» Cosmetic Procedures
Tummy Tuck - Liposuction - Nose Reshaping - Correction of Deviated Nasal Septum - Cheek Implants
Chin Enlargement - Botox - Neck Lift - Face Lift - Skin Peel - Vein Sclerosing - Ear Pinning - Scar Repair
Who Is A Candidate?
- If you have loose or sagging abdominal wall skin, frequently associated with abnormal relaxation of the anterior abdominal wall muscles (frequently secondary to multiple pregnancies or prior surgery).
- If you are unable to tighten abdominal wall skin with exercise.
Intended Results
- A smoother, flatter abdomen.
Procedure Description
- The procedure is usually performed under general anesthesia either within the hospital or in an outpatient setting. (Mini and modified abdominoplasties are similarly performed.)
- Mini-abdominoplasty tightens the lower abdominal wall skin only (shortest scar).
- Modified abdominoplasty addresses conditions where just the muscle wall or just the abdominal skin requires attention.
- Standard abdominoplasty tightens all of the abdominal wall skin and muscles (standard scar).
- Extended abdominoplasty tightens the abdomen and the flanks or sides (longest scar extending around the flanks onto lower back.)
Recuperation And Healing
- Abdominoplasty can be one of the more uncomfortable plastic surgery procedures, and probably requires more time consuming, limiting recovery.
- One to three days of hospitalization, skilled nursing care, or assistance at home is usually indicated.
- You will be encouraged to move and walk regularly within 1-2 days.
- Light activity is comfortable in 10-20 days. Sports will not be comfortable for about 6 weeks.
Other Options
- Additional procedures that may enhance the result are Liposuction Breast Procedures or a Thigh Lift.
Insurance Guidelines
- This procedure is now considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
LIPOSUCTION*Who Is A Candidate?
- If you have excess subcutaneous fat, which is resistant to diet and exercise.
- If you wish to change the contours of your body. Commonly involved areas are the anterior part of the neck (under the chin), upper arms and armpits, mate chest breasts, trunk, abdomen, waist, hips, thighs, inner knees, calves and ankles.
- Most patients are near normal weight and desire permanent contour changes.
- Improved techniques now allow larger amounts of fat removal. Liposculpture can be useful to heavier persons as well.
Intended Results
- A permanent improvement in the contour and proportion of the treated areas.
- A more flattering figure or physique, in or out of clothing.
Procedure Description
- The procedures are done on an outpatient basis.
- General anesthesia is usually used for safety and comfort.
- Small suction tubes (cannulas) are inserted through very short incisions placed in inconspicuous locations near the fat deposits, and excess fat is removed.
- If very large volumes of fat are to be removed, we will probably ask you to donate one or two units of blood, and take supplemental iron before surgery. Your own blood will be used as a transfusion at the end of surgery.
Recuperation And Healing
- The patient goes home with a compression garment (or tape) covering the treated areas. Compression is advised for about a month as it helps reduce swelling and helps you achieve the final result more quickly.
Once pain and soreness decrease, it is frequently more comfortable to wear lycra or spandex exercise pants. - Initial discomfort is easily controlled with oral medication.
- Bruising and swelling usually subside in 2-4 weeks. The final result takes shape over 2-3 months.
Other Options
- Additional procedures that may enhance the result are Tummy Tuck (Abdominoplasty), Breast Reduction, Breast Lift, Breast Augmentation, Thigh Lift, or Buttock Lift.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
NOSE RESHAPING*Who Is A Candidate?
- If you have an abnormal appearance of the nose as a result of birth defects, injury, or disease.
- Nose that is cosmetically unattractive or does not “fit” with other facial features.
Intended Result
- More attractive nasal shape. Nose is in better proportion, to other facial features.
Procedure Description
- The procedure is done on an outpatient basis under sedation, with local or general anesthesia.
- Standard Rhinoplasty: Incisions are made inside the nostrils. The nasal bones, cartilage, and soft tissues are reshaped to improve the external contour.
