Suture Lift

Chosen clients on whom this procedure is done are able to achieve significant tightening or lifting of the following areas (i.e.) eye brows, cheek, nasolabial folds, jawls and neck.

A stitch is applied to lift the area desired and anchored to a fixed point with a small incision, when doing a brow lift, nasolabial lift or cheek lift.

When doing a lift of the jawl and neck a small amount of skin may need to be removed. A small amount of folded skin in front of the ear would shrink in about 6 to 8 weeks.

An initial obligation face consultation is required as to ensure the procedure would suit you.

Together with this minimal lift other minimal procedures can be done. Permanent or temporary skin fillers can be used to enlarge the lips fill the nasolabial folds, cheek, chin, corners of mouth and frown lines.

A combination of procedures can also help to improve the face, common procedures being liposuction of the jawl, neck, and chin implant while doing a stitch lift.

Down time is about 4 to 5 days.

Varicose Spider Veins

Imagine wearing shorts without being embarrassed. Imagine not worrying about unsightly facial spider veins. It's all possible at our centre.

You may not realise it, but whether or not you have ugly (and sometimes painful) varicose or spider veins is really up to you. It's a choice, because you can get them removed easily and virtually painlessly.

You can take advantage of the experience we've gained by helping thousands of men and women put an end to these unsightly veins. And you'll feel reassured knowing that over 95% of our patients are more than pleased with the results.

Your varicose and spider veins can disappear without surgery.

In years past, the only way to remove varicose or spider veins was through painful surgical vein stripping and a long hospital stay.

But now our sclerotherapy treatment enables us to remove varicose and spider veins without surgery using just simple injections. The veins fade away in a few weeks, with little discomfort and no surgical scars, so you can get back to doing the things you love to do immediately.

Discover how easy it is to lose those ugly veins with a no risk consultation.

We offer all new patients the opportunity to see the difference we can make to them.

You'll receive results of actual cases, receive a comprehensive medical evaluation of your vein problem, get ultrasound testing if necessary, and get a confidential consultation.

So get the look you've always wanted. It's simple, at our centre.

Facial veins are also successfully treated by our Argon laser.

Aeshetic Plastic Surgery At Turkey

WORLD QUALITY AESTHETIC PLASTIC SURGERY

Years and years Clinic save a lot of person all over the europen country.It’s very prides save yourself.If you are beeing aesthetic operations in Turkey, please you will not determine as you acknowledge with us.

You Enter This Clinic , find another intelegence and be conforted with another clinic…you will see detail in scientific mission and live franchise in technological installalation.You have not only holidays but also change all your life.

ARE YOU READY FOR THE VARITION..?
Especialy price for you…
Rhinoplasty 1500 - 2500 €
Liposuction 1500 – 3000 €
Breast plastic surgery 2500 - 3500 €
Abdominoplasty 2000 €

For Questions MD Phone: 0090 532 527 75 24

Package services includes
Examination
Operation
Chek up examination on the day after the operation
A day of accomadation in hospital

1. pocket
4 star hotel single room 120 €
• room
• breakfast

2.pocket
5 star hotel single room 150 €
• room
• breakfast
• turkish bath
• sauna

**** That’s enough 6 days 5 night accomadation all of the operations.

If you want to airport - hotel – hospital transfer, you will connect with us:

Md Phone: 0090 532 527 75 24

Dermatologic Peeling Dermabrasion

Wrinkles, pigmentations, freckles, acne prone skin or post acne scarring are conditions suitable for skin-resurfacing treatment, either chemically or mechanically. A chemical peel is done to remove the top layers of facial skin. It reduces fine wrinkles and evens out the skin tones, leaving younger looking skin. A peel can be done on the entire face or just specific areas. It does not replace a facelift as it won’t eliminate sagging skin, but many patients benefit from a combination. Usually three different agents in different concentrations and mixtures are used for this purpose: Phenol, Trichloro-acetic-acid or Alpha-hydroxy-acids.
Phenol-peeling: Phenol has a deep penetration and is the most powerful agent. Therefore some disadvantages as depigmentation, pain and hypersensibility to sun-exposure are common.

Trichloro-acetic-acid ( TCA ): TCA does only have a relatively superfical effect but with a pre-peeltreatment with Retin-A and hydrochinone, a sufficiently deep effect is achieved.

Alpha-hydroxy-acids ( AHA ): The AHA-s are since ancient ages in use and have recently gained a renaissance. The active agent is a component in commercially available differnt brands, mostly handed out by cosmeticans, who also usually make superficial peelings, whereas deeper peels should be made by physicians. The AHA´s gives the skin a "polish" but never removes scars or even wrinkles. This procedure takes between 15 minutes and 1 hour depending on how much is being peeled. A general anesthetic will be used if the full face is being done. Patients can expect swelling, and crusting for 1-2 weeks. There is usually almost no discomfort. If the full face is done you can expect to be off work for two weeks. Usually you can begin driving in one week and exercise in two to three weeks.

In dermabrasion, the superficial layers of the skin are planned out with an abrading device, leaving a wound permitting scarless healing. This procedure needs some kind of anaesthetic.

Plastic Surgery of Carpal Tunnel

The major physical findings reflect that pressure is increased in the carpal tunnel. If more information is needed to make the diagnosis, electrical studies of the nerves in the wrist may be requested. Several tests are available to see how well the median nerve is functioning, including the nerve conduction velocity and electromyography (EMG). This test measures how fast nerve impulses are conducted through the nerve.

In the early stages of Carpal Tunnel syndrome, a splint will sometimes decrease the symptoms, especially the numbness and pain occurring at night. It may also help control the swelling of the tenosynovium and reduce the symptoms of carpal tunnel syndrome. If this fails to control your symptoms a cortisone injection into the carpal tunnel may be suggested. This medication will decrease the swelling of the tenosynovium and may give temporary relief of symptoms. If all of the previous treatments fail to control the symptoms of carpal tunnel syndrome, surgery will be required to reduce the pressure on the median nerve.

The median nerve runs into the hand to supply sensation to the thumb, index finger, long finger, and half of the ring finger. The nerve also supplies a branch to the muscles of the thumb, the thenar muscles.
One of the first symptoms of carpal tunnel syndrome is numbness in the distribution of the median Nerve. This may be quickly followed by pain in the same distribution. The pain may also radiate up the arm to the shoulder, and sometimes the neck. If the condition is allowed to progress, weakness of the thenar muscles may occur. This results in an inability to bring the thumb into opposition with the other fingers and hinders one's grasp.
Looking at a cross section of the wrist allows one to visualize the anatomy of the carpal tunnel. The carpal tunnel is an opening into the hand that is made up of the bones of the wrist on the bottom and the transverse carpal ligament on the top. Through this opening, the median nerve and the flexor tendons run into the hand. The median nerve lies just under the transverse carpal ligament. The flexor tendons allow us to move the hand, such as when we grasp objects.

The Tendons are covered by a sheet called tenosynovium. The tenosynovium is very slippery, and allows the tendons to glide against each other as the hand is used to grasp objects. Any condition which causes irritation or inflammation of the tendons can result in swelling and thickening of the tenosynovium. As all of the tendons begin to swell and thicken, the pressure begins to increase in the carpal tunnel because the bones and ligaments that make up the tunnel are not able to stretch in response to the swelling. Increased pressure in the carpal tunnel begins to squeeze the median nerve against the transverse carpal ligament. Eventually, the pressure reaches a point when the nerve can no longer function normally. Pain and numbness in the hand begins.

There are many conditions which can result in irritation and inflammation of the tenosynovium, and eventually cause carpal tunnel syndrome. Different types of arthritis can cause inflammation of the tenosynovium directly. A fracture of the wrist bones may later cause carpal tunnel syndrome if the healed fragments result in abnormal irritation on the flexor tendons. The Key Concept to remember is that anything which causes abnormal pressure on the Median Nerve will result in the symptoms of pain, numbness and weakness of carpal tunnel syndrome.

Evaluation begins by obtaining a history of the problem, followed by a thorough physical examination. Description of the symptoms and the physical examination are the most important parts in the diagnosis of carpal tunnel syndrome. Commonly, patients will complain first of waking in the middle of the night with pain and a feeling that the whole hand is asleep. Careful investigation usually shows that the little finger is unaffected. This can be a key piece of information to make the diagnosis. Other complaints include numbness while using the hand for gripping activities, such as sweeping, hammering, or driving.

Pediatric Surgery

PIGMENTED LESIONS OF THE SKIN
Pigmented lesions in the newborn are frequently difficult to interpret regarding their present or potential malignancy. Early consultation with a plastic surgeon and pathologist initiates (1) planning for surgical removal or other appropriate treatment, and (2) providing treatment options and counseling to the parents. Large congenital nevi pose a significant risk of early malignancy or later malignant transformation. Large and sometimes hairy nevi also are physically uncomfortable and psychologically damaging for child and parents. Surgical excision with skin grafting is often a treatment of choice.

MALFORMATIONS OF THE EAR
Ear malformations such as microtia can severely affect a child's self-image, especially if the condition is allowed to go uncorrected until school age. The importance of well formed ears in overall facial esthetics is reflected in the severe teasing inflicted by schoolmates on a child with malformed ears. Microtia is usually apparent at birth or soon after, seen as a "remnant" ear lobule, concha, acoustic meatus, tragus and incisura intertragica. Microtia is usually unilateral. Bilateral microtia may be associated with severe hearing defects that require consultation with an otologist. As soon as microtia is identified, the plastic surgeon should become a partner with the primary care physician in planning an approach to reconstruction. Consultation with the child's parents will help to plan the age at which reconstruction should begin; usually, reconstruction should be completed before the child enters school. Because autologous rib cartilage is commonly required to form a new ear framework, definitive reconstruction may take place at about age 5 or 6 years when rib growth has been adequate. Parents should be informed regarding potential complications of harvesting rib cartilage. Skin flap techniques are commonly used to mobilize the skin used to cover the new ear framework. The ultimate success of microtic reconstruction depends upon patient selection, adequate counseling of parents, selection of the proper material for an ear framework, surgical skill, and detailed attention in the intraoperative and postoperative periods to prevent complications such as infection, skin flap necrosis, and undue pressure on the operated ear.

MALFORMATIONS OF THE HAND
Hand malformations include syndactyly (webbed fingers), polydactyly (extra fingers), trigger fingers, crooked fingers, absent thumb, short fingers and missing fingers. All congenital hand malformations should raise suspicion of associated deformities of other organs or tissues. Syndactyly, for example, is frequently a readily visible manifestation of Poland's syndrome--congenital absence of thoracic structures in association with hand malformation. Plastic surgery can correct many hand malformations definitively; in other instances, plastic surgery can provide some degree of functional capacity. An example of functional restoration is microvascular toe-to-hand tissue transfer, which offers potential for surgical correction of hypoplastic or aplastic fingers. Consultation with the patient's parents must stress the importance of restoring function to the malformed hand, even if cosmetic appearance must be a secondary consideration. The unique function of the hand throughout life mandates that function be restored as fully as possible--e.g., providing pinch and grip function will be essential to many occupations. The primary care physician has an essential role in working with the patient and family to assure that exercise and rehabilitation regimens are followed, in order to maximize the advantages of surgical reconstruction and prevent debilitating complications such as contracture.

ANOMALIES OF THE BREAST
Congenital breast asymmetry may be a manifestation of underlying congenital anomalies. Poland's syndrome, the most frequent congenital cause of breast asymmetry, is a syndrome of thoracic structure deformities, breast asymmetry, and ipsilateral syndactyly. Computed tomography and magnetic resonance imaging are definitive in identifying the thoracic deformities. Treatment of breast asymmetry due to Poland's syndrome may include prosthetic augmentation, use of a musculocutaneous flap to fill hollow space on the exterior of the chest, or augmentation with tissue from the opposite breast. Definitive treatment includes surgical repair of the chest wall. As in the case of other congenital deformities, Poland's syndrome may be seen in association with anomalies of other tissues and organs.

SOFT-TISSUE INJURIES AND SUPERFICIAL BURNS
Falls, traffic accidents, animal bites, hot liquids, electrical equipment and physical abuse all produce injuries to the soft tissues of children. Treatment in an emergency department is often adequate, but failure to provide appropriate or definitive treatment in the emergency setting may produce permanent injury or disfigurement. It is important for the primary care physician to recognize when consultation with a plastic surgeon is indicated for definitive treatment.

SOFT-TISSUE INJURIES OF THE FACE
Facial injuries require special attention because of their potential for permanent disfigurement. Contusions, lacerations, puncture wounds, tattoos with debris and especially avulsive injuries all have the capacity to permanently disfigure the patient. Inadequate suturing of even small lacerations on the face can result in poor healing and scarring. Definitive repair of facial soft-tissue injuries is best carried out in an operating room rather than an emergency room, and preferably by a plastic surgeon. Should the injuries be complex or severe, the surgeon can perform procedures that will be definitive or will lay the foundation for later revision surgery. Injuries to particularly vulnerable facial features require special attention. Injuries to the forehead and eyebrow, eyelids, ears, nose, cheeks and chin have the most potential to result in disfigurement. In the case of injuries to cheek and chin, injuries also may result in loss of function if facial nerves or muscles are injured. Repair to facial nerves and muscles should be placed in the hands of a plastic surgeon experienced in this type of surgery.

ANIMAL BITES
Animal bites can present special problems--e.g., most dog bite wounds are to the face in children and are typically tearing-type soft-tissue wounds. Aggressive cleaning and meticulous repair by a plastic surgeon can frequently salvage a serious injury cosmetically and functionally. Snakebite presents the possibility of envenomation in addition to bite injury. If the type of snake is unknown, emergency treatment proceeds with observation and suspicion of envenomation. Bites inflicted by rattlesnakes may result in tissue necrosis--often severe--that requires wide dissection and debridement. Skin grafting or reconstruction with skin flap technique may be needed after primary healing of the wound site.

SUPERFICIAL BURNS
Most burns suffered by infants and young children are hot-liquid scalds, and as many as 15 percent of scald burns may be due to child abuse. Scald burns on the buttocks are especially likely to have resulted from abuse--e.g., sitting the child in very hot water as punishment. The immediate concern in scald injury is estimation of the extent of injury. The ratio of head-to-total body burn must be calculated differently in infants and children than in adults, due to inherent differences in relative size of head to body. Estimation of the severity of the burn is dependent upon (1) temperature of the scalding liquid, and (2) amount of time the skin was exposed to the liquid. Good emergency management of a superficial burn--i.e., limited extent, less than full-thickness--should result in healing without complications. Elements of good management include (1) evaluation, (2) rinsing with saline solution and light cleaning with mild soap-and-water solution, (3) debridement of any blisters that interfere with function, such as blisters on the eyelids, (4) instruction to the child's family in how to care for the burn after the patient is released from the hospital, and (5) examination of the patient by the treating physician within 2 days after the first dressing change, to rule out the possibility of wound-site infection. Burns of the ears and hands require special attention. Even superficially burned ears may later develop scarring or deformation. Burned hands can potentially develop scarring and contracture that limit function. A plastic surgeon should be called into consultation for burns on vulnerable sites such as ears and hands.

CONGENITAL ANOMALIES
A deforming birth defect has a devastating psychological impact upon the child's parents, and has the potential for life-long impact upon the physical, psychological and socioeconomic well-being of the child. Plastic surgery can improve or correct many of these birth defects. Because timing of surgery is often an important factor in improving the prospect for successful outcome, early consultation should be sought with a plastic surgeon. The primary care physician and the plastic surgeon work closely together in designing a maximally effective treatment plan for the affected child. Commonly, they work in the context of a multi-disciplinary team. The family physician and pediatrician may work together with the surgeon to help the parents deal rationally with treatment options. The physicians also may counsel the parents regarding the emotional, psychological and financial resources that may be strained by treatment that sometimes requires many months or years to complete.

CLEFT LIP
Anomalies of the heart and other organs are found in a substantial percentage of cleft lip/cleft palate patients, especially in conjunction with bilateral clefts. Every neonate with facial clefting should have a complete pediatric examination for indications of additional anomalies. Cleft lip may occur alone or in conjunction with cleft palate. Its forms range from mildly disfiguring to bilateral complete cleft with nasal deformity and involvement of the hard palate and teeth.

Treatment
Treatment begins soon after birth with pediatric evaluation of the patient for any coexistent anomalies, evaluation of the defect by a plastic surgeon, and consultation with the family regarding treatment options. Nonsurgical treatment may be used early--elastic headcap traction, a nose retainer and preoperative orthodontics if indicated. Lip repair can be performed any time after birth. In general, most repairs are timed according to the "Rule of 10s"--10 weeks old, weight of 10 pounds and 10 grams of hemoglobin. Secondary surgery may be necessary later for repair of a nasal deformity, revision of an earlier repair as the patient grows and develops, or repair of postoperative abnormalities in the scar. Severe bilateral cleft lip requires treatment and on-going coun- seling throughout the patient's childhood and adolescence.

CLEFT PALATE TREATMENT
Repair of the palate is directed at producing normal speech, restoring eustachian tube function, attaining closure of oronasal fistulas and minimizing alterations in maxillary growth. Depending on the patient, repairs may start as early as 10 months or as late as 24 months. Planning for primary surgical repair begins in the hospital shortly after the child is born, or soon after discharge. A small or moderate degree of clefting may be repaired by simple closure; a larger defect may require a pharyngeal flap, alveolar arch alignment, orthodontic and dental work, and bone grafting. Dental, orthodontic or prosthodontic consultation is sought when teeth are malformed or missing. Bilateral clefts are the most complex to repair, requiring a spectrum of medical and surgical specialists. In some cases, secondary soft palate (velopharyngeal) surgery may be necessary some months or years after primary palate repair, to correct hypernasal speech. Speech-language pathologists may assist in identifying the specific defect to be repaired. Velopharyngeal repair procedures include (1) palatal pushback plus pharyngeal flap lining, (2) posterior pharyngeal wall implant with Teflon injection, (3) pharyngeal flap, (4) palatopharyngeal flap, and (5) tissue expansion to create a flap. Long-Term Treatment: Some patients require months or years of speech-language training to acquire normal speech. The family members of a cleft palate patient may need long-term guidance and counseling to support them through the years of treatment.

HEMANGIOMAS AND OTHER BENIGN VASCULAR LESIONS OF THE SKIN
Hemangiomas and lymphangiomas, the most common benign tumors of the skin in neonates, may be present at birth or appear in the first months after birth. Some lesions regress and disappear in the first few months of life--e.g., the strawberry hemangioma. Large vascular lesions in critical locations can be life-threatening as well as disfiguring--e.g., multiple hemangiomas of the newborn involving skin, liver and intestinal tract. Consultations with a plastic surgeon may include consults with other specialists such as a hematologist when a lesion is very large or life-threatening. Laser treatment is often a treatment of choice for vascular lesions, including port-wine stain and unregressed strawberry hemangioma. Careful evaluation is required before laser treatment is undertaken.

Whats Cleft Lip Palate

Most children with clefts do not have other birth defects. Most are normal in intelligence and abilities. Children with clefts do have a higher incidence of a problem called serous otitis media-fluid in the ear. If untreated, frequent ear infections and even hearing loss can result. Many children with clefts have abnormalities of the teeth-this can range form crooked teeth to extra or missing teeth.

What is the treatment for cleft lip and palate?
Children with clefts benefit from specialized team care. Cleft teams consist of specialists in Plastic Surgery, Otolaryngology, Pediatrics, Oral and Maxillofacial Surgery, Genetics, Dentistry, babySpeech, Pathology, Audiology, Nursing, and Psychology. These teams work with the child's own pediatrician to provide the best care possible. Excellent care is also available outside of cleft teams, but requires more coordination of various specialists by the parents. Most surgeons repair cleft lip when the baby is 6 to 10 weeks old. Most surgeons repair cleft palate at 6 to 12 months of age. The exact age for repair will depend on the size and health of the child and the surgeon's preference.Some children with cleft palate will require a second operation on the palate to help get better speech. This happens in about 20% of cases, and cannot be predicted at the time of the original palate surgery. Many children with clefts involving the gun line will benefit from an operation to put extra bone in the gum. This is called an alveolar bone graft. This allows the permanent teeth to come in better. This operation is done sometime between the ages of 6 and 10, depending on how fast the permanent teeth are developing. Children with clefts of the lip may need or want touch up operations to improve the appearance of the scars. As teenagers, some need nasal surgery to improve breathing or appearance. In some children with clefts, the jaws are not in good alignment. In these cases, surgery can be done to align the bite.

Blepharoplasty Procedures and Topics

The blepharoplasty procedure will not eradicate the wrinkles around the eyes (crow s feet) nor will it elevate droopy eyebrow. There are other procedures designed for these purposes. Dark circles under the eyes may improve a bit if this is related to large bags , but most often the dark appearance of the lower eyelid skin remains. The best patients are those who are healthy, psychologically stable and well motivated. Some medical conditions may increase the risk of blepharoplasty surgery such as thyroid disease, high blood pressure, and patients who do not make sufficient tears to keep their eyes well lubricated.

Fortunately, when performed by a competent plastic surgeon, complications are infrequent and minor. All patients will experience some bruising and swelling for a few days after the surgery. In addition, a temporary problem with closure of the eyelids is usually seen. Some may have temporary blurring of their vision, usually due to the ointments applied to the incisions post operatively. In rare resiminstances, the lower eyelid may be pulled down causing an ectropion. If this does not resolve on its own, further surgery may be necessary. The theoretical complications of any surgical procedure, such as bleeding, infection, wound disruption and heavy scarring are also possible, but rare.

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat--usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won't remove crow's feet or other wrinkles, resimeliminate dark circles under your eyes, or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift. If you're considering eyelid surgery, this information will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, resimthink carefully about your expectations and discuss them with your surgeon. The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.

resimWhen eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery. The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle. Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

Eyelid surgery is usually performed under local anesthesia--which numbs the area around your eyes--along with oral or intravenous sedatives. You'll be awake during the surgery, but relaxed and insensitive to pain. (However, you may feel some tugging or occasional discomfort.) Some surgeons prefer to use general anesthesia; in that case, you'll sleep through the operation. .

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones. In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures. If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

After surgery, the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by your surgeon. If you feel any severe pain, call your surgeon immediately. Your surgeon will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. (Bruising varies forn person to person: it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month.) You'll be shown how to clean your eyes, which may be gummy for a week or so. Many doctors recommend eyedrops, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision. Your surgeon will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they're out, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better.

You should be able to read or watch television after two or three days. However, you won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while. Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.Your surgeon will probably tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line. On the other hand, the positive results of your eyelid surgery-the more alert and youthful look-will last for years. For many people, these results are permanent.

Reconstructive Surgery Operations

There are two main divisions of Plastic Surgery

* Aesthetic Surgery (Cosmetic Surgery) (Other Topics)
* Reconstructive Surgery ( This Topic )


Hemanjiom(Red Spots)

Usually starts seen one month after the birth. Can be place all over the body with different sizes, usually on the face area. If there is no functional problem, does not recommended earlier operation than normal operation time.

Hypospadias(Prophet Circumcision)

Pissing hole placed down than it has to be on the penis for males. It could be in all levels. Operation could be after the age of 2.5 – 3. Operation must over before the school period. Operation techniques can be change according to area which pissing hole placed. Operation could be only one or several times. There is always a fistula risk in operations.

Syndaktili(Attached Fingers)

Especially could be for fingers and sometimes for toes. Could be on only skin and sometimes until the bones. Separating could be after the age of 2.

Mikroti(Earless ness from birth)

There can be too many of formations. Approximately the age of 6 recondition must over before the school period.

Lip - Palate Split

There are many kind of this anomaly, happens only ones in every 1000 birth. There are Lip Split by it self and Palate Split by it self and many combination of these. The most important subject is if the blood counting is available of children the age of 2.5 – 3 months and over 5kg can operate lip reconstruction. Palate must operate in age of 12-15 months. If you do not pay good enough attention for the operation of Palate Split, there can be a problem about speaking for children. In every condition, only one day is enough to stay at the hospital for patients.

Facial Aesthetic Operation of Nose Surgery

SURGERY

Plans will be made for your admission to the hospital the morning of your surgery for a general physical examination by the anesthesiologist, appropriate blood tests, and occasionally nasal and sinus x-ray films. These are certainly important and necessary preoperative studies to ensure your well being during surgery.The operation is usually performed under general anesthesia. Almost all patients are discharged a few hours following surgery feeling quite comfortable and generally free of pain.

Aesthetic rhinoplasty typically is performed to reduce the overall size of the nose, reshape a tip, remove a nasal hump or improve a poor angle between the nose and the upper lip. In sone patients it is necessary to add tissue in order to improve contour. One or all of these changes can be made during a single operation. (Fig. 1)

You will find your operation essentially a comfortable experience, generally with little or no discomfort. Anesthesiologists will administer intravenous sedatives and tranquilizers before the operation to keep you very comfortable. Happily, little if any pain occurs after rhinoplasty. Pain medication, however, is always available should you find it necessary.

The small bandage protecting the outside of the nose remains in place for 5 to 7 days. We generally don’t place intranasal packs or splints. If they are placed all internal nasal dressings placed at surgery are ordinarily removed the morning after surgery. We will provide you with a detailed list of "do's and don'ts" to optimize your postoperative course. The patients are advised not to take aspirin—it may precipitate bleeding—and take care to not hit your nose in any way and to keep the nasal splint bandage dry.

At approximately 1 week from the date of surgery, nasal splint is removed. Generally patients are able to return to normal activities such as work or school at this time. Strenuous sports, exercises, swimming, or other physical activities should be curtailed for approximately 3 to 6 additional weeks.

Although the new shape of nose is apparent rather quickly after removal of the splint, it takes several weeks for the majority of the swelling to disappear and shrinkage of the new nasal configuration to occur. This is a gradual process that cannot be hurried. Small, subtle, and generally favorable changes take place over a period of several months.

The degree of improvement depends on the extend of the corrective work undertaken and basic struture of your nose and skin. An obviously disfigured nose will show dramatic results. On the other hand, a slight bump and a tip that is a bit too large may be succesfully corrected, yet the results may be subtle. 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.

Plastic surgery of the nose is an exciting and challenging branch of surgery for the patient as well as the doctor. Rhinoplasty is clearly the most elegant and sophisticated of all facial plastic surgical procedures. With modern surgical refinements, uniformly better results are obtained than were possible in past decades. It is obvious that the best results in rhinoplasty are the nose simply appear naturel and in harmony with the other facial features.

Rhinoplasty surgery is a highly delicate and technical form of plastic surgery and enjoys a very high rate of success and patient satisfaction. Although usually performed on the younger age groups, excellent results may be obtained on patients in their fifties and sixties.

Rhinoplasty surgery is performed from inside the nose by using special delicate instruments. The bone, cartilage, and soft tissues of the nose are reduced in size, rear­ranged, or sculptured to obtain a desirable natural appearing result. No external scars are left, unless excessively large nostrils require reduction in size. If any external incisions are necessary, we will discuss them with you and camouflage them through tiny incisions in natural skin creases.

The resulting improvement in appearance may be psychologically beneficial, almost always bringing increased self-satisfaction and self-confidence. Patients, however, should not always expect universal approval from all of their family members, friends, and acquaintances following surgery since they may not be aware of your reason and motivation for a change in your appearance. It is more important that patient and surgeon be pleased with the eventual surgical outcome. Ethically no surgeon can guarantee the results of any cosmetic surgery he can only promise to do everything possible to do his best to correct the patient's problem.

Plastic surgical correction of the nasal deformities should never be performed without contemplating and analyzing the surrounding facial features. In our discussions we will explain to you how we can best accomplish the changes you desire, always keeping in mind the need to keep the nose in harmony with your particular individual facial features. At times, as your surgical advisor, we may recommend other subtle changes in your face (chin contour, lip shape, etc), to help you look your very best following surgery.

All surgical procedures carry some degree of risk. Fortunately, tile risk factors in rhinoplasty surgery are quite small. The vast majority of patients undergo surgery and postoperative healing with no significant complications of any kind. Rarely and infrequently, complications such as some degree of postoperative bleeding, delayed healing, and small irregularities and slight asymmetries of the nose can occur, since not all of these factors are under the control of the surgeon.

