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Procedures
Arm Lift
Botox
Breast Augmentation
Breast Lift
Breast Reduction in Men (Gynecomastia)
Brow Lift
Chin Surgery (Mentoplasty)
Facelift (Rhytidectomy)
Facial Implants
Laser Facial Vein Removal
Laser Hair Removal
Laser Resurfacing
Lip Augmentation
Liposuction
Soft Tissue Fillers (including Collagen, Hylaform, Restylane/ Perlane, & Juvederm)
Tummy Tuck (Abdominoplasty)
Fluctuations in weight, growing older and even heredity can cause your upper arms to have a drooping, sagging appearance. And while exercise may strengthen and improve the underlying muscle tone of the upper arm, it cannot address excess skin that has lost elasticity or underlying weakened tissues and localized fat deposits.
If the underside of your upper arms are sagging or appear loose and full due to excess skin and fat, an arm lift may be appropriate.
An arm lift:
- Reduces excess skin and fat between the underarm and the elbow
- Reshapes your arm to result in smoother skin and contours
- Results in a more toned and proportionate appearance
N.B.: This procedure results in a scar on the inside of the patient’s upper arm.
Source: American Society of Plastic Surgeons — www.plasticsurgery.org
Botox Cosmetic is a purified protein produced by the Clostridium Botulinum bacteria. It has been used safely by ophthalmologists for more than 15 years as a form of wrinkle therapy with no serious side effects.
Botox Cosmetic injections (Botulinum toxin, in small amounts) target the muscles that produce wrinkles, making them temporarily inactivate. This effectively causes frown lines, laugh lines and crow's feet to diminish or disappear altogether, while injections near the eyebrow or corners of the mouth can produce a temporary brow lift or lip lift.
Recently, Botox has been show to reduce the sweating of hands and armpits (hyperhydrosis) and even offer relief from mild forms of headaches.
Normally, it takes a few days after the injection to notice the wrinkle smoothing effect, and the results typically last for between three and six months. Patients may return for follow-up treatments after the desired effect of a treatment has expired.
Complications from Botox injections to the upper eyelid include occasional bruising from the injection, and a temporary lowering of the eyelid, which rarely occurs after frown line injection. Botox is used in extremely small amounts and is delivered by the physician to localized areas. Patients may return to their normal routines almost immediately.
The American Society of Plastic Surgeons (www.plasticsurgery.org) has additional information on Botox and the parameters for its safe, effective use.
Breast augmentation plastic surgery is an extremely common procedure that can increase fullness and projection of your breasts, improve the balance of your figure, and enhance your self-image and self-confidence. That said, Augmentation Mammaplasty, as it is technically known, it is a very personal choice to have the surgery and has its limitations. Patients need to weigh the benefits against the risks and potential complications — all of which should be discussed during one’s consultation with their surgeon.
Women decide to have breast enlargement surgery for various reasons, including a perception that their breasts are underdeveloped or because of differences in the sizes of the breasts or from changes after pregnancy or breast feeding. Some people simply want ‘fuller’ breasts, while others are dealing with the aftermath of weight loss, aging or childbirth — all of which can affect a woman’s breast volume and shape leading to a woman to opt for a breast augmentation.
A breast lift, or mastopexy, can help counter the loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast-feeding ultimately affect the shape and firmness of your breasts. Patients who are generally satisfied with the size of their breasts can have a breast lift to raise and firm them, resulting in a more youthful breast contour and/or ‘perky’ appearance. Some women feel they have lost significant breast volume and hope to reverse this situation. In such cases, implants inserted in conjunction with a breast lift can increase breast size at the same time as the shape and position of the breasts are enhanced.
Breast reduction in Men (Gynecomastia)
Gynecomastia can be surgically treated by removing excess fat, glandular tissue and/or skin. The result is a better proportioned and more masculine-contoured upper body.
Enlarged male breasts, also known as gynecomastia is characterized by:
- Excess localized fat
- Excess glandular tissue development
- A combination of both excess fat and glandular tissue
- Gynecomastia may present unilaterally (one breast) or bilaterally (both breasts)
The Procedure: Surgical removal of excess tissue is performed by excision and/or liposuction. This procedure can include areola reduction.