- Open Rhinoplasty: Frequently used for difficult or larger noses. Involves one external incision across the columella (strut between the nostrils). Bones, cartilage and soft tissues are reshaped under direct vision.
Tip-Plasty: If only the nasal tip is abnormal, it may be corrected with either a standard or external (open) approach. - Large nostrils may be reduced through tiny incisions at the outer base of the nostrils with either type of rhinoplasty.
Recuperation And Healing
- The patient goes home with an external cast or splint in place. The nose may be packed for 24-48 hours. The cast or splint is usually removed in 7-10 days.
- Initial discomfort is easily controlled with oral medication.
- Majority of swelling and bruising subsides progressively over 2-4 weeks.
- External sutures (if any) are removed in 4-6 days. Internal sutures dissolve.
- Semifinal result is evident in 3 months. Final result is evident in 12-14 months, which is the time necessary for complete tissue softening.
Other Options
- An additional procedure that may enhance the result is a chin enlargement.
- If you need to improve breathing, correction of a deviated septum (Septoplasty) may also appropriate.
Insurance Guidelines
- This procedure is not covered by insurance, if being done for cosmetic reasons. If however, the nasal deformity is due to recent injury, insurance coverage may be available.
- Pre-authorization information can be obtained from your insurance company.
CORRECTION OF DEVIATED NASAL SEPTUM*
Who Is A Candidate?
- If you have a nasal obstruction (difficulty breathing) because of developmental or post injury crookedness of the nasal septum (divider between the two sides of the nose).
Intended Result
- Reduction of nasal obstruction -- ability to breathe better.
Procedure Description
- An outpatient operation done under sedation, local or general anesthesia.
- The crooked cartilage is partially removed, straightened, or both.
Recuperation And Healing
- The septum is splinted at the end of the operation.
- If nasal packing is used, it is usually removed in 2-7 days.
- Splints are usually removed in 7-10 days.
- There is usually no visible bruising after septoplasty.
Other Options
- An additional procedure that would enhance the result is nose reshaping (rhinoplasty).
Insurance Guidelines
- Septoplasty is usually covered by insurance, if it is done to correct a functional problem.
Who Is A Candidate?
- If you have a desire and need for more prominent cheek contour.
- Small or significantly reduced cheek tissue and cheekbone contour, as an inherited characteristic or as a result of aging.
- Facial asymmetry.
Intended Result
- Enhanced cheek contours.
- Greater facial balance.
- Improved symmetry.
Procedure Description
- The procedure is done on an outpatient basis under attended local or general anesthesia.
- A small incision is made under the upper lip, in the lower eyelid, or in the hairline, and a biologically inert, pre-shaped implant is placed next to the bone.
- Several optional incision locations are used: (a.) under the upper lip above the gum line (b) beneath the eyelashes in the lower eyelid (c.) in the hairline or through a facelift incision.
- The selection of incision will be discussed at the time of consultation.
- A biologically correctly shaped implant is inserted over the natural cheekbone contour. It will be held in place by the normal tissues that surround it.
Recuperation And Healing
- There are usually no dressings.
- Initial swelling is usually moderate and gradually disappears over a month or two.
- Discomfort is mild to moderate and is controlled with oral medications.
- Sutures in the mouth dissolve and do not need to be removed.
- Sutures under the eyelid are removed in 4-5 days.
- Sutures or staples in the scalp are removed in approximately 10 days.
Other Options
- Additional procedures that would enhance the result are other facial cosmetic procedures such as Face Lift, Eyelid Lift, Brow Lift, Rhinoplasty, or Chin Augmentation.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
Who Is A Candidate?
- If you have a small or receding chin.
- A chin that looks too small in comparison with other facial features and possibly makes the nose appear longer.
- Desire for increased chin prominence.
Intended Result
- An improved profile.
- A more attractive jaw line that creates a better balance between the chin and other facial features.
