Upcoming Events

May 17-18, 2013
Vein Treatments for the Cosmetic Surgeon
Detroit, Michigan

September 21-22, 2013
Innovations in Aesthetic Breast Surgery
Tulsa, Oklahoma

October 2-5, 2013
World Congress on Advanced Liposculpture and Body Contouring
New York City, NY

Jan. 15-18, 2014
30th Annual Scientific Meeting
Fort Lauderdale, Florida

Body Contouring

Abdominoplasty (Tummy Tuck)

Abdominoplasty (tummy tuck) is an operation that is designed to reshape the abdomen . Often, through weight gain and loss, pregnancies and aging, the skin stretches beyond its elastic limit or ability to return to normal shape. An abdominoplasty removes excess skin and fat while the underlying muscles are tightened.

The actual placement of incisions and design of the abdominal incisions vary depending on the looseness of the underlying tissues, the amount of fat to be removed, the condition of the overlying skin and prior scars.

For those women where the sagging skin is mainly in the lower abdomen the mini-abdominoplasty is an additional option. This procedure is not as extensive due to a smaller incision that is easily hidden under a two piece bathing suit. This procedure offers a more rapid recovery and may be done on an outpatient basis.

Who is a Candidate?

• Women with loose or sagging abdominal wall skin.
• Women with abnormal relaxation of the anterior (front) abdominal wall muscles due to weight gain or loss, pregnancies, or prior surgery.
• Those who are unable to tighten the abdominal wall skin with exercise.

Intended Results

• A smoother flatter abdomen.

Procedure Description

• The procedure is usually performed at an accredited outpatient facility or hospital.
• Anesthetic options include local anesthesia with oral sedation, conscious sedation and general anesthesia.
• Mini-abdominoplasty can usually be performed under conscious sedation on an outpatient basis.
• Standard abdominoplasty tightens all of the abdominal wall skin leaving a standard scar.
• Mini-abdominoplasty tightens the lower abdominal wall skin only leaving a shorter scar.
• Small suction drains may be inserted with both procedures.

Recuperation and Healing

• Discomfort is usually controlled with oral medications or nasal spray.
• Recovery may be at home with a responsible adult caregiver, at a supervised recovery facility or at the hospital with an overnight stay.
• If placed, drains are removed in 2-7 days.
• Sutures are usually removed in 2-3 weeks.
• A compression garment with dressings over the incision sites is used.
• Light activity may be resumed in 7-21 days. Sports will probably not be comfortable for about 6 weeks.
• An abdominal binder (compression garment) is usually worn for 4-6 weeks.

Other Options

• Liposuction-liposculpture of the area.

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 rare.

Breast Augmentation

Breast enlargement, known as augmentation mammoplasty, can enhance the body contour of a woman who is unhappy with her breast size. This procedure may also be used to improve the loss of breast volume following pregnancy and nursing. Additionally, the operation may help balance breast asymmetries. Saline filled or the newly FDA approved silicone gel implants may be surgically implanted by three standard routes with placement either above or below the chest muscle. The standard routes are periareolar (around the areola), inframammary (lower breast folds) and transaxillary (arm pits). Also, saline implants may be placed transumbilically (via the navel).

The implant is composed of an outer flexible, silicone shell and filled with either saline or silicone gel. The outer surface may be smooth or textured. Implants also have various sizes, profiles and shapes to meet the individual needs of each woman.

While breast augmentation will enlarge the breasts, the surgery will not alter underlying basic defects in breast shape and form. Major asymmetries may be improved but will not be completely corrected with breast enlargement alone. A noticeable difference in the size, shape or orientation of the two breasts is considered normal and is actually the rule. If breast size and/or nipple position asymmetries are severe, additional procedures to further improve symmetry may be necessary.

Long term experience with breast enhancement surgery has demonstrated that this operation has a high patient satisfaction rate.

Who is a Candidate?

• Women who want larger breasts.
• Women who want to improve their breast shape.
• Healthy women without connective tissue diseases.
• Healthy women without breast malignancy.

Intended Results

• Larger and shapelier breasts.
• Less asymmetry and size difference.

Procedure Description

• Breast Augmentation is usually performed in an accredited outpatient surgical facility under general anesthesia or conscious sedation with local anesthesia.
• Surgical scar(s) are usually hidden as much as possible in skin folds.
• Saline or silicone implants may be placed either above or below the chest muscle.