In some patients with badly deformed noses (severely twisted, badly frac­tured, etc.) it is not always possible to correct all nasal deformities in one single operation; occasionally a second "touch-up" minor procedure might be required several months following the initial major operation to improve the result and/or correct inappropriate healing. Generally, small "touch-up" procedures do not require hospitalization and under most circumstances will be performed as an outpatient procedure.

Postoperative Recovery Breastlift or Mastopexy

After surgery, pain that is controlled easily by medication will subside in a day or two. If you have been operated in a hospital, you will be released in the same day. Within the first week, the dressing will be replaced by a soft bra which you will be advised to wear for several weeks.

Swelling and discoloration around the incisions generally will subside in a few days. After surgery, there may be temporary loss of sensation in the nipples and breast skin. If it occurs, this condition will improve with time. Sutures will be removed within two weeks of surgery.

The objective of mastopexy is higher, well-contoured breasts. (Fig.4) Although we make every effort to keep scars as inconspicuous as possible, mastopexy scars are permanent. They often remain highly visible for a year following surgery, then fade to some degree. However, since incisions are made around and below the nipples, scars should not be noticeable even in low-cut clothing.

Breast lift, or mastopexy, is a surgical procedure to raise and recontour sagging breasts. In some cases, it can be performed in conjunction with surgery to enlarge the size of the breasts with breast implants.

A consultation with a plastic surgeon is the first step an individual should take it considering inastopexy. You should discuss candidly your expectations about looking and feeling better after surgery, while keeping in mind that the desired result is improvement, not perfection.

We will conduct a routine breast examination and, depending on your age and family history, may determine that mammograms, or breast x-rays, are required. After examining you, we will discuss other variables that influence the decisions involved in the procedure, such as your age, the size and shape ot your breasts and the condition of breast skin. A patient considering breast-feeding following mastopexy should discuss the matter with us at this time.

During the initial visit, we will explain the specific details of your case, including the surgical technique to be used, the anesthesia, where the operation will be performed and what the surgery realistically can accomplish.

Thousands of breast lifts are performed successfully each year. Nevertheless, you should be aware of the potential risks of surgery and specific complications associated with mastopexy. Postoperative complications such as infection or blood clots are rare. Poor healing may necessitate subsequent scar revision. Smokers should be made aware that nicotine can delay healing. Risk of complications can be minimized by closely adher­ing to your surgeon's advice on follow-up care.

The Surgical Procedure

Mastopexy typically is performed to lift sagging, loose breasts or breasts that have lost volume and elasticity after childbearing. It also can reduce the size of the areola, the dark pink skin surrounding the nipple. (Fig. I) The extent of the procedure depends on what changes are desired and what we deem appropriate.

Mastopexy usually is performed under general anesthesia, although local anesthesia may be used in particular cases.

In the operation a keyhole-shaped incision is made above the areola to define the new location for the nipple. Working through incisions, excess is removed skin from the the breast. The nipple, areola and underlying breast tissue are moved up to a new higher position, after the nipple is relocated, flaps of skin formerly above and to the sides of the nipple are brought down, around and together to reshape the breast. (Fig.3) Sutures close the wounds under the breast and around the nipple area. In patients with only minimal sagging, a modified procedure may be used to excise only skin from the large areola and the area immediately surrounding it. When breast augmentation is performed in conjunction with the lift, a breast implant, is placed, in a pocket created either directly under the breast tissue or underneath the chest wall muscle. The prosthesis is a flexible plastic envelope that contains a silicone gel. (Fig. 2). Following surgery, a bulky gauze dressing is wrapped around the breasts, or the patient may be placed in a surgical bra.

Depending on the extent of the surgery, the procedure usually lasts about two hours.

Malar implants and procedure

Augmentation of cheek bones plays a significant role in facial contouring. The patients who present with a generally flat appearance of the midface will benefit from malar augmentation. The results of midface augmentation in the appropiate patient has been very gratifying. It can produce a nice contour to a flat or poorly defined face. Silicon or polyethylene (porex) implants can be used for augmentation of cheek bones. We prefer polyethylene implants in most of our cases. Our preffered way of implantation through the intraoral way. Malar augmentation is usually combined with face lift procedures.

A long sweeping elegant jawline is a most desirable feature in an attractive face and neck Retrognathia, manifested by bony mandibular deficiency and/or loss of muscular skin pad posture, creates facial disharmony and proportion imbalance. Inadequate chin projection is commonly encountered in patients seeking aesthetic facial surgery. Although chin augmentation may be performed as an isolated procedure, it is frequently performed as an adjunct to rhinoplasty or rhytidectomy. Submental lipectomy associated with chin augmentation adds a further refinement to the mandibulocervical definition.

Malocclusion and significant facial skeletal abnormalities are of course not corrected by chin augmentation alone. Patients with major mandibular deficiencies and asymmetries are best treated by orthognathic and orthodontic correction.

In the rhinoplasty patient, augmentation of the chin brings the lower third of the face into improved alignment and harmony with the middle third. The degree of apparent nasal projection is often dramatically changed in appearance by relative changes in chin projection.

The rhytidectomy patient, as a consequence of aging, commonly exhibits poor chin projection associated with an obtuse cervicomandibular angle. Conservative augmentation with a chin implant establishes better projection and increased differentiation of the mandibular horizontal and cervical vertical planes. The implant may also serve to augment the ptotic chin softtissue structures frequently found in the aging chin; significant chin pad sagging, however, requires cephalic repositioning of the ptotic muscle pad to correct an inferior malposition of these tissues.

Chin implants can be placed through an intraoral or a small external incision. External incision is placed under the chin and is not visible. Silicon and polyethylene (porex) implants are available in market for chin augmentation. We prefer polyethylene implants in majority of our applications.

Blepharoplasty Endoscopic Forehead and Eyebrow lift

Blepharoplasty alone is less effective in improving and recoutouring the leateral orbital rhytids ("crow's-feet" or "laugh lines"), which contribute to the aging appearance and thereby displease patients. Oblique and vertical glabellar frown lines remain unchanged without direct surgucal interruption of the involeved animation muscles. Some form of adjunctive "lifting" proceure in the uppper third of the face is thereby required to augment the improvement archieve by blepharoplasty. Most useful among these are the brow-lift (browplasty), temporal (temple) lift, the midforehead lift and the forehead (coronal pretrichal) lift. Specific indications exist for each and will be explored later.

The relentless passage of time combined with gravity inevitably creates forehead and eyebrow drooping and malposition. The aesthetic facial unit comprising the eyelid-orbital region, when flawed by gradual aging, asymetry, or familial abnormaliti, cannot always may compound the problem of redundant upper eyelid skin by crowding the eye and producing an abnornal appearance of both fatigue and premature aging. A temporal quadrant visual defict may develop, furter justifiying interventional surgery to restore lost function. If upper lid blepharoplasty alone i used in attempts as correction, the eyebrow is often drawn nearer the lid margin and adequate delineation of the infrabrowcleft obliterated by sacrificing excessive upper lid skin in a misguided attempt to correct this problem. Incorpatating one of the brow elevation procedures to enhance the resultsant appearance is a perfered approachthat preserves sufficient upper lid skin to achieve a pleasant sweeping delineation of teh upper lid cleft.



Careful patient selection to ensure effective, satisfactory outcomes assumes major importance in all form of aesthetic surgery, especially important in orbital region rejuvenation. Patiens regularly request eyelid surgery when instead or in addition to eyelid surgery they need forehead-, brow-, and temple-lifting. Educating patients about the most effective procedure(s) often requieres superior communication skills and gentle guidance, since few patients are aware that forehead/brow ptosis is responsible for the aging oribtal changes apparent. Clearly more of the surgeons's time must be expended to realize the laudable goals of effective patient understanding and truly informed consent.

Patient selection, particularly from the viewpoint of motivations and ex­pectations, assumes major importance in the caliber and effectiveness of the final outcome. In aesthetic surgery, pure technical excellence will not al­ways result in a happy, satisfied patient. Useful guidelines to patient se­lection (and rejection) exist; each individual, however, requires careful and sensitive screening to identify proper candidates.

Although different regions of the face age at different rates, influenced primarily by genetic factors, the upper facial third possesses its own unique fashion of aging (see Fig 1-6). As elasticity progressively declines, the fore­head, temple, and glabellar skin descends. Ptotic low-positioned brows de­velop, crowd the orbital region, and increase the degree of skin redun­dancy in the upper lid area (Fig 7-1). Fine lines, the result of gravity and repeated orbicularis muscle contraction, appear at the lateral canthus and temple (Fig 7-1). Progressively deep horizontal creases appear in the fore­head, the consequence of repetitive frontalis muscle contraction and hy-pertonicity (Fig 7-2) (their absence in a paralyzed forehead validates this observation). Synergistic actions of the corrugator and procerus muscles produce vertical, oblique, and horizontal creases in the glabella and nasal root (Fig 7-3).

Forehead-lifting procedures may be effectively combined with methods to rejuvenate the middle and lower facial thirds (facelift and necklift). Since the various regions of the face may age at different rates, forehead/brow-lifting is also commonly accomplished as an isolated procedure or as a pre­liminary step to blepharoplasty.

With rare exceptions, the brow elevation procedure should be carried out prior to upper lid blepharoplasty, thereby facilitating judgment as to the precise amount of upper lid skin excised and thus preventing an over-aggressive elevation of the brow-upper lid complex with consequent dif­ficulty in normal upper lid closure.

Three factors bearing heavily on the surgeon's choice of sequence and combinations of operations are (1) the relative position of the brows, (2) the mobility of the scalp and forehead layers, and (3) the sex of the pa­tient. The male brow classically is heavier in hair content, occupies a more inferior (caudal) position, and is less laterally arched than the female brow, which commonly occupies a transversely horizontal position (Fig 7-4). This effect, although occasionally objectionable in a female, is not usually displeasing in a male. In contrast, the preferred female brow (many varia­tions obviously exist) arches higher laterally than medially, ideally assum­ing its highest point at about the junction of the middle and outer thirds (Fig 7-5). The female brow typically thins as it courses laterally, and this diminishes the ease of potential scar camouflage in the hair-skin junction. Therefore a critical evaluation prior to technique selection is assessment of the eyebrow position, attitude, and shape with the patient sitting and in repose. By manually elevating the brow and forehead with the patient gaz­ing straight ahead, a tentative judgment can be made about the favorable effect of brow elevation on the aesthetic unit of the eye and orbit (Fig 7-6). Individuals with ptotic brows commonly attempt to unconsciously elevate the brow and cause excessive forehead animation. This facial posture is ordinarily an unconscious habit and gives rise to a "surprised" facial ex­pression as the drooping brow is temporarily elevated (Fig 7-7). Preop­erative estimates of the benefits of surgical brow elevation will be much more accurate if all animation is consciously eliminated and the brow po­sition is judged with the patient in complete facial repose. By having the patient close the eyes and open them slowly after allowing the facial muscles to relax, the true brow position in repose may be determined. The individual anatomic situation will then dictate the choice of which of the brow elevation procedures would most favorably complement the planned blepharoplasty operation

Other technique Liposuction Liposelection

The patients usually have explored nonsurgical alternatives to liposuction before their first appointment with aesthetic surgeon. Patients report that they have followed strenous diet and exercise regimens, attempted to hide their appearance, and avoided embarrasing social situations with increasing frustration and lowered self esteem. Disproportionately deposited pockets of genetically determined adipose tissue do not respond even to unhealthy extremes in diet and exercise.

Perceptions of beauty have undergone many changes troughout the millennia. The body types appreciated by the Egyptian and Greco-Roman civilizations have persisted througout the ages, whereas the rounded forms idealized by Rubens are not considered ideal today. Liposuction (suction-asisted lipectomy) can be defined as an aesthetic procedure that removes subcutaneous fatty tissue from the body in an attempt to bring the body into conformity with current perceptions of attractiveness. The focus of body contour procedures is the body unequal distrubition of fat, its overabundance in some areas and absence in others.


Liposuction (suction-assisted lipoetomy) consist of the removal of body fat using a device called a cannula that aspirates fat cells by suction. This procedure is effective in removing exess fat of the face, chin, arms, axillary breasts, abdomen, hips, trochanteric area (saddle bags), thighs, knees and ankles. There are limits to amount of the fat that can be removed and the degree of body sculpturing that can be accomplished with liposuction. However, in patients with abnormal deposition of fat liposuction is extremely helpfull in enhancing appearance.

Liposuction is effective in most patients who have good skin elasticity because the skin contracts after the fat has been removed. In most areas of the body where abnormal collection of fat have developed, liposuction has been beneficial in recontouring the area. Older patients and others with poor tissue elasticity may benefit from liposuction in conjunction with traditional body contour methods, such as facelift, abdominoplasty and thighplasty.

Liposuction is performed through small stab incisions (3 mm) A cannula is inserted into a layer of fat under vacuum extracts fat only while the surgeon strokes the cannula. Today smaller diameter cannulas (1,5mm to 4 mm) are preffered to decrease the probability of irregularities. Recently with the delivery of local anesthetic -epinephrine containing fluids into the fat layers before aspiration, liposuction can be performed with a considerable reduction in blood loss and large amount of fat can be aspirated without necesitatating blood transfer.

Most liposuction is now performed as an outpatient procedure under sedation or general anesthesia. Majority of patients can be sent to home a few hours after the surgery. If large amount of fat is removed (more than 5 liters) the patient is discharged from hospital in the next morning following the operation

With the use of local aneshetic solutions pain is minimal and can be controlled with anargesics. A special elastic girdle or binder is applied at the end of surgery to reduce postoperative edema and bruising. The patient may shower 48 hours after surgery, removing the girdle. The patients are advised to wear the elastic girdle 2-3 weeks. The patient may return to daily activities and work in a few days. Exposure to full sunlight should be avoided and suctioned areas should be covered until bruising has subsided, generally for 6-8 weeks. Sunscreens should be applied liberally.

Facelift Rhytidectomy FAQ

You’ll find basic information about a facelift in this brochure. However, the best way to get complete answers to sprecific questions that relate to your individual needs to have a personal consultation with a plastic surgeon certified by the Board of Plastic Surgery.


Some of the most visible signs of aging first appear on the face. Although the changes appear gradually, there may come a day when you look in the mirror and decide that the face you see doesn’t reflect the way you feel about yourself. If you’d like to look as good as you feel, a facelift can help. Also known as rhytidectomy, a facelift smooths the loose skin on your face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer and fresher.

Is a facelift right for me?

Facelifts are most commonly performed on patients in the 40-60 age range. However, the procedure can produce good results for people in their 60s, 70s and 80s as well. You may be a good candidate for a facelift if you have any of the following types of conditions :

* A deep line that runs from the corner
* Loss of a well-defined jawline
* Deep wrinkles in the cheeks and sagging skin near the cheekbones
* Loose skin, wrinkles or excess fatty tissue in the neck.

Facelift surgery needs to be approached with extra caution if you have any of the following medical conditions:

* Uncontrolled high blood pressure
* Blood-clotting problems
* The tendency to form excessive scars.

Be sure to alert your plastic surgeon if you are affected be any of these conditions.
a) A facelift can improve the deep cheek folds, jowls, and loose, sagging skin arround the neck that come with age.
What should I expect from the consultation?


A personal consultation is the first step for every patient considering a facelift. During this meting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to providee complete information about:

* Previous surgeries
* Past and present medical conditions
* Treatments you have received
* Medications that you are taking, including nutritional supplements and herbal remedies.

If you are overweight and have a realistic desire to lose more than 15 pounds, your weight loss could affect your results. It’s important to discuss these plans with your surgeon.

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the severity of the wrinkles and folds will also be considered. Your hairline will be examined to determine where incisions can be conisdered in developing your surgical plan.

Your plastic surgeon may explain additional procedures that can be performed along with a facelift to meet your appearance goals. For example, a facelift is frequently combined wih:

* Forehead lift, to correct lines or furrows in the brow
* Eyelid surgery, to eliminate drooping upper eyelids or bags beneath the eyes.
* Nose reshaping
* Skin treatments, such as a chemical peel or laser resurfacing, to minimize fine wrinkles.
* Face contouring with micro fat or tissue cocktail injection.



How is a facelift performed?


The technique chosen for your surgery depends on your features, your surgeons’s perferences and your desired results. There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your chin.

Working through these incisions, your plastic surgeon frees the facial skin from its underlying tissues and pulls it upward and back. The excess skin is then removed. In some cases, the deeper tissues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows your surgeon to remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.

How will I learn about the safety of facelift surgery?


Each year, thousands of people have facelifts and experience no major complications. However, it is important for you to be informed of the risks as well as benefits.

One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of facelift surgey. In addition yo listening carefully to what your surgeon tells you, be sure to raise any questions you may have about the safety of the procedure.

By carefully following your surgeon’s advice and instructions – both before and after surgery – you can do your part to minimize some of the risks.
b) Incisions usually begin above the hairline at the temples follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp.
c) Facial, neck tissue and muscle may be separated; fat may be trimmed or suctioned and underlying muscle may be tightened.
d) After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place.
e) Most of the scars will be hidden within your hair and normal creases of your skin
What can I do to prepare for my surgery?


When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

* Avoiding certain medications that may complicate surgery or recovery.
* Stopping smoking for a period of time before and after surgery
* Arranging for help and special care following surgery
* Letting your hair grow long enough so that it will cover your incisions while they heal
* Hair coloring before surgery if you do usally.



How will I be cared for on the day of my surgery?


Your facelift may be performed in a hospital, an outpatient surgery center or an office-based surgicak suite. If you are admitted to a hospital or surgery center, your stay will be a short one, perhaps just one or two nights. We have arrenged a three days package programme in the hospital that you may benefit.

Medications are administered to keep you comfortable during the surgical procedure. Your plastic surgeon may use local anesthesia and intravenous sedation for your facelift. However, for some patients, general anesthesia may be the best choice. Your surgeon will monitor your physical status throughout the operation and during your recovery.

How will I look and feel right after surgery?


When surgery is complete, you’ll be taken to a recovery area. A bandage may have been wrapped around your face to help control swelling. Sometimes, small drainage tubes are placed beneath the skin to drain away fluids that might otherwise accumulate. Discomfort is usually minimal, but any pain you feel can ce controlled with medication prescribed by your surgeon. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

* In this early stage of healing, you should rest with your head elevated to help minimize bruising and swelling



Within the first week

* Swelling reaches its peak, and then begins to subside.
* Bandages will ve removed and you may shower.
* Stitches will dissolve or be removed.
* You may return to light activity, but continue to sleep with your head elevated.
* You can wear makeup to conceal any discoloration.


Within two weeks

* Most of the bruising will disappear
* You may resume many of your normal activities, including non-strenuous.


After several weeks

* You may resume exercise.
* Swelling and puffiness will continue to subside.
* Numbness in the facial area will diminish; however, some numbness may persist for several months.

Throughout the healing period, you should avoid exposure to direct sunlight and, for the long term, be conscientious about using sun block preparations to protect your skin.
After surgery, you’ll present a fresher, more youthful face to the world.

What should I know about my results?


If you are like most people who have the procedure, you’ll be very pleased with your refreshed and rejuvenated appearance. Although the healing may take some time, you can expect the end result to be woth the wait.

A number of factors, including your heredity and your lifestyle, play a role in how long the results of your facelift will last. Even though the aging process continues, patients are usually happy with their apperance for many years following a facelift. Some patients find that they want to make additional improvements at a later time.

How long will I continue to see my plastic surgeon?


After the initial healing period, you will return to your plastic surgeon’s office for a postoperative foollow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It’s important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

No matter what type of plastic surgery you’re considering, one of the most important factors in its success is the surgeon you choose. Although it may seen hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It’s advisible to consider the following points before scheduling a consultation:

Find out if he or she is certified by the Board of Plastic Surgery. Surgeons with this certification have completed a minimum of six years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgement. After tarining, a surgeon must pass comprehensive oral and written examsbefore being granted certification. It is also very important to find out the post graduate education, experience, competency for specific procedures and scientific status of Plastic Surgeon.

Face Lifting FAQ

The technique chosen for your surgery depends on your features, your surgeon’s surgical preferences and expertise, and your desired results. Extreme emphasis is placed on creating a natural result. Usually the objective is to produce a better you not a different person.

Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow's feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.

There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There may also be a small incision hidden beneath your chin.

Working through these incisions, the facial skin is elevated from its underlying tissues followed by deep tissue dissection to your smile lines and nasal cheek juncture. The deep structures including the cheek pad is securely tightened in an upwards and backwards direction followed by excision of excess skin. There is no emphasis on placing excessive tension on the skin. An incision is usually placed under the chin that allows removal of the muscle band in your neck. Removal of fat is also performed through this incision.

If you do not have a significant amount of excess skin, you could be a good candidate for an endoscopic facelift. This minimally invasive procedure requires small incisions that are placed inconspicuously according to your individualized surgical plan.

Although most patients report very little pain after surgery, medication will be prescribed. Some swelling and bruising are to be expected and may be minimized with cold compresses. Dressings will be removed at a follow-up examination in one to two days. All sutures are removed between five to ten days. Recovery usually takes about ten days.

The final result is a firmer, younger appearance to the midface and neck area. Though individual results may vary, patients report increased self-confidence in addition to the rejuvenating effects of their face lift.

Procedures For Rohat Kutlay

Depending on the procedure, your recovery period and related results may be relatively short (as in an eyelid surgery) or longer (as in a trunk liposuction). When you see yourself for the first time, postsurgically, remember that there may be swelling, stitches, or discoloration which will decrease over time. You will not see the person you last saw prior to surgery. You need to psychologically prepare yourself.

You have finally decided that you are having the surgery. Your physical appearance will be changing, sometimes drastically and sometimes minimally, within a short period of time. Have you thought about how you will cope with this change? Do you have a good handle on the effect this change will have on you? Have you thought about how family and friends will react to the change?


Patients who are in a personal crisis should postpone surgery until the crisis has ended. Changing your appearance to get "back at" a divorced spouse may not leave you with the desire results. If you have not dealt with the death of a spouse and feel getting a "facelift" will help you feel better, question yourself as to why you are really doing this?

Make sure you have a support person available to you postoperatively. This should be a close friend or relative that you can rely on to discuss any feelings of self-doubt you may have. There may be periods, especially during the post operative period, where you will question yourself. This is especially true of patients who tend to take longer to recover and for procedures where the end result is longer to visualize.

Post operative depression can be mild to severe for some patients. It is normal to feel some mild discontent several days after surgery. This can be attributed to any number of physical or metabolic changes to your system. Try to get "up and out". Do things that usually make you feel good. Talk with your surgeon if you feel you may not be improving after a week.

Keep in mind, this surgery was for you. This is to make you feel and look better.



AUGMENTATION MAMMOPLASTY

By most estimates almost 2 million women in this country have had an augmentation mammoplasty. Breast augmentation has been one of the most gratifying cosmetic operations from the standpoint of both the patient and the surgeon, and until recent controversies over the safety of silicone implants, it was the most common cosmetic surgical operation carried out in the United States. Although every operation involves some risks, breast augmentation is generally not considered to be high risk.

While breast augmentation will enlarge the breasts, it will not alter basic asymmetries in breast shape or form. Major variations may be improved, but will not be corrected. Slight differences in the size or shape of the two breasts are considered normal, and should not be a cause for concern. Long experience with this operation has demonstrated highly satisfactory results for the majority of patients who are considered suitable candidates for the surgery.

Modern silicone prostheses have been in use for thirty years. Both silicone gel and saline filled implants have been available. There have been innumerable media reports, and even some medical reports of patients with implants developing a neurological disease or connective tissue problems, suggesting that there might be a connection between the two; however, we know of no true scientific data to support this causal relationship. Extensive studies have been carried out, and there has, so far, been no evidence that the implants or silicone have any relationship to breast cancer, or systemic illnesses in patients. At the present time, in the United States, surgeons and patients are restricted to the use of saline filled implants for primary augmentations. Many recent studies have confirmed the safety of silicone breast implants. Specifically, patients with breast implants have no higher incidence of auto immune or connective tissue disease such as rheumatoid arthritis, scleraderma or lupus, in comparison with the general population.

Breast implants are available in a round or teardrop shape, with a smooth or textured surface. The procedure may be performed using intravenous sedation with local anesthesia, or with general anesthesia. The incision may be placed in one of three locations: Under the breast in the inframammary crease, under the areola (the pigmented skin around the nipple), or in the axilla (armpit). The implant is placed under the breast tissue and on top of or under the pectoralis muscle. You and your surgeon will make the final decision regarding which approach, or which placement to use.

After the procedure, you will be advised regarding wound care, bra selection, and follow-up. You may be asked to take it easy and remain quiet the night of surgery as bleeding around the implant can occasionally occur. It usually takes about 2-4 weeks for swelling and discoloration to subside, and for you to return to a normal activity level.

Postoperative bleeding is one possible complication. If this occurs, it will usually be within the first couple of days, and may require another operation to remove a collection of blood (hematoma). Infection is very uncommon, but should it occur adjacent to the implant, it might be necessary to remove the implant to resolve the infection. A fairly common problem that can occur with breast implants is related to the natural tissue capsule that forms around the implant within the body. Even though a capsule forms most of the time, only occasionally does it thicken or contract causing unnatural firmness and/or shape to the breast. In severe cases, it can also cause pain or discomfort and can lead to the formation of fine calcium deposits. In early cases, capsule formation can be corrected by gentle external massage, but in more severe cases, further surgery is required. This condition is called capsular contracture. In the past, surgeons often recommended firm compression to treat capsular contractures, a maneuver called closed capsulotomy. This is no longer recommended in most situations, because of the risk of breaking the outer shell of the implant. After augmentation mammoplastv, many patients have breast fed without difficulty, and occasionally, stretch marks can develop.

Breast implants have never been shown to cause any form of cancer in women. Implants do make mammography somewhat more difficult to interpret. This was true more pertinently with silicone gel filled implants. If you are having a mammogram, advise your radiographer about your implants so that the mammogram technique can be modified to include the extra views recommended.

Recently, some health insurance providers are excluding coverage for breast disease if a patient has had breast implants. There is no medical substantiation for this at the present time. In spite of the potential problems, most women who have had this surgery are very happy with the results. They report feeling better about themselves, and having improved self-esteem.

REDUCTION MAMMOPLASTY

Large breasts can be the source of problems in many aspects of a woman's life. Women with large, heavy breasts may have symptoms caused by the size, weight and position of the breasts. They may have back and neck pain, grooves in the shoulders from bra straps and rashes under the breasts due to moisture collection and heat. Some women with arthritic conditions of the back and shoulders may have more symptoms than usual because of the added weight and pull of the breasts. These symptoms may contribute to limited performance in certain occupations and in sports.

Some full-breasted women may appear heavier than they really are and may have difficulty obtaining stylish clothing. In some cases, it may even be difficult to find a properly fitting bra. Often, women with large breasts feel very self-conscious. Teenagers may not develop proper poise and posture as they try to hide the fullness of their breasts, a subject they may be unlikely to discuss freely with their parents.

Finally, large breasts may be difficult to assess for lumps or masses, thus making cancer detection much more difficult for the patient or for her physician. This may well be a source of further anxiety in a patient who is already embarrassed about her condi-tion. Breast reduction can eliminate or minimize these problems. Because of these medical problems, in many cases, medical insurance will cover the cost of breast reduction.

The goal of reduction mammoplasty is to reduce and recontour the breasts. The excess skin and tissue can be removed and the mounds reshaped into smaller, more attractive breasts. The procedure is performed in the ambulatory surgery unit or hospital under general anesthesia. The nipple areola complex is repositioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and/or outside portion of the breast. A preoperative plan is made which allows both the surgeon and the patient to share in the decision as to the proposed size of the breast after surgery. The surgeon will attempt to make the breasts as identical as possible, but some asymmetry often remains. It is also not possible to pre-dict exactly how large the breasts will be after surgery, as there is some contraction, swelling and tissue reorganization after surgery. The incisions are designed so that the scars will not be visible with normal clothing. In time they fade and become less noticeable. Drains may be left in at the time of surgery and removed in a few days. The patient is usually up and about the day of or the day after surgery. With the advent of managed care, this surgery is performed more and more on an outpatient basis. Sutures are removed in approximately one week following surgery.