Procedure Description
- The procedure is done on an outpatient basis under sedation and local or general anesthesia.
- An incision is made inside the lower lip or under the chin, and an implant is placed.
- In an alternative method called sliding osteotomy, a portion of the chin bone is permanently moved forward.
Recuperation Healing
- The patient goes home with a small pressure dressing over the chin.
- Initial discomfort is easily controlled with oral medication.
- Swelling, tenderness, and possible local numbness gradually subside within a month or two.
Other Options
- Additional procedures that would enhance the result are liposuction of the neck, nose reshaping (Rhinoplasty), neck lift, or laser skin resurfacing.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance; the patient is responsible for payment.
What Is Botox?
- Botox is a new concept in treating facial wrinkles in the forehead, between the eyes and in the “crows feet” areas (upper third of the face). Botulinum toxin, or Botox works by weakening the muscles of facial expression. Once the resting tone of the treated muscles is weakened, the pull of the muscles relaxes and the overlying skin flattens. This approach is different than the other local treatments for the aging face. Silicone, collagen, autologous fat transfer, Alloderm, Softform etc. all work by filling in wrinkles or depressions. These fillers are frequently not as effective as Botox in removing wrinkles in the upper third of the face. By physiologically weakening the muscles, wrinkles are removed naturally.
- How Long Does It Last
Injection of this material into the small muscles between the brows, in the forehead and at the corners of the eyes causes those specific muscles to halt their function (be paralyzed), thereby improving the appearance of the wrinkles. This paralysis is temporary, and re-injection is necessary within three to ten months. Options for alternative treatment include injection of either collagen or free fat, or the surgical excision of the muscles, usually through a brow-lift incision. Complications are rare, but may include paralysis of a nearby muscle, resulting in its temporary loss of function (e.g., a drooping eyelid). - How Is It Used
Botox is prepared fresh on the day of injection. Once prepared, the medication needs to be used within 12 hours, as the potency diminishes with time. Because of the short-shelf life and the cost, Botox is not available every day in our office. In order for the treatment to be cost effective, more than one patient must be treated on the same day. Very small amounts of Botox are injected into the muscles to be paralyzed using a very tiny needle. Depending on the areas being treated, 5-15 needle pricks (or more) may be required. Discomfort is minimal, and lasts only a few seconds. - Side Effects
Occasionally, the tiny needle may puncture a small blood vessel during the injection, and a small black and blue area may develop. Such an area can last 5-10 days and requires makeup to cover. - There are no known generalized side effects to Botox.
- If any of the Botulism toxin, reaches a facial muscle not being treated, partial weakness of that muscle may last for several months. (It is for this reason that you are requested not to massage the injected areas for 12 hours following injection.) In the event of an area of unwanted muscle weakness, the only “treatment” is to wait for the effect of the toxin to wear off in several months.
- Botox has been used safely in the treatment of muscular facial spasms for approximately 15 years.
- Botox In Combination With Facial Surgery
Botox injected in conjunction with nearby facial surgery has caused spread of the toxin and unwanted facial weakness in at least one patient. For this reason, we will inject Botox only as an isolated facial procedure or treatment.
Who Is A Candidate?
- If you have localized deposits of flit in the anterior part of the neck - under the chin.
- If you have muscle laxity under chin only!
- If you have sagging with skin folds in the anterior part of the neck (under chin only!).
Intended Result
- A more youthful neck with a better contour.
Procedure Description
- The procedure is done on an outpatient basis under sedation and local or general anesthesia.
- The procedure requires an incision under the chin.
- Fat is suctioned or directly excised, muscles are tightened, and a small amount of skin may be removed - all depending on individual findings.
Recuperation And Healing
- The patient goes home with chin and neck, wrapped in dressings or in an elastic neck sling.
- Initial discomfort is easily controlled with oral medication.
- Swelling and bruising disappear over approximately 2 weeks.
- The final result is evident in 1-3 months.
