Plastic & Aesthetic Surgery Specialists

Products And Services

• Facelift

  Facelift (Rhytidectomy) in Louisville In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces and necks. Deep creases appear beside the mouth, the jaw line slackens and becomes jowly, and the neck develops loose folds and fat deposits. Facelifts counteract these signs of aging by tightening muscle, removing fat, and trimming excess skin, giving your face a fresher, youthful look. After surgery, some patients look 10-15 years younger. What can a facelift do for me? Facelifts, technically known as rhytidectomies (literally, "removal of wrinkles"), rejuvenate the mid- to lower face and neck. Facelifts are most effective for patients who want to correct: Midface sagging Deep creases under the eyes Deep creases between the nose and mouth (nasolabial folds) Jowls due to loss of muscle tone Sagging areas of fat Loose skin and fat under the chin and jaw Am I a good candidate for a facelift? The best candidates for rhytidectomy: Wish to improve one or more of the signs of aging indicated above Are men or women whose faces have begun to sag, but whose skin still has some elasticity Are generally healthy Do not smoke Have realistic expectations Are considering a facelift for personal reasons, not because someone else is pressuring them to do so During your consultation, your doctor will discuss whether a facelift is right for you. How is a facelift performed? Facelifts are typically outpatient procedures and may be performed in an office-based facility, surgery center or hospital. Patients may have a choice of IV sedation or general anesthesia. The procedure takes about two hours. The way a facelift is performed varies depending on the surgeon, the patient's facial structure, and the extent of correction desired. The three most common incision techniques are: Traditional Facelift The "full" facelift for rejuvenating the face, jowls and neck, including fat sculpting, lifting and repositioning of muscle and deeper tissues, and skin trimming and redraping. The incision begins at the temples and travels down to the front of the ear, around the earlobe, and behind the ear to the lower scalp at the hairline. Sometimes, another incision is made under the chin. Limited-Incision Facelift For limited rejuvenation around the eyes and mouth, including nasolabial folds and other deep creases. Short incisions are made at the temples and around the ear, and possibly in the lower eyelids and/or under the upper lip as well. Neck Lift A neck lift concentrates on jowls, loose skin on the neck, and fat under the chin. The incision is made around the ear lobe and behind the ear to the lower scalp. In all three methods, incisions are closed with stitches or tissue glue. Scars are hidden in the hairline and natural contours of the face. What is the recovery from a facelift like? After your rhytidectomy, your doctor will wrap the incisions in bandages and may place drainage tubes in the area. The tubes will be taken out the next day when your hair will be carefully washed. If surgical clips are used to hold the incisions closed, they will be removed one week after the facelift along with your stitches. At first, you may experience swelling, numbness, bruising, and a feeling of tightness or tension in the face and neck. Your face may look uneven or distorted, and your facial muscles may feel stiff. Most of these usually resolve within 3-6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy or itchy in time. Many patients return to work by the third week. Camouflage cosmetics can be used to minimize the appearance of bruising. You should be gentle with your skin and hair as you recover. Men may need to shave behind the neck and ears where areas of beard-growing skin have moved. How long do the effects of a facelift last? Results of a facelift do not last forever. You may want to have another procedure in five or ten years. In another sense, the effects are permanent; years later, your face will continue to look better than if you had never had a facelift. What are the risks of having a facelift? Possible complications of facelift include: bleeding, infection, bruising, uneven swelling or discoloration, allergic reaction to the anesthesia, skin blistering (usually only seen in smokers), and temporary or permanent loss of sensation in the face.