Potential complications include postoperative bleeding, infection and healing problems, which may result in heavy scars. When the nipple/areola complex is transferred to its new position, it may not 'take' or heal, and a portion or all of it may be lost. This is uncommon; smoking may contribute to this problem. As the nipple is repositioned with the breast tissue during the procedure, this can lead to disturbance of the superficial nerves to the nipple, and a decrease in sensation may occur. Ability to breast-feed will also be lost in most women undergoing this operation. Since these conditions are usually expected side effects of breast reduction surgery, a woman should consider these factors seriously before deciding to have the surgery. Although every attempt is made to obtain symmetry, there may be some irregularities in the size and shape of the breasts and in the position of the areola and nipple.

Most women report that their back and neck pain is reduced. They have fewer problems finding suitable clothes and are able to become more involved in sports. There is always a time of adjustment, and breast reduction usually results in the quickest body-image change. Therefore, most women need time to adjust to their new look. Most women are very pleased with the results.

RHINOPLASTY

Rhinoplasty, or cosmetic nasal surgery, is one of the most common cosmetic procedures performed today. The operation is usually carried out because a patient desires to improve his or her appearance. It is also frequently requested for repair of injuries, or correction of disfigurement from trauma. In addition, patients may also be influenced in their desire for surgery because of breathing obstruction, or other related functional problems. As this is a common procedure, and has been carried out for many years, technical refinements have allowed consistently good results, which are considerably better than they were 25 to 50 years ago. Nevertheless, patients must understand that the goal of this operation is improvement, and that perfection usually cannot be achieved. Patients who expect too much may be disappointed. Cosmetic nasal surgery is performed to bring the nose into harmony with the face, thereby improving overall appearance.

There is no standard operation for rhinoplasty. The plastic surgeon takes into account the patient's nasal features that need to be changed, carefully examining the nasal structure and the overlying skin covering. With this information, the surgeon and patient discuss the realistic modifications that can be made to obtain the desired result. Often there is an underlying deviation of the nasal septum, which causes difficulty in breathing. This can be corrected at the same time.

The surgery is usually performed through incisions inside the nose, and if any external incision is made, it is usually small and inconspicuous. The surgeon separates the skin of the nose from the underlying bone and cartilage, re-shapes the cartilage skeleton, then redrapes the framework with the skin. The skin, with its natural elasticity, usually re-shapes nicely over the new-formed framework. This surgery can be done under local anesthesia with intravenous sedation, or general anesthesia, usually in an outpatient surgical facility. The various procedures during the reshaping include removal of the hump on the bridge of the nose, narrowing the nose, refinement of the nasal tip, and correction of the deviated septum. Chin augmentation may or may not be suggested to further enhance the facial profile. The nose is usually splinted for support and to reduce swelling. A dressing may be placed inside the nose. This dressing is usually removed within the first day or two after the procedure.

Swelling and bruising around the nose and eyes is expected for two to four weeks. Although most of the swelling subsides by six weeks, some long-term swelling may take six months to one year to resolve. Complications related to this operation include bleeding, infection, diminished sense of smell, scarring and minor irregularities. These problems are rare and resolve in time. It is important to remember that healing after this operation continues for up to a year, as the skin shrinks and adjusts to the new framework. Occasionally, the final result may be different than what was anticipated by the patient and/or the surgeon. Minor irregularities can be corrected with a revision procedure after all healing is complete.

Following rhinoplasty, the nose has an improved esthetic appearance, in harmony with the other facial features. The improved appearance of the nose is long lasting. Most patients are highly satisfied with the results of their rhinoplasty.


ABDOMINOPLASTY (TUMMY TUCK)

Abdominoplasty is an operation designed to remove the excess fat and skin of the abdomen, and at the same time, tighten the muscles of the abdominal wall. Following pregnancy, or loss of weight, a patient may have residual excessive skin and/or fat on the abdomen, along with stretching of the abdominal muscles. When the only problem is excess fat in this area, and the skin and the muscles are not stretched, this can be corrected by liposuction alone. More commonly, the problem involves stretching of the skin and muscles, along with the excess of fat, and an abdominoplasty has to be performed to correct all three problems.

This operation is usually performed under general anesthesia in an outpatient surgical center. Though, some surgeons may have the patient spend one or more nights in a post surgical facility. The operation usually takes two to three hours to perform. It is usually necessary to restrict physical activities for a few weeks after surgery, and it may take four to six weeks before the patient returns to completely normal activities. Patients are usually given abdominal support in the form of an abdominal binder, for a few weeks after surgery.

The operation is performed through an incision along the lower abdomen, just above the pubic hairline, extending from one hip to the other. Another small incision is made around the belly button, which is left attached to the abdominal wall. The skin and fat are then elevated, and at this time, as needed, some fat may be removed from the flanks using liposuction. If needed, the abdominal muscles are tightened by stitching them together along the mid line. This will also tend to shorten them. The excess skin and fat is removed, and the residual skin and fat is pulled down and stitched into position. This usually requires the patient to be flexed at the hips at the time of the operation. The belly button is brought out through a small incision, and stitched to the new skin, in its normal position. Occasionally, drains are left beneath the skin for several days following the operation.

There can be some swelling and fluid collections following surgery, and it may be months before all of the swelling has subsided. There is numbness in the skin of the abdominal area, and occasionally in the upper thighs and flank areas, which can take a few months to improve. The scars around the belly button and the lower part of the abdomen gradually fade, and become less visible. Occasionally, the scars can become wide because of tension. Stretch marks and old scars in the lower part of the abdomen will be removed during the course of the surgery, but all of these may not be gone. Other complications, as in all operations, include bleeding, infection, and healing problems, leading to thicker scars. There may be some lack of symmetry, and because the skin has been undermined, there is a slight risk of inadequate circulation and loss of some skin. This risk is greater in patients who smoke, and these patients are usually advised to quit smoking a few weeks prior to surgery. Patients are also advised to refrain from taking aspirin or other medications that can cause bleeding. Another serious, though extremely rare complication of this operation may be blood clots in the legs.

Patients enjoy a more attractive figure with a firmer, flatter abdomen after abdominoplasty, and are usually delighted when trying on new clothes.

LIPOSUCTION

When we gain or lose weight, we are not adding or subtracting fat cells, but are changing the amount of fat within each cell. Fat cells lie beneath the skin throughout the body, but accumulate in greater amounts in certain areas. It is not surprising, therefore, that many people find in spite of weight loss; they are left with bulges or fat deposits in certain areas on the body. Liposuction is a surgical technique in which special probes, attached to a high suction pump, are passed through tiny punctures made in inconspicuous places around the body. Fat cells are then suctioned out, allowing the surgeon to shape and contour various parts of the body.

In 1982, removal of fat from the body by suction technique was brought to this country from France. Today, it has proven to be a safe and effective surgical technique that can result in a better body contours, with minimal scarring. This procedure gives the best results when used to remove localized areas of undesirable fat, after one has reached an appropriate weight with diet and exercise. It is a suitable operation for both men and women. Liposuction can be performed on virtually any area of the body, and is particularly useful in the neck, abdomen (tummy), waste, hips and thighs. In addition, it can be used on the arms, buttocks, calves, and ankles. In men, liposuction can be used to correct gynecomastia (enlarged breasts), and is frequently used to reduce excessive fat around the waist. Age is not a factor if the patient is in good general health. Liposuction is considered a contouring procedure, and is not specifically intended for the treatment of obesity. It can however, be an adjunct to diet and physical conditioning in the management of over-weight patients, where contour problems play a distinct role. If very large volumes of fat are to be removed, it may be necessary to carry out more than one operative procedure over time.

Except in instances where only a small amount of fat removal is desired, this procedure is generally performed under general anesthesia. However, it can be performed almost uniformly as an outpatient procedure. The length of the procedure varies depending upon how much fat is removed. The following technique is commonly used in performing liposuction, although individual surgeons may vary the sequence, extent, and technique of each operative step. A small one half-inch incision is made in the area of fat to be removed. A long fine needle is introduced, and a special liquid is infiltrated. The infiltration of liquid is called is called the "tumescent technique". Tumescence makes it easier to remove the fat, with less bleeding, postoperative bruising and pain. Patients recover quicker and are back to their usual activities sooner as compared to older techniques. After infiltration of the fluid, a thin, blunt tipped cannula is inserted under the skin, through the same incision, and carefully manipulated through the fat tissue. The probe is attached to a high vacuum hose, which suctions out the unwanted fat cells. After the desired amount of fat is removed, the incisions are closed and dressings applied. Intravenous fluid replacement is generally not needed for tumescent liposuction surgery. The patient is usually instructed to wear a pressure garment, to reduce swelling and aid in the healing process. In spite of this, there will be some swelling and discoloration, which will subside over a period of several weeks. The swelling may take many months to completely go away.

All surgical procedures carry certain risks. Fortunately, serious complications are very uncommon after liposuction. While there have been reported cases of perforation, skin loss, severe scarring and even death, these are extremely rare. Other complications such as infection, and blood clots in the lungs have also been reported, but again are rare. Minor problems, including serum filled pockets, or collections of blood under the skin, will resolve with time. The most common problem is a waviness or sagging in the skin, resulting from irregular fat removal or inadequate skin shrinkage over the newly contoured areas. Cellulite (dimpling) and other surface irregularities that were present before surgery will still be present after the procedure. Postoperative dimpling is more common in patients with poor skin elasticity. This problem can be minimized by faithful use of elastic garments for a few weeks following surgery, as per your plastic surgeon's recommendations. The area is frequently numb for sometime after surgery, but normal sensation usually returns after a period of time. Sometimes, minor secondary procedures are required to achieve the best results.

Ultrasonic liposuction

This technique is a useful innovation in cosmetic surgery. This procedure uses sound waves to break up fat cells before the fat is suctioned from under the skin. This technique utilizes ultrasound energy to break up the fat cells, and converts the fat to oil so that it can be removed more easily. The ultrasonic generator is attached to a special cannula. Tumescent fluid is introduced into the area from where the fat is to be removed. The ultrasound energy then breaks up the fat cells. The emulsified fat is then suctioned out through the hollow cannula. With ultrasonic liposuction, it is possible to remove fat from difficult areas such as the upper abdomen, flanks, hips and back. It is also possible to remove more fat in an area that is re-operated upon. Ultrasonic liposuction is not a replacement for traditional tumescent liposuction, but used in conjunction, allowing the surgeon to remove fat from more difficult areas. The results of ultrasonic liposuction are similar to traditional liposuction. There is, however, the possibility of more complications. If you're planning to have liposuction, make sure you discuss this in detail with your surgeon. Ultrasonic liposuction is a fairly new technique, and there are surgeons that may not be completely comfortable using it.

BLEPHAROPLASTY

Eyelid surgery is performed to give the eyes a more youthful, alert appearance. By removing excess fat, and possibly excess skin and muscle, from the upper and lower eyelids, eyelid surgery corrects eyelid drooping and under eye bags. Both of these make a person appear more tired and older.

Eyelid surgery may be performed in conjunction with a face lift, brow lift, or laser resurfacing, depending upon patient preference and/or need. It is not uncommon to perform only upper or lower eyelid surgery, again depending upon patient need and/or preference.

Eyelid surgery is usually performed around the age of 35 or older, but may be performed earlier in patients with a predisposition to bulging fat pads below the eyes.

The operation is performed through incisions made in the fold of the upper eyelid and just below the lash line in the lower eyelid. Once incisions are made, fat pads which cause bags are removed; if necessary, excess skin and/or muscles are excised in order to improve tone and appearance.

When the problem in the lower eyelid is primarily bulging fat, without excess skin, the operation may be carried out through an incision completely hidden inside the lower eyelid. This operation is called transconjunctival eyelid surgery. It is often performed in conjunction with laser resurfacing of the lower eyelid skin.

Most often eyelid surgery is performed under local anesthesia with oral or intravenous sedation. The procedure usually takes 1-3 hours. The patient is allowed to go home following a few hours of postoperative recovery. Most plastic surgeons will recommend that a patient keep their head elevated and apply ice packs for the first 24-48 hours. Recovery is usually quite rapid with most people returning to work in one week to 10 days. Possible complications of eyelid surgery include dryness of the eyes, which may be caused by an inability of the eyelids to completely close. In most cases, this will resolve with time, but may take several months. In some cases it may be permanent, and is treated with eye drops and ointment. People who have problems with dry eyes prior to the surgery have a greater risk of this occurring. Another potential complication is drooping of the lower lids which may require further operative repair if persistent. Temporary visual changes such as blurred vision may occur, and usually resolve as the healing process continues. A complete loss of vision may occur, but is extremely rare.

FACELIFT

The traditional facelift is most effective in improving the mid and lower face, as well as the neck. Additional procedures can be performed at the time of facelift, or as separate operations, to improve the forehead and brow, eyelids, and wrinkles around the mouth. The facelift procedure is performed to tighten the skin of the face and the neck, and give the patient a more youthful, rested and freshened appearance. This procedure includes, as necessary, tightening of the muscles of the neck, and removal of excess fat in the neck.

This procedure is generally performed under general anesthesia, but can be performed under local anesthesia with intravenous sedation. Though most commonly this operation is done as an outpatient procedure, minimal activity during the first 24 hours, with some form of skilled nursing observation is recommended by most surgeons, as problems such as postoperative bleeding can occur during this time.

The operation is performed through incisions that begin on the scalp, in the temple area, and extend in front of the ear. It then continues around and behind the ear, curving into the hair-bearing scalp. The skin of the face is lifted off of the facial muscles then pulled back in a tighter position. Some surgeons may tighten the facial muscles at the same time. Both sides of the face are addressed in a similar fashion. In some patients tightening the muscles of the neck, and removal of excess fat in the neck, is also done through a small incision made beneath the chin.

The surgery can last a few hours, and the stitches are usually removed in stages over the next five to ten days. Bruising and swelling can last up to 4 weeks, and it may be several months before all of the swelling is gone. The scars fade over several months, and in most cases is minimally noticeable. In some cases scars may heal thicker than normal and require some secondary procedures. Like any operation, the risks include blood accumulation under the skin, which can cause scarring, irregularity and discoloration of the skin. Occasionally, it may be necessary to reopen the incision to remove the blood. Other problems may include infection, hair loss, and poor skin healing with scarring. Skin loss is more common in individuals who are smoke, and quitting tobacco, at least a few weeks before surgery, is strongly suggested by most plastic surgeons. Numbness in areas near the incisions is normal for several months following surgery, and in a large number of cases it resolves over a period of time. In rare situations there can be loss of function of the muscles of animation and facial expression, because of injury to the nerves supplying these muscles. In most cases this is temporary, but in rare cases it can be permanent.

The goals of facelift surgery are to give a more youthful and rested appearance, and how long the results last vary from patient to patient. Makeup can be applied within a few days after surgery.
There is no upper or lower age limit for individuals desiring this operation. While correction is usually performed in the '60s or even early '70s, over stretched muscles with lack of tone may become more difficult to repair, and the results, while still excellent, may not last as long. When surgery is carried out at a younger age, the results tend to last longer, although the initial change may not be as striking. In general, patients are extremely pleased with this kind of surgery, and some may even repeat it after a few years.

CHEMICAL PEELING

Chemical peels are most commonly performed for cosmetic reasons, i.e. diminish acne scars, and in some cases, control acne, smoothing fine lines of the facial skin, and even out skin pigmentation discolorations. Peels remove the outer layer of skin allowing the collagen and dermis layers to rejuvenate. As we age, our skin sheds naturally. If the skin that is shed is not removed, it can affect the underlying areas, forming deep wrinkles and furrows in the epidermis.

Chemical peels consist of trichloroacetic acid (TCA), alphahydroxy acids (AHA) or phenol. The specific formula is adjusted to each patient's needs once you have discussed this with your plastic surgeon.

The mildest peels are the alphahydroxy acids. These are also called glycolic peels, lactic peels or fruit acid peels. Glycolic acid can be mixed with a cream as part of a daily regime for skin care. Persons with wrinkles, acne, sun damage, or pigmentation problems would benefit from glycolic peels. The AHA peel exfoliates the stratum corneum (outer most layer) of skin. The alphahydroxy acid peels can be done more frequently to get your skin to a maintenance level of every 4-6 weeks. The recovery time is minimal and often the patients can put on their makeup and resume normal activity within 24-48 hours. The peels may cause some redness and irritation to the skin. You may also experience some flaking and dryness.

Trichloroacetic acid (TCA) is the most intense peel used for superficial blemishes, fine surface wrinkles, and pigmentation problems. The recovery time is quicker than a phenol peel with new skin within 7-10 days. TCA is used the "blue peel" and your face may appear blue immediately after the treatment. TCA is preferred for darker skinned patients. The depth of the peel can be adjusted depending on the amount of damage your skin has. You may need more than one treatment to maintain results. Any discomfort should diminish within the first week.

Phenol is the deepest peel. It can cause changes in skin pigmentation and is not recommended for use on the neck and other body areas. It is used mainly for smoothing out very coarse wrinkles and pigmentation changes caused by overexposure to the sun or the aging process. After a phenol peel, the skin may lose its ability to tan and must be protected from the sun's rays at all times. Recovery time is longer than any other peel, usually several months. A phenol peel is not recommended for darker skinned and heart patients and you should inform your plastic surgeon if you have a heart condition.

Anesthesia is not required for the peels and they can be done in the plastic surgeon's office. Before considering any type of peel, consult your plastic surgeon to review all alternatives available to you.

EAR SURGERY

Surgery of the ear is most commonly performed for correction of ears that appear too large, or for protruding ears. The usual problems with protruding ears are a lack of development of the middle ear fold, which needs to be completed.

Surgery of the ear is commonly performed upon children and young adults ages 4-18. By the age of 4 the ears are fully developed, and having the operation performed early avoids teasing. Surgery of the ear should never by considered by parents unless the child is also aware of the problem and wishes to have it repaired.

Other indications for ear surgery include "lop ear", when the top of the ear folds forwards; or "shell ear", when all of the natural folds and creases in the ear are missing. Surgery can also improve stretched earlobes, lobes torn by earrings, or lobes with large creases and wrinkles.

Otoplasty is usually performed as an outpatient procedure, allowing the patient to go home the same day. It may be performed with local anesthesia and intravenous sedation, but in the case of very young children, it is usually performed under a general anesthesia. The patient is usually instructed to wear a head dressing for two days postoperatively, then a headband to protect the ears at night. Adults are usually returning to work, and children to school, within a week. Physical activity will usually be limited for approximately one month to protect the ears.

The operation is performed by a high or middle skin incision in back of the ears. Once the incision is made, cartilage is both remolded and held in position by using sutures, or cartilage and skin may be removed depending upon the problem. Reshaping of the cartilage is performed in order to form the natural folds of the ear. The procedure usually takes 2-3 hours depending upon what needs to be accomplished.

Possible complications of the ear surgery include bleeding, infection and asymmetry in the ears. Ears are not perfectly symmetrical, and slight differences may be seen. In most cases, the results of ear surgery are very pleasing.

BREAST RECONSTRUCTION

Many women opt to have their breasts reconstructed after surgery for breast cancer or any other disease. This gives the woman a better sense of self-esteem and self worth with an enhanced appearance. A patient may elect to have the reconstruction immediately post mastectomy or wait until the mastectomy has healed and the patient has had time to adjust to the trauma.

When to have the reconstruction is something you need to discuss with your plastic surgeon preferably prior to the mastectomy. If you are not comfortable with discussing this prior to your mastectomy, you cannot expect to have the reconstruction done at the time of surgery. Your physician will be able to give you pros and cons as to when to have the reconstruction. Some patients may have to wait, depending on the type of reconstruction flap that may be necessary. The emotional readjustment most women face after undergoing a mastectomy may also re-occur when the breast is reconstructed. Normal sensation to the breast will not be restored with reconstruction but some feeling may return.

You will want your breast surgeon and plastic surgeon to work together to form a plan of treatment that will be beneficial to you. You should have the final say in what will ultimately take place.

Reconstruction of the breast is usually done in stages. The first stage is reconstructing the breast mound. If your surgeon recommends using an implant, he will discuss the options with you. The FDA has approved silicone implants only for those patients participating in approved studies. Your physician would have to be an approved investigator in order to use silicone implants. There are also saline-filled implants available to patients. Review this completely with your physician.

Some patients will require tissue expanders prior to permanent implant insertion. Your physician will insert a balloon expander beneath the skin and muscle of the chest. The expander will be injected with a saline solution over a period of time to gently expand the skin. After the skin has been expanded enough, the expander will be removed and a permanent implant inserted.

If you do not need tissue expanders, your surgeon may be able to insert implants immediately if you wish.

Several tissue flap techniques can be used instead of implants. They are more intensive, require a longer healing period; however, with your own tissue being transferred, it may look more natural to you.

In one tissue transfer, the tissue is taken from the abdomen, back or buttocks. It remains attached with its own blood supply and is transferred beneath the skin to the chest. It consists of the skin, fat and muscle. This will create a pocket for an implant or make a complete breast mound without an implant.

Another tissue transfer, tissue is taken from the abdomen, back or buttocks but is cut from the area and transplanted to the chest. The blood vessels are then revascularized by the surgeon in the new area.

In either transfer, scars are left at the place of the donor skin and where the mound is reconstructed. Over time, they will fade but may never totally disappear.

The nipple and areolar area can also be reconstructed. The areolar area can actually be "tattooed" with a natural color to look just like your matching breast.

Recovery is more complex than most reconstructive surgeries. You may have drains to remove fluids from the surgical site. You will have stitches that will most often come out within the first 7-10 days. You will probably take up to six weeks to feel your old self again. Your surgeon will give you postoperative instructions on exercises and mobility.

Your reconstructed breast may not be identical to your natural breast. Some surgeons will recommend an operation to reduce, enlarge or lift your natural remaining breast.

MASTOPEXY

Breast lift is a procedure performed to raise and reshape sagging breasts. Breast sagging is a common problem following weight loss, pregnancy or aging. With aging, the breast skin is stretched, and there is a loss of breast volume. Due to the loss of volume, the location of the nipple to the areolar complex sag downward and there is a loss of cleavage.

If breast sagging is minimal, sagging and loss of volume may be corrected with the placement of breast implants alone. In many cases, this is advantageous, as the scarring is less.

Mastopexy involves making skin incisions around the areola, vertically downward then under the breast, at the inframammary crease. Once the skin incisions are made, the nipple and areola are moved to a more normal position and excess skin from beneath the breast is removed. Closing the skin incisions then recontours the breast to a higher position, with a more youthful appearance. If the breast tissue available is made adequate to fill the desired size, breast implants may be placed at the same time depending upon the patient's desired goal.

Breast lift usually takes one to two hours, and is usually performed with local anesthesia and intravenous sedation. General anesthesia may also be used. Most mastopexy's are performed as outpatient procedures, allowing the patient to go home the same day.

Most plastic surgeons recommend minimal activity for the first week following the procedure. Usual activities are allowed by four weeks postoperatively. Possible complications include bleeding, infection, and minor differences in position of the nipples and/or minor difference in the size of the breasts. The possible side effects may be decreased sensation to the nipple and areola and there may be an inability to breast-feed. In some patients, healing problems may lead to thickened or widened scars, and loss of tissue. Breast lift is enjoyed by many women, and in the proper patient, is a very gratifying procedure.

GYNECOMASTIA

Gynecomastia is a medical term describing enlarged male breast tissue. It affects approximately 40% of young men between the ages of 11-14, decreasing to 15% by the age of 16. In young men, breast enlargement is usually the result of hormonal changes during puberty. Gynecomastia, when occurring in older men, may be the result of hormonal changes, or medications; however, most often no cause is found. Breast enlargement may be seen in one or both breasts, and involves an increase in breast tissue immediately beneath the nipple-areolar area.

An evaluation by a physician will begin with a thorough history and physical exam to uncover any identifiable causes for the breast enlargement. If the male is uncomfortable or self-conscious about the breast enlargement, breast reduction surgery can help.

The operation is most often performed using intravenous sedation and local anesthetic. It is performed as an outpatient procedure allowing the patient to go home within a few hours. The operation is usually performed through an inconspicuous incision made around the lower ½ of the areola, which is the dark colored skin around the nipple; or through an incision under the arm. Through this incision, the plastic surgeon removes the excess fat and breast tissue, leaving a flatter, more contoured chest wall.

Liposuction may be used to remove excess fat, and aid with contouring, and may be the only method used if the tissue to be removed is primarily fat, rather than breast glandular tissue.

Depending upon the amount of tissue removed, a drain may or may not be left in place. The drain is usually removed in 1-3 days following the operation.

Possible complications of the surgery for gynecomastia include bleeding, infection and injury to the skin. Some people experience decreased sensation around the nipple - areola, and this may take up to a year to resolve. Following the operation you will probably be asked to wear an elastic pressure garment for 1-2 weeks, and most plastic surgeons will recommend minimal physical activity for about three week. This will decrease the risk of any injury to the chest wall.

Most patients are able to return to work within 2-4 days depending upon the type of work. Swelling will be present for approximately 4 weeks, but it may be 4-6 months until the final results will be obtained.

LASER SURGERY

The carbon dioxide laser is an alternative to chemical peels and dermabrasian for skin resurfacing. These lasers are now commonly used to treat surface damage to the skin caused by aging, acne scarring, uneven pigmentation and damage caused by the sun. Laser resurfacing may be the best tool to treat fine lines and wrinkles around the eyes and mouth, and may be performed in conjunction with facelifts, used to correct deep skin wrinkles or sagging.

The procedure is usually performed as an outpatient, and takes 30-60 minutes depending on the extent of treatment. It may be performed with local anesthesia and intravenous sedation, or general anesthetic, depending on the amount of area to be treated. Laser surgery removes the outer layers of skin, leaving the treated area moist and raw for approximately 7-10 days.

During the initial healing phase most patients are instructed to keep the skin moist with an antibacterial ointment. The initial redness will diminish often the first 1-2 weeks, after which time moisturizers and makeup may be used. Once the surface has healed the skin will remain pink for 3-6 months. During the healing phase, it is important to avoid sun exposure and wear sun block. Moist people are able to return to work in 2 weeks.

Risks of laser resurfacing are increased pigmentation, flare up of viral infections and burns caused by laser heat.

The results of laser resurfacing are long lasting, although the natural aging process continues. Following treatment, fine lines around the eyes and mouth will be diminished, if not eliminated, and the skin should be smoother, with more even pigmentation.

Other plastic surgical uses of lasers:

The laser is commonly used to remove tattoos, "age" spots, unwanted body hair and very small veins of the legs and face. For tattoo removal, local anesthetic may be used. It may take more than one treatment before maximum benefit is achieved and if the tattoo color is very deep in the skin all of the tattoo may not be removed with this method alone. "Spider" veins of the legs or very small veins of the face may be treated without anesthesia. More than one treatment may be necessary. The area treated area will show some discoloration, which will fade with time.

Many types of lasers are available for removal of unwanted body hair. Each laser has pros and cons, so the technique and type used should be discussed with your board certified plastic surgeon. During the removal of hair, a topical anesthetic may or may not be used, depending upon the area to be treated. More than one treatment may be necessary as the hair to be removed is in different cycles of growth. Hair removal by laser is not permanent, but multiple treatments can result in long term hair reduction.

SPIDER VEIN TREATMENT

Spider veins, or tenangietasis are small, thin veins that are near the surface of the skin. They become unsightly, and appear mainly on the legs, calves and ankles. They can be hereditary or associated with pregnancy, standing or sitting too long, weight gain or a sequela of certain medications. They can appear as a "spider", thus the name, with extensions from a central point. They can also appear a branches or simple thin lines.

Plastic surgeons use "sclerotherapy" to diminish the veins. Veins are injected with a sclerosing solution to make them collapse and fade. It may take more than one injection for them to totally face away. It will not prevent other veins from surfacing in the future.

There are few complications from the procedure itself. They may range from a blood clot forming in the vein, inflammation of the site of injection, allergic reaction to the sclerosing agent used, or a small scar left on the skin. You will have some bruising for several weeks after treatment. Always choose a qualified plastic surgeon who has done a number of the procedures prior to proceeding.

Usually the surgeon will check for signs of more serious deep vein conditions on your initial visit. Varicose veins are different than spider veins and usually need surgery to correct. Your physician will discuss your current health status, medications and treatments.