Other Options
- Procedures that may enhance the result are face lift, liposuction and chin augmentation.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
Who Is A Candidate?
- If you have experienced a loss of skin elasticity and muscle tone of the face and neck.
- If you have the appearance of jowls and deep creases between the base of the nose and the corners of the mouth.
- If you have developed facial and neck wrinkles.
- If you believe you lack youthful chin and neck contours.
- If you think you have a tired facial appearance.
Intended Result
- A more rested and youthful contour to the face and neck.
Procedure Description
- Face lifts range in size from “mini” to “standard” depending on location and extent of skin laxity.
- The operation is done on an outpatient basis under local anesthesia with sedation or under general anesthesia.
- Incisions are made within the hairline (or along the hair margin) above the ear, extending down around the lobe, and ending in or below the hairline behind the ear. The subcutaneous layers and neck muscles are tightened, the facial skin is redraped and lifted, and the excess skin is removed.
Recuperation And Healing
- The patient goes home with their head and neck wrapped in dressings, which are usually removed the next day.
- Minimal initial discomfort is easily controlled with oral medication.
- Sutures are removed within 14 days. Bruising and swelling decrease to “socially acceptable” levels in 10-20 days.
- The final result is evident in 4-6 weeks or sooner, with continued improvement for several months.
Other Options
- Additional procedures that would enhance the results are Eyelid Lift, Brow Lift, Chemical Peel, Facial Sanding (dermabrasion), Chin Enlargement, Nose Reshaping (rhinoplasty), Fat Suction, and Laser Skin Resurfacing, Cheekbone Enhancement, Augmentation/Enhancement of Lips and Reduction of Earlobes.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
Who Is A Candidate?
- If you have superficial wrinkles of the face, neck, upper chest, arms, etc.
- Deep-facial wrinkling.
- Uneven pigmentation problems caused by sun exposure, prescription drugs, or disease.
- Enlarged facial pores.
- Superficial acne scars of the face.
- “Age spots”
Intended Result
- Smoother, youthful appearing skin of more uniform color.
Procedure Description
- These procedures are done on an outpatient basis under sedation and local or general anesthesia. Light peels may be done without any anesthesia. Light and medium depth peels do not require any anesthesia.
- After preparing the skin, a series of solutions may be applied.
- Light, moderate, or deep peels are available. A consultation is required to determine which type of peel (if any) will be most suitable for you.
Recuperation And Healing
- You will be sent home with specific written instructions. The treated areas are washed, and medicated lotions are usually applied several times daily.
- After light peels, the treated skin turns red or pink and heals without crusting.
- After medium or deep peels, a superficial crust or membrane usually forms and peels off 3-7 days later like a sunburn blister - revealing a new skin surface that is smoother.
- The skin's redness after deeper peels, fades in a month or two.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
Who Is A Candidate?
- If you have small, unsightly spider veins on your legs and/or face.
Intended Result
- Removal of spider veins on the legs and/or face.
Procedure Description
- Using magnification to improve accuracy, a small amount of concentrated salt solution or a scierosing agent is injected into the visible spider veins.
- Sedation is not usually required.
Recuperation And Healing
- Discoloration usually persists in the area for five to seven days.
- Discomfort is usually minimal. Mild pain medication is all that is required.
- The final result is evident in 10 to 14 days.
Insurance Guidelines
- This procedure is not covered by insurance.
Who Is A Candidate?
- If you have ears that stick out too far from the side of your head.
- If your ears have an unusual or undesirable shape.
Intended Result
- Ears that have normal folds and shape with normal protrusion from the side of the head.
Procedure Description
- The operation is usually performed on an outpatient basis under sedation and local or general anesthesia.
- The ears are usually bandaged with a dressing that wraps around the head in a turban-like fashion for several days.
- Initial mild postoperative discomfort is easily controlled with oral medication.
- The procedure is appropriate beginning at age 5 or 6 or at any time thereafter.
Recuperation And Healing
- The ears usually look “normal” within 10-20 days.