Results: Initial swelling should dissipate in 2-4 weeks. Final results may appear in 2-4 months. Incision lines will continue to fade for up to 1 year. Significant weight gain can reverse results.
Source: American Society of Plastic Surgeons — www.plasticsurgery.org
Expression lines or other signs of aging in the forehead and brow region can be unsightly and troublesome. If this is the case, a brow lift (“forehead lift”) can be worth considering.
A brow lift:
- Minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes
- Improves what are commonly referred to as frown lines
- Repositions a low or sagging brow that is hooding the upper eyelid
- Raises the eyebrows to a more alert and youthful position
A brow lift is designed to correct these aging features, while restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.
The Procedure: Brow lift surgery can be performed through multiple limited incisions hidden within the hairline or through a single incision in the natural crease of each upper eyelid. When there is significant excess skin in the forehead, an alternate technique using a wide incision across the top of the scalp may be recommended.
Results of a brow lift may be enhanced through laser resurfacing or a chemical peel that can further improve skin tone and surface appearance.
Results: Swelling should subside in 2-4 weeks. Final results may appear within 1-2 months. Incision lines will continue to refine and fade for up to 1 year.
Source: American Society of Plastic Surgeons — www.plasticsurgery.org
Chin surgery, also known as mentoplasty, is reshapes the chin either by enhancement with an implant or reduction surgery on the bone.
Many times a plastic surgeon may recommend chin surgery to a patient having nose surgery in order to achieve facial proportion, as the size of the chin may magnify or minimize the perceived size of the nose. Chin surgery helps provide a harmonious balance to your facial features.
Source: American Society of Plastic Surgeons – www.plasticsurgery.org
A facelift may restore the smooth contours to a patient’s face and neck. The procedure can be beneficial to a range of patients including those with a deep line, or fold, running from the corner of your nose to the corner of your mouth, jowls, deep wrinkles in the cheeks and sagging of the "highlight" areas of the cheekbones, and loose skin, wrinkles, or vertical “cords” or excess fatty tissue in the neck.
A facelift will not correct for sagging eyebrows, excess skin and fatty deposits in the upper and lower eyelids, or wrinkles around the mouth. Your plastic surgeon can provide further information about Blepharoplasty (Eyelid Rejuvenation) and other procedures to treat these areas.
For those dealing with a dramatic loss of weight (post-bariatric) a combined Face & Neck Lift is an option that may revitalize flaccid skin in the face and neck areas. The surgeon will create incisions that are inconspicuous (placed in front of and behind the ears, and extend into the hair above and behind the ear) to raise the cheek pads, correct the jowls, and remove the loose and sagging skin.
Post-bariatric surgery patients may, according to the American Society for Aesthetic and Plastic Surgery, be nutritionally deficient, and this can have consequences for surgery and recovery. Patients may be referred for nutritional counseling and advised to wait a year or longer following their weight loss before undergoing plastic surgery. It is also important for the patient’s weight to stabilize before body contouring begins.
A consultation with a Board-certified surgeon is the best way to determine one’s candidacy while learning about the benefits, risks, and limitations involved in post-bariatric treatments.
If you would like to change the contours of your face, facial implants may be right for you. They can improve proportion and profiles and correct imbalance caused by injury or hereditary traits.
The Procedure: Appropriately sized and shaped implants most commonly in the cheek, chin, jaw or nasal region will be carefully selected and placed. Incisions inside the mouth or discreetly placed external incisions create space in soft tissues for implant positioning and support.
Results: Almost immediate, initial swelling should subside in 2-4 weeks and dissipate in 1-2 months as final results appear.
Source: American Society of Plastic Surgeons — www.plasticsurgery.org
Unsightly facial veins are enlarged blood vessels caused by aging, pregnancy or oral contraceptives. Many women develop varicose veins in their legs after pregnancy.
When facial and leg veins are treated with a laser, the laser light is absorbed into the blood cells, and causes the blood to coagulate. This leaves the blood vessel walls unsupported, causing them to collapse. During the healing process, the blood vessels contract, scar and are eliminated.
Laser removal of veins is painless, leaves no bruises, and is very effective. Most small to medium veins can be treated with great effectiveness, minimal discomfort and no side effects.
Laser treatment of spider veins can eventually eliminate most blood vessels; you can leave our office without bruises after you are treated and return to work. Large leg veins may need to be treated with sclerotherapy – form of injection.