Prior to the treatment you will be asked to not use any oil or moisturizer based products on your skin where the spider vein will be treated. If the veins are on the legs, you will want to wear comfortable clothing. The procedure is usually done in the physician's office with no anesthesia necessary. It usually lasts 15-45 minutes depending on the number and type of veins being injected.

Your skin may have some mild bruising after the treatment. Usually within one month after the procedure all bruising will be diminished and you will be ready to show off your new legs. Millions of women are now seeking treatment for spider veins and treatment for men is on the rise.

Nasal Refinement Operations

The goal of nasal correction is always based upon careful evaluation of the internal and external nasal anatomy.Corrective surgery of the nose can be purely cosmetic or functional , but often the patient's dissatisfaction with their nose will involve both its appearance, and its breathing ability. The exam cannot be rushed, and may require radiographic studies of the nasal passages and sinuses.The evaluation starts with an assessment of any significant events in the patients past such as fractures or sinus symptoms which may contribute to the patient's concerns, followed by an internal and external exam , and photo-morphological analysis. The data is then diagrammatically presented to the patient in a concise and logical way. It is crucial that the patient be comfortable with the techniques presented and the benefits obtainable.,

The changes brought about as a result of the aesthetic procedure must result in total harmony with the remainder of the face.Any alterations of the nasal structure will affect its shape and air flow characteristics, the patient must understand the need to balance aesthetic refinement with the need to breathe freely. The improvement to the overall appearance should be obvious, but the reason subtle; this can only happen with precise surgical correction which does not distort or overly modify the nose

Total Facial Rejuvenation

Minimally invasive corrections can be done on an out-patient basis in the office surgical suite, full facial rejuvenation requires an overnight hospital stay, with discharge the following morning. The most critical aspects of facial aesthetic surgery are the minimization of risk and a natural totally harmonious result.

Rejuvenation of the aging face must be individualized to the patient's own perception of their aging process. The critical phase of the surgical plan is a detailed exam and medical history, at all times the patient's views and self assessments must be the starting point for any recommendations by the surgeon. The goal of facial aesthetic surgery is to restore in complete detail those areas where the aging process is advanced, and not to overcorrect the facial regions where aging is less severe. Sequential intervention corrects the aging process as it becomes obvious to the patient, in the least invasive way while ensuring a long-lasting, natural result. Often correction of just the problem areas with minimally invasive surgery, can have an extremely beneficial effect on the entire face. Our goal, "preserve when possible, restore when necessary"


An analysis of the patients aging concerns will often entail a lengthly exam and detailed explanation of the causes of the aging changes in each facial region, visual aids are used to ensure the patient fully comprehends the surgical plan of rejuvenation. Photographs of similar patient corrections are shown and explained, and discussions with post-operative patients are possible. The surgical risks , although minimal are accurately disclosed, and the patient is given a written outline of all costs involved. No charge is made for any post-operative visits, or minor office based touch-up procedures.

Mentoplasty Informations

Aesthetic Plastic surgery includes both reconstructive and cosmetic surgery.

Reconstructive surgery is used to correct abnormal structures of the body. These abnormalities are usually caused developmentally, or through tumors or diseases. Reconstructive surgery is typically performed to improve functions, however it is sometimes performed where a normal appearance is desired.


The chin may be enlarged by using injectable fillers while the patient is awake, using a local anesthesia. Augmentation using an injectable filler is temporary and will need to be repeated on a regular basis.

Permanent chin enlargement can be achieved with an implant. A small incision is made, in the natural crease under the chin or inside the mouth. A pocket is made in the facial tissue to accommodate the implant. The implantis inserted and the incision closed. This is normally performed under general anesthesia.

A stronger chin can minimize the appearance of a prominent nose, and is often performed in combination with rhinoplasty. In some cases chin augmentation may even be an appropriate alternative to rhinoplasty.

Chin augmentation can improve the appearance of a double chin or fleshy neck. The procedure may be performed in combination with liposuction. A weak chin can also make a person look older. Strengthening the chin and bringing the features into balance can restore a youthful appearance.

Chin enlargement is one of the few cosmetic procedures more popular with men than women.

Reduction
A small incision is made, in the natural crease under the chin or inside the mouth. The bone is sculpted to the desired size and shape and the incision closed. Chin reduction surgery is performed under general anesthesia and takes about one to three hours.

A chin that is too large can make the nose appear too small. Chin reduction can reduce the prominence of a protruding chin or improve the shape and angle of a chin that is too wide.

Bringing harmony to the face
The goal of any chin surgery is to bring all of the features into balance and restore harmony to the face. Chin surgery is commonly performed in conjunction with other procedures. In younger patients it is often combined with rhinoplasty and/or cheek implants to improve the entire shape of the face. Patients seeking a more youthful appearance may choose chin surgery in combination with a face or neck lift, to enhance the overall results.

Chin surgery, either augmentation or reduction, may also be performed as part of gender reassignment surgery, to correct a chin that is asymmetrical due to developmental abnormalities or injury, or to correct a patient’s ability to speak or chew normally.

All operations Procedures Other Dr

Breast Lift
Breast lift can correct for the natural effects of aging, like the bust line's loss of elasticity, sagging, or drooping.Gravity and time, pregnancy and nursing, and excessive weight loss or gain can all take their toll on a woman's bust line. Breast lift can restore your curves to their youthful state.

During breast lift, excess skin and tissue are trimmed away and the bust line is tightened and lifted. Remaining tissue and the nipples will be repositioned to create the most natural-looking results. Risks include scarring, temporary bruising, swelling, and loss of feeling in the breasts or nipples. An extremely safe and effective procedure, breast lift takes one hour or more to complete, depending on the work required, and is often performed in conjunction with breast augmentation for more dramatic results.


Breast Reconstruction
Many women feel insecure or self-conscious about the appearance of their breasts following mastectomy (removal of the breast due to cancer or pre-cancerous condition) or because of breast deformities. Breast reconstruction can restore the bust line's natural curves and drastically improve a woman's quality of life.

Breast reconstruction techniques are usually performed in stages and can span across six months. The first procedure - the longest and most complex - is typically performed at the time of the mastectomy. Subsequent surgeries are most often on an outpatient basis and involve minimal pain and recovery.

The two categories of breast reconstruction are: 1) implant-based reconstruction, and 2) techniques that use only the patient's own tissue. There are many factors and variables to consider, and a treatment plan is formulated to meet your unique and specific goals and needs.

Breast Reduction
Neck and back pain, bra strap indentations on the shoulders, and general discomfort are unfortunate realities for women who have exceptionally large, heavy breasts. Oversized breasts can make a woman feel self-conscious and embarrassed as well as physically uncomfortable. Breast reduction is a reconstructive/cosmetic procedure during which the breasts are made smaller, lighter, and more proportionate to the body.

The breast reduction procedure begins with an incision, which is made around the areola (the dark circle of skin surrounding the nipple) and below the natural curve of the breast. Next, excess fat, glandular tissue, and skin are removed, and the remaining skin is tightened around the newly contoured breast. The procedure may take up to three hours and is performed under anesthesia on an outpatient basis. Although there will likely be swelling, temporary bruising, and some pain, these side effects diminish as the breasts heal.

Gynecomastia
Many men feel self-conscious about extra fat and tissue located in their chest area. Fortunately, this condition (known as gynecomastia) can be treated with a procedure sometimes referred to as "male breast reduction." Two variations of this procedure may be used, depending on your needs. If fat, skin, and glandular tissue need to be removed, the procedure will be done using a scalpel or scalpel-liposuction approach. For this procedure, the incision can usually be placed discreetly in the underarm area or around the areola (the dark area surrounding the nipple). If only fatty tissue needs to be removed, the procedure can be done with liposuction alone, which entails a much smaller incision.






Non-surgical Skin Rejuvenation

Dermabrasion
Exposure to harsh elements over time - especially sunlight - and the natural aging process can make skin look dull, blotchy, and lifeless. Acne scars, heredity, blemishes, wrinkles, and other factors can also make skin look sallow and older than it truly is. Dermabrasion is a non-surgical method of treating the visible signs of aging.

During dermabrasion, a wire brush (or burr), attached to an oscillating handle, is used to scrape away the top layers of skin and reveal the fresher, newer skin waiting just beneath your skin's damaged outer layers. The skin will be red and swollen after the procedure, and patients typically experience some tingling, burning, and general discomfort.


Fat Injections
Fat injections can be used to fill in wrinkles and lines, to create contours in the face, and to fill in scars. Because fat is taken from one area of a patient's body to fill in another, there is little chance of allergy or incompatibility.

Fat injections are usually done on an outpatient basis with local anesthetic. The donor site (often the buttocks or abdomen) is first numbed and injected with fluid to make extracting the fat easier. The donor fat is collected through a needle and syringe. After the fluid is removed, another needle is used to reinsert the fat into the treatment area. The treatment area is slightly overfilled initially as some of the injected fat will be reabsorbed by the body.

Most patients can resume normal activities soon after undergoing fat injection. Some minor swelling and bruising can occur during the first few days following the procedure. Fat injections are not usually permanent. Duration of results varies among individuals, but fat injections can be repeated as necessary.

Lip Enhancement
Full, curvaceous lips and a perfectly pouty smile can be yours through the miracle of lip enhancement. We offer a full range of lip enhancement treatments to fill in fine wrinkles, smooth the skin around your lips, and get you smiling fast - in one office visit, in most cases! Looking good increases your self-confidence and lifts your spirits, so why not try one of the following soft tissue fillers to enhance your smile?

· Collagen
Collagen is the fibrous protein that gives skin its elasticity. Collagen injections have been used for decades to replenish the skin's suppleness and to help maintain its youthful appearance. Collagen is a safe, non-surgical treatment that can smooth out facial lines, wrinkles, and scars. The effects of collagen injections can last between six months and two years. Collagen injections can be repeated as necessary.

· Radiance
Radiance is a modern, long-lasting soft tissue filler offered by our practice for lip enhancement. Radiance injections, intended to safely and easily reduce wrinkles and plump up the lips, can restore the youthful beauty of your lips almost instantly. It may also be used to fill the nasal labial folds - the lines that run from the nose to the corners of the lips - so that your face looks younger and fresher.

· Restylane
Restylane is a revolutionary solution to wrinkles and thin lips. It gently smooths away fine lines around the lips and mouth and on the forehead, leaving no scars at the injection sites. Restylane is completely biodegradable and contains no animal proteins, so it is natural and considered extremely safe. Performed in 30-minute sessions, Restylane treatments are long-lasting and can be repeated as necessary, typically every six to 12 months.

Restylane is available in three tissue varieties: Restylane, Restylane Fine Lines, and Restylane Perlane. Restylane is primarily used for lip enhancement, especially to prevent lipstick "bleeding" and to correct wrinkles. Restylane Fine Lines is most effective in filling fine, superficial lines in the chin and cheeks. Restylane Perlane is used for shaping facial contours and for lip augmentation.


Microdermabrasion
Microdermabrasion can help reduce the first signs of aging and help correct for imperfections, blemishes, small scars, and wrinkles. The result of microdermabrasion is smoother, more youthful looking skin.

During microdermabrasion, sterile, sand-like crystals are applied to the skin to remove toxins, impurities, blemishes, imperfections, and dry, scaly skin. The procedure is relatively simple and has virtually no side effects.

Obagi "Blue" Peel
Obagi "Blue" Peel is an exciting new way to refresh your skin by removing its wrinkles, age spots, and scars or restoring its elasticity. The peel may include one to four steps, depending on the patient, and involves the topical application of a glycolic acid solution. This solution essentially removes the outer layers of the skin, exposing the undamaged layers underneath.

Permanent Makeup
Applying makeup day after day is a tedious, monotonous job. Imagine waking up every morning looking well rested, awake, and fresh - without the daily effort! With permanent makeup application, that convenience can be a reality. Permanent makeup is one of the easiest and safest cosmetic procedures available. During permanent makeup application, a special coil machine is used to gently apply pigment to the upper lashes, lower lashes, or lips. This "makeup" can be as subtle or dramatic as you wish, but no matter which look you choose, your lashes will look thicker and fuller, your lips will have beautiful color, and your natural beauty will be enhanced.


Procedures for the Face


Chin Surgery (Implants/Reduction)
Chin implants can help bring definition to the lower portion of the face, while a chin reduction can correct for a protruding or too large chin. Chin implants can strengthen a person's jaw and can bring balance and harmony to the face. A chin reduction improves the overall proportions of facial features. Balanced and harmonious facial features can boost self-confidence. For more information about our chin implant or reduction procedures, please contact us.


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Cleft Lip/Cleft Palate Reconstruction
Cleft lip/palate is a common birth defect that often occurs during fetal development and affects the lip and/or palate of a newborn child. Typically, a vertical separation - or cleft - is present in the lip or palate or both. An infant's speech and feeding can be adversely affected by cleft lip/cleft palate. Reconstructive surgery can correct this deformity and is generally recommended within the child's first three months of life.

Dr. Freeman and Dr. Syribeys specialize in reconstructive surgery and have extensive experience in cleft lip/cleft palate reconstructions. A series of reconstructive surgeries may be needed, which can be done in stages. To find out more about cleft lip/cleft palate reconstruction, please contact Dr. Freeman and Dr. Syribeys at the Plastic Surgery Associates of Macon.



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Eyelid Surgery (Blepharoplasty)
Drooping or puffy eyelids can make you appear tired or older than your true age. Eyelid surgery, or blepharoplasty, can restore the skin around your eyes to its natural, youthful appearance and drastically reduce the signs of aging. In some cases, it can even improve vision impaired by sagging lids.

Eyelid surgery begins with a small, discreet incision made along the eyelid. Excess fat, muscle, and skin are then trimmed away from the eyelid. This outpatient procedure typically takes one to three hours and is performed under anesthesia. Following surgery, side effects such as dry eyes, swelling, bruising, and sensitivity to light may occur, but these fade within about 10 days. Although permanent, eyelid surgery will not prevent future natural aging effects. Contact our practice for more information about eyelid surgery.

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Facelift
Sun exposure, weight fluctuation, and the natural aging process make skin loosen and sag, resulting in wrinkles and jowls. The muscles on the neck can slacken, too, causing you to look years older than you are. Facelift is a surgical procedure designed to eliminate face and neck wrinkles simultaneously, thereby rejuvenating the skin and restoring your youthful appearance. Fresh, taut skin can make you look decades younger!

Facelift starts with incisions made along the hairline, by the ear, on the chin, or along the earlobe. Next, excess skin is lifted and removed. The remaining skin is then smoothened, tightened, and secured with sutures or small metal clips. Depending on the condition of your skin and your desired results, the procedure may take up to three hours. Side effects may include swelling, numbness, bruising, and tightness, but most patients report little pain and only minor discomfort. For more information about facelift, please contact us today.

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Forehead Lift
Horizontal lines on the forehead and creases above the nose can make you look tired, sad, angry, or older than your true age. Wrinkles are intensified by sun exposure, heredity, and weight gain or loss. Forehead lift can subtract years - even a decade - from the appearance of your face by tightening and lifting your forehead skin, thereby eliminating wrinkles and expression lines. The end result is a more refreshed, youthful appearance.

During endoscopic forehead lift (usually chosen by younger patients who are just developing brow wrinkles), an endoscope is inserted beneath the skin. The skin and underlying muscles are then lifted and tightened. The brow will heal in the new position. Traditional and endoscopic forehead lift are often combined with other facial cosmetic procedures, including facelift, Collagen or Botox injections, or eyelid surgery (blepharoplasty). To learn more about forehead lift, please contact our practice today.

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Laser Skin Resurfacing
Smooth, healthy-looking skin can be yours through laser resurfacing. Harnessing the safe but highly effective power of the laser, resurfacing can remove the damaged outer layers of skin. Wrinkles, age spots, acne scars, and other imperfections can be removed with a low chance of bleeding or other complications. Please contact us to learn more.



Lip Reduction
Overly large or puffy lips may cause embarrassment or interfere with speaking properly. Lip reduction is a surgical procedure intended to reduce the size and refine the shape of the upper and/or lower lip to create a smile that is in better proportion with the rest of the face. The benefits of lip reduction include a reduction in the anxiety and self-consciousness that often afflict people who have extremely large lips, improved speaking ability, and a more pleasing appearance. Contact our practice to learn more about lip reduction.






Reconstructive Surgery
With questions reguarding these procedures please contact Paul Syribeys, M.D.

Lower Body Lift, Thigh Lift, Hand Surgery, Limb Salvage, Peripheral Nerve Repair, Surgery For Neurogenic Pain, Head/Neck Reconstruction, Hair Transplant, Oculoplastics And Brow Lift, Autologous Fat Transplant/Transfer



Scar Revision
Many factors determine the severity of scarring: the size of a wound, its depth, the blood supply to the area, and skin tone. No surgeon can completely remove a scar, but the appearance of most scars can be greatly improved. Scar revision is a surgical procedure used to improve the appearance of scars that do not respond to cortisone drugs, steroids, or skin gels. Several techniques are available, including excision, dermabrasion, and laser treatment. Please contact us to learn more about scar revision.


Skin Cancer Post-Reconstruction
After skin cancer has been diagnosed and removed - especially following Mohs surgery - reconstructive surgery is often needed to close or cover the treated area and restore your natural appearance. Skin cancer post-reconstruction is a surgical procedure intended to complete the skin cancer removal process for some patients.


Abdominoplasty
If you do dozens of daily crunches and abdominal exercises and still find it impossible to lose the excess fat and skin around your midsection, abdominoplasty might be a good option for you. Abdominoplasty, also known as a "tummy tuck," is a cosmetic surgical procedure intended to give you sleeker, more defined abs.

Abdominoplasty begins with an incision made from one hip to the other, creating a skin flap. Next, the skin is separated from the abdominal muscles, which are then tightened, narrowing the waistline and flattening the midsection. The flap of skin is then folded down and excess skin is removed. Last, the flap is replaced and the incision is stitched closed. The entire procedure takes between two and five hours, depending on how much work is needed to achieve your desired results. Bruising and swelling, which typically subside within 10 days, are the most common side effects of this procedure. Please contact our office today to find out more about abdominoplasty.


Endermologie
Fight cellulite with this revolutionary skin rejuvenating treatment. Endermologie is a non-surgical method of combating the fatty deposits that lead to the formation of cellulite. Weekly sessions of Endermologie keep your skin toned and supple. The relaxing motions of this non-invasive treatment help keep your skin cellulite-free and in its best condition. Contact us to find out whether Endermologie is a good option for you.



Liposuction, Tumescent
Tumescent liposuction is a surgical procedure used to eliminate fat pockets and cells from your body's problem areas. Tumescent liposuction - considered the safest type of liposuction currently available - allows for the removal of a large quantity of fat with very little blood loss. Performed under local anesthesia, tumescent liposuction can be done quickly and has a short recovery period. Most patients return to work the next day and can resume exercise within one week. There have been no serious complications associated with tumescent liposuction. Please contact us for more information.


Otoplasty
When a child or young adult has especially large or protruding ears, self-esteem can suffer. Ear pinning (or otoplasty) is a surgical procedure that can change the size and shape of the ears. This procedure is most commonly performed on children and adolescents between the ages of 5 and 14, but it can be performed on adults as well. Ear pinning is a highly effective procedure that can improve both appearance and self-confidence.

Otoplasty begins with an inconspicuous incision made behind the ear. Next, excess cartilage is removed, and the remaining cartilage is then sutured - or pinned - into place and left to heal. An ear pinning procedure takes one to two hours to complete, and most normal activities can be resumed within several weeks. Contact us to learn more about otoplasty.



Upper Arm Lift
Excess skin on the upper arms is often an unwelcome after-effect of a significant reduction in weight, just as a major increase in weight may result in pockets of fat developing in the upper arms. Upper arm skin can also become loose and sag with age. An upper arm lift (brachioplasty) can correct these cosmetic problems by removing excess skin and surplus fat from the upper arms.

Usually performed on an outpatient basis under general anesthesia, an upper arm lift begins with a discreet incision made near the armpit or on the inside of the arm. Next, extra skin, fat, and tissue are removed. The skin that remains is then lifted and tightened, and the incision is sutured closed. Minor pain and swelling are the most common side effects, and these typically subside within a few days' time.


Breast Enlargement
A full, shapely bust line can make any woman feel more feminine and beautiful. Every woman deserves to love her body, and breast enlargement can add to a woman's sense of security and confidence. Breast enlargement, or augmentation, is a cosmetic procedure designed to increase and enhance the size and shape of a woman's breast. The end result is a more curvaceous, sexy bust line and a natural, sculpted look.

During this outpatient procedure, an incision is made under the breast, around the nipple, or under the arm, and a saline-filled implant is carefully inserted under the breast tissue or pectoral muscles. Once the implant is in place, the incision is stitched closed. The procedure is performed under local anesthesia with sedation or under general anesthesia and takes one to two hours to complete. During recovery, patients typically experience breast sensitivity, soreness, swelling, and, sometimes, temporary decreased nipple sensation.

Spider Vein Treatment and Laser Scar Revision Procedure

Innovative Skincare Products
Innovative Skincare manufactures some of the world's finest medically-formulated skin care products. Innovative Skincare products can help you keep your skin healthy and youthful by encouraging the natural processes that refresh, nourish, and rejuvenate your skin – exfoliation, circulation, and cellular regeneration. We also offer a wide variety of Innovative Skincare treatments designed to control acne and other skin ailments.

Laser Scar Revision
Any time skin is damaged, scarring can occur. This damage can result from wounds, or from acne, chicken pox, or other diseases that attack the skin. These scars can come in the form of depressions, raised hypertrophic scars, or even large, bulbous keloid scar tissue.

The Vibraderm™ microdermabrasion system. This system has several advantages over older types of microdermabrasion, which would in effect sandblast skin with fine crystals. In the Vibraderm™ system, dead skin is removed with a vibrating microdermabrasion paddle. The paddles are safe and sanitary, as each patient purchases a paddle set that is used solely for their microdermabrasion procedure.


Spider Vein Treatment
If you avoid wearing shorts because you have dark, unsightly veins visible on your legs, you are not alone. Some estimates indicate that half or more of the adult female population is troubled by spider veins.


Dr. can greatly improve the appearance of many different types of scarring by resurfacing the scarred area using a special laser. With the laser, Dr. Heimer can remove layers of scarred skin, leaving just the fresh, clear skin beneath.


Spider veins are small, non-essential blood vessels that lie very close to the surface of the skin. Although no specific cause has been identified in the formation of spider veins, there are a number of factors that increase the likelihood that spider veins will form. Heredity, hormonal changes, weight gain, and long periods of sitting or standing all affect the likelihood that you will suffer from spider veins.

Since spider veins are not essential parts of your circulatory system, the most effective treatment for this cosmetic problem is to collapse the veins. Dr. Heimer accomplishes this using Intense Pulsed Light (IPL). IPL is high-energy but not as intense as laser light, making it perfect for the delicate job of collapsing spider veins.

Skin Rejuvenation with Intense Pulsed Light (IPL)
Intense pulsed light (IPL) is a highly effective way to give sun-damaged skin a more youthful appearance, reducing the appearance of age spots (sun-induced freckles), most benign brown pigmentation, and blotchy redness in the skin. The popularity of IPL is on the rise, because it is effective, quick, and requires no down time – you can get back to your life immediately after treatment!

An IPL treatment basically consists of broad-spectrum light, which your doctor carefully directs at the areas of your skin in need of treatment. IPL can be used on virtually any part of the body that is exposed to the sun, including face, hands, chest and neck. A noticeable improvement is usually achieved after four to six IPL treatments.

"I am very pleased with the Kerastick/IPL photofacial treatment performed on my face. My skin feels rejuvenated, my chances of skin cancer have been reduced, and all the rough, scaly and itchy patches have been removed."


Acne Treatment with Clear Light™
Acne is commonly thought of as a problem for teenagers, but in reality, this skin ailment can trouble people in their 20s, 30s, and even 40s. Acne can cause you to feel uncomfortable and self-conscious about your appearance, and serious cases can even lead to permanent scarring.

The whiteheads and blackheads that are the visible signs of acne are caused when your skin's pores become clogged with oil, dead skin, and bacteria. Clogged pores can become infected, causing pimples or larger cysts to form.

Using the Clear Light™ system of acne treatment Dr. Heimer can, over the course of about four weeks, dramatically decrease the appearance of acne. Clear Light™ uses a focused beam of light to destroy the bacteria that cause acne to appear. The system is drug-free, has no side effects, and is completely painless. If you feel self-conscious because you are troubled with acne, contact Dr. Heimer to find out if you are a good candidate for Clear Light™ acne treatment.

LightSheer™ Hair Removal
Unwanted body hair can be a nuisance. Constantly having to shave to remove hair is time-consuming, and then the hair comes back just as thick as ever. Waxing is painful, and hair still returns. With LightSheer™ laser hair removal, you will never have to worry about shaving or waxing again.

LightSheer™ is one of the most advanced hair removal systems on the market. It uses an incredibly precise, focused beam of laser light to cause hair follicles to stop growing hair permanently. The patented ChillTip™ cools and protects the skin, ensuring that only the hair follicles are affected by the laser.

Hair can be removed from any part of the body with LightSheer™, and it can be used to treat all skin types and colors. Contact us if you are ready to stop shaving and waxing forever!

Vibraderm™ Microdermabrasion
Microdermabrasion is an advanced exfoliation procedure that can reduce the appearance of fine wrinkles, as well as diminish blemishes, age spots, and other pigmentation problems. The dead top layer of skin is removed, leaving just the fresh, vibrant skin beneath.

Man Gynecomastia Woman Breast Implants

These breast implants yield the most natural breast augmentation results, giving optimal fullness while eliminating the upper pole "shelf" appearance. Dr. Shatkin understands that some breast augmentation candidates still desire a rounder look. He offers his breast augmentation patients a choice between anatomic or round breast implants.

Anatomic Breast Implants

Breast Lift (Mastopexy)
Unfortunately, gravity takes its toll and breasts may begin to sag or droop, making you feel less confident about your body. If you have experienced this problem, breast lift is a great alternative. During the breast lift procedure, excess skin and tissue are trimmed away and the remaining tissue is lifted and tightened. The breasts are then repositioned into a more flattering location. This procedure is commonly combined with breast augmentation.

Breast Lift Implants

Correcting Problems with Breast Implants
If you have suffered any problems from your current breast implants, Dr. Shatkin can help. He has the knowledge, skill and expertise needed to correct any problems related to your breast implants, ultimately providing you with the healthy breasts you deserve.

Gynecomastia
Even if they are fit and slim, some men tend to develop fatty tissue pockets on their chests, creating the appearance of small breasts. Although this is quite embarrassing for many such men, it is a common problem (called gynecomastia) that can be easily fixed by a procedure called male breast reduction. During male breast reduction, extra fat and tissue are removed by either a scalpel or via liposuction - ultimately revealing a firmer, more masculine chest.


Breast Reduction
Too-large, heavy breasts sometimes interfere with women's lifestyles - they make exercise and clothes shopping difficult, and bras rarely seem to fit over them comfortably. In fact, some women eventually develop deep grooves in their shoulders from their bra straps. Breast reduction is a procedure that allows for the excess fat, tissue, and skin to be carefully removed, leaving behind a more proportionate, flattering bust. Breast reduction can be truly life altering! If you are considering breast reduction surgery, schedule a consultation with Dr.


Breast Reconstruction

For breast cancer patients, lumpectomy and mastectomy are a vital part of
beating the disease. However, despite the necessity of such procedures,
losing a breast is still traumatic for most women. Dr. Shatkin is dedicated
to helping these women feel as comfortable with and confident about
their bodies as possible after surgery, which is why he offers breast
reconstruction. During this highly personalized, multi-stage, and
extremely delicate procedure, Dr. Shatkin fashions a new breast by
the use of an implant or your own transplanted tissue. Even a
natural-looking nipple can eventually be positioned on the new
breast.

