Marc J. Salzman, MD, FACS is recognized in Louisville for his cutting-edge plastic surgery
techniques. He is a double Board Certified aesthetic plastic surgeon who has been practicing in
Louisville since 1992. Dr. Salzman’s favorite procedures to perform are breast augmentation,
revisional breast surgery, liposuction, and facial surgery. If you are looking for non-invasive
solutions, our Medspa offers Botox® in Louisville, Juvéderm®, Restylane®, and many other
treatment options.
Keywords
Breast Cosmetic Surgery,
Body Cosmetic Surgery,
Face Cosmetic Surgery,
Medical Spa,
Face Masks,
Injectables.
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Dr. Salzman is a board-certified plastic surgeon who has been practicing in Louisville, KY since 1992. Originally from Miami, Florida, Dr. Salzman completed his undergraduate education at the University of Florida, earning both Phi Beta Kappa and Phi Kappa Phi accolades. After graduating from college, he received his medical degree from Tulane University in New Orleans where he was selected to Alpha Omega Alpha Honor Medical Society, graduating at the top of his class. He then completed a five-year residency in General Surgery at the Mount Sinai Medical School in New York City and obtained Board Certification in General Surgery in 1990. His Plastic Surgery Fellowship was completed at Duke University Medical School in 1992. He is also Board Certified in Plastic Surgery since 1994 and a Fellow of the American College of Surgeons.
Dr. Salzman is an Assistant Clinical Professor of Plastic Surgery at the University of Louisville.
He is a former president of the Kentucky Society of Plastic Surgeons, and former Chief of Surgery at Saint Mary and Elizabeth Hospital in Louisville, KY. Dr. Salzman is a member of numerous national plastic surgery societies including the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. He has been a guest lecturer on various plastic surgery topics both at national and international plastic surgery meetings. He has been named “Best of Louisville” in Louisville Magazine and recognized as a Leo Magazine Readers’ Choice Award Winner. Dr. Salzman is the CEO of Bellanovus Development, a medical device manufacturer in Louisville. He is a patent holder for the Ouchless Needle device which alleviates the discomfort of cosmetic injectables. Dr. Salzman’s practice is limited to cosmetic surgery, but he has expertise in primary and revisionary cosmetic breast surgery, body contouring, and facial aesthetic surgery. When he is not operating or teaching, Dr. Salzman enjoys golf, squash, and travel.
There are many choices in breast enlargement, and we believe it is important to be given all of the options at the time of consultation. There are saline and gel implants, as well as expandable implants and shaped implants. The gel implants come in different consistencies with smooth or textured surfaces. The placement of the incision can also be in numerous locations. We take these considerations, as well as the preoperative state of the breast, the size of the patient, her desires, and activity levels, and address all of these at each and every consult.
The consultation for breast lift first begins with a question. Are you happy with the size of your breasts? From this point, we can then decide if we will be augmenting, reducing, or keeping the same size as we lift the breast. We stress to our patients that gravity is unyielding. Adding weight to an already-sagging breast and then trying to lift it and keep it there is often hard to accomplish. Therefore, adding large implants and doing a lift at the same time may be counterproductive. It is always better to add a smaller implant to just fill the upper portion of the breast and perform a lift that removes as much of the stretched skin as possible. There are many different types of lifts, ranging from the removal of small crescents of skin above the areola to lifts that produce scars extending around the areola and vertically downward to the crease (lollipop shape). The options of each type of lift and whether an implant will also be used will be discussed at consultation.
Sometimes, despite the best efforts and intentions of your primary plastic surgeon, the outcome of a breast enhancement surgery may not be what you had expected. Breast implants are one of the most commonly performed plastic surgery procedures in the US and, although rare, sometimes the surgery may need to be re-done with new implants of a different size, shape, or type.
Breast reduction is performed on patients with large, pendulous breasts to not only reduce the size and weight but also to lift the breast to a more youthful location on the chest wall. Patients will have less shoulder and back pain, as well as less bra strap grooving afterward.