During laser treatment you will experience a mild snapping sensation rather like being snapped with a rubber band. Laser treatment of veins does not require you to take pain medication or receive local anesthetic.
Right after your treatment the veins treated may appear darker but the color will fade over the next six weeks.
Three treatments at three-month intervals may be necessary to eliminate all veins.
Laser hair removal works by targeting the pigment inside the hair follicle without damaging delicate pores and structures of the skin. Because hair cycles through "growth" and "dormant" phases, and because during the dormant phase the follicle has no pigment, at least 2 or 3 treatments will be needed. Dark hair is more effectively treated, as it has more pigment than red or blonde hair. Grey hair has no pigment, and therefore can not be treated.
The area to be treated is shaved. A small hand-piece, or "wand", is placed against the skin and a burst of coolant is applied as the laser is activated. The hand-piece is repositioned and the laser is activated again. The size or the area treated will determine the number of laser pulses required.
With electrolysis, the operator inserts a needle into the hair shaft with the intention of reaching the follicle, then sends a small electrical charge designed to ablate the follicle. The operator then removes that particular hair with a tweezer.
Hair removal is much faster with a laser as the laser is pulsed about once per second across the surface of the skin. Each "pulse" of laser light disables a large numbers of hair follicles. Electrolysis operators can only treat those hairs that they can see and which they can reach the follicle through the hair shaft. A laser treats any "active" follicle, even if the hair has not yet reached the surface of the skin, or if the hair shaft is not straight.
The number of sessions will vary for each individual. During the initial visit, the laser light disables those follicles in the "active" phase of the growth cycle. Follicles in the "dormant" phase will not be affected. Since follicles cycle through "active" and "dormant" phases, additional sessions may be desired once the "dormant" follicles become "active". For this reason, we recommend a series of three treatments.
While some areas of the body are more sensitive than others, most patients report manageable discomfort. For more sensitive patients, anesthetic creams can be applied prior to the treatment.
Immediately after the treatment the skin will look pink and slightly swollen, similar to a sunburn. This will subside within an hour or two and the skin will return to normal. Occasionally, a patient will have temporary pigment changes, blistering, or scabbing. As with electrolysis, cases of scarring have been reported with laser hair removal, but these are extremely rare. A test spot is the best determinant of how each individual's skin will react.
Damaged skin and wrinkles whether caused by age, sun exposure, heredity, lifestyle or acne can be improved with laser skin resurfacing. Laser resurfacing removes layers of skin thereby revealing a new, younger looking layer of skin underneath.
The laser can be used on specific areas or the entire face. Skin color is not necessarily a barrier to treatment though skin thickness and texture may determine whether you are a good candidate for laser resurfacing. The laser produces a tightening effect on the skin which can be beneficial when used on thin skin, particularly the lower eye lid.
If you are having other facial cosmetic surgery such as a facelift, you may be able to have laser skin resurfacing at the same time.
Your surgeon will assess your skin type and the extent to which you have sun damage, uneven pigmentation and skin imperfections since fine lines and deeper wrinkling or depressions will require different approaches to treatment.
The effect of skin resurfacing using a carbon dioxide (CO2) or Erbium YAG laser is similar to the results obtained using chemical peels and dermabrasion. The laser, however, removes skin layers by vaporization rather than with chemicals or sanding.
Risks of laser resurfacing are few but include infection or abnormal healing. If you have had allergic reactions or herpes, skin resurfacing can cause a recurrence of these conditions. There are medications available to help prevent these outbreaks.
Some patients form raised or thickened scars following the procedure. This response can be unpredictable. Loss of pigmentation can occur after treatment, and this may take months to develop.
Following laser resurfacing, you must avoid sun exposure until the redness of your skin has gone. In fact, it is better to avoid the harmful effects of the sun permanently with sun block and head coverings.
A scab may or may not form over the treated skin but you will be advised about this and cleansing your skin by your surgeon
Camouflage makeup can be used within a two weeks of resurfacing and you should be able to return to work within a week to ten days depending on the extent of treatment.
Lip augmentation is considered an “injectable filler” that can create fuller, plumper lips and reduce fine wrinkles around the mouth. Lips may be injected with collagen or with fat transferred from another place in the patient’s body. Both liquid collagen and fat are absorbed and repeat treatments are necessary to maintain results. (Newer, longer-lasting options for implantable materials are available. Ask your surgeon about these options.)