Genital Vaginal Surgery Labiaplasty

The female external genitalia consists of vaginal opening, urinary opening and a peak with many sensitive nervous endings – clitoris. This whole part is on sides covered with gentle skin folds of tissue – the inner lips (labia minora) that come together right in the area of clitoris. The female external genitalia is on sides covered with bigger skin folds with fat cushions – the outer lips (labia majora). The outer lips usually cover and close the external genitalia. Sometimes it happens that the labia minora grows into bigger size or length and thus they can protrude between the labia majora. Mostly this overlap is not too big so it doesn‘t cause any discomfort neither aesthetically nor functionally. If the inner lips protrude too much they can cause discomfort in aesthetic way and also in everyday life. Sometimes it is difficult to fit this abnormally enlarged labis into tight underwear or swimsuit, not even mentioning underwear of “tanga“ type, sometimes it can cause discomfort by sport activities – for example bicycle riding. It can also cause some problems with intimate hygiene and this “defect” can represent also a psychic obstacle during the intercourse. The labiaplasty is then effective with good results. Sometimes the plastic surgeon can meet the request for modification or reduction of outer lips, although these procedures are performed relatively rarely. Sometimes there is even request for hymen reconstruction surgery that can also be performed.

Relatively frequent request for modification or reduction of vagina is although already part of gynecological procedures.
Preparation for the surgery

As a necessary condition for the procedure is an adult patient. Another necessity is thorough consultative examination with plastic surgeon when the patient gets not only the examination itself but also detailed instruction how the surgery will be performed and what is to be expected. In most cases the patient can agree on her requirements for size or shape of the operated area with the plastic surgeon. The date of the surgery should be then scheduled so that the patient will be operated shortly after the ended menstruation. The plastic surgeon has to instruct the patient also about the need of right intimate hygiene in the period after the surgery.
The surgery itself

The labiaplasty is performed almost always under general anaesthesia, on the operational table in gynecological position. The surgeon measures precisely the direction of surgical incisions before the surgery so that the final scars will not be visible and mainly that they will not make any discomfort to the patient. Great attention should be paid to the area of clitoris so the gentle nerves that give special sensitivity to this area will not be corrupted.

Beside very gentle and careful work it is very necessary to cease the bleeding during the surgery. After the modification very tight and also gentle suturing of surgical wound is necessary. To stitch the wound various types of suturing material are used, sometimes absorbable othertimes nonabsorbable (such sutures have to be removed after the wound is healed). Which suturing material is used depends always on the plastic surgeon and his/her experiences. The surgery takes according to the size of the procedure around one hour and is not especially difficult to the patient. Also soreness after the procedure is normally not big, the patients mention only unpleasant but not that strong burning in this area.
After surgical care

The patients after the labiaplasty usually go home next day after the surgery. It is good to stay calm in the next period for about one week, to avoid long sitting, including long car drive and to have the opportunity of perfect hygiene several times a day. We recommend showering and washing with a soup for intimate hygiene or with good and gentle antiseptic soup after each visit of the toilet and to cover the area with pad. Although some patients heal better if the wound is left on countrary totally uncovered or “free“. The operated area get relatively often quite swelled, but usually the swelling disappears after several days. It is better if you are regularly checked by your surgeon. In any case you should know that the healing process takes minimum 10 but mostly 14 days, sometimes even more. Smaller swelling can stay even for longer time and the operated place gets its final shape approximately after 6 weeks, after this period the patient can start with her sexual life again.
Results

The labiaplasty brings almost always very satisfactory results to the patients. Of course it very much depends on the experiences of the plastic surgeon, so that he/she is able to avoid possible complications that are nevertheless not too common. It also depends very much on the cooperation and discipline of the patient so that she can fulfill all the recommendation in the period after the surgery. Some doctors – sexologists – don’t like these surgeries too much, they are afraid of possible reduction of sexual sensation in operated women. The experience of last years, when labiaplasty has been performed here, the opposite has been seen. Women who undertook the surgery mention mostly improved sensation during sexual intercourse. Also that by the surgery their psychic problem of their genitalia appearance is removed contributes to global relaxed and improved experiences in their sexual life.

Acne scaler treatments

How to prepare for a treatment?

A treatment does not require any preparation or interruption daily activities.
Certain drugs should be discontinued before treatment, doctor informs you.
Drinking an alcohol is not recommended 3-4 days before treatment.
After a laser treatment you have to avoid sunbathing and protect skin from solar radiation with UV filter cream, which also recommend you a doctor.

How does a laser affect on acne?

Researches have shown, that an action of laser ray on diluted vessels (this method has been long used in treatment of different skin changes) has anti-inflammatory effect at inflammatory forms.
Studies continued in research of Propionibacterium acnes. It is a bacteria, which multiplies in diluted ceruminous gland and causes an inflammation, which shows like a red pimples. This bacteria transpires agent, which is let down with light-ray action, wherewith start destruction of own bacteria.
This effect is visible during the first month after a treatment, which is 3 times faster than the effect of local or general administered antibiotics and lasts on average 3 months.

Is a treatment painful?

For the effect of fine vessels at inflammatory skin changes same as for eradication of bacteria in ceruminous glands at acne manifestation, are recommended very small doses of light energy in a very short interval.
This gentle treatment does not cause a pain on skin and sirious side effects. Feeling of itching, which patients feel during a treatment, is usually endure well and does not require skin anesthesia.

What are the undesirable effects of treatment?

A fine erythema can lasts 1-2 days. Patients, who are prone to formation of bruises in treated area, there can occur minor bruises, which clear off in 7-10 days.
A growth of crusts or scars is rare, if you follow doctor?s advices.

Removing face skin Pigmentation

Types of pigment spots

Melasma or chloasma is often on a face and areas exposed to sun: cheeks, forehead or upper lip. It is a darker spot (from tanned to brown tone).
So and from this is extracted name for this skin change ? melas means in Greek black and chloasein means green.

The reason for this pigment disorder is hormonal changes in organism, which start during a pregnancy or are connected with using a hormonal contraception.
Skin colour affects production of skin pigment melanin in cells, which are called melanocyte. These cells are in substrate skin and with help of long downgrowth transmit pigment granules to other cells in skin.
Different processes, which are in organism, can affect (increase or allay) pigment production.

Spots, which are the results of increased skin pigmentation, can be removed with an adequate treatment. A pigment, which is in upper part of dermis, is difficult to remove and we must count with a long-term treatment.
After inflammatory hyper pigmentation: can appear after any inflammatory process, which run in skin (after acne, eczemas, contact dermatitis and so on).

Phototoxic (Berlogue) dermatitis:
- after contact with plants, which contain phototoxic agents: ivy, fig and many grasses
- application of cosmetic products, which contain certain agent, for example fragance
- using phototoxic drugs.

Freckles and lentigo: round or oval dark doted spots with inherited origin.

Old age spots: are results of long-term adverse action of solar radiation.
They appear in later age in areas, which are exposed to sun, on a face and back of the hand.

Removing of pigment spots

Bleaching creams contain different agents, which prevent to production of skin pigment in melanocyte. It is necessary to apply these creams 2 times a day for at least 3 month to reach lightening of brown spot colour.
Chemical peeling with glycol acid is made in an out-patient clinic after 2 or 3 weeks (it depends on type of skin and kind of pigment spot). This method can be combined with application of depigmentation cream.
Laser removing of pigment spots.

How does an alexandrite laser work?

A light of laser ray is absorbed by skin pigment melanin during which time melanin granules fragment into very small particle in cells.
This melanin particle are cleaning cells (Macrophage), able to destroy and with its enzymes to completely decompose them. But this process is not immediate.

Port wine stains

Before we started using laser for a treatment of port wine stains, was this affection a sober cosmetic problem for children born with this vessel changes. They are treated like veins in face, because are formed with a lot of minor and interconnected veins.

Which kind of laser is used for a treatment?
Up-to-day appliance is a pulse pigment laser. We use this type of laser of American company Candela V-beam. This laser enables doctor to choose an adequate treatment method for every patient.

When start with a treatment?

During a life port wines stains often get dark and become a prominent. That is way is better to start with a treatment very early, without any problem in an infantile age. Later you start with their removing, more visits you will need.

How many visits are necessary?

Number of visits depends on affection level. Darker changes require more visits. For an optimal result is necessary to count with 5 visits. After first 2-3 treatments is an improvement the most significant.

What is a success of treatment?

Most of the port wine stains lighten at least about 75%, some about 95%.

Undesirable effects and treatment complications

If is a patient treated with the same appliance, are risks and undesirable effects the same like at a treatment of diluted veins in face.

Laser operation Surgeons

Depending on the extent and seriousness of your disease, and regarding the necessity of accommodating treatment tactics to your overall conditions, your physician will select a specific treatment procedure. Treatment may require several repetitions that will gradually solve your problem ( in case of repeated plastic operation of soft palate for the “snoring“ syndrome“ the numer of operations can be from 1 to 3). Several diseases ( typoval “snoring“ syndrome ) have several cause, therefore treatment may consist of various operations in your throat and the nose cavity. The probability of treatment success varies between 70 to 80 %. Most operations are performed with local sedation, more redical treatment ( e.g. so-called “radical option of snoring operation“) is recommended to be performed in analgo-sedation ( controlled sleed ). After treatment, there is a frequent pain ( e.g. in throat, comparable to angina ), swelling, itching, minor bleeding cannot be excluded eiher. More or less theoretical complications include temporary or permanent penetration of foot into nose and a change in voice tone. You have been prepared for the expected course of your operation, ask for details.


The patient has been informed about the following facts: Laser is gong to be applied to trend your disease in the area of your neck, nose, or ears. Laser produces a very strong, but exactly focused light. I tis necessary to protect one´s eyes dutiny treatment usány spicial glasses, or non-transparent covers, otherwise there is a Langer of a heavy damane to your health. With pre-disposed porsons or upon a failure to observe physician´s instructions, potential treatment risks include creative of scars. The proces sof scars creation may, however, in your case be a part of treatment which has been clarified to you by your physician.


Upon signing this dokument, the patient was given the Notification of care after laser treatment“. Any failure to observe the principles stated therein might have the above-given aftermath, namely prolonged and complicated cure. The patient has been acquainted with the treatment price list, has taken it into consideration and approves of its opplication without any reservations. I, the hereafter signed patient, upon my free will Ereby empower the folowing physician.

Removal face skin wrinkles Memory

How is the treatment carried out?
The method is not time-consuming nor physically demanding for the client. Using a very thin needle, Dysport is injected directly in several spots by finely puncturing the respective muscles. The treatment is ambulatory and there is no need of any special preparation for the patient.

What is Dysport?
Dysport is a solution containing the substance called "botulinum toxin A" in medication form. In corrective dermatology, it is injected in very small quantities to problematic areas of the face. When it is injected into a muscle, it blocks the specific nerve impulse. The muscle activity - that causes the developing of facial wrinkles - is disabled, and the respective muscle can no longer be tensed as usual. Other nerve functions - such as the skin's sense of touch - are not influenced.
What does Dysport remove?

* facial mimic (dynamic) wrinkles on the forehead, glabella (between eyebrows) and around eyes ("crow's feet")
* small asymmetria of the face
* excessive sweating of armpits, palms and soles


What is the effect of the Dysport application?
By injecting very small quantities of botulinum toxin A, the respective facial muscle is inhibited which in turn prevents the usual facial wrinkles on the forehead and crow's feet from developing or worsening. The effect develops in 2 - 3 days after the injection and lasts approximately for 3 - 6 months. Repeated treatments can extend the effect up to one year. The effect of Dysport can be enhanced by combining this preparation with other wrinkle-romoving methods (such as chemical or laser resurfacing etc.).

What are the advantages of Dysport application?
Before the procedure, the patient does not need to undergo any test, so that he/she can be treated instantly.
Following the treatment the client does not need to absent from work and after four hours he-she can perform all common daily activities.
The final effect is not permanent and the client can decide whether he-she is satisfied with this method and will continue with Dysport applications.

Sticking out ears procedure and risks

Stickling out ears

The flyaway auricles is quite often congenital handicap that is mainly very unpleasant in the childhood, when the other children can sour the life to the one with this problem. But even in the adult age the flyaway auricles do not add to the self-confidence. This handicap can be one-sided as well as combined with different shapes and sizes of the auricles.
The surgery itself

The surgery is done with local anesthesia or in combination with intravenous anesthesia in certain cases. The surgery is done on the rear side of the auricles in order for the scars to be as unnoticeable as possible. The surgery takes one hour. The compression bandage is applied after the surgery.
Post-surgical period

The bandage redressing follows on the second day after the surgery. First 2 days after the surgery the auricles hurt, but the pain is relieved with the common analgesics and gradually decreases.

The bandage is kept on the auricles for the period of 10 days. Even after taking off the bandage one must be careful and protect the auricles from the injury, do not play team sports for the period of one month after the surgery and at night protect the auricles with elastic bandage. One month after the surgery is the place well healed up.

Pre-surgical period
One has to count with 2 weeks of healing.
At least one month prior to the surgery the patient is forbidden to use any drugs containing acetylsalicylic acid, which reduces the blood coagulation and could cause post-surgical bleeding. These drugs are for example Acylpyrin, Acylkoffin, Aspro, Alnagon, Aspirin etc. The usage of these drugs highly increases the risk of heavy bleeding during and after the surgery; such patient cannot undergo the surgery !!

The patient cannot suffer from any virus-based or any other diseases or undergo convalescence (recovery).

The surgery is paid for on the day of the surgery. The patient will receive a receipt for the amount paid.

Surgery risks

As with any other surgeries they are bleeding and the infections. These are tried to be reduced to a minimum by elimination of all the circumstances that can lead to these complications. The scars quality depends on the individual healing process.

Face and neck operation procedure

I hereby confirm with my signature that I was wholly informed about the potential issues and problems of the surgery, which I voluntarily decided to undergo. I carefully read all the instructions about the surgery and I fully understand it. I am aware that even if both the surgeon and the patient adhere to all the rules, the requested aesthetical result cannot be fully guaranteed. I was informed about the price of the surgery prior to the surgery. I agree that the photographs and the documentation can be used for the scientific purposes.

What's the aesthetic surgery for?

Increasing age of a person brings inevitable, sometimes slower, sometimes faster, changes of the whole organism. On one side we collect experiences and knowledge, on the other our body wears out. The best is to preserve a person in its full physical and mental capability for as long as possible, because even balanced person is resentful to signs of ageing. The goal of the aesthetical surgery is to correct and minimize the body abnormalities.

When is the time for the surgery?

Generally it is around the 40th year of life, but in reality it is very individual and depending on many factors. Some of the big factors are inheritability, way of living, workload and presence of stress in one's life. Part of ones look or appearance is also created by eating habits, regularity of skin care and health in general. Aging is very individual process, which demonstrates itself with drying up of skin, loss of its elasticity and slack skin in certain body parts. Skin folds and wrinkles start to form. And this is the moment when it is still possible to put off the signs of aging through the plastic surgery. The upper age limit for plastic surgery is determined by the overall health condition of the patient.

Face and neck lifting is quite big and serious surgery. It requires good health condition and therefore one must undergo internal pre-surgical check-up. It must be pointed out that above the age of 70 years is the surgery more risky and the healing process slower even when the person is in good general condition.
What can be expected from the surgery?

During the surgery, the skin in the areas of temples, cheeks, neck and lower jawbone is stretched. We cannot generally say that after the surgery the patient will look 10 years younger. In case of narrow face and neck is the final effect stronger than in case of patients with thick layer of hypodermic fat. The skin quality also matters: it should be tensile, not too fragile, movable against the base and not too dry and thin. All these factors create the result of the surgery.

Another problem are the wrinkles, especially the "nose-to-lip" lines around mouth, on the cheeks and in the area of the external eye corners. The wrinkle in the skin actually means the skin is broken, the same way you fold a sheet of paper. The surgery can reduce this problem, but cannot remove it entirely. If the skin is stretched too much, the mimic muscles will be put out of function and the face would become a mask, in its negative meaning. Another question are the mimic wrinkles, which are formed as the result of the motion of mimic muscles. These wrinkles reappear even after the bigger stretch of a skin, because the facial expressions cannot be put out of function. In a social life,

the individuals without distinctive facial expressions are usually not too successful, because the face loses its character. Therefore the consultation with the plastic surgeon is very important prior to this surgery. The goal of this surgery is to remove signs of aging and preserve the natural look of the person.
How long do the results last?

The surgery's effect is permanent, because not only the skin of face and neck is stretched, but also the hypoderm and muscle structures, which age together with the skin. Unfortunately the process of aging continues and probably after certain time from the surgery the patient will look the same way he or she looked before the surgery. In case all the conditions for the surgery are fulfilled again, the surgery can be repeated. The time after which the surgery should be repeated is different and depends on the skin quality, thickness of hypoderm layer, way of living and the care one dedicates to himself.
The consultation with the plastic surgeon

The consultation with experienced plastic surgeon is the first step before the decision to undergo the surgery. Generally speaking, very important is the motivation of the patient, which leads him to undergo the surgery. It goes without saying that necessary qualification to undergo this surgery is good health condition of the patient.
Pre-surgical instructions

1. After the consultation with the plastic surgeon and determining the date of surgery the patient gets the recommendation for the internal pre-surgical check-up, which cannot be older than 1 month before the surgery. This check-up will confirm patient's good health, only in this case the surgery is possible.
2. Patient must count with 2 weeks off in terms of terms of the workdays.
3. Please consult the surgeon if you use any drugs.
4. The patient cannot suffer from any virus-based or any other diseases or undergo convalescence (recovery).
5. Please leave all your jewellery (earrings, necklaces, rings) at home.
6. Ladies, please come without your make-up on.
7. Starting the midnight of the day of the surgery the patient cannot eat, drink nor smoke.
8. At least one month prior to the surgery the patient cannot use any drugs containing acetylsalicylic acid (which reduces the blood coagulation), for example Acylpyrin, Acylkoffin, Aspro, Alnagon. The usage of these drugs highly increases the risk of heavy bleeding during and after the surgery; such patient cannot undergo the surgery!
9. The surgery is paid for on the day of the surgery. The patient will receive a receipt for the amount paid.
10. The patient leaves after complete awakening, preferably accompanied.
11. The bandage redressing follows the next day.

The surgery itself and the post-surgical period

The surgery is carried out on a specialized site with experienced anesthetist combining intravenous and local anesthesia. The surgery takes on average 2 hours. The incision is carried out from the hair part of the head above the ear auricle downward, tightly around the auricle and ear lobe, through the line behind the ear and from here to the hair. The compression bandage is applied after the surgery. The bandage redressing follows the next day. It is in the best interest of the patient to follow the surgeon's instructions. The surgeon will determine the frequency of post-surgical checkups. The healing process is individual and the stitches are removed between the 10th and 14th day after the surgery, always depending on the healing progress. The 3rd day after the surgery the bandage is usually removed, the hair is washed and the patient leaves without the bandage on. We do not shave the hair before the surgery; we only adjust the hair parting in the area of the incision.

Please note that after the bandage is removed it can seem that lot of hair falls off, but this is the hair that piled up under the bandage during several days and can be normally combed out. In the areas where the skin was made loose from its base (in order to be stretched), there is impaired sensitivity for several weeks, but this should go back to normal (with possible exception in the ear lobe area).

For the period of one month after the surgery we do not recommend hair coloring and permanent waves, because certain products used for such purposes are highly concentrated and the skin and hair are much more sensitive after the surgery. We also do not recommend the face massage, because it loosens skin and muscles, thus decreases the skin tension. Also please revise the sunbathing, because the sun rays dry out the skin, which then gets thinner and the wrinkles appear much faster.
Surgery risks

In case of face and neck lifting it is mainly post-surgical bleeding, which we try to eliminate as much as possible. Therefore the thorough internal check-up is necessary prior to the surgery.

It must be made very clear that one month prior to the surgery the patient is forbidden to use any drugs containing acetylsalicylic acid, not even one pill!! The blood bruises on the cheeks and neck are not considered as a risk and can occur after the surgery. Their occurrence is individual and they disappear after 2 to 3 weeks. The damage to zygomatic (facial) nerve we know only from the literature, because it means huge ignorance to surgical technique and anatomy. Impaired sensitivity in the area of the ear lobe, which can rarely become permanent, also belongs to the risks of this surgery. The scar quality depends on the individual healing process.

Aesthetic Pediatric Dentistry

The treatment of children requires additional special care. Our effort is to help the child relax and induce a comfortable atmosphere. Through a system of regular visits we are able to eliminate a lot of unpleasant treatments and help toward a non- problematic development of children's teeth.

Note well, that paying attention to the teeth during childhood will be most beneficial at adult age.

During a short consultation we will advise you how to help your children take care of their teeth.

eething is very individual and occurs mostly between the sixth month and the third year. It usually involves discomfort of the gums. You can help your child using a moist towel, cold spoon or with a soft toothbrush.

It is a common misconception that it is not necessary to take care of milk teeth because they fall out anyway. But caries attack not only permanent teeth but also temporary or milk teeth. The fact is that these teeth are a constituent of the permanent tooth development. There is a general and simple rule - if healthy milk teeth fall out then healthy permanent teeth develop.

The risks to temporary teeth lie not just in unsatisfactory hygiene but mainly with sugar, which is their biggest enemy. Dipping a pacifier into honey, or sweet or sticky drinks - we face the problem known under the term honey teeth. Also long-term breast feeding is not always entirely positive. Mother's milk contains sugar which can also cause caries. Because of this parents can inadvertently start caries in the teeth of their children.

Long term use of a pacifier, drinking from a bottle or finger sucking can lead to among other things an uneven jaw development. Later in life this can cause uneven teeth or other dental defects.

By helping take care of your children's teeth you can greatly influence their dental health in adult age. In additon to proper everyday hygiene, visiting a dentist is also very important. The child should visit a dentist at the latest between the sixth month and first year of life, which means in the period when the milk teeth begin to cut.

The sooner the first visit happens, the bigger the chance to avoid problems. This visit does not automatically mean treatment, it is only the first contact with a dentist.

Our intention is to overcome a child's fear of the dentist and induce a comfortable atmosphere. Do not let the situation get so far that only pain, swollen gums or brown teeth is the reason for the first visit to the dentist. If this is the case, the first contact with the dentist will result in a traumatic experience and this can often last into adult age.

We should also not forget about a regular prevention examination which you should ensure your child has at least every 6 months. Proper attitude of the dentist and related trust gaining is a very important part of this prevention.
In principle we are only referring to prevention check-ups without treatment or the simple application of fluoride gel. Through regular meetings the child gets to know the dentist, gets used to the facilities in the surgery and a positive perception is also reinforced with a small present for the child's courage.
These regular check-ups have the purpose of monitoring correct teething, growth and the early arrest of caries, etc. An integral part of prevention is also regular oral hygiene and proper meal habits.

It is very important to introduce the child to proper hygiene habits from a very young age. Teeth must be treated as soon as they start to cut. From a very young age the parents should start the cleaning of the mouth and gums with the help of a piece of cotton or gauze. Once the teeth cut, it is then possible to move on to cleaning with a soft toothbrush. Around the 3rd or 4th year the child can start to take care of its own teeth and gradually, with help from the parents, can acquire good oral hygiene habits. The proper techniques and other information we will be happy to advise you through a personal consultation or in the "children's course on tooth care" .

When a child reaches the age that they start to take care of their teeth by themselves, it is the ideal time for attend the "children's course on tooth care".
This course is ideal for children from 3 to 10 years whom are divided into small groups of 5 to 10. Parents, who attend this course with their children, can get to know a lot of interesting information about teeth and their everyday care.

The purpose of the course:

* eliminate the fear of dentist in children
* learn basic rules and techniques of oral care in a funny way
* minimise the stress of the child during a preventive check-up
* early diagnostics of caries, orthodontic problems, etc.

Children's toothpaste and toothbrushes have their own specifications and are different from the dental tools of adults. With children it is necessary to be careful about the brush softness; brushes which are too hard could harm the gums. From the very beginning we encourage cleaning without a toothpaste, until the child learns how to use a brush correctly and to rinse. The child can accidently swallow when rinsing, therefore the taste of the toothpaste should not be so strong as for adults. There are a lot of kinds of fruit flavoured toothpaste available for children.

From the age of four it is possible to start using toothpaste with the content of fluoride which creates a protective covering on the enamel. This protects and strenghtens the teeth. For children the amount of flouride should be lowered than for adults. Up to the age of four children should use the toothpaste without flouride due to the risks of swallowing.

If we cannot treat the child's teeth any other way, then we use general anaesthesia. For example this is used for children with a big fear of the dentist or for time demanding treatments on large numbers of damaged teeth.

The whole treatment proceeds in the safest possible way under a specialized pediatric anaesthetist. After the treatment the child returnes home accompanied by a parent.

What is an implant

An implant is an artificial replace of a tooth, similar to the natural tooth attached directly to the jaw. It is usually a titanium roller or screw which is inserted into the spot of a missing tooth. According to a specific schema and conditions, the implant is monitored for 2-3 months during which time a tight connection is created between the bone and implant. If it is necessary to correct the volume or quality of the bone before the implantation (augmentation), the implantation follows 4-6 months afterwards. After a certain time an abutmant is screwed onto the implant to which is later applied the crown or a bridge. Any doubt that the implant will not be accepted by the body is mostly nonsense - in general a success rate of 95-98% is achieved.
It is occasionally possible for the implant and the temporary crown or bridge to all be attached on the day of implantation.

The durability of an implant dependes on many factors - most importantly proper hygiene, care of implants, quality and volume of the bone in the jaw, health status etc. Generally speaking, the implant durability is not limited.

An implant is ideal for anybody who desires a modern, gentle and a functional replace of a tooth. Exceptions are patients with a serious form of diabetes, with haemophilia and heavy smokers. An implant dependes on the jaw beiing fully grown, which means approximately the age of 15-16 years. There are no other restrictions.

The implementation of the implant itself is not complicated. Its takes approximately 20 minutes. The entire procedure usually involves a local anaesthetic and is PAINLESS. In the case of time demanding treatments it is possible to accomplish the process using analgesia or general anaesthesia . After the treatment it is necessary for the patient to go home attended.

Wisdom teeth

It can occur that the tooth cuts only partly and often also in an infavourable setting.Wisdom teeth are the last ones co cut (between the 18th and 30th year) therefore it can very often happen that there is not enough room for them in the mouth. This can result in inflammation or eventual damage of the neighbouring teeth.
For these reasons the treatment can be simple as with other teeth or with a bad setting can be complicated and time demanding. Recovery period is usually one week. In the case of difficulties the treatment is done using local aneasthesia or analgesia.

Primary Facelift Surgery Check Lift Forehead Lift Procedure

For individuals seeking a facelift for the first time, the composite facelift is a comprehensive procedure that offers the perfect solutions the problems inherent in the traditional facelift. Lower eyelid surgery, cheek lift and forehead lift are all components of this surgery.


Until the advent of the Composite Facelift, the science of facelift surgery had changed very little. The prevailing trend in facelift surgery has been to perform small procedures, such as cheek lift and forehead lift, independently. While this might be convenient, it is important to remember that the face ages as a whole and this piecemeal approach to facial rejuvenation can result in an appearance of disharmony that might require more surgery as time passes.

For those interested in complete rejuvenation, it has long been accepted that a taut jawline, contoured neck, elevated forehead, and rested eyes create a more youthful profile. As compared to traditional facelift surgery, where different areas of the face might be treated individually and the lift is in a single direction, the success of the Composite Facelift is due to an integrated surgical technique that requires all areas of the face be moved together, keeping each adjacent area balanced and adding a vertical direction of lift. Lower eyelid surgery, cheek lift, and forehead lift are components of every Composite Facelift surgery performed at Dr. Hamra’s Dallas practice.

COMPOSITE FACELIFT vs. TRADITIONAL FACELIFT
The traditional facelift is usually a “skin lift” or a “SMAS lift.” In the skin lift, the skin is separated from the underlying fat and facial muscles and redraped, in a single direction, toward the ear. In the SMAS lift, the lower face muscle (SMAS) is moved independently from the skin, and is also pulled toward the ear. Facial fat is not addressed.

Typically, after this type of cosmetic surgery, one's face seems fresh and rejuvenated. But over time the natural, fresh look from the traditional facelift disappears. The face seems to "fall" and several areas of the face begin to show signs of tension and pull.


Unlike a traditional facelift that pulls the face in one direction only – toward the ear – the Composite Facelift addresses the gravitational fall of the aging face by using a two-direction lift. In a Composite Facelift, all “parts” of the face – skin, facial fat, eyelid muscle, and SMAS muscle – are kept together when lifted, never losing their intimate relationship with one another. This reverses the progressive downward movement of the cheek, fat, and muscle and repositions this anatomy to its original position.