Recuperation and Healing

• Discomfort is controlled with oral medications and long-acting local anesthesia.
• A soft bra or compression garment is usually worn for several days postoperatively.
• Patients are usually discharged to the care of a responsible adult and recover at home.
• All sutures are usually removed in 1-2 weeks.
• Light activity may be resumed in 7 days. Sports activities may be resumed in 3-6 weeks (depending on your surgeon).

Other Options

• Breast lift — if sagging is an issue.
• Areolar reduction.

Note

• The specific risks and suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Breast Lift

As women age, the breasts lose shape and firmness. The skin gradually loses its elasticity and no longer holds the breasts in a youthful, upright position. Pregnancy, breast feeding, weight gain and loss also add to the tissue burden of loss of skin elasticity. Women who have sagging breasts (ptosis) my benefit from breast lift (mastopexy). If there are also problems of excess volume or size of the breasts, a reduction may also be done at the same time. Volume loss may be corrected by breast augmentation at the same time. Asymmetries may also be improved.

Excess skin is removed, the nipple areolar (dark skin around the nipple) complex is lifted and the breasts are recontoured to create a more youthful appearance with firmer breasts. Depending on preoperative size, appearance and assymetries, the nipple areolar complexes may also be reduced. There are incisions made directly on the breasts which may extend around the nipple areolar complex, into the front of the breast and into the breast fold, depending on the degree of droop, asymmetry and volume considerations.

Who is a Candidate?

• Women who have sagging breasts.
• Women who want to improve their breast shape.
• Healthy women without underlying breast disease.
• Women who will tolerate breast scars.

Intended Results

• Higher breasts (lifted).
• Tighter breast envelope (increased skin tightness).
• Improved breast symmetry.
• More pleasing breast shape.
• More youthful appearance.

Procedure Description

• Mastopexy operations are usually performed in an accredited outpatient surgical facility under general anesthesia or conscious sedation with local anesthesia.
• There are several types of mastopexy procedures depending on the severity of ptosis (breast droop). In most cases incisions are made around the nipple areolar complex and in front of the breasts. Sometimes they may extend into the breast fold.
• The nipple areolar complex is lifted to a more youthful position.

Recuperation and Healing

• Postoperative discomfort is usually controlled with oral medications and long-acting local anesthesia.
• A soft bra or compression garment is usually worn for at least several days postoperatively.
• A postoperative care facility or closely monitored overnight home care is standard practice.
• The patient may be seen the next day.
• External sutures are usually removed between 2-3 weeks after surgery.
• Light activity may be resumed in 7 to 10 days. Sports activities may be resumed in 6 weeks (depending on your cosmetic surgeon).

Other Options

• Breast reduction or breast augmentation may be required with your mastopexy for the best results.
• Breast contouring may be appropriate with mastopexy (speak to your cosmetic surgeon).

Note

• The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation with your cosmetic surgeon. A standard mastopexy always requires the placement of surgical incisions on the breasts. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occasionally occur. Major complications are rare.

Breast Reduction

Breast reduction is designed to reduce the size of a woman's breasts. It may also improve the overall appearance or shape of the breast and help balance breast asymmetries. It helps in treatment of physical complaints such as neck, shoulder and back pain experienced by many women with large breasts.

Skin, along with breast tissue and fat are removed to create smaller, shapelier breasts. An added benefit where ptosis (droop) exists is a simultaneous uplift of the nipple areolar complex to a more normal position. The areolae (darker skin which surrounds the nipple) may also be reduced in size and made more symmetric.

Who is a Candidate?

• Patients who want smaller breasts.
• Patients with extensive breast asymmetry.
• Healthy patients without breast cancer.
• Patients who possess realistic expectations.
• Patients who will tolerate breast scars.
• Patients who complain of chronic neck, shoulder and back pain from excessive breast size.
• Patients with large breasts who experience chronic skin irritation along their bra straps and under the breast folds.

Intended Results

• Smaller breast size.
• Improved breast contour.

Procedure Description

• Breast reduction is performed in an accredited outpatient surgical facility or in the hospital under general anesthesia or conscious sedation with local anesthesia.
• Depending on several factors, breast reductions are performed using surgical techniques that preserve breast tissue and maintain a healthy blood supply to the breasts.
• Various external skin envelope closures are available which will determine the placement and size of your postoperative scars (talk to your cosmetic surgeon).
• A drain may be inserted at the time of surgery.
• Breast tissue is usually submitted for biopsy (pathologist examines).