- Usually, a thin stocking cap or head band is worn at night for 3 weeks after the first dressing is removed to protect the ears.
- Contact sports should be avoided for about a month.
Other Options
- Any facial procedure that is desired or appropriate would enhance the result.
Insurance Guidelines
- This procedure is usually not covered by insurance. Our staff can assist you in making that determination.
Who Is A Candidate?
- If you have wide, thick, depressed, or unsightly scars.
Intended Result
- A scar that is less noticeable (flatter, thinner, smoother, etc.)
Procedure Description
- Scar revisions are usually done under local anesthesia, if the scars are large or if the patient prefers, the procedure may be done under sedation and local or general anesthesia.
- The old scar is removed, and one of several plastic surgery techniques is used to repair the incision. The technique will be used that will allow the best chance of obtaining an improved or excellent scar.
Recuperation And Healing
- Scar revisions are almost always done on an outpatient basis.
- Postoperative pain is usually minimal.
- Sutures are usually removed in 4-6 days for the face and in 7-l0 days for other parts of the body.
- The new scar will initially be red. Fading occurs within 6-24 months depending on the scar’s location.
Other Options
- Additional procedures that will enhance the result are Z-plasty (a surgical method of releasing tight or contracted scars), Dermabrasion (sanding of the skin to minimize surface irregularities) and Laser skin resurfacing.
Insurance Guidelines
- If the injury causing the scar was covered by insurance, scar revision may also be covered.
- Our office will assist you in making that determination.
JUVADERM *
Juvaderm is an injectable gel and smooth dermal filler…
“For a smooth natural look and feel that lasts”.
EYE LID LIFT *
Who Is A Candidate?
- If you have excessive, sagging or wrinkled upper or lower eyelid skin.
- If you have excess upper eyelid skin that interferes with vision
- If you have lost your natural upper eyelid crease.
- If you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.
Intended Result
- A more youthful and rested appearance of the eyes.
- Widening of visual fields if excessive upper lid skin has partially blocked vision.
- It will not remove or erase all wrinkle lines. It will soften wrinkle lines.
Procedure Description
- The operation is done on an outpatient basis under sedation and local or general anesthesia.
- The incisions are made where the natural crease should be in the upper lids and below the lash line in the lower lids. Excess fat and skin are removed.
- If only excess fat is present in the lower lids, it may be removed through an incision inside the lower lids with no external incision or scar (transconjunctival blepharoplasty).
Recuperation and Healing
- All sutures are usually removed within 7-10 days.
- Initial mild discomfort is easily controlled with oral medication
- Bruising and sensitivity to light last at least a week or two. Swelling progressively disappears over several weeks.
- Eye makeup can be used shortly after sutures are removed.
- Contact lenses can be worn when comfortable - usually within 3-7 days
Other Options
- Additional procedures that would enhance the result are: Forehead Lift, Face Lift, Chemical Peel or Laser Skin Resurfacing
Insurance Guidelines
Occasionally, if surgery is being done to improve the field of vision, insurance may cover GUIDE upper lid surgery. Otherwise, these procedures are considered cosmetic and the patient is responsible for payment.
CALF ENLARGEMENT *
Who Is A Candidate?
- If you have thin calves due to injury, illness, or family history.
- If you are unable to achieve the degree of enlargement or contour you wish inspite of calf-developing exercises.
Intended Result
- The implants provide more natural contours and fullness to the calves.
Procedure Description
- The operation is done under general anesthesia.
- An incision is made in the space behind the knee and pockets are made under the muscular fascia and preformed silicone rubber implants are placed. These implants are currently made of “solid” silicone and do NOT contain silicone gel or liquid. They do not leak.
Recuperation and Healing
- Bed rest with the legs up is indicated for a few days.
- Wearing higher heels during the initial healing phase is more comfortable.
- The lower legs usually feel “normal” within several weeks.
Insurance Guidelines
- This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment.
NOTE
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.
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