A natural or synthetic biocompatible material, or the patient’s own fat, is injected or implanted in the lips. A single injection is usually sufficient to produce the desired result, which may be temporary, depending on the material used. Injections may need to be repeated periodically. Proper placement of the injected material is important.
Patients should be aware that of the risks and possible complications (ranging from allergic reactions to short-lived results for collagen injections, etc.), all of which may be reviewed with the surgeon during the consultation phase. Similarly, patients should know that soft tissue augmentation does not stop the aging process. If a patient wishes to change the elements of your face, surgery such as a facelift, brow lift or Eyelid Rejuvenation (Blepharoplasty) may be the answer.
Despite good health and reasonable active lifestyles, some people still have bodies with more shape than they prefer due to localized fat deposits — situations that may be the result of genetics rather than a lack of weight control or fitness. Liposuction (lipoplasty) can slim and reshape specific areas of the body by removing excess fat deposits, improving the patient’s body shape and proportion.
Liposuction is an attractive option for both women and men, especially those who are of relatively normal weight but have isolated pockets of fat. Liposuction is often the only way to eliminate these fats deposits.
While it is possible to undergo liposuction at almost any age, you will, according to the American Society for Aesthetic Plastic Surgery, obtain the best results if your skin still has enough elasticity to achieve a smooth contour following fat removal. When skin is inelastic, as in some older patients, it may not redrape well and a skin tightening procedure may be necessary.
Experts agree that liposuction is not a treatment for obesity nor is it a substitute for proper diet and exercise. It is also not an effective treatment for cellulite, the dimpled skin that typically appears on the thighs, hips and buttocks, or loose saggy skin.
Soft Tissue Fillers
(including Collagen, Hylaform, Restylane/ Perlane, & Juvederm)
The aging process produces wrinkles that appear as the result of collagen and elastin fibers breaking down in one’s skin. This breakdown can also be attributed to excessive squinting, frowning and smiling. Prolonged smoking can have dramatic negative effects on a person’s skin and resulting appearance.
Wrinkles can be smoothed out by filling the skin or the tissue under the skin with fillers, of which there are many types, including those made from synthetic materials (e.g. polymethyl methacrylate or beads).
Synthetic fillers are intended to be permanent, although these may be rejected by the body due to exposure or infection. Natural substances such as collagen, hyaluronic acid or dermis are also used as fillers, providing temporary results. A third option is for a patient to have a permanent filling that involves the transfer of fat from one part of their body to another. This procedure is known as fat grafting or lipo-filling.
In addition to filling out wrinkles, lipo-filling can be used to re-contour the face and produce a ‘fullness’ to cheeks, chin, lips and lower eyes. In this procedure, the fat is liposuctioned from the abdomen or thighs and injected into the desired location in the face that requires more volume.
It should be noted that fat that is injected into areas of non-movement, such as below the area below one’s eyes or the hollows of one’s cheeks, lasts longer than in movement areas, such as around one’s lips. (Fat grafting has also been shown to improve atrophic aging of the hands.)
Some injectable fillers, such as collagen, pose a small allergic risk. Fat transfer is widely used because it tends to be well tolerated, due in large measure to the fact that one cannot be allergic to substances that originate in their own body.
Patients should be aware that swelling and bruising is expected after fat injection. Discomfort following most procedures can be easily controlled with mild medication.
Your plastic surgeon will discuss the risks and benefits of all available tissue fillers and help you decide what, if any, are the options for you.
Women and men who have loose abdominal skin and fat that is concentrated in the abdomen can benefit from Abdominoplasty, or what is commonly referred to as a “tummy tuck”. Sometimes the conditions that make a tummy tuck desirable are the result of genetics, while others may have undergone substantial weight loss that has caused abdominal skin to sag. Abdominoplasty also can tighten muscles that have been separated and weakened by pregnancy. (The procedure may somewhat improve the appearance of stretch marks, especially those located below the navel.)
Those who may qualify for Abdominoplasty include patients suffering from excess or sagging abdominal skin, an abdomen that protrudes and/or is out of proportion to the rest of their body, abdominal muscles that have been separated and weakened, or excess fatty tissue concentrated in the abdomen.
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