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• Brow Lift

  As we age, the brow decreases and we develop frown lines and forehead wrinkles, giving us an older, more tired appearance. A brow lift elevates the brow to the appropriate position. It also eliminates or minimizes the forehead wrinkles, leading to a more youthful appearance. Also known as a forehead lift, a brow lift is a surgical procedure performed to reduce signs of aging in the forehead area. It aims to remove or minimize deep horizontal creases across the forehead and bridge of the nose, and the frown lines between the eyebrows. It also lifts the eyebrows, making the eyes look more open. Common Brow-Lift Techniques There are two techniques used for performing brow lifts. The classic lift requires a long incision that runs across the top of the head, at the hairline, and down to the ears. However, for a woman who has a high forehead, a coronal incision, which is made behind the hairline, may be used. The endoscopic lift requires three to five small incisions that are made across the forehead, at the hairline. These shorter incisions mean a shorter recovery time and less scarring than those from a traditional brow lift. Which technique is chosen depends on the thickness, texture, and elasticity of the skin, the bone structure of the face, the overall appearance of eyebrows and eyelids, and the position of the eyebrows. The Brow-Lift Procedure Brow-lift surgery usually takes about one to two hours to perform, and takes place at a hospital, an office-based surgical suite, or an ambulatory center. Either general anesthesia or intravenous sedation is used. Depending on the surgical technique used, one long incision or a series of small incisions is made. Tissue and muscle underneath the skin are moved or repositioned as necessary. At the end of the procedure, the incision(s) is closed with sutures, screws, adhesives or surgical tape; a drain may be put in to collect excess blood and fluid. Postsurgery, the patient is moved to a recovery area for observation. Recovery From A Brow Lift A patient typically returns home on the day of the brow-lift surgery, although an overnight stay may be necessary for some. Swelling may be pronounced for the first day or two after surgery, although most swelling goes away within 2 weeks. To prevent post-operative bleeding, bending and heavy lifting should be avoided for a few days. It can take up to 6 months for swelling to fully subside and scars to fade. Results Of A Brow Lift Depending on the patient's presurgical appearance and goals, a brow lift's results, which can be seen immediately, can be either subtle or dramatic. Eyes will appear more "open," and creases across the forehead, bridge of the nose, and between the eyes will be much less prominent. Risks Associated With A Brow Lift Prior to scheduling surgery, the patient and surgeon should fully discuss the risks associated with a brow lift. In addition to those associated with any type of surgery, a brow lift's risks include the following: Hair loss around the incision site(s) Facial asymmetry Higher hairline Injury to facial nerves Eye dryness/irritation The chance of complications is minimized by choosing a board-certified plastic surgeon who has experience in performing brow lifts.

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• Blepharoplasty (Eyelid Surgery)