FOREHEAD LIFT
When addressing facial harmony, it is vital that the forehead is not ignored. When fullScreen facelift surgery is performed, the forehead is sometimes treated as a separate entity from the rest of the face; sometimes a forehead lift is performed with a facelift, other times it is not. A forehead lift is a vital component of the Composite Facelift because it lifts the eyebrows to their original youthful position and smoothes out a furrowed forehead.

Breast Reduction Surgeons – Performing the Finest in Cosmetic Alteration

Breast reduction is achieved by removing excess breast tissue and skin and then repositioning the nipple and areola (the darker skin surrounding the nipple) to ensure that they sit in a natural position. Lastly, the remaining breast tissue is reshaped. Our surgeons strive to preserve breast and nipple sensation and are able to do so in the vast majority of cases. Most women who undergo breast reduction retain the ability to breast feed following the operation.

At the Cosmetic Surgery Associates of Westchester, breast reduction can be a life-enhancing event that has a dramatically positive impact on both a woman’s health and self-esteem. For insurance purposes, breast reduction is at times considered a reconstructive procedure, due to the fact that greatly oversized breasts may interfere with normal function and can lead to severe back problems. However, one cannot overlook the cosmetic component to the operation: breast reduction surgery will vastly improve the shape of the breasts and nipple areas.


We frequently recommend the procedure to young women who are in the early stages of the physical and psychological dilemmas associated with having excessively large breasts. Depending on your symptoms, insurance may cover at least part of the cost of this procedure. Most insurance carriers have specific requirements as to the amount of breast tissue that must be removed in order for the procedure to be classified as reconstructive and therefore qualify the patient for coverage.

Laser Skin Treatments Leading Edge Rejuvenation Technology

The laser may be used to treat your entire face or for "spot treatment;" for example, it is frequently used in combination with transconjunctival eyelid surgery to smooth and tighten lower eyelid skin. The laser is a state of the art tool used to improve skin texture, reduce sun damage, tighten skin and remove wrinkles. This high energy light source vaporizes the outer skin layers. Using the laser, we can customize treatment for the various areas of your face; it is possible to very accurately control the depth of the treatment so that superficial wrinkles are not treated in the same manner as deeper wrinkles.

At Cosmetic Surgery Associates of Westchester, we have extensive experience in laser skin resurfacing, and our results are consistently outstanding. Depending on your needs, we can perform a light or a deeper resurfacing treatment.

Chemical Peel The Evolution of Skin Enhancement

During the treatment, a solution that gently peels away the top layer of the skin is applied to areas in need of rejuvenation. Peel solutions may contain alpha hydroxy acids, trichloroacetic acid (TCA) or phenol as the peeling agent, depending on the depth of your wrinkles and your skin type. Several light- to medium-depth peels can often achieve similar results to one deeper peel treatment with less risk and shorter recovery time.

Fine lines and wrinkles around the mouth and on the forehead and cheek areas may be improved with a wide range of skin treatments. One of the most effective methods is chemical peel.

Alpha hydroxy acids are derived from foods, such as fruits and milk, and can improve the texture of skin by removing layers of dead cells and encouraging cell regeneration. There may be little or no down time after this type of light chemical peel.

Trichloroacetic acid is used for peeling your face, neck, hands and other exposed areas of the body. It has less of a bleaching effect than phenol and is excellent for "spot" peeling of specific areas. It can be used for light, medium or deep peeling, depending on the concentration and method of application.

Phenol is sometimes used for full-face peeling when sun damage or wrinkling is severe. It can also be used to treat limited areas of your face, such as deep wrinkles around your mouth. A "buffered" phenol peel offers yet another option for severely sun-damaged skin and may be a good choice for some patients who want a deep peel with a somewhat faster recovery.

Hair Transplant and Restoration

If you are troubled by hair loss, medical or surgical hair restoration may be the answer for you. During your initial consultation, the cause of your hair loss will be carefully evaluated and your treatment options will be thoroughly explained.

In men and women, hair loss, or "pattern baldness," often results in a receding hairline or thinning crown. In women, hair loss most often occurs across the top of the scalp rather than at the frontal hairline. A family history of baldness often is a factor for both men and women who are losing their hair.

Medical treatments can effectively slow or even reverse hair loss in many patients. Some patients, however, prefer hair restoration surgery that can provide the most natural-looking and permanent solution to baldness. There are many approaches to hair restoration and during your personal evaluation your surgeon will go over each and help you determine the approach that will work best for you. Although hair restoration takes time, once the process is completed, you will never have to worry about hair loss again.

Vein Injections Eliminating a Variety of Leg Veins

Using magnification and microscopic techniques, a sclerosing agent is injected directly into the vein. This affects the lining of the vessel, causing fibrous tissue to develop, which collapses the vein and makes it disappear. Because sclerotherapy does not affect the melanin pigment in your skin, the risk of blotchy skin discoloration (hypopigmentation or hyperpigmentation) is reduced, and patients with tanned skin are not excluded from treatment.

Sclerotherapy is the primary treatment method for superficial leg veins and is effective in treating the varying sizes of spider veins that most patients have.

Although lasers may sometimes be used in treating leg veins, laser treatment is generally not as effective or predictable as sclerotherapy. Laser treatment alone may be adequate, however, for treating tiny spider veins such as those that often form around the feet and ankles. Circumstances also exist where lasers offer the only treatment option. Although rare, a patient may be allergic to the sclerosing agent, and pregnant women should not be exposed to the chemicals used with sclerotherapy. After childbirth, it is advisable to wait about 6 to 12 weeks after delivery to determine if treatment is necessary. as there is a high likelihood that prominent veins will regress or disappear when hormone fluctuations stabilize.

In most cases, veins that have been treated do not recur. Those that do recur, as well as newly-developed veins, may require "touch-ups" every few years.

Other Contouring Procedures Abdominoplasty Body Lift

Abdominoplasty is a body contouring option we offer to San Jose and Palo Alto residents as well as those of the surrounding areas as a way to correct these problems. Abdominoplasty removes excess skin and fat, and tightens abdominal muscles. The incision is made low on the abdomen, near the pubic region, so that any scarring is hidden by most underwear and bathing suits. For individuals with loose abdominal muscles and minimal skin excess, a “mini abdominoplasty” may be all that is needed. Many patients find this procedure highly beneficial because it results in a shorter scar.

Panniculectomy, abdominal lipectomy, tummy tuck Pregnancy and weight loss can cause the skin of the abdominal wall to become loose and sometimes leave permanent stretch marks behind. In addition, abdominal wall muscles can become lax and cause the lower abdomen to appear more prominent. This condition is often unresponsive to exercise and skin creams.

The Abdominoplasty Procedure
A full abdominoplasty at our office near San Jose takes between two to four hours depending on the extent of work involved and whether or not it is combined with some degree of liposuction. After the incision is made, the abdominal skin above the umbilicus is lifted. The umbilicus is cut free from this skin and left on its attachment. This is later brought out through a new incision. The abdominal muscles are tightened with heavy sutures to help narrow your waistline. Excess skin and fat are removed and the incision is closed. An abdominal binder or compression garment is placed to support the abdomen and help to decrease swelling during your recovery.

Recovery
Drain tubes are left in place for approximately one week after surgery. During your recovery, you will remain somewhat flexed at the waist and the knees to feel comfortable and to minimize tension on your incision. The abdomen feels “tight” for several weeks after surgery. Numbness is common in certain areas and may be permanent for some. The scar begins to fade two to three months later and may take one to two years to reach its final appearance. Swelling will resolve within six weeks by 75 percent, and the remainder will be gone after six months.

Showering is permitted once the drain tubes have been removed. Heavy lifting, aerobic activity, and vigorous exercise should be avoided for six to eight weeks. Lifting should be limited to fifteen to twenty pounds during the first six weeks. Patients are encouraged to walk around as soon as it feels comfortable, as this will aid in their recovery.

Please contact Atherton Plastic Surgery today if you are interested in learning more about abdominoplasty or any of the other body contouring options we offer at our center near Palo Alto and San Jose.

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Body Lift
circumferential tummy tuck, torsoplasty, belt lipectomy Following massive weight loss, skin wrinkling and loss of tone can change the body’s contour, leaving excessive skin over a large area of the body. A body lift procedure at our office near San Jose can eliminate loose skin and help restore a more toned figure. The procedure consists of an abdominoplasty (tummy tuck), thigh, and buttock lift. The scar required for this procedure is placed very low on the abdomen, near the pubic region. It continues across the sides and along the lower back. This scar is hidden by most underwear and bikini swimsuits. Patients require a two to four night stay in a care facility or hospital following this operation.


The Body Lift Procedure
A body lift takes between three to five hours, depending on the extent of work. Excess skin and fat are removed from the abdomen, waist, thighs, and buttocks. The abdominal wall muscles are tightened to help narrow the waist and firm the abdominal wall. In some cases, liposuction is utilized in the body lift to improve contour. As with the abdominoplasty, the umbilicus is brought out through a new incision after the excess skin is removed from the abdomen. Drain tubes are placed under the skin to minimize fluid accumulation after the operation. These are left in place approximately one to two weeks after surgery. Dissolvable skin sutures are carefully placed for skin closure. Patients are placed in a binder or a compression garment for post-operative comfort and to help minimize swelling.

Recovery
Because the procedure is rather extensive, patients often take several weeks to recover from a body lift. San Jose residents and those of the surrounding areas who undergo the procedure, however, will find our cosmetic surgeon and her friendly staff available to address any post-op concerns.

Following the surgery, you may shower once the drain tubes have been removed. You will be discharged from the hospital or care facility after two to four days. It is necessary to have an adult to drive you home and stay with you during your first 24 hours at home. Patients from out of state should plan to stay locally for approximately two weeks.

Discomfort during the first few days is controlled with pain medication. You will be swollen in certain areas for some time. Generally 75 percent of the swelling is gone at six weeks. The remaining swelling may take up to six months to one year to resolve. It is important that you start walking as soon as possible during your recovery. This helps prevent blood clots in your legs and helps to keep your lungs open. Deskwork employment may be resumed two to three weeks following surgery. If your work involves prolonged standing, heavy lifting or vigorous activity you are advised to wait six weeks before returning. Vigorous exercise should not be resumed until after six weeks. Temporary numbness is common and may become permanent in some cases. You will feel like you need to be flexed at the waist for a few days after surgery. With time, you will be able to stand upright again. The scars will begin to fade two to three months after surgery. Although they never disappear completely, scars become considerably less visible over the next one to two years.

If you have undergone massive weight loss and are interested in learning more about body lift, abdominoplasty, or any other contouring options at our center near San Jose and Palo Alto, please contact us at Atherton Plastic Surgery today.

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Thigh Lift
Time and gravity can cause the skin of the inner thigh to lose tone and elasticity. This is especially true following massive weight loss. The thighs may be affected by both a fat collection and saggy skin, which can produce an unpleasant contour that does not respond to diet and exercise. A thigh lift involves liposuction along with the removal of excess skin to restore a healthier looking contour. If the skin tone is good and excessive fat is the main problem, liposuction alone may improve the condition.


The Thigh Lift Procedure
A thigh lift takes approximately two hours. The procedure involves liposuction as well as removal of the loose skin. After excess skin and fat have been eliminated, dissolvable sutures are used to close up the incisions. You will be placed in a compression garment for two to four weeks to help minimize swelling.

Recovery
It is not unusual to have some drainage from your incisions for the first couple of days. Walking during the first 48 hours is encouraged. Climbing stairs, squatting and aerobic activities should be avoided for several days. You will be seen back in the office two to three days following your surgery. Most patients have a “tight” and swollen feeling in the thighs. This gradually goes away. Most of the swelling is gone by six weeks time. Individuals with a “desk job” may return to work after one week. Positions that require lifting more than 25 pounds, prolonged periods of standing, walking, or heavy lifting should not be resumed for three to six weeks. The scars will begin to fade two to three months after surgery and will have diminished considerably in one to two years, though they will not disappear completely.



Arm Lift
Hanging skin on the underside of the arm with loss of skin tone frequently occurs following massive weight loss. The loose skin is sometimes associated with fat deposits from the elbow up. The arm lift is a procedure that is performed to remove excess skin and some fat in order to restore a more youthful appearance in the arm. A scar is left along the length of the upper, inner arm where it is hidden whenever your arms are by your side. Liposuction - another body contouring procedure - is a good alternative to an arm lift for those with good skin tone and disproportionate amounts of fat.

The Arm Lift Procedure
The arm lift, or brachioplasty, takes between two to three hours to perform. Some liposuction is commonly done as well as removal of excess skin. The incisions are closed with absorbable sutures. Often, a drain tube is left in each arm. Each patient is placed in a compression garment to help minimize swelling.

Recovery
The arms remain swollen for several weeks following the procedure. You will be seen in the office two to three days after your surgery to remove dressings and possibly drains. You should refrain from lifting anything greater than 15 pounds for six weeks after surgery. Most patients are able to return to work in about one week. The scars will not disappear completely though they will begin to fade in two to three months, and will reach their final appearance in one to two years. It is important that these scars are not exposed to sun while they are still red as this may lead to darkening/pigmentation. If sun exposure is to occur, a sun block of 15 SPF or higher should be used.

Risks of Body Contouring
Although body lift, abdominoplasty, and other contouring techniques are regularly performed by cosmetic surgeons in San Jose and elsewhere, there are risks involved with these procedures, as with all surgeries. Infection and blood clots are rare. However, if an infection does occur it can be treated with antibiotics and drainage, which will prolong your recovery. The risk for developing blood clots can be minimized by moving around or walking as soon after surgery as possible. Poor wound healing may result in a conspicuous scar that could require a second revision operation. Smokers are advised to discontinue smoking three weeks prior to surgery, as smoking increases the risk of complications and delays wound healing by altering the circulation to the skin. During your preoperative visit, Dr. McCormack will discuss other complications that may occur.

Before Your Body Contouring Procedure:
Medical History
A full medical history is required prior to surgery. This helps to ensure that anesthesia and the stress of surgery is well tolerated. If you have significant medical problems, a consultation with other specialists may be required before surgery. You may also require specific laboratory tests. A full weight loss history is also important. This includes any prior surgeries and how long your weight has been stable. If you are continuing to lose weight it may be wise to wait until your weight stabilizes for 6-12 months before embarking on body contouring surgery to maximize your results.

Physical Exam
Dr. performs full physical exams to determine which body contouring procedures are best for her patients in and around Palo Alto and San Jose. Photographs are also an essential part of the process.

Out of town patients
We try to accommodate out of town patients by accomplishing as much of the preoperative work up as we can prior to the patients arrival to the Bay Area. Patients can fill out our online medical questionnaire and supply us with pictures through this website or by regular mail. Patients are asked to arrive at least 2-3 days prior to surgery for a full physical evaluation and to complete the final preoperative workup. We ask that patients spend at least 10-14 days locally, assuming that no complications occur. We can assist you with arranging to stay in a nursing care facility or local hotel after your discharge from the facility. We recommend that you put us in touch with a physician from your hometown who is willing to help take care of you until you are completely back to normal. Frequently, you will see your primary care physician ahead of time so that labs and any necessary tests for medical clearance can be obtained.

Who is Not a Candidate for Body Contouring
If you are still massively obese you are not a candidate for body contouring. This is because your contour will not improve and the surgical risks are much greater. If you have significant medical problems that put you at greater risk while under general anesthesia, then this type of surgery is not safe for you.

Breast Lift Reduction Mastopexy

Every so often, a patient will come in thinking she wants a breast augmentation, though she does not actually want any increase in breast size-an impossible task with a breast implant.

For patients who like their volume in a bra but simply do not like their breast position when the bra is removed, an implant is not necessary. A breast lift will suffice. The only caveat is that only implants will give upper pole fullness.

When a natural breast is lifted, as with mastopexy, the upper pole will be full until the tissues relax and settle. When dealing with a natural breast, normal drooping (not nearly as low as prior to surgery) will eventually occur. To obtain more upper pole fullness, patients can elect to have an implant performed at the same time as the breast lift.


Breast Reduction
Breast reduction is truly a life-changing event. While insurance carriers routinely turn down patients for breast reduction, it is perhaps the biggest disservice that they do their clients. Reduction of weight on the chest wall often improves posture, muscle tone, and the ability to diet and exercise. Many of my Washington, D.C., Maryland, and Northern Virginia patients go on to better, healthier, and happier lives after breast reduction surgery. Fortunately, breast reduction can be performed as a cosmetic procedure.


Ancillary Breast Augmentation ProceduresIn addition to breast augmentation, breast lift, and breast reduction surgery, I also perform nipple reduction and correction of inverted nipples, either as a part of other breast enhancement procedures or on their own.

Rhinoplasty Consultation

Dr. offers free rhinoplasty consultations at his Livingston, New Jersey office in Essex County. He often schedules evening hours to meet the demands of working patients.

Before discussing the cost of rhinoplasty, it is important to understand that our practice treats each patient as an individual and that different factors may influence the actual price of the procedure. No two noses are alike, and rhinoplasty is customized according to the goals and needs of each patient. During free rhinoplasty consultations at his office in Essex County, Dr. asks patients some basic questions and takes a short medical history. Dr. listens to patients describe his or her expectations for the surgery. He then examines patients and informs them of all their available options before helping them decide on a course of action.

At this point, patients will discuss cost and payment options with our nurse. She will also offer a unique perspective on rhinoplasty, a perspective that comes from 32 years of experience as an operating room nurse. Patients leave our office with a greater knowledge of rhinoplasty and more of the tools required to make an informed decision about whether to proceed with surgery.

If you are considering scheduling a consultation with Dr. to discuss rhinoplasty, we suggest that you download and fill out the following forms prior to your consultation. This will help to expedite the process and save you time.


In addition, you will sign consent forms and complete all necessary paperwork. The doctor and his nurse will address any questions or concerns you may have about the surgery, and our nurse will personally prepare you by providing instructions on what to expect during and after the operation.

The majority of procedures are performed on an outpatient basis at Morristown Memorial. Patients return to the office six to eight days after the surgery for removal of sutures, splints, and cast. Most patients can return to most normal activities within 10 days.


Frequently Asked Questions


Q: How long will it be after my surgery before I can return to work?

A: On average, our patients return to work in 10 days. Usually, after surgery on a Thursday, patients are able to report to work the following Monday.

Q: What will Dr. discuss during the consult?

A: During the consult, Dr. will analyze your nose, discuss your concerns and goals, and describe the changes he will be able to make through rhinoplasty. Dr. will discuss with patients exactly what he plans to do during surgery.

Q: How long will post-operative swelling last?

A: While most of the major swelling and initial bruising will subside in 10 days, swelling can take a few weeks or months to completely resolve. Patients’ noses continue to improve subtly from months to years later.

Q: When will the appearance of my nose become more or less permanent?

A: Patients often see dramatic improvement in the following weeks to months following surgery, and the results continue to improve several months to years following surgery.

Rhinoplasty Seconder Rhinoplasty Procedure

Just as there are many types of noses, there are almost as many approaches to rhinoplasty. Adjustments to size, shape, and angle – these are just some of the changes people often wish they could make to their noses. Dr. Fodero can make your nose larger, smaller, straighter, or smoother; he can improve the bridge, tip, or nostrils..

A person’s nose has a much greater effect on his or her overall appearance than many of us realize. Being the central feature of the face, the nose has a prominent effect on its overall symmetry, and symmetry is one of the main factors our brain uses to subconsciously measure attractiveness. Correcting a crooked nose or a malformed nasal structure can have dramatic effects on a person’s appearance.

Open Rhinoplasty
There are two main types of rhinoplasty, open and closed. Open rhinoplasty at Dr. Fodero’s New Jersey practice is the most common procedures he performs. In the procedure, Dr. Fodero makes a small incision in the columella, the flap of skin between the nostrils on the underside of the nose. Open rhinoplasty at the New Jersey practice allows Dr. Fodero a better view of the nasal structures, and with this technique, he can make a wide variety of corrections, including reshaping and repositioning. Closed rhinoplasty, on the other hand, involves incisions confined to the inside of the nose. Dr. Fodero uses this technique in very straightforward cases in which the patient only wants a bump removed or doesn’t require much adjustment to or reshaping of the tip of the nose.

Secondary, or Revisional Rhinoplasty
Revisional rhinoplasty, sometimes called secondary rhinoplasty, at Dr. Fodero’s office in New Jersey can correct and reconstruct noses that are still undesirable after previous operations. Surgeons have less leeway in performing subsequent nose jobs than they do with the first, which means that revisional procedures have to be handled with exceptional precision and care by a highly skilled professional. With Dr. Fodero’s dedication to the nose and experience performing the procedure, revisional rhinoplasty at his New Jersey office is the ideal choice for patients seeking to correct a previous operation. As always, Dr. will be honest and straightforward in helping you to develop realistic expectations during your consultation.


Primary Rhinoplasty
If you are considering rhinoplasty for the first time, rhinoplasty performed by Dr. Fodero in Morristown, Livingston, or Summit, can give you the healthy, attractive nose you want with a low likelihood of revisional or secondary surgery. In the last twelve years, Dr. Fodero has built a reputation for exceptional rhinoplasty in Northern New Jersey. If you’re considering a nose job, contact Dr. for a free consultation.


Male Rhinoplasty
Male rhinoplasty requires a unique set of skills because the corrections have to be subtler. The one-size-fits-all button nose factory approach to rhinoplasty can lead to unsatisfactory results in either gender, but is particularly ineffective in male patients. Male rhinoplasty has to be done with care by a doctor who can build a strong, natural looking, masculine nose. Dr. Fodero focuses on creating a nose that perfectly complements your facial features. For male rhinoplasty in Morristown, or one of the other areas where Dr. Fodero operates, contact the office today for a free evaluation.


Challenging Noses
Certain types of noses do not lend themselves as easily to rhinoplasty as others. The more subtle the correction, the thicker or more delicate your skin, the more difficult the surgeon’s task becomes. Dr. Fodero prides himself on his integrity and gives his patients the most realistic expectations, but his dedication to rhinoplasty also means he can handle more challenging cases. Even if other surgeons have told you that your case is too difficult, contact Dr. Fodero for rhinoplasty in Morristown, Livingston, or Summit. Chances are, he’ll be able to make significant improvement to your nose.

Ethnic Noses
Rhinoplasty on the non-Caucasian nose requires unique set of skills. Black, Asian, Hispanic, and other non-Caucasian patients need a surgeon with experience working on noses similar to theirs. Many of these patients are unhappy with their noses, but worry that rhinoplasty might come at the expense of their cultural identity. Dr. has extensive experience with patients facing this dilemma, and he has the skill and specialization in rhinoplasty to soften bumps and make hooked noses less harsh without compromising the unique characteristics of a patient’s nose and ethnicity. In short, he can give you an attractive nose that still reflects your heritage.

Arm Lift

Hanging skin on the underside of the arm with loss of skin tone frequently occurs following massive weight loss. The loose skin is sometimes associated with fat deposits from the elbow up. The arm lift is a procedure that is performed to remove excess skin and some fat in order to restore a more youthful appearance in the arm. A scar is left along the length of the upper, inner arm where it is hidden whenever your arms are by your side. Liposuction - another body contouring procedure - is a good alternative to an arm lift for those with good skin tone and disproportionate amounts of fat.

The Arm Lift Procedure
The arm lift, or brachioplasty, takes between two to three hours to perform. Some liposuction is commonly done as well as removal of excess skin. The incisions are closed with absorbable sutures. Often, a drain tube is left in each arm. Each patient is placed in a compression garment to help minimize swelling.

Recovery
The arms remain swollen for several weeks following the procedure. You will be seen in the office two to three days after your surgery to remove dressings and possibly drains. You should refrain from lifting anything greater than 15 pounds for six weeks after surgery. Most patients are able to return to work in about one week. The scars will not disappear completely though they will begin to fade in two to three months, and will reach their final appearance in one to two years. It is important that these scars are not exposed to sun while they are still red as this may lead to darkening/pigmentation. If sun exposure is to occur, a sun block of 15 SPF or higher should be used.

Liposuction Frequently Asked Questions

How do I know if I need a tummy tuck (abdominoplasty) or liposuction?
If you have loose skin in the abdomen or weak abdominal muscles (usually due to pregnancies, excessive weight gain, or weight loss) you will likely need an abdominoplasty.

I work out a lot and eat right but cannot trim my thighs or waistline; will liposuction help?

Liposuction is ideal for people who have isolated areas of fat that persist in spite of a good diet and exercise. If you live in or near Baltimore, Maryland and would like to learn more about liposuction, we would be happy to discuss your options for liposuction.
Can't I have liposuction instead of a tummy tuck?
Liposuction is a preferred technique for isolated pockets of fat on the legs, tummy and hips. Therefore, not all patients are candidates for liposuction. To be effective, there must be little excess skin. However, for many patients in Baltimore, Maryland, if the lower tummy tissues are excessively stretched, abdominoplasty (tummy tuck) is indicated. Occasionally, the two techniques can be used together. In the majority of cases, the tummy tuck is performed first and a second stage liposuction is done several months later.


I have heard horror stories of liposuction accidents and even death. Is the procedure dangerous?

Liposuction is exceedingly safe and complication-free when performed by a qualified surgeon in an accredited surgical facility. Dr. Vogel is a qualified surgeon and our facility is fully certified! The horror stories and deaths were almost all associated with excessive fat and fluid removal or procedures not performed by an experienced liposuction surgeon.

I need to lose a lot weight in a hurry. Can liposuction help?

Liposuction can remove localized pockets of fat. There is a limit to the amount of fat that can be safely removed during one operation. Therefore, liposuction is not a diet or exercise substitute. It is simply intended to eliminate unsightly fat deposits in unwanted areas.


Do I need to lose as much weight as possible before having liposuction?

In general, it is preferred but not always necessary. Each case much be individualized. There are two reasons for this answer. First, even with general weight loss, some fat remains in the deep pockets of the thighs, hips, love handles, and tummy; liposuction is ideal for these areas. Second, realistically speaking, it can be tough to lose those final pounds and liposuction can provide that incentive to lose additional weight and keep it off.

Since I had my children, my stomach makes me look fat. Am I a candidate for liposuction?

A fat stomach after childbirth is usually due to the stretching of the abdominal skin and muscles. Liposuction may not be an effective treatment for this problem. A tummy tuck, which would eliminate excess skin and tighten the stomach wall, would be a better treatment choice.

What is liposuction recovery like?

You will have moderate soreness after liposuction for a few days but this improves quickly thereafter. You will have bruising for 2-3 weeks. Drains are not used. Most people take off one week from work to recuperate from liposuction.

Can liposuction get rid of cellulite?

No, it cannot. However, our practice offers Endermologie®, an FDA-approved, minimally invasive technique designed to visibly reduce the appearance of cellulite.

Can I speak to some of your previous patients who had this surgery and get a reference?

Absolutely, we would encourage this. Our past patients are my greatest endorsement. Our staff will gladly arrange this for you.

Hair Transplant Frequently Asked Questions

Introduction to Corrective Hair Transplant Procedures

In the 1950's hair transplants were first introduced into use as we know it today. The first transplants were large round grafts containing 8-12 hairs per graft and these were placed into large round holes in the scalp. This is now known as the pluggy transplant appearance. But in those days it was all that was available. The state of the art techniques in hair transplanting are illustrated by the examples above. In this section options for correcting previous transplants in need of repair are presented. This is a sub specialty for Dr. Vogel and he has had extensive experience with these difficult problems. Dr. Vogel is particularly well qualified and experienced for this type of repair surgery because of his training as a plastic surgeon.

Please refer to one of Dr. numerous articles on hair transplant corrections cited above for more details on the procedures. Briefly, the problem with the pluggy appearance is the large round plugs and the limited donor hair available. Thus two fundamental approaches are usually taken to improve the appearance of the pluggy look.The first is plug reduction and hair recycling and the second is linear excision of the hairline and hair recycling. Both of these techniques directly address the plug as a culprit for the undesirable appearance and recycle the plug hair respecting the precious and scarce amount of available donor hair.

Plug Reduction and Recyling

In this technique the large round hair plugs are reduced by approximately 80-90% and the removed hair plug is recycled into follicular units. These (recycled) hairs, now small and natural appearing grafts, are placed at the hairline to soften the appearance. The reduction of the plug also greatly contributes to the softer and more natural appearance.