This term is confusing to most people. Plastic surgeons refer to this implant as “form stable,” meaning that even if the shell were stripped away from the silicone filling, the shape of the silicone filling would remain. These are usually shaped implants. The shaped implants, rather than being round, have different height, width, and projection ratios. For instance, the implant can be moderate in height, moderate in width, and extra projecting. Three different heights, widths, and projections are possible for the same volume of the implant. Dr. Salzman was involved in the FDA trials of this implant (style 410 Inamed) and has used it extensively in his practice. It is not presently available for free and unrestricted use. All silicone gel implants today contain a “cohesive gel.” Unlike the gel implants of the ’70s and ’80s, these newer implants have a thicker gel and are sometimes known as “gummy bear” implants
IDEAL IMPLANT® Structured Breast Implant is a new type of implant that is filled with saline but has an internal structure to make it behave as if filled with silicone gel. The IDEAL IMPLANT contains a series of nested shells that provide support to the edges and control fluid movement to prevent bouncing. The result is an implant that combines certain key features and benefits of both saline and silicone gel implants.
There are multiple causes of male breast enlargement (also called gynecomastia), including drugs, steroids, and natural hormonal changes with puberty. Dr. Salzman will address the different types of enlargement with either liposuction or a combination of liposuction and excisional removal of breast tissue.
Liposculpture procedures are done under anesthesia at our own on-site, AAAASF-Certified surgery center. We commonly use a laryngeal mask anesthetic, as well as a tumescent local anesthetic, to numb the area and make the blood vessels smaller to limit bruising. With a laryngeal mask, a rubberized insert is placed in the back of the mouth whereby inhalation gases can be given to keep you asleep. Intravenous medications are also given prior to the mask so that you do not feel or remember anything. We also use a BIS monitor to measure your brainwave activity. With this technique, we can give you just the right amount of anesthesia to keep you asleep and yet wake up quickly with little hangover effect. Smaller areas can be done with the LiteShape™ technique in-office with a local anesthetic and oral sedation. The gentlest liposuction technique available is Vaser Liposuction.
VASER Lipo is the most gentle liposuction technique available. VASER Lipo is Tumescent Resonance Ultrasound followed by Fat Extraction, which describes what makes it different. First, tumescent fluid is placed into unwanted fat. Then, resonance ultrasound is used to shake the fat from the connective tissues so as not to disturb or damage them. Finally, the fat is extracted through a tiny cannula. This state-of-the-art Vaser technology achieves greatly-advanced surgical fat removal by providing a more gentle procedure which results in less patient discomfort and downtime. During your consultation, we use our Vectra system. This is a system that shows 3D images of the body and allows us to simulate how you may look after the surgery.
The LiteShape™ procedure is done in-office under a local tumescent anesthetic. Oral sedatives, if needed, can also be prescribed. Tiny incisions are made, and a diluted numbing medicine is placed with a pump. The laser is then inserted through a hollow tube and worked around the fat to melt and disrupt it. We then remove the resultant liquid with a handheld syringe, called a liposculpture cannula. The last step is to replace the laser fiber, this time on another customized blended wavelength that will tighten the overlying skin. The tiny incisions are glued back together and a band-aid dressing is placed.
Dr. Salzman is an extremely experienced tummy tuck surgeon, having performed thousands of tummy tucks since 1989. His procedure is done without any blunt tearing of the tissues, producing a more comfortable postoperative experience.
Mini tummy tucks are performed on patients who struggle with skin laxity, stubborn fat, and muscle weakness that extends only below the belly button. In more extensive cases, a traditional tummy tuck may be required for best results. These procedures are commonly combined with liposuction of the waist and hips in order to further slim down the area. Patients should be at or near their ideal weight and have no further plans for pregnancy, as this can reverse the great results of a mini tummy tuck.
ThermiDry is the newest technology available for excessive underarm sweating. It uses a controlled temperature radio frequency device to heat and obliterate sweat- and odor-producing glands in the armpits. It is done using a local anesthetic and is a quick, minimally-invasive procedure done in-office.
Losing inches without surgery and downtime has become incredibly popular in recent years, and why wouldn’t it? Today’s plastic surgery patients want legitimate methods for fat reduction that are quick, easy, and fit into their busy schedules.