  Blepharoplasty (Eyelid Surgery) Blepharoplasty (eyelid surgery) is a plastic surgery procedure for correcting sagging or drooping eyelids. The eyelid, because its skin is much thinner than that in other parts of the face, is often one of the first facial areas to exhibit signs of aging. Eyelids that sag or droop can affect peripheral vision, making daily activities such as driving more difficult. Blepharoplasty may become necessary when various factors, which include aging, sun damage, smoking, and obesity, cause the muscles and tissue that support the eyelids to weaken. Blepharoplasty tightens the eyelid's muscles and tissue and removes excess fat and skin. Blepharoplasty eliminates the drooping of skin into the visual field, greatly improving peripheral vision. It is also performed for strictly cosmetic reasons. Functional Blepharoplasty If the eyelids begin sagging into the field of vision, a functional blepharoplasty may be required. The procedure may be covered by medical insurance if it is deemed medically necessary. A determination of how much vision is affected is done by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer. Cosmetic Blepharoplasty Blepharoplasty can be performed on either the upper or lower eyelid, or on both, for cosmetic purposes. For a lower eyelid that needs fat rather than skin removed, a transconjunctival blepharoplasty is performed. During transconjunctival blepharoplasty, an incision is made inside the lower eyelid, so there are no visible scars, and the fat is removed. This procedure has no effect on vision, but results in a person's looking younger and more refreshed. It is important for a patient to have realistic expectations before undergoing cosmetic blepharoplasty. Although the procedure can enhance the appearance and improve self-confidence, it does not radically alter the face. Candidates For Blepharoplasty The best candidates for blepharoplasty are those who are in good overall health, do not smoke, do not have any serious eye conditions, and have healthy facial tissue and muscle. People with eye disease, including glaucoma or retinal detachment, thyroid disorders, diabetes, cardiovascular disease or high blood pressure are not good candidates for blepharoplasty. The Blepharoplasty Procedure Blepharoplasty is typically performed as an outpatient procedure requiring local anesthesia and sedation. General anesthesia may be used for anxious patients. Patients can choose to have this procedure on their upper or lower eyelids or both. The procedure can take anywhere from 45 minutes to 2 hours, depending on whether both the upper and lower eyelids are operated on. If the upper eyelid is being operated on, an incision is typically made along its natural crease. Once the incision is made, fat deposits are repositioned or removed, muscles and tissue are tightened, and excess skin is removed. For the lower eyelid, an incision is usually made just below the lash line so that excess skin can be removed. After the procedure, the incisions are closed with sutures, tissue glue or surgical tape, and usually loosely covered with gauze so the area can heal. Recovery After Blepharoplasty After blepharoplasty, patients may be advised to apply lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients return to work within a few days to a week, but should avoid exercise and strenuous activities for at least 2 weeks. Stitches are usually removed after 3 or 4 days. Most swelling and other side effects typically subside within 2 weeks. Contact lenses and eye makeup may not be worn for 2 weeks after surgery. Patients are typically advised to wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from sun and wind. Risks Of Blepharoplasty Although there may be swelling and bruising around the surgical site, they will subside on their own, and the eyelids will improve in appearance for up to a year. Uncommon side effects include infection, reaction to anesthesia, and double or blurred vision. Eyes may be irritated and dry due to a temporary change in tear distribution. Side effects such as uneven healing and permanent scarring are rare but, if they occur, may require surgical correction. The scars from blepharoplasty are well-concealed and usually fade with time until they are virtually undetectable. Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results. Lower Eyelid Blepharoplasty Blepharoplasty, also known as eyelid surgery, is a surgical procedure that improves the appearance of the eyelids by tightening muscles and tissue or removing excess fat and skin. A lower eyelid blepharoplasty is used to treat the following: Under-eye bags Drooping lower eyelids Excess skin Fine wrinkles Circles under the eye