Recycling of the hair plug is essential because there is a shortage of donor hair and every follicle that is usable must be re-used. Recycling the hair also decreases the amount of hair needed for harvesting from the donor area (i.e. back of the head)

No matter which option is chosen the patient must be realistic about what can be achieved and be aware that several procedures are needed to achieve optimal results. Dr. Vogel will spend time explaining the options and details about which procedure is best for you as well as the goals, likelihood of success, alternatives and risks.



Who Are Hair Transplant Surgeons? And, How Can I Find Someone Qualified to Perform Hair Transplants?
No one medical specialty represents hair transplantation surgery as its exclusive domain. Today, hair transplants are performed by physicians with differing backgrounds and specialties. Therefore, it is crucial to select a surgeon based on proven work, reputation and surgical experience. In addition, a mutual understanding and good relationship with your physician and his staff are essential. Furthermore, be sure to check into the facilities in which the hair transplant will be performed, speak to the doctor’s staff who will be assisting him during the surgery, and finally, gauge your degree of comfort with the entire prospect of having hair transplantation surgery by this team.

Why Am I Going Bald and How Much Hair Will I Lose?
It is generally agreed upon that almost all men and many women will experience some degree of hair thinning as they age. While some women develop generalized and diffuse hair thinning, many lose hair in a rectangular pattern directly behind the anterior hairline. Many men will experience a pattern of hair loss that frequently follows that of a male relative. We refer to these typical hair loss distributions as “male or female pattern baldness.” The medical term for baldness is alopecia. Alopecia is an inherited condition like eye color or physical stature. Since this trait is inherited, there is nothing you can do to prevent hair loss. A combination of the male hormone testosterone and the genetic trait for hair loss are the two primary factors responsible for “pattern hair loss.”

It is impossible to definitely predict how much hair an individual will lose. However, the amount of anticipated hair loss and remaining donor hair are essential to evaluate because they are crucial elements in the individualized treatment plan for your hair transplantation.

Hair transplants, which are becoming increasingly popular among our patients from or who travel to Baltimore, Maryland – just miles from Washington, DC – are a permanent solution to alopecia.


What patients are good candidates for hair transplants?
Potential candidates for hair transplants at our Baltimore, Maryland practice, close to Washington, DC, must be in good health and have adequate donor hair. The results are dependent upon many factors. These include current age, extent of hair loss, anticipated future hair loss pattern, texture, color and thickness of your donor hair, and the number of sessions needed to complete the hair transplantation. It is also important to outline what limitations exist to achieving complete hair restoration and to carefully evaluate your hair loss pattern to provide you with a realistic expectation of what can be accomplished. Hair transplants are not for everyone, so we will evaluate your case on a personal basis.

What are Hair Transplants?
Hair transplants are a very specialized surgical technique. Here’s how it works: hair from the fringe above the ears and around the back of the head is transferred to the crown and the front portions of the scalp. In the vast majority of individuals, the hair from the fringe and back of the scalp is genetically encoded to grow throughout life. Thus, the transplanted hair will continue to grow indefinitely. This permanently growing hair in the fringe serves as the donor area. These permanent hair grafts are transplanted into small slits that are created by the surgeon in the area of alopecia. This is known as the recipient area for hair transplants.

What Types of Grafts Are Used?
The most common type of graft we used in called a follicular unit. A follicular unit is the way hairs gather together in their natural state. In other words, some hairs grow as single units; others grow in pairs, and still others exist in thicker gatherings of three to four hairs. We prepare each graft as a follicular unit, the way they exist in nature, and transplant them into very tiny slits just large enough for the graft.

These types of grafts are totally natural in appearance. The only down side to follicular unit grafting is that a somewhat thin or "see through" appearance is produced. What this means is that more grafts are needed to produce a fuller appearance. Sometimes, grafts that are larger than follicular units are used to provide additional bulk. This is only done in areas where the appearance will remain totally natural and added thickness is required. In women, we often use larger grafts to satisfy the need for bulk but are still able to maintain a natural look.


What Can I Expect After Surgery?
After their hair transplants, our patients from or visiting Baltimore, Maryland, near Washington, DC, go home with a complete set of instructions and medications. We do not bandage our patients’ heads. Most people are able to return to work within a few days. If swelling does occur, it takes place maximally on the third post-operative day in the forehead. Typically, there is some mild to moderate discomfort in the donor area but minimal pain in the recipient sites.

Vigorous activity should be postponed for seven to 10 days following the surgery. Soon after the transplant, the new follicles go into a resting stage, during which time no growth will occur. This stage lasts approximately three months. After this stage, your new hair growth will begin - but it will take approximately five months to mature and develop into a result that can be assessed. This is a general guide regarding growth rates. Some patients have accelerated growth, and others have delayed rates of growth and cannot be fully evaluated for a full year following the transplant.


Will The Hair Transplants Be Natural After The Hair Has Grown In?
Using new methods of grafting, we are able to create the most natural hairline possible. Through the use of follicular unit grafting, we create a natural transition zone between the forehead and the back of the scalp. In men, this technique simulates the natural hairline seen in many older individuals who still have their hair but have some natural thinning and recession. This natural mature hairline, which frames the face, is what we strive for when performing hair transplants in our office in Baltimore, Maryland, near Washington, DC. It is unrealistic to anticipate that a hair transplant or other procedure can recreate the hairline that you once had at age 18. In women, we often use larger grafts to satisfy the need for bulk but still are able to maintain a natural look.


Do The Hair transplantation Procedures Hurt?
The hair transplants we perform in our Baltimore, Maryland office, near Washington, DC, are relatively painless. These procedures are performed using local anesthesia or intravenous sedation administered by our certified nurse anesthesiologist. Often, a mild sedative is given during the procedure when sedation is not used.


What Happens To The Donor Area Of My Head?
The hair transplant “donor area” is closed with stitches and the surrounding hair covers the site completely. This usually leaves the donor area completely undetectable immediately after a procedure. While a permanent scar will remain in the area of the donor hair harvest site, it is almost always invisible when the hair length is 1/8 inch or longer.


What Is A Scalp Reduction?
A scalp reduction is a procedure to remove bald scalp and bring the hair-bearing scalp closer together. This is a useful procedure in select patients but is much less frequently performed today as compared to a few years ago. The improved hair transplant techniques and results, the resulting scalp reduction scar, and the progressive nature of hair loss with more exposure of the scar are factors that have made this a less frequently chosen option in our hair restoration practice.


What Are Hair Flaps?
Hair flaps are techniques to transfer large portions of hair on the sides and back of the scalp to the front and central areas of the head. The most efficient method to perform a flap procedure is to first expand the scalp using a tissue expander. This is a balloon-like device frequently used in reconstructive surgery. The concept of a tissue expander is to enlarge the surface area of the hair-bearing scalp on the sides of the head. By enlarging the supply of scalp with hair, more is available to replace the bald areas. This procedure has limited application for the majority of patients. Most patients who are candidates for this surgery have reconstructive needs following burns or another type of injury to the scalp.


Can I Have Some Improvements Made To Previous Hair Transplants I’ve Received?
YES. If you have previously had hair transplants or another hair transplantation procedure and you wish to have some improvements made, this can often be done. This is one of Dr. Vogel's special areas of interest in hair restoration. Please refer to the articles posted at the top of the hair section for more details on the topic of corrective or repair hair transplant procedures. Corrective surgery is one of the special areas where we can draw upon Dr. Vogel’s surgical experience in plastic and reconstructive surgery and is a unique asset to custom design a plan best suited to your particular requirements.

Frequently Asked Questions Breast Augmentation

My breasts have a tubular shape. Is this normal?

Yes, this is a common variation on breast shape. Typically a breast has a pyramid shape, but some people have breasts that have a shape closer to that of a tube. The appearance of the breast in this situation typically includes some breast tissue pushing against the areola and expanding it, a tight, narrow breast base near the chest, and a short distance between the bottom of the areola and the infra-mammary crease. This tubular appearance can be improved with breast augmentation and some additional skin tailoring.

Below is an example of this type of improvement in the Tubular breast shape

What size breast implants should I be getting?
You are the person who will live with your breast augmentation results on a daily basis, and the decision for size is a very personal one. We will recommend a size based on what you tell us you are looking for. You may wish to bring in photos from publications to demonstrate a desired look and size. Some women prefer to appear totally natural and others prefer a fuller look. We are happy to provide both options.

What is the life span of the breast implant?
Patients enjoy long-lasting results when their breast augmentation is performed in our Baltimore, Maryland surgical suite. It is possible that the breast implants may need to be replaced during the patient’s lifetime. The likelihood is approximately 1% per year that deflation will occur. So, if someone has breast implants for 25 years there is a 25% likelihood that deflation will occur at that point. If this does occur it will happen slowly but over a 24-hour period. There is no health hazard associated with the leakage of the saline breast implant, but it does need to be replaced.

Is it better to choose smooth round or the anatomic- (tear drop-) shaped breast implants when getting breast augmentation?
Contrary to "hype" and information "on-line," in the majority of cases the shape of the implant is very unimportant. Fundamentally, the shape of the augmented breast will not differ between the two types of breast implants. Other differences do exist and if they apply to your case we will be happy to answer and explain them to you.


How can I avoid capsular contracture (hardening of the breast implants due to scar tissue build up)?
No one really knows why this occurs in some breast augmentation patients, and it cannot be 100% eliminated. Some theories state that contracture is related to a variety of factors, these include: low-grade infection, inherent scar formation tendencies by the patient, or location of the breast implant above or below the muscle. We take every possible precaution to avoid these potential problems that might lead to contracture. In addition, we are big believer in massage of the breast implants following surgery. It is known that massage softens scar tissue and my patients have a very low rate of contracture.

Is it better to have the breast implants placed above or below the muscle?
Some surgeons only place the breast implants below the muscle, others only above. We will recommend what is best for you based on the way your breasts appear and the look you desire. During your thorough breast augmentation consultation, we will decide on what method is best for you.

Am I able to breast feed after I get implants?
Most patients who have breast augmentation in our Baltimore, Maryland office do not have problems breastfeeding.

Can I get silicone breast implants?
There are some special circumstances in which we are able to provide silicone breast implants to our patients. At this time the FDA regulations are quite stringent about which patients are suitable for silicone breast implants. The future options for less stringent conditions to obtain silicone implants is favorable, however. We will be happy to discuss with you what type of implant should and will be used during your breast augmentation.

Are mammograms less effective when breast implants are in place?
Breast implants do hide a certain amount of breast tissue on mammography. Additional mammographic views are recommended to maximize the amount of breast tissue seen, however. This does mean additional radiation at the time of mammography but the total amount is certainly not excessive.

If my breasts droop is a breast lift needed?
Generally, if the nipple is at or below the breast crease, a lift (mastopexy) can be beneficial. Weight loss or past pregnancies are the most common causes for breast droop. The medical term for breast droop is ptosis. To achieve a lifting of the breast, the breast skin is excised and the "breast skin envelope" is made tighter. The scars on the breast that result from this lift are considerable but usually heal very well. With the excess skin removed, the breasts rise to a more youthful level. Some women may require a breast implant (augmentation mastopexy) as well in order to get adequate lift and fullness.

What is recovery like?
Most breast augmentation patients have only moderate soreness for a few days, but this improves quickly thereafter. Contrary to what you read on the Internet, breast augmentation patients in our Baltimore, Maryland office truly have very little pain postoperatively. Most people take off 3-5 days from work to recuperate.

Can I speak to some of your previous patients who had this surgery and get a reference?
Absolutely, we would encourage this. My past breast augmentation patients are my greatest endorsement. The staff in our Baltimore, Maryland office will gladly arrange this for you.

What is Vascular Anomalies

Procedure and informations:
Vascular anomalies are birthmarks resulting from the irregular development of lymph or blood vessels.While vascular anomalies typically remain unchanging,some become more aggressive and require treatment.Treatment may be necessary to maintain an aesthetic appearance, or to eliminate a lesion that is painful or presents a health risk.

Facelift Rhytidectomy Procedures

Precodure informations:
Mini-lift or necklift alone may be useful in certain patients.
As people age,the effects of gravity,exposure to the sun,and the stresses of daily life can be seen in their faces: deep creases from between the nose and mouth, the jawline grows slack, and jowls, folds and fat deposits appear around the neck. The facelift procedure rhytidectomy can't stop this aging process.What it can do is set back the clock improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

Breast nipple reconstruction

Breast nipple problems:
The loss of a nipple as a result of mastectomy or lumpectomy does not have to be permanent. Dr. is extensively trained in nipple reconstruction, a plastic surgery procedure designed to restore the breast's natural appearance and ultimately increase the patient's self esteem.During the surgery,skin is grafted from other parts of the patient's body and discreetly molded into place. After healing is complete, the newly created nipple is tattooed so that it matches the color of the natural one.

Waxing informations

About:
Waxing If you are tired of shaving but aren't considering permanent methods of hair removal,waxing might be just the answer. This long-lasting method effectively removes hair from the legs, back, arms, face, upper lip and other body parts, causing only minimal discomfort and resulting in few side effects

Radiesse

Administration FDA Unlike the above Dermal Fillers, Radiesse lasts from 3-7 years and the use of nerve blocks is required prior to the injections. Nerve blocks are needed to minimize pain during the procedure making the procedure take a longer time to complete. Resting is essential for the rest of the day to assure the filler stays in the places it was injected, this means minimal talking and applying ice to the sites of injection.
The biocompatible nature of BioForm implant products means that the physicians can concentrate on delivering care without concerns about reaction, inflammation or rejection. The primary compound used in BioForm implants is pure, synthetic calcium hydroxlapatite particles composed of calcium and phosphate ions. Because these occur naturally in the body, the compound is said to be tissue friendly.Identical in composition to the mineral portion of human bone,these particles are metabolized through normal homeostatic mechanisms, because no derivative of human or animal tissue is used in any of BioForm's implant products, there is assurance that no human or animal disease can be contracted from the implant material. In addition, all of the ingredients in the product's aqueous gel carrier are biocompatible and classified as Generally Recognized as Safe GRAS by the U.S. Food and drug

Gynecomastia Male Breast Overdevelopment

Gynecomastia:
Male breast overdevelopment, known medically as gynecomastia is exceedingly common. Afects an estimated 40to60 percent of allmen to some degree.While the condition has been linked to certain drugs and medical conditions, no cause is definitely identified.

Scar revision and procedure

Wound healing characteristic varies from person to person. It depends on the person’s age, race, genetic factors and location of the wound on the body. There are several methods used to reduce the prominence of scars and improve the skins texture and flexibility. Technique of revision is chosen according to scars characteristics.

Whether caused by injury, surgery, or burn, scars can be disfiguring. Scars stand out against the rest of the skin because scar tissue is made of collagen cells which produce fibrous tissue rather than ordinary skin cells. As a result, scars are usually a different color, and do not have sweat glands or hair follicles. The severity of a scar depends on many factors, including the size and depth of the wound, the blood supply to the area, and the thickness and color of the skin. A wound including all skin layers leaves a scar which is inevitable consequence of wound healing process.



Linear scars which do not cover a large surface are surgically removed by cutting the skin around the scar, and wound is closed by fine and delicate stitch techniques in order to leave inconspicuous scar.

Dermabrasion can be performed for the superficial scars even which extend large surface. Dermabrasion smoothens out surface irregularities such as deep lines or scars by removing the topmost layers of the skin.

Tissue expansion can be considered for thick and irregular scars which even extend large surface on the body. Tissue expanders are silicone balloon in various shape and size which are placed underneath the skin where the expansion is required. In this procedure, an expander is inserted under a patch of healthy skin near the scar. The expander is inflated with a saline solution 1-2 times each week to stretch the skin. Inflation can be done in the office and is not painful. Inflation quantity depends on the size of the expander. Inflating period depends on the size of the expander and the volume of the saline solution added into the expander each time, but it usually takes 6-8 weeks. When the skin has been adequately stretched, the expander is surgically removed, the scar is then removed, and the balloon-stretched skin is pulled over the previously scarred area and carefully closed. This is a two staged procedure. After the second stage is completed, large scar become a thin linear scar.

Hypertrophic scars, which are thick, red, raised and occur within the edges of the wound. Keloids, which look like hypertrophic scars, but are firm and extend beyond the edges of the wound. Keloids can be swollen and often itch or hurt. Keloid formation depends on the person’s age, race, genetic factors and location of the wound on the body. When a keloid formation is anticipated, using silicone gel sheets and steroid applications may prevent the formation of keloid scars. These clear sheets are placed on the scar and wrapped firmly with tape. Steroids can help flatten and reduce the redness of hypertrophic and keloid scars. Steroids are applied or injected into the scar to break down the skin’s collagen. This is especially effective on hypertrophic and keloid scars, both of which continue to form collagen after the wound has healed. These injections can also help reduce the itching and or pain associated with these scars. Because of wound healing process may cause recurrence of keloid formation after surgery, surgery is not usually considered for keloids except particular cases. Surgery can only be considered for very firm keloids which cause to discomfort and dysfunction; and do not respond to medical applications.

While scar revision cannot make a scar vanish completely, scar revision procedures can diminish the appearance of scars, and help restore a damaged self-image. Sometimes the procedure can even improve the function of the site treated by easing the stiffness of the skin.

Lifelong Post Bariatric Surgery Diet Guidelines

The following are dietary guidelines you must follow for life. Failing to do so can be detrimental to your weight loss and your overall health. Your specific post obesity surgery dietary plan will be discussed during your consultation at our bariatric surgery center in Dallas, Texas.

Eat Slowly –You should try to eat food very slowly (take 30 to 40 minutes to finish a meal).

Chew Food Thoroughly – Food should be chewed until it is the consistency of baby food. When you eat meat, you should cut it into very small pieces and chew it very well. Failure to chew food thoroughly can lead to stomach blockage.

Avoid Drinking Liquid with Meals – Do not drink liquid with your meals. Between meals, drink water or low calorie beverages to prevent dehydration.

Take Nutritional Supplements – Since you may not be getting enough vitamins and minerals naturally, it is important that you take nutritional supplements to stay healthy.

Eat Three Meals a Day – Try to eat three meals a day and avoid skipping meals.

Avoid Overeating – Overeating can slow weight loss, promote stretching of your stomach pouch, and make you sick.

Avoid High Calorie & High Fat Food and Drink – High fat foods (such as fried food and ice cream) and high sugar foods (such as cake and candy) should be avoided. LAP BAND® surgery patients should be careful to avoid high-calorie and high-fat drinks because they will go through the small stomach opening and stall weight loss.

Obagi

The Obagi® skin care system goes beyond other plastic surgery alternative systems to treat skin on the cellular level. Used successfully by top skin care centers around the globe, Obagi® has become an invaluable component to our skin care treatments at Dr. Eckhardt's office in Illinois. Our Obagi® system consists of two main components: Obagi® Nu-Derm and Obagi® Blue Peel.

Obagi® Nu-Derm is a rejuvenating skin therapy system of cleansers, toners, and creams that help smooth, balance, and improve facial appearance. Containing tretinoin, daily application of this plastic surgery alternative system can decrease the appearance of fine lines and wrinkles, improve skin elasticity, correct blemishes, reduce age spots and other irregular pigmentation, and diminish pore size. The skin’s tolerance is increased and can even hold more moisture, giving your face a healthier, more natural look.

The Obagi® Blue Peel is a lighter type of facial chemical peel that smoothes the skin and can remove blemishes, age spots, wrinkles, and scars. When repeated over a period of time, the Obagi® Blue Peel can produce results equal to those of a deeper peel while requiring less recovery time - only seven to 10 days. With proper treatment, the skin’s natural elasticity is restored, and fresh, healthy skin is revealed.

Captique Injectable Gel

Experience the quick, safe, effective, and natural way to erase years from your face! Captique Injectable Gel is an FDA approved non-animal hyaluronic acid dermal filler designed to naturally diminish fine lines in the face and create gently plumped lips. The clear, purified gel is composed of hyaluron, a substance that naturally occurs in your skin, and recreates the full, healthy look of a young face.

Captique is commonly used to fill smile lines around the mouth, nose, and lips, as well as frown lines between the eyes. The procedure is so quick and easy that patients come in during the lunch hour and walk away with a gorgeous, revitalized new look! Captique results are long lasting and incredibly natural, gently plumping areas of the face that are saggy or loose. Your appearance will improve in a dramatic, yet subtle way.

Frequently Asked Questions

Do I qualify for LAP BAND® or gastric bypass surgery?
You may be a candidate for weight loss surgery with Dallas surgeon Wade M. Barker if:

You have a body mass index (BMI) of 40 or more (about 100 pounds overweight for men and 80 pounds overweight for women)
You have a BMI between 35 and 39.9 and a serious obesity-related health problem (such as heart disease, type 2 diabetes, or severe sleep apnea).
You have been obese for at least five years
You do not have a history of addiction or psychiatric problems (such as depression)
You possess a thorough understanding of weight loss surgery and the lifestyle changes it will require you to make.

How much weight can I expect to lose after undergoing gastric bypass or LAP BAND® surgery? How long will it take to lose the weight?
With LAP BAND® surgery, an average patient loses about 50 percent of excess body weight. This weight loss occurs over a period of two to three years, with the majority of weight loss occurring in the first year. With gastric bypass surgery, patients with a BMI over 50 tend to lose about the same amount as LAP BAND® patients, about 50 percent of excess body weight. Gastric bypass surgery patients with a BMI under 50 often lose about 70 percent of their excess weight. Following a gastric bypass, our patients in Dallas and greater Texas can expect to lose about three-quarters of their total weight loss in the first six months; the rest occurs by one year to 18 months.



Can my gastric bypass or LAP BAND® surgery be reversed in the future?
Gastric bypass surgery cannot be easily reversed. LAP BAND® surgery, however, is more easily reversible. If necessary, you may undergo surgery to remove, replace, or alter the band.



What happens if I don't obey my dietary guidelines following weight loss surgery?
Ignoring dietary guidelines following surgery can slow down weight loss and make you sick. Many gastric bypass patients who overeat and consume high-fat and high-sugar foods experience "dumping syndrome," which is characterized by sweating, fatigue, and diarrhea. Overeating can also cause vomiting.


Will I need to undergo plastic surgery to eliminate excess skin? Will it be covered by insurance?
After losing weight, many patients find that they are left with large amounts of excess, saggy skin on their bodies. To remove this skin, some patients choose to undergo plastic surgery. Since this is considered cosmetic surgery, it is typically not covered by insurance. Therefore, patients who think they might like to have plastic surgery to remove excess skin should save money for it as soon as they decide to undergo LAP BAND® surgery or gastric bypass weight loss surgery at our Dallas, Texas practice.


Can I drink alcohol after undergoing weight loss surgery?
After undergoing gastric bypass weight loss surgery, you will find that even small amounts of alcohol will affect you quickly. For the first year, it is suggested that you completely refrain from drinking alcohol. After that, you may have small amounts of alcohol with your doctor's approval. Patients who undergo LAP BAND® surgery or gastric bypass surgery should avoid alcoholic drinks because they tend to be high in calories and can hamper weight loss.


If I choose to undergo weight loss surgery, will I still be able to smoke?
Patients who smoke cigarettes are asked to quit six to eight weeks prior to LAP BAND® or gastric bypass weight loss surgery.


Why is exercise important after weight loss surgery?
Not only does exercise burn calories, but it also helps to build and preserve muscle. If you don't exercise daily, your body will consume your unused muscle as you lose weight. This will cause you to lose muscle mass and strength. For this reason, patients are encouraged to begin exercising soon after LAP BAND® or gastric bypass surgery.


Can I get pregnant after undergoing weight loss surgery?
You should avoid pregnancy for at least one year after weight loss surgery at our Dallas County surgical center. This is because rapid weight loss and nutritional deficiencies can be harmful to a developing fetus. Once a year has passed and you have returned to a regular diet, you should be able to have a healthy pregnancy. Please consult your LAP BAND® / gastric bypass surgeon for more information.

Restylane

Restylane is another filler material that our Manhattan practice uses to enhance lips or eliminate wrinkles. During treatments, Restylane is injected beneath the skin covering deep lines, or into the lips, providing a firm, full appearance. Restylane is a man-made, FDA-approved material. It is manufactured from hyaluronic acid, a natural sugar/protein complex present in the body, which significantly decreases the likelihood of an adverse reaction. Because it is smooth, soft and long lasting (it lasts almost twice as long as collagen, or four to eight months), Restylane is rapidly replacing collagen as the material of choice, not only at our Manhattan office, but also through the entire world.

Chin and Cheek Implants

A small chin or flat cheekbones can seriously affect the way your facial features work together. An imbalance in these bony structures can cause a large nose to look even more prominent. Enhancing your bone structure can improve the balance and symmetry of your face dramatically. Whether you would be best suited with chin implants or cheek implants, our New York City practice can help you decide.

Both chin implants and cheek implants are made from special medical-grade materials that, when placed, look and feel like normal bone. Every year, the availability of synthetic materials used in cheek and chin implants increases, offering patients more options for their surgery. However, we insist that the chin and cheek implants materials we use be proven durable and safe before we introduce them into our practice. In a consultation for cheek or chin implants at our New York City practice, we will show you the various implants materials and explain how each one will work within your facial structure.

Ultrasound Assisted Liposuction

Ultrasound Assisted Liposuction (UAL) is one of the newest types of liposuction available today. Like other types of liposuction offered by our offices in Maryland, ultrasonic liposuction allows for removal of excess fat cells from problem areas on the body. However, this procedure is slightly different because it incorporates ultrasonic energy application (sound waves) and tumescent (saline) injections to allow for maximum fat removal. Often, patients choose ultrasonic liposuction because they are interested in removing the largest deposits of fat possible from problem areas. The sound waves are sent to the tip of the cannula, liquefying the fat and allowing for easier extraction. This method results in less skin dimpling and puckering and is usually reserved for large volume removal. Our Maryland ultrasonic liposuction patients are often very satisfied with the dramatic results this procedure provides.

Anti aging Medicine

Comprehensive Diagnostic Testing: A journey in wellness begins with a first step. To know where you are going in health, and if you have achieved your goals, you must begin with a baseline of physical, mental, and physiologic tests. Our extensive testing includes: cardiovascular risk comparison; cardiovascular risk and protection factors; pro-oxidant, anti-oxidant, vitamins, minerals, and trace metals assessment; liver and kidney functions; cancer risk assessments; age-related hormone levels; physical and physiologic benchmarks. This is followed with a detailed consultation reviewing the findings with you and making goal setting and management recommendations for memory, weight, tone, energy/endurance, sleep, libido, and other desires.

Nutrition, Fitness & Stress Reduction: Personalized weight reduction and weight management to enhance and sustain wellness and longevity. Stress reduction options, including physical, hormonal and hypnosis therapies to assist in managing life's crises and age accelerating habits.

Nutritional Supplements: Customized formulations based on lab analysis, age, sex, and gender.

Skin Health & Rejuvenation: All levels of skin rejuvenation, including Retin-A, the Obagi Nuderm system, peels, and resurfacing.

Cosmetic Surgery: Appearance enhancing procedures of the face, neck, trunk, and extremities. Board certified plastic surgeon, Dr. Dean Kane performs all of our plastic surgery in our Baltimore office.

Hormone Replacement Therapy: Human Growth Hormone, DHEA, testosterone, estrogen, progesterone, and melatonin are part of the comprehensive anti-aging program.

Gene Therapy: Alterations in genetic material to prevent aging and diseases is the future for anti-aging medicine.
Thank you for visiting us at the Center For Anti-Aging Medicine. In addition to plastic surgery, Washington D.C. and Baltimore patients are increasingly becoming interested in our scientific approach to slowing the aging process. We are pleased because your very interest in this exciting program shows that you are among the growing numbers of men and women who are concerned about improving and maintaining the highest quality of life attainable today.

At the Center For Anti-Aging Medicine, we believe that "normal aging" is a process in which one's health erodes, making one more susceptible to chronic disease. We believe that true health is not merely the absence of disease, but rather the presence of optimal physical, mental, and emotional well-being. Therefore, in addition to aesthetic plastic surgery, our Baltimore staff provides for our patients the most advanced, scientifically validated therapies for reversing the aging process, preventing chronic disease, and optimizing health.