The gold standard for total body contouring has been some type of liposuction. Numerous methods of liposuction are being used today including laser-assisted, ultrasound-assisted, power-assisted, and water pressure-assisted. Most of these require a general anesthetic or at least a local anesthetic with an oral or intravenous sedation. Non-invasive fat reduction usually does not require any type of anesthetic and very little– if any– downtime. Most patients can return to their normal activities the next day or even the same day.
In patients with massive weight loss, especially after bariatric surgery, the resultant skin excess can extend circumferentially around the trunk area. In this situation, a body lift will address the extra skin of the abdomen, flanks, hips, and buttock areas.
An arm lift, or brachioplasty, is done for patients with excess skin of the upper arm that can hang when the arm is in an upright position. Frequently, these patients have seen significant weight loss that produces extra skin.
Dr. Salzman uses the safest and most reliable methods to add fat to the butt. By using ultrasonic separation of fat into smaller individual cells and removing the fat with powered assisted cannulas, the fat has been shown to have a higher survival rate. The fat is filtered through a system that processes it in a way that allows only the good fat to be used. Fat is removed around the buttocks, hips, and thighs, and sometimes the abdomen. Dr. Salzman injects the fat into the butt while visualizing where it goes in real time using ultrasound. At present, there are only a handful of plastic surgeons in the US using this technology. Dr. Salzman now offers courses for other physicians to learn his technique. The Brazilian Butt Lift is done under general anesthesia in our AAAASF-accredited operating room. Like any aesthetic plastic surgery procedure, safety is our number one priority. Over the last several years, as the popularity of this procedure has increased dramatically, there has been an alarming increase in the mortality of this procedure.
A Mommy Makeover uses a customized combination of procedures to change the ratios of the bust-line and waist-line, as well as also provide a flatter tummy. It may include a Breast Lift, Augmentation, or Reduction (any asymmetry will be corrected), along with a Tummy Tuck and/or Liposuction. Each patient has different needs and is looking for lasting results. Dr. Salzman will create a procedure plan that best suits the needs of the individual patient, so her particular goals are met.
Hi-definition vaser liposuction is a method by which one can thin the overlying fatty tissues to accentuate the underlying muscle contours. The best candidates for this procedure are patients with a mild amount of overlying fat and a healthy, toned, underlying musculature. Commonly, in men, the abdomen and chest wall can be combined into one unit. In women, the abdomen and arms are common areas where one may want to accentuate the look of the underlying musculature.
Cellusmooth® treatment was developed by Dr. Salzman using software changes to a dual-wavelength body contouring laser developed by Sciton. Cellusmooth® is done in the office under a local anesthetic with oral sedation if necessary. Tiny, no-stitch needle holes are made in the area, and numbing medicine with adrenaline is placed with a pump and fine cannula under the skin. Diagnostic ultrasound is sometimes used to help locate the septa contributing to the depression. The laser is used in a “burst mode” to sever the septa. The same laser is then used to melt the fat just under the skin and heat the dermis from the inside out to tighten the overlying skin. Tiny needle holes are covered with a band-aid.
As we age, not only do our faces show some of the tell-tale signs of sun exposure, environmental toxins, and genetic programming, but our hands also show the same. The skin over the back of the hand thins and the fat melts away, exposing the veins and tendons at the back of the hand, making them appear older. The skin of the hand deteriorates with increasing brown spots and a rough texture. Fortunately, we have many solutions to improve the appearance of the back of the hands.
The Ageless™ Minilift was developed by Dr. Salzman to specifically address early facial aging. This procedure is usually done at the offices of the Salzman Institute of Cosmetic Surgery in Louisville under a local anesthetic with an oral sedative. We use a tumescent local anesthetic to numb the area. Limited separation of the skin and underlying fat is done. A series of dissolvable sutures are placed in the muscle layer of the face to draw the more mobile and sagging areas up and back to the more fixed tissues close to the ear. The extra skin that is produced is then trimmed and sewn back to the zig-zag incisions in the hairline and in the natural creases around the front of the ear. A light dressing is placed around the ears and the patient goes home.