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• Rhinoplasty

  Rhinoplasty The nose is the most prominent feature of the human face. For many people, it is simply a part of their good looks and rarely merits a second thought. For countless others, the nose is an almost constant source of embarrassment. Today plastic surgery can correct a multitude of faults. Rhinoplasty can shorten, tilt-up, build up or straighten. Rhinoplasty can make the most prominent feature on your face a permanent source of pride. It can give you a whole new appearance and a new outlook on life. Rhinoplasty is one of the oldest operations in plastic surgery. Often this procedure can be combined with functional improvement of the nasal airway through correction of abnormal internal nasal structures. Rhinoplasties are individualized to meet the patient's needs and expectations. Rhinoplasty Procedure and Requirments During a rhinoplasty procedure, the surgeon is able to reshape, reduce or augment a patient's nose for cosmetic, and sometimes functional purposes. An individual undergoes this procedure to usually correct a birth defect, to repair an injury, or to improve breathing, or for aesthetic purposes. You must be at least 13 years old to qualify for this procedure. Meeting the age requirement is important because patients must have finished their facial growth before proceeding with this surgery. If you are considering rhinoplasty, it's imperative to have good overall health. You should not be smoking and should have realistic expectations about the outcome. Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia and takes from 1 to 2 hours. There are two methods for performing a rhinoplasty: open and closed. The surgeon will choose the appropriate procedure for each individual patient. Post-Rhinoplasty Procedure Immediately after surgery, the patient's nose and eyes are usually bruised and swollen. Splints and some packing material will remain inside the nose for a few days. Most patients feel like themselves within a few days and are able to return to regular activities in about a week. During recovery, the rhinoplasty patient should refrain from strenuous exercise and showering, use sunscreen of SPF 30 or higher and avoid nose blowing, vigorous toothbrushing or any activity that puts pressure on the nose. Rhinoplasty Risk As with any surgical procedure, there are risks involved when a rhinoplasty procedure is performed. An individual can be exposed to excessive bleeding, adverse reaction to anesthesia, localized pain, and discoloration or numbness. Occasionally, a patient may be dissatisfied with the cosmetic results of the operation and a second surgery, called a revision rhinoplasty, may be desired. For most patients, however, rhinoplasty is an uncomplicated procedure with pleasing results. Revision Rhinoplasty Revision or secondary rhinoplasty is a procedure that corrects deformities caused by a previous operation on the nose. Patients who are dissatisfied with the results they have received on a previous rhinoplasty, and want to opt-in for a revision for either functional or cosmetic reasons. In some cases, a revision rhinoplasty may be performed. Revision rhinoplasty at times can be a more difficult procedure to successfully perform in comparison to primary rhinoplasty. This is because of the fact that there may be less cartilage to work with and that there may be scarring or tissue contracture or tightening within the nose. In some cases, additional cartilage may be taken from the ear or even the ribs to reconstruct the nose. For dissatisfied patients, revision rhinoplasty is not always the only option available to correct problems with previous surgery. Some doctors can correct deformities or fill gaps or grooves within the nose with injections of medical liquid silicone. Patients should consult with their doctor or plastic surgeon if they are dissatisfied with the results of a previous rhinoplasty and see what options are available to improve both the appearance and the function of the nose. Rhinoplasty FAQs Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed. During a rhinoplasty, the surgeon is able to reshape, reduce or augment a patient's nose to improve appearance. A rhinoplasty may be performed as a reconstructive procedure to correct a birth defect, a repair surgery to remedy an injury like a broken nose, or simply for cosmetic reasons. Sometimes the procedure is performed in conjunction with endoscopic sinus surgery for patients with ongoing sinusitis or with a septoplasty, a procedure to correct a deviated septum. In these cases, the operation effectively treats health and breathing problems, as well as improving the patient's appearance. What Are The Benefits Of A Rhinoplasty? Rhinoplasty has several specific goals. Some facilitate breathing as well as improve facial appearance.

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• Otoplasty

  Face Procedures Brow Lift (Forehead Lift) Brow Lift | Eyelid Surgery | Blepharoplasty | Louisville KYAs we age, the brow decreases and we develop frown lines and forehead wrinkles, giving us an older, more tired appearance. A brow lift elevates the brow to the appropriate position. It also eliminates or minimizes the forehead wrinkles, leading to a more youthful appearance... read more Eyelid Surgery » For more information about brow lifts, click here Eyelid Surgery (Blepharoplasty) Eyelid surgery (blepharoplasty) is designed to remove excess skin, muscle and fat from the upper and lower eyelids. The procedure can correct drooping upper lids that tend to sag with time and the puffy bags below the eyes. Stitches can be removed after three or four days. Blepharoplasty can be done as a single procedure, or in conjunction with other facial surgery such as a facelift or a browlift...read more Eyelid Surgery » For more information about eyelid surgery, click here Eyelid Surgery Rhinoplasty (Nose Reshaping) Brow Lift | Eyelid Surgery | Blepharoplasty | Louisville KYThe nose is the most prominent feature of the human face. For many people, it is simply a part of their good looks and rarely merits a second thought. For countless others, the nose is an almost constant source of embarrassment. Today, however, plastic surgery can correct a multitude of faults. Rhinoplasty can shorten, tilt up, build up or straighten. Rhinoplasty can make the most prominent feature on your face a permanent source of pride. It can give you a whole new appearance and a new outlook on life. Rhinoplasty is one of the oldest operations in plastic surgery. Often this procedure can be combined with functional improvement of the nasal airway through correction of abnormal internal nasal structures. Rhinoplasties are individualized to meet the patient's needs and expectations...read more Rhinoplasty Louisville | Nose Surgery Elizabethtown » For more information about rhinoplasty, click here Rhinoplasty Louisville | Nose Surgery Elizabethtown Otoplasty (Ear Pinback) Otoplasty or ear pinback is done to correct protruding ears. It happens to be one of the few cosmetic surgeries performed on adults as well as children. An incision is placed in the natural creases behind the ear and the cartilage of the ear is reshaped so that it maintains the appropriate position. Recovery normally takes one to two weeks and results are immediately apparent.

