a breast lift will help me get the results I'm looking for?

Mastopexy can be a very good solution for many women with drooping, pendulous breasts, but it is not always the ideal choice. Scheduling a consultation and evaluation is the best way to determine if a breast lift is an appropriate choice or if another option might be a better solution. Some women will benefit from having a breast augmentation at the same time as breast lift surgery to help restore the breast to a fuller, more natural-looking profile and to replace volume lost as a result of aging or following pregnancy and breastfeeding. A consultation appointment can also help determine if a combined procedure is appropriate to achieve the desired result.

How can rhinoplasty improve the appearance of the nose?

Rhinoplasty uses different techniques to address specific issues, including:

A nose that appears too largeA nose that appears too wideBumps or other unevenness in the nose, including the bridge and the tipNostrils that are uneven or appear too wide

Because the nose is located in the central portion of the face, rhinoplasty can have a dramatic effect on the appearance of the entire face, helping patients achieve improved aesthetics, better symmetry and a more pleasing balance among the features. Rhinoplasty may also be referred to as nose reshaping or a “nose job.”

How is rhinoplasty performed?

The specific approach will depend on the issue that is being addressed by the surgery, but generally speaking, the procedure will begin with incisions made either outside the nose along the creases where the nose meets the face to camouflage incisions or inside the nose where incisions cannot be seen. Once the cartilage, bone, and other tissues are exposed, special instruments will be used to remove and reshape the tissue, then the skin and other tissues will be redraped, and the incisions will be closed using very tiny sutures. The nose may be packed with surgical gauze to control bleeding and swelling, and a bandage and splint will also be used to help protect the nose and “hold” it in its new position during the initial stages of healing.

What is the recovery period like?

After rhinoplasty, there will be swelling and bruising around the eyes and nose, and compresses and painkillers can be used to reduce discomfort. There will be some limitations on activities like bending and lifting during the first week or so. The head should also be kept elevated during this time to help reduce swelling. About a week after surgery, the splint will be removed. Bruising and swelling usually resolve entirely by about two weeks after surgery.