Lack of youthful appearance of the face, neck, and skin. Signs of facial aging in the cheeks and jowls, appearance of nasolabial folds and wrinkles, fine lines, sun damage, discoloration, rough texture, and scars.
The PERFECT Lift is an acronym for the Platelet-Enriched Radiesse Facial Enhancement & Correction Treatment. It was designed and developed by Dr. Salzman for his patients who are in-between needing injectable filler treatments and an Ageless Mini Facelift. The PERFECT Lift is the newest, most innovative injectable facial lifting technique combining deep biologic filler (Radiesse®) and superficial hyaluronic acid (Restylane® or Juvederm®) with your own Platelet Rich Plasma (PRP) in one treatment.
Eyelid surgery is usually done at our own on-site, AAAASF-Certified surgery center.
Upper Blepharoplasty alone can sometimes be performed in our office procedure room under local anesthetic with an oral sedative. In the upper lids, the incision is made with a black diamond scalpel and is hidden in the natural crease above the lid margin. Skin, with a small sliver of redundant muscle and fat excess, are all removed.
Lower Blepharoplasty (or Lower and Upper Blepharoplasty at the same time) is always done under anesthesia. The lower lids are approached first through an incision made on the inside of the lid. The fat is removed with a fine electric needle to limit bruising. Any extra skin is “pinched” below the lash line and trimmed with a fine scissor. Several sutures are placed to close the incision.
Forehead lift or brow lift helps those who have an eyebrow that has descended too low on the bony orbital rim. A decrease in space between the eyebrow and upper eyelid. Deep vertical furrows between the eyebrows (also called frown lines).
ThermiRase treats the nerves that cause the muscles to frown. Two different nerves are treated to get the desired effects. Radiofrequency energy is applied to them with a pen-like probe. This RF energy works to interrupt the nerve, causing the muscle to contract.
LiteShape Lipo of the neck is performed in-office using local anesthesia. A fine laser fiber is placed into a small incision under the chin. A stream of coherent light energy is applied to the neckline for several minutes. This will liquefy and destroy the fat cells. The fat is then gently removed. A second application of a different light energy is applied; this tightens the skin from the inside. Finally, two small incisions are made behind the ear. A bridle of two permanent sutures is woven to the neck muscle to suspend, lift, and hold the contour of the neck. Your own collagen bundles around the suture to help maintain the elevation or lifting effect.
Laser resurfacing is indicated in patients who have a sun-damaged, wrinkled appearance to the skin sometimes associated with uneven skin tones and/or large pores. Acne scarring, surgical or traumatic scars, and stretch marks can all be softened with laser resurfacing.
Rhinoplasty (nose reshaping) is done under a general anesthetic in an ambulatory setting. Either an open or closed approach is utilized. In the open approach, a small zig-zag incision is made between the nostrils to better visualize the structures and implement the changes in a more predictable fashion. The closed approach has no visible incisions as they are all inside the nose.
Chin implants are done in an ambulatory setting under a general anesthetic or a local anesthetic with IV sedation. An incision is placed inside the mouth, below the teeth, or under the chin. A Medpor®, porous polyethylene (plastic material) is then customized to correct the chin deficiency.
Depending on each individual patient’s needs, lip lifts can either be done at the margin of the upper lip or just under the nose. Lip Lifts are done in-office under a local lip block and direct local injections. The unwanted tissue is excised and the lip is advanced upward.
Otoplasty (ear pinning) is done under a general laryngeal mask anesthetic or a local anesthetic with IV sedation in adults. Incisions are hidden behind the ear. The ear cartilage is reshaped, and sutures are placed to move the ear back towards the head. Children with prominent ears can have surgery beginning at age 6.
Cheekbone implants are made of porous polyethylene (Porex)™, a firm plastic with a surface that allows for ingrowth of tissue into the implant to anchor it in place. This type of implant material can also be customized during the procedure for better correction. Cheek implants are placed through an incision inside the upper gums above the teeth. Commonly, general anesthesia is utilized, and the patient goes home shortly after the procedure.