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• Chin Surgery

  he chin is an important facial feature. It may be disproportionately too large or too small. Procedures are available to place the chin in balance with the rest of the face.

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• Laser Skin Resurfacing

  Lasers can be used to improve the quality of the skin. There are often used to treat fine lines and wrinkles, especially around the eyes and mouth. They can also be used to treat irregular pigmentation, moles, and various birthmarks, as well as other skin conditions. They can also be used to treat spider veins on the face and extremities.

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• Non-Invasive Face Procedures

  At Plastic & Aesthetic Surgery Specialists, we offer the following Non-Invasive Face Procedures: Chemical Peels IPL Skin Treatment Laser Hair Removal BOTOX® Cosmetic Dysport® Restylane® Juvéderm™ Injectable Gel Radiesse™ Fraxel™ Sculptra® Bellafill® LipoDissolve™

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• Breast Augmentation

  Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. and one of our most popular services. Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast. Our patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under our doctors' expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation. We know that every woman is unique in both her desires and her body shape. With that in mind, we take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type and implant placement is best. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind. Complementary Procedures for Breast Augmentation Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. Saline and Silicone Gel Breast Implants Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. We will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle. After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants. The IDEAL Structured Breast Implant The Structured Breast Implant combines the best of both worlds. They combine the advantages of saline and silicone and eliminate the disadvantages. The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located: In the armpit (transaxillary), In the crease on the underside of the breast (inframammary), or Around the areola, the dark skin around the nipple (periareolar) The breast is then lifted, creating a pocket into which the implant is inserted. Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach. Breast Augmentation Surgery - Placement Options Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery. We will discuss which option may be best for you. In the TUBA procedure, implants cannot be placed beneath the chest wall. After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed, then taped and bandaged. In a few days, these bandages may be replaced with a surgical bra. Breast Augmentation Recovery Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. Stitches are removed in a week to 10 days after breast augmentation. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. Complications from Breast Augmentation Complications following breast augmentation surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast. If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. If a silicone implant leaks, you will need to see a doctor immediately.

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• Breast Lift

  Over time, the effects of gravity along with the loss of the skin's natural elasticity begins to have an effect on the appearance of a woman's breasts. These factors, combined with pregnancies and nursing will often cause the breasts to lose their youthful shape and firmness. A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. The procedure can also reduce the size of the areola (the darker skin surrounding the nipple). Breast implants inserted in conjunction with a mastopexy procedure can increase both firmness and size.

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• Breast Reduction

  Large, pendulous breasts may cause a woman to potentially experience various medical problems caused by the excessive weight of the breast tissue. Problems with posture, skeletal deformities, back and neck pain, skin irritations and breathing problems are common with this condition. Bra straps often leave indentations in the shoulder area. Many women, especially teenage girls, are very self-conscious if they have unusually large breasts. Breast reduction (reduction mammaplasty) removes fat, glandular tissue, and excessive skin, resulting in smaller, lighter and firmer breasts that are better-shaped in proportion to rest of the body.

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• Breast Reconstruction

  Reconstruction of the breast after a mastectomy due to cancer or other disease is possible with today's surgical procedures. Using the newest medical techniques, a plastic surgeon is often able to create a breast that is similar in form and appearance to that of the natural breast. A consultation will provide you with information on the many available options for post-mastectomy breast reconstruction.

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• Male Breast Reduction

  Male breast enlargement occurs in adolescent as well as adult males. Various medical conditions can cause gynecomastia, but in most cases none can be identified. Men who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.