The new millennium has brought about the discovery of using hormone replacement therapies, as well as other supplements, to stall and possibly reverse the aging process. As we age, many of our bodily functions decrease in efficiency, slow down, and even stop working. This comprehensive approach to wellness and longevity is called Anti-Aging Medicine.

Improved energy and psychological well-being
One of the first changes one will experience is an increase in energy and an improved outlook on life. Irritations become less stressful and a more positive attitude prevails.

Decreased abdominal fat and increased lean muscle mass
Patients often experience a decrease of 20 percent in fat around the waist, while at the same time increasing muscle seven to 14 percent.

Decreased blood pressure and improved cholesterol profile
Patients with elevated blood pressure often have a decrease in their need for medication, and those with elevated cholesterol experience a decrease LDL and an increase in HDL.

Improved bone mineral density and skin tone
In patients with osteoporosis, growth hormone causes a greater increase in bone density than estrogen. Skin tone is improved, causing decreased wrinkle production.

Improved immune system function
With age, our immune system declines. The Center For Anti-Aging Medicine programs rejuvenate the immune system, making one less susceptible to chronic infections, and it increases killer T cell function, which destroy early disease cells.

Improved clarity of thought and memory
Enhanced brain function, as well as youthful hormone levels, improve short-term memory and cognitive function.

About Breast Enlargement Surgery

While the form of a woman's breasts is determined by genes, many people may not realize that breast size and position can present a number of challenges for the plastic surgeon performing breast enlargement surgery. Generally speaking, small-breasted women develop tight "skin envelopes," (the skin that envelops the breast), reducing the amount of room available to place the breast implants. Women whose breast volume has diminished as a result of pregnancy may also have additional issues that must be addressed before having breast enlargement surgery in Dallas, Texas with Dr. In addition to surgical considerations, his patient's comfort is another main concern; Dr. performs all breast augmentation surgeries with techniques designed to minimize discomfort and down time.

Breast augmentation with breast implants is not a one-size-fits-all procedure. A good plastic surgeon will carefully customize breast enlargement surgery by making the right surgical choices to meet each patient's individual needs and provide the most natural looking results possible. As a skilled and talented breast augmentation surgeon, Dr. helps patients achieve the body and bust line they have always desired with customized breast enlargement surgery in Dallas, Texas. Dr. Deuber's breast augmentation patients are always offered a choice with regard to the location of the incision (inframammary, periareolar, and transaxillary), location of the breast implant itself (above or below the muscle), and the type of breast implants smooth or textured, round or anatomic.

No needle mesoteraphy

The draw back to Mesotherapy has always been needle sticks involved. Although not especially painful, the idea was really a “turn-off” for many people.

To get around that problem and offer the significant advantages of Mesotherapy to his friends and patients, Dr Brown has pioneered No-Needle Mesotherapy in the North Texas area. Based on space age technology, this new device uses electrical wave forms and laser to drive the Mesotherapy medications into the skin without injections. Cellulite is significantly improved with this treatment and it is also used to smooth bumps after liposuction.

Although it is not a substitute for liposuction, for the person that has only a few small bulges that detract from their appearance, Mesotherapy can be a significant alternative. Let us talk to you about this new treatment program.

Although the field of Mesotherapy is very broad and the method is useful in the treatment of muscular, joint, and neurological problems, in Dermatology it is primarily used in controlling limited, unsightly fat deposits and is called Lipo-therapy.

A sub-field of Mesotherapy dealing with the treatment of fat just below the skin has been called Lipo-therapy. It is a slightly different technique and uses different medication but the idea of injecting medications just beneath the skin in the area to be treated is just the same. Standard tumescent liposuction remains the best way to remove large areas of superficial fat below the skin. Lipo-therapy must be regarded as a helper or adjunct to liposuction or for treatment of areas not really practical for liposuction. Areas such as the fat pads in the lower eyelids, the chin and jowls are especially good for Lipo-therapy. Also, it can be helpful to eliminate small pockets of fat left after liposuction.

At the present time, the medications used in Mesotherapy and in Lipo-therapy are introduced under the skin by injection using very small needles with only minimal discomfort.

Mesotherapy and Lipo-therapy should be only a part of a rejuvenation program. A consultation in our office can further answer any questions you may have.

Laser Resurfacing

The gold standard for facial regeneration over the last twenty years has been CO2 laser resurfacing. The results that could be produced on fair northern European skin were beyond compare. Major sun damage, moderate lines and wrinkles, blotchiness, and sallow ness were all removed. The results were “baby-bottom” skin that was tight, smooth, and of a uniform fair color all lasting for years.

However, recovery time was very prolonged with a week or more of confinement at home required for healing. If that wasn’t enough, the redness might last for three or months. Other difficulties included being very problematic for skin of any degree of natural color and the results in men tended toward an un-masculine look.

Switching from the CO2 to the Erbium laser definitely decreased the time required for healing but confinement at home for a time, albeit shorter is still required.

Techniques have also been altered using less energy and fewer passes of the laser beam but in our present society few have the time or temperament for more than a weekend of “down time”.

Consulting Dermatologic Specialists continue to offer both CO2 and Erbium Laser for those who desire their remarkable results.

Most of the desirable tightening effects of laser resurfacing have to do with heating the tissue beneath the skin to cause a wound that heals with contraction. The problems arise from the effect of the energy used on the outer skin called the Epidermis. This layer is ablated, or literally blown away and must heal from a raw draining wound. Newer techniques that put the energy deeper within the skin without affecting the Epidermis have been called Non-Ablative Resurfacing.

Double Eyelid Surgery

It is not unusual for Asian patients to be born with eyelids that have either a barely discernable crease or no crease at all in the upper lid, lending the lids a heavy, tired appearance. Through double eyelid surgery, Dr is able to create a clear, natural looking fold in the upper lid with absolutely minimal incision. In some cases, blepharoplasty may also be used to expose and add definition to a faint crease. Whatever the case, Dr works with the patient to establish a treatment plan consistent with the patient’s goals and needs. As a result, he is able to produce exceptional results without infringing upon the desirable, unique characteristics of his Asian patients’ eyes.

Otoplasty ear surgery

Otoplasty (ear surgery) is the surgical correction of protruding or otherwise abnormal ears. Protruding ears are the most visible ear deformity and can cause self-consciousness and embarrassment, especially in school age children. Surgical correction of protruding ears can be effective in patients as young as five years old.

Dr. performs otoplasty by contouring the ears’ flexible cartilage structures. A variety of techniques are available to correct the position of the ears.

Post-Operative Information
Patients must wear a full head dressing for seven days after surgery to protect the ears and prevent accumulation of fluid under the skin during the early healing period. This procedure has no effect on hearing and balance and the minor pain associated with the operation is easily controlled with medication.

Liposuction Suction Lipectomy

This procedure can be performed on patients of almost any age and can be used to target several areas of the body at the same time. However, it should not and cannot be used as a substitute for dieting and exercise. As with other procedures, liposuction can be performed in a hospital, an office surgical suite, or an outpatient surgical center. Various types of anesthesia can be used for this procedure.

After making a small incision near the area to be suctioned, Dr. Strasser inserts a small, hollow tube through the incision and into the underlying fat. In a back and forth motion, he gently vacuums out the excess fat. The amount of recovery time depends upon the extent of surgery. Swelling will usually reach its peak within the first week and then subside over the next several weeks.

Post-Operative Information
Recovery time depends on the extent of surgery. Most patients can resume normal activity within three to five days. After undergoing liposuction, you may be asked to wear a compression garment over the area where fat was removed.

Blepharoplasty procedur

Blepharoplasty is a procedure to improve such complaints. Blepharoplasty, can be performed conjunction with upper face lifting in the cases with forehead wrinkles and brow sagging, conjunction with cheek or mid-face lifting in the cases with cheek sagging. Because of anatomic structure and localization of upper and lower lids are different, each lids are assessed individually. Therefore the surgical techniques for each lid are also different.
On the upper lid, skin is cut along the natural fold line. Redundant skin is removed and tightened both vertically and horizontally, and fat pads that cause bulging are also removed. Skin cut remains hidden along the fold and does not cause visible scars.
On the lower lid, skin is cut 1 mm below the eyelash margin. Redundant skin is removed and tightened vertically; and fat pads are repositioned. The technique that I always use which fat pads are repositioned provides much better result than traditional technique that fat pads are removed which causes hollow eye. Skin cut remains hidden within the shadow of the lower lashes and does not cause visible scars.

Breast augmentation

Every women desire to have aesthetically beautiful shaped breasts. Underdevelopment of the breasts or weight loss may cause breast size smaller than normal. In such cases obtaining the fuller and larger breasts that appear more beautiful is feasible by the procedures aimed at breast enlargement. Quantity of enlargement is determined as considering the person∙s desire, chest size and size of the existing breasts. When the implant placed into the breasts which are loosened, lost their volume and sagged; loosened breast tissue would sag again over the implant. In such cases, breast lift should be combined with implant placement.

BREAST PROSTHESES

The material used for breast enlargement is silicone prostheses. Silicone is not harmful material for human body. Silicone is an inert material which does not interact with body; and its molecular structure does not change after insertion. It is proven that there is no relationship between silicone and breast cancer.

Implants are divided into 2 groups according to their contents (filling material) inside the silicone shell:

1. Implants which include saline

2. Implants which include silicone

Implants are divided into 2 groups according to their shape:

1. Round implants: Hemisphere shaped round prostheses provides upper pole fullness as well after insertion.

2. Anatomic shaped implants: Tear drop shaped anatomic prostheses provides lower pole fullness. Their shape is more appropriate to natural breast shape.

Only FDA (Food and Drug Administration) approved implants are used in our clinic.

Breast reduction

Surgical technique depends on the existing breast size. Making the mild or moderate oversized breasts smaller and lighter is feasible by new techniques advented in recent years which leave a minimum scar circling the nipple and continuing vertically towards to crease below the breast. Although lactation reduces, mostly breast feeding may be feasible after pregnancy depending on the amount of removed excess tissue by using such techniques. The techniques used for reduction of larger breasts are different. In these techniques additional scar remains along the crease below the breast than explained former technique and breast feeding become impossible. The clarity of the scars depends on the age, genetic characteristics and skin quality, but not surgical technique. Remaining scars are usually not conspicuous on the patient with fair skin and good wound healing character.
Surgery is done in a hospital under general anesthesia and takes about 3-4 hours. You need 1-2 days hospitalization after surgery. Although surgery covers a large area on the body, severe pain as much as you feel discomfort is not usual, possible slight pain can easily be alleviated by medication. Breasts are over lifted at the surgery as considering they will reshape and sag by effect of gravity over the time. Swelling and slight bruising are natural results of the surgery. The feature of over lifted breasts with swelling and bruising may cause you to be disappointed and repented. But swelling will subside, bruising will disappear within 3 weeks, breast mass will begin to sag and reshape 4 weeks after surgery and scars will become paler and crease below the breast will become clear within a few months. Gaining the constant shape of the breast mass and reducing the scars take at least 6 months. The little problems which may manifest long term after surgery due to changing the equilibrium of the static forces on the skin surface such as slight displacement of nipple or conspicuous scar can easily be revised under local anesthesia.
Breast reduction is a surgery which leaves scar on the breast. Surgery is designed as minimum scar will remain on the breast for breast reduction in our clinic. Breast reduction improves the person’s both physical and psychological status. Of all plastic surgery procedures, breast reduction has one of the most immediate dramatic results. The chronic physical discomfort is gone, the body is better proportioned, and clothes fit better.

Tummy Tuck Abdominoplasty

Body contouring includes tummy tuck surgery (abdominoplasty) and surgery for flabby arms, legs, and the removal of "love handles." The most common reasons for this surgery are the stretching of the abdominal wall due to pregnancy and significant weight loss. Unfortunately, diet, exercise, and suction lipectomy are not enough to correct these conditions since the problem stems from excessive stretching of the skin that has lost some of its elasticity.

All body contouring procedures require skin incisions with removal of the extra skin and underlying fat. Tummy tuck surgery includes tightening of the abdominal muscles. In all body contouring operations, incisions are carefully placed and well hidden.

General Considerations
Body contouring procedures are custom fitted to the needs of the individual patient. When you come in for a consultation, we will discuss your surgery goals and decide which procedure or combination of procedures is right for you.

Thermage ThermaCool Wrinkle Reduction

Employing patented radio frequency technology called ThermaCool™ to deliver tighter skin and renewed facial contours, non-invasive Thermage® is an attractive option for our Atlanta-area clients. During this skin rejuvenation procedure, we use a state-of-the-art device to uniformly heat collagen in the deeper layers of the skin while simultaneously protecting the outer layers with a cooling cryogen spray. The heating action immediately tightens the skin. You'll also notice additional tightening over time.

Eye browlift

To effect a more complete facial rejuvenation, brow lifts are frequently done in combination with other procedures such as upper facelift to firm and tighten skin on the entire face, upper eyelid blepharoplasty to lift and tighten drooping eyelids, or lower eyelid blepharoplasty to remove excess puffiness or wrinkled skin beneath the eyes. A brow lift can be done in the hospital or in an office surgical suite, depending on your preferences. Most brow lifts are performed under local anesthesia combined with a sedative to make you drowsy. You will be awake but relaxed, and although you may feel some tugging and mild discomfort, you will not feel any pain. The longer the procedure is expected to take, the more likely that general anesthesia will be recommended. You may be allowed to return home within a few hours of the surgery, and spend the night at your home. Brow lift does not cause to feel pain and you can return to routine life immediately. You will be able to shower and shampoo your hair within two days. 1-2 cm. skin cuts are done both sides behind the hair line; therefore scars are camouflaged by hair.

People with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can also gain more alert, refreshed look and self confidence with this procedure

Cosmoderm and cosmoplast

Helpful in skin rejuvenation, soft tissue fillers CosmoDerm™ and CosmoPlast™ safely, effectively, and naturally correct the effects of aging, sun damage, pollution, smoking, and other enemies of healthy skin. An alternative to collagen injections, CosmoDerm™ and CosmoPlast™ injections are the newest approach to boosting skin tone and texture by smoothing out fine lines and wrinkles and replenishing your skin's elasticity. (And because they are natural collagen products, there is virtually no risk of allergic reaction.) Treatment results last three to six months.

Sclerotherapy

Sclerotherapy is the introduction of a sclerosing agent into a vein using a small needle. Your doctor will clean the area, then inject a solution into the affected veins. During the procedure, you may feel a slight prick as the needle is inserted and a burning sensation as the solution is injected. The solution replaces the blood and naturally causes the vein to decompose and disappear over a period of several days to a few weeks. After one area is injected, the doctor will proceed to the next area. Occasionally, additional treatments may be required in order to complete the collapse of the entire vein. If you have extensive veins requiring treatment, multiple sessions may be recommended. Each treatment is usually limited to 15-30 minutes.

Face Lift

A face lift can be done in conjunction with eyelid surgery, nose surgery, chin reduction or augmentation, liposuction to below the chin and injection of fat or tissue.
Face divides into three regions anatomically and surgery is planned for each individual regions. Upper face includes temple region, forehead and brows and the surgery is called as upper face lift or forehead lift for this region. Middle face includes cheek area, and the surgery is called as mid-face lift or cheek lift for this region. Lower face includes jowls and neck, and the surgery is called as lower face lift or neck lift for this region. Each region can be operated individually or combined.
Upper face lift is aimed at lifting the brows, tightening the forehead and temple region. In the traditional upper face lift, the skin is cut behind the hairline, from ear to ear. Then, the skin of the forehead is lifted away from the underlying muscles. The excess skin is trimmed away, and the skin cut is closed with stitches. This technique causes much bleeding and remarkable scars. Another technique that I always use is modern endoscopic forehead lift. In this procedure, 2 cm in length 4 skin cuts behind the hairline are done; an endoscope is placed under the skin in order to get a clear view of the muscles and tissues under the skin. Then the surgeon inserts another instrument through a separate skin cut to lift the forehead skin and remove or alter the muscles and underlying tissues. The forehead skin is tacked up in a higher position. This technique causes much less bleeding and much less scars.
Mid-face lift is aimed at lifting the cheeks and tightening the cheek skin. Cheeks sag together with muscles, fat tissue and skin. If this procedure is done as tightening the skin alone, sagging of the muscles and fat tissue is only camouflaged and effectiveness is lost within the short period.

Blue Peel

Obagi® Blue peel is an exciting new way to refresh your skin. It removes wrinkles, age spots, acne blemishes, and scars, thus restoring the skin's elasticity. The peel, which includes one to four steps over the course of several months, involves the topical application of a glycolic acid solution. Each treatment takes about 30 to 45 minutes to complete in our Atlanta-area skin rejuvenation centers. The solution essentially removes the outer layers of the skin, exposing the undamaged layers underneath. For more information about the Obagi® Blue Peel, please contact us today.

How to Choose a Plastic Surgeon

Making the decision to have plastic surgery can take a lot of time, energy, and tears. There are many important choices you will have to make before your surgery, including which procedure is best for you, where you should have the surgery performed, and, most importantly, which plastic surgeon will perform your surgery.

The most important thing to us is that you are comfortable and confident with your decision to have surgery. That means choosing a plastic surgeon who is experienced and knowledgeable, and who will listen to all of your concerns, aspirations, and apprehensions. Plastic surgeon Rick Paulson would be extremely honored to have you select our Bismarck practice for your surgery; however, we want to make sure you have the appropriate tools to make a well-informed decision. Here are some questions you should ask yourself before choosing a plastic surgeon.

Laser Skin Resurfacing precodure

When blemishes, wrinkles, scars, and brown spots can’t be reduced by conventional treatments, laser skin resurfacing may provide a solution. This involves the removal of undesirable outer layers of skin, which are replaced during healing by new, smoother skin. Dr. Zeff prefers to use the CO2 laser, which gives him excellent depth control, thus minimizing complications.

Breast Lift

Every women desire to have aesthetically beautiful shaped breasts. Breasts may gain saggy feature due to underdevelopment of breasts or weight loose after pregnancy. Mastopexy is done aimed at to regain the firmness and shape of the breasts. Mastopexy alone may not be satisfactory for the breasts which have not adequate volume. Mastopexy is a surgery for the breast to reshape and lift, it does not provide extra volume. In such cases breast prostheses should be placed additional to mastopexy in order to gain extra volume and fullness.Surgical technique depends on the degree of sagging of the breasts. Nipple is moved to its normal position and redundant skin is tightened around the nipple in the breasts with mild sagging. This technique leaves a circle scar around the nipple. For more saggy breast, redundant skin of the lower part of the breast need to be tightened, so a vertical scar also remains descending from the nipple towards to crease below the breast additional to circle scar around the nipple. Breasts are reshaped, tightened, and lifted as repositioning the nipple and tightening the redundant skin by such procedures. During the procedure, breast prostheses can also be placed in order to add extra volume and to gain fullness. The surgery does not damage the breast gland and ducts, therefore breast feeding is feasible after probable pregnancy even if a prostheses is placed.
The clarity of the scars depends on the age, genetic characteristics and skin quality, but not surgical technique. Remaining scars are usually not conspicuous on the patient with fair skin and good wound healing character.
Surgery is done in a hospital under general anesthesia and takes about 2-3 hours. You need 1 day hospitalization after surgery. Severe pain is not usual, and possible slight pain can easily be alleviated by medication. Swelling which subsides within a few weeks is natural results of the surgery. Gaining the constant shape of the breast mass and reducing the scars take at least 6 months. The little problems which may manifest long term after surgery due to changing the equilibrium of the static forces on the skin surface such as slight displacement of nipple or conspicuous scar can easily be revised under local anesthesia.
Your breasts will be more youthful and full than they would have been without the surgery and you may also experience an increase in confidence and self-esteem. However, the effects of gravity, pregnancy, and weight changes will continue to affect your breasts over time.

Other Abdominoplasty page

Abdominoplasty generally takes about 3 hours, depending on the extent of the repair. Mini-abdominoplasty takes about 1 or 2 hours. 1-3 days stay after the surgery is most common. If the area of repair is minimal, you may be able to go home the same day. For the first few days, your abdomen will probably be swollen and you are likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery and the technique used, you may be released within a day. Bed rest for two to three days is recommended. While in bed, your legs should be bent at the hips in order to reduce the strain on the abdominal area. After about three days, you may begin light activities. Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible. It may take you several weeks to feel completely back to normal. If you are in top physical condition, recovery will be much faster. Most people return to work after two weeks.

Not only excess skin is removed, natural dimpling similar to its original shape is also created around the belly button by our surgical techniques. Because of the surface stitches are absorbable, the stitches will not be removed. Scars will remain below the bikini line. For the first few months, scars would be manifest, and become inconspicuous as the time goes on. Undesirable scars that may form due to skin tension can be revised under local anesthesia.

As long as you keep your weight relatively constant, eat a healthy diet, exercise regularly, and follow your surgeon’s instructions about how to resume physical activity, the long-term results from this procedure are generally excellent.

Liposuction

Possible slight pain can easily be controlled by medication. You can stand up and walk with help of somebody a few hours after surgery. You are allowed to leave hospital the same or the next day. The pain is not felt during rest; it is felt with body movement or any pressure on the skin. You may walk and do light activities by yourself 2 days after surgery and you should be able to return to work within a few days if your work is fairly sedentary. To speed the healing process and to reduce the likelihood of post-operative complications, you should begin light activity as soon as possible. You should avoid strenuous activities for a few weeks as your body heals, but within 4-6 weeks you should be able to resume all normal activities.
You may experience some swelling, bruising, fullness, tightness and itching which are all natural results of the liposuction. Swelling may cause you to feel like fat deposit was not removed. Most of the swelling subsides within 3 weeks and actual contours of your body begin to appear. As swelling subsides, when you contact, you may feel your skin stiffer than normal on the suctioned area as a result of wound healing process. Bruising may last 3 weeks as reducing each day. You should wear a tight compression garment for up to 4 weeks after surgery. This specially designed garment will help to reduce pain and swelling, and help your body to settle into its new shape. You should see the visible results of your surgery within 2-3 weeks, but the full effects and actual body shape with totally subsided swelling may not be evident for 3 months.
Although liposuction cannot alter skin quality or muscle tone, and should not be a substitute for regular exercise and a balanced diet, your body will always be slimmer than they would be if you had not had this procedure. Most people are pleased with their new contour, and often feel a boost in energy and self-confidence.

Lipthickening

Fat injection can be done to only lips or whole face to get fullness. Fat is injected into the cheeks, chin and around the mouth for whole face fullness, likewise for lip augmentation, fat is injected into the upper and / or lower lips..

Apart from the fat, some preparations such as silicone and collagen are used for filling material. Such preparations have become less useful because of negative effects which manifest in long term. The most reliable technique is the technique which the person’s own tissue is used.

The fat for injection is obtained via liposuction. Fat can be harvested from anywhere on the body where the fat deposits are copious. The amount of the fat that will be harvested depends on the necessity of the fat to be injected. The procedure is done under local or general anesthesia depending on the extensity of the operation. . Recovery time is also depends on the extensity of the operation. Severe pain is not usual after surgery; slight pain can be controlled by medication. Swelling and bruising that will subside within 7-10 days on the injection side are the natural results of the procedure About half of the injected fat is absorbed by the body within the 6 months, rest of the fat remains constant. If tissue cocktail is injected, absorption rate is much lower than the fat injection.

Micro-Rhinoplasty

Rhinoplasty

can correct a variety of conditions including an over-sized nose, a hump on the bridge, an undesirable shape of the nasal tip or a narrow or wide span of the nostrils. Rhinoplasty can also be used to correct for breathing problems caused by narrow or partially obstructed nostrils and nasal airways. Aesthetic and function cannot be divided in rhinoplasty. Therefore, succesfull rhinoplasty should provide both a natural shape in harmony with whole face and relieve the breathing.
During the consultation, the changes that you would like to make in your appearance should be discussed. Because the appearance of your nose is a matter of personal perception and preferences, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives. The expectations which are unrealistic or targeting the perfection may cause the person to be disappointed. So the people who expect the better nose shape with harmony, but not perfect result would be satisfied after surgery.
In our clinic, rhinoplasty is not done as standardized; the procedure is designed specially for each individual. Realistic expectations, healthiness and psychological status of the individual are the important factors for the rhinoplasty candidates.
During consultation, your nose is examined in detail both internally and externally by your doctor. Possible extra problems (sinusitis, nasal polip etc.) can be determined during examination. 6 distinct poses of your nose are photographed. These pictures are used for computerized imaging. Computer imaging is a very useful adjunct to visualizing what you may look like after the procedure. While not a guarantee of results, it is a great benefit in preoperative planning. Skin cuts are made inside the rim of the nostrils, so the scar remains invisible inside the nostrils.
Rhinoplasty is done in a hospital, and general anesthesia is preferred. Operating time depends on the surgical planning; it takes 2 hours in general but on rare occasions it may take longer.

Surgical procedure of abdominoplasty

Tummy Tuck (Abdominoplasty) Most Frequently Asked Questions: The information below concerns the most commonly asked question that Board Certified Plastic Surgeon, David P. Rapaport's, patients inquire about. If your questions is not answered here please feel free to contact the Plastic Surgeon at this Manhattan, New York Plastic Surgery practice.

The Place: The tummy tuck surgery may take place in the plastic surgeon's state of the art surgical facility in Manhattan, New York or a local NYC hospital.

Procedure Length: A complete tummy tummy tuck surgery normally takes between 3 and 5 hours depending on the particular procedures being performed. A partial tummy tuck, on average, lasts between 1 and 2 hours.



The Incision: Generally, a horizontal incision is placed just within or above the pubic area. The length of the incision, which extends toward the pelvic bones, depends largely on the amount of skin to be removed. The contour of this incision will vary somewhat according to the structure of your abdomen and the style of bathing suit or undergarments that you prefer. Your plastic surgeon will try to keep the incision within your bathing suit lines, but this may not always be possible.

Anesthesia: You and Board Certified Plastic Surgeon, David P. Rapaport will decide on the type of anesthesia to be used in the tummy tuck plastic surgery. General anesthesia may be employed in order to to allow you to sleep through the operation. The second option is a local anesthesia which will allow you to stay awake for the duration of the procedure, combined with a sedative to keep you relaxed.

Board Certified Plastic Surgeon, David P. Rapaport often asks his patients to bring in a bikini bottom or panty they prefer (to his Manhattan, New York surgical center) the day of their abdominoplasty (tummy tuck) so that he can be able to design his incision to fall underneath the garment.

Some patients have loose skin above the navel. In such cases, the surgeon may make a second incision around the navel so that the redundant skin above it can be pulled down. The excess abdominal skin is then removed. The position of the navel remains unchanged.

Skin of the lower abdomen that contains stretch marks may be removed as well. Any remaining stretch marks may be somewhat flattened and improved, but you should not expect a dramatic change in their appearance. The procedure may include tightening of the underlying abdominal muscles using sutures.

The American Society for Aesthetic Plastic Surgery

Hello;
Founded in 1967, is the leading professional organization of plastic surgeons certified by the American Board of Plastic Surgery who specialize in aesthetic (cosmetic) plastic surgery. With more than 2250 members (all categories) in the U.S and Canada, as well as international members in many other countries, ASAPS is at the forefront of innovation in aesthetic plastic surgery around the world.

ASAPS is an educational organization, sponsoring scientific meetings on the latest advances in cosmetic plastic surgery. ASAPS meetings are designed for attendance by qualified plastic surgeons. ASAPS is an accredited sponsor of Continuing Medical Education (CME). Aesthetic Surgery Journal, an official publication of ASAPS, is the most widely read clinical journal of aesthetic surgery.

The mission of the American Society for Aesthetic Plastic Surgery includes continuing medical education, public education and patient advocacy.


ASAPS is a research organization, collecting data on aesthetic surgery, publishing annual statistics on the number of cosmetic procedures performed, and supporting scientific and clinical studies in aesthetic surgery.
ASAPS is a public information organization, providing accurate and timely information on all aspects of surgery through this web site and by working extensively with the news media through our Communications Office in New York City.
ASAPS is a patient advocacy organization, promoting the highest standards of professional conduct among our members as well as representing the rights of patients to be fully informed about the training and credentials of their doctors and the risks and benefits of cosmetic surgery.