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• Tummy Tuck

  Abdominoplasty, often called a "tummy tuck," is a very popular surgery in America. Tummy tucks help to flatten and shape the abdomen and waist by removing excess fat and skin and tightening muscles. Our doctors have been performing abdominoplasties with excellent cosmetic results for many years. Patients love the look of their new flat stomachs after surgery under our doctors' exceptional care. The best candidates for abdominoplasty are in good physical condition with pockets of fat or loose skin that haven’t responded well to diet and exercise. We can also help older, slightly obese people whose skin has lost some of its elasticity. Abdominoplasty can also be useful for women with stretched skin and muscles from pregnancy. Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to delay abdominoplasty. We also encourage patients who intend to lose a lot of weight to wait before undergoing the procedure, since skin in the abdominal area typically loosens after substantial weight loss. Customized Treatment for Optimal Cosmetic Results We take the time during every pre-operative consultation to learn what his patients want to achieve from a tummy tuck both for their bodies and for their self-confidence. By listening to what patients have to say and closely examining them rather than performing a one-size-fits-all procedure on every person, we provide patients with completely customized treatment that takes into account their specific goals. The Tummy Tuck Procedure Abdominoplasty takes approximately two to five hours under general anesthesia. The surgeon will make two incisions: one from hipbone to hipbone close to the pubic area, and another around the navel. He or she will separate the skin from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. He or she will stretch the skin flap down and over the newly tightened muscles, remove excess skin, and reattach the navel in a natural position. Finally, he or she will close the incisions and apply sterile surgical dressings over the sutured areas.

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• Mini Abdominoplasty

  Mini abdominoplasty is appropriate for people with redundant lower abdominal skin but acceptable skin above the belly button. Mini abdominoplasty is similar to abdominoplasty except a shorter incision is made and the skin is only lifted to the navel, which does not have to be moved (although it may be pulled into a different shape as skin is stretched).

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• Lower Body Lift

  The lower body lift is performed to tighten and elevate sagging thighs and buttocks. It is usually performed for patients who have lost significant amounts of weight as a result of diet, exercise, weight loss surgery or who have loose, elastic skin for other reasons. The procedure is often combined with others such as breast lifts, facelifts, abdominoplasties and arm lifts to retain a proper body proportion.

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• Thigh Lift

  A thigh lift is performed to remove excess skin and fat from the inner and/ or outer thighs. Candidates typically have loose, inelastic skin after extreme weight loss due to diet, exercise or weight loss surgery. Because of this, the procedure is often combined with others such as breast lifts, facelifts, abdominoplasties and arm lifts to achieve an attractive body proportion.

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• Buttock Augmentation

  If you want to enlarge or re-shape your buttocks and have discovered that they do not respond to diet or exercise, buttock implants may be the solution. Implants come in a variety of shapes and sizes and are made of soft silicone, which provide a firm, smooth yet natural feel. They are placed away from the bony area on which you sit. Incisions are made inconspicuously in the depression between the buttocks. It may be performed in conjunction with liposuction for a more dramatic change in contour. Types Of Buttock Augmentation Buttock augmentation is usually performed with implants or fat transfer, or a combination of the two. Which method is used depends primarily on the shape and size of the buttocks, the skin's quality and elasticity, and the amount of body fat available for transfer. Buttock Implants For Buttock Augmentation Typically, incisions for buttock implants are made in one of four areas: in each gluteal crease, overlying the tailbone at the top of the buttocks, in the crease between the buttocks, and at the side of each buttocknear the crease. After the incision or incisions are made, a silicone implant is inserted in each buttock within or above the gluteal muscle. The tissue within the buttocks is sutured, and the incisions are closed using sutures, adhesive or tape. Drains are usually inserted to prevent fluid from building up, and are left in place for about 7 days. During surgery, either general anesthesia or intravenous sedation is typically used. The results of buttock augmentation using implants is permanent, and are immediately apparent after surgery. Final results are evident after 3 months, at which point most of the swelling has subsided and the implants have "settled." Fat Transfer For Buttock Augmentation The fat used for buttock augmentation is usually taken from the patient's abdomen, hips, thighs or lower back. Fat is removed using liposuction, in which a cannula (a thin, hollow tube) is inserted through small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or cannula-attached syringe. The fat is then purified, and injected into the buttocks at different depths for maximum absorption. It can take up to a year to see the final results of fat-transfer buttock augmentation, because the fat needs time to be completely absorbed. The results of buttock augmentation using fat transfer are often more natural-looking than those from implants, but a downside of the fat-transfer method is that the body reabsorbs part of the fat over time, so some of the initial fullness is lost. According to the American Society of Plastic Surgeons, patients tend to retain 60 to 80 percent of fat that has been transferred.

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• Liposuction

  Now among the most popular cosmetic surgery procedures, liposuction (also known as "lipoplasty" or "suction lipectomy") sculpts the body by removing undesirable fat from areas around the thighs, knees, buttocks, waist, hips, abdomen, chin, cheeks, neck and upper arms. Ultrasound-assisted liposuction (UAL), tumescent technique and the super-wet technique are among the various techniques used to provide precise results. Liposuction is not a substitute for a healthy diet and exercise, but the procedure can eliminate areas of fat that are unresponsive to typical weight-loss methods. Risks of Liposuction In addition to the usual risks associated with surgery, risks associated with liposuction include the following: Loose or rippled skin Worsening of cellulite Asymmetry Contour irregularities Pigmentation irregularities When large amounts of fat are removed, surgery to remove excess skin may be necessary. Recovery from Liposuction After liposuction, patients experience mild swelling, bruising and discomfort in the treated area. Compression garments or elastic bandages are typically worn to help reduce these symptoms as the area heals. Patients can return to work and other regular activities as soon as they feel comfortable, which is usually after a few days. Exercise and other strenuous activities should be avoided for a few weeks. SlimLipo™ Laser Manufactured by Palomar™ Medical, the SlimLipo™ Laser system is a revolutionary liposuction technique that uses tiny laser fibers to melt away fat cells and slim targeted areas of the body for an overall improved body contour. This procedure melts up to five times more fat than other laser liposuction procedures, such as SmartLipo, and is considered safe for most patients. SLIM, which stands for Selective Laser Induced Melting, is an advanced technology that offers patients effective, long-lasting results with less bleeding, smaller scars and faster recovery times. Only the fat cells are destroyed, unlike standard liposuction procedures that can affect all tissue in the area. The SLIM laser system also tightens skin during the procedure to eliminate the need for additional treatments.

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• Brachioplasty (Arm Lift)

  After substantial weight loss, weight gain or simply from the effects of aging, skin on the upper arms can become inelastic, loose and flabby. Arm lifts, also known as brachioplasty, remove that excess skin and fat. Patients who have significant amounts of fat may want to consider combining the procedure with liposuction. Brachioplasty Procedure Explained During brachioplasty, an incision is made along the inside of the upper arm; it often spans the underarm to the elbow. Excess fat is removed, either by direct excision or liposuction. Excess skin is trimmed away, and the arm's underlying supportive tissue is tightened using internal absorbable sutures. Skin is then sutured back together; absorbable stitches may or may not be used to close the incision. Brachioplasty is performed under general anesthesia or intravenous sedation and, depending on the amount of skin and fat that are removed, takes 2 to 4 hours. Patients are able to return home the same day as surgery. Patients who need only a small amount of skin and fat removed, a minimal-incision Brachoplasty may be performed. A less invasive way to remove excess fat and tissue, it requires only a few small incisions near the underarm. Brachioplasty Risks In addition to the risks associated with any surgery, those most common risk in associated with brachioplasty include the following: Loss of sensation Permanent swelling Persistent pain Fat necrosis Fluid accumulation Nerve, blood-vessel and/or muscle damage The scar left by brachioplasty is significant, although it fades over time. Brachioplasty Recovery After brachioplasty, patients typically experience swelling and bruising, as well as mild discomfort that can be managed with pain medication. Drainage tubes may be placed at the incision site to collect any excess blood or fluid for the first few days after surgery. Compression bandages are usually worn to promote proper healing. The results of brachioplasty are visible right away, but become more apparent as swelling and bruising subsides, which usually takes 2 weeks.

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