Recuperation and Healing

• Postoperative discomfort is controlled with oral medications or pain pump.
• Surgical drains may be present after the surgery. Your cosmetic surgeon will determine when these are to be removed.
• A special postoperative support bra may be worn after surgery for several weeks.
• Postoperative care the first night may be at home with a responsible adult, an overnight care facility, or overnight at the hospital.
• The patient may be seen the next day for evaluation.
• Sutures will remain in place and are removed at an appropriate time as determined by your cosmetic surgeon (usually 2-3 weeks).
• Light activity may usually resume in less than 10 days. Sports activities may be resumed in six weeks or longer (depending on your surgeon's advice).

Other Options

• Breast volume reduction by breast fat liposuction-liposculpture.
• Breast contouring using breast skin resection with or without liposculpture .

Note

• The specific risks and suitability of this procedure for a given individual can only be determined at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications that do no affect the outcome occur occasionally. Major complications are rare.

Male Breast Reduction

Excess male breast development is called gynecomastia. This condition may occur in men due to a variety of causes including weight gain or loss, use of certain drugs like hormones or steroids, fatty tumors, genetic predisposition or hormonal imbalances. In many cases, no cause is found.

In cases where there is one sided enlargement, medical testing may be necessary prior to consideration of surgical treatment. If a mass is found, this must be addressed and may require testing, imaging and biopsy (pathological evaluation).

Treatment of gynecomastia involves stopping the use of the causative agent if possible, control of weight and may include either conventional or laser assisted liposuction-liposculpture alone or direct excision supplemented with liposuction-liposculpture. Often scars are hidden in the breast folds and around the areola (darker skin around the nipple).

The choice of techniques is individually determined and depends on the size of the breast tissue, the assessment of the amount of fat versus actual breast tissue and the amount of breast droop.

Who is a Candidate?

• Men who have unwanted breast development.
• Men who are healthy.
• Men who want to improve their physique.
• Men who have realistic expectations.

Intended Results

• Less chest fat and breast tissue.
• Improved male physique.
• More self-confidence.

Procedure Description

• Male breast reduction is usually performed in an accredited outpatient surgical facility under local anesthesia, conscious sedation with local anesthesia or general anesthesia.
• Direct surgical excision of tissue may be required along with liposuction-liposculpture.
• Several adjacent anatomical body areas may need to be addressed and treated in addition to the breasts, for improved results.

Recuperation and Healing

• Discomfort is controlled with oral medications and long-acting local anesthesia.
• A special postoperative garment is usually worn for several weeks according to your cosmetic surgeon's instructions.
• A postoperative care facility or closely monitored overnight home care is standard practice.
• The patient may be is seen the next day for a follow-up visit.
• There will normally be postoperative tumescent fluid drainage for several days.
• Sutures may be required with liposuction, and are required following direct surgical procedures. Removal is usually within 1-2 weeks.
• Light activity may be resumed in two days. Sports activities may be resumed in 2 to 4 weeks (depending on your cosmetic surgeon's instructions).

Other Options

• Medical therapy and follow-up with an endocrinologist (medical doctor who specializes in hormones) may be appropriate in certain cases.
• Diet and exercise with a trained dietician and/or exercise therapist may be helpful.
• A combination of the above therapies, including psychiatric support, can be beneficial.

Note

• The specific risks and suitability of this procedure for a given individual can only be fully determined at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications which do not affect the overall cosmetic results occur occasionally. Major complications are rare.

Buttock Implants

These procedures are for the individual who is unable to develop proportionate Gluteal muscles, lacks buttock fat, or simply desires more augmentation in the buttock area. The buttocks are augmented with the use of implants specifically designed for such a use or with your own fat, if applicable. Weightlifters sometimes request buttock implants to augment underdeveloped gluteus muscles to give a more balanced look as they have less actual body fat percentage to liposuction and re-inject. Buttock implants and buttock augmentation with fat grafting are for anyone who would like more curves where they have none.

Calf Lift

Calf enlargement is a procedure that can help to restore symmetry to the legs when the calf is much smaller in relation to the thigh than looks balanced or when the lower extremity as a whole is thin as compared to the upper body.

For body builders, the calf muscles are usually the most difficult of all muscles to enlarge by exercise and they often request calf implants or calf augmentation for this reason.

Occasionally, after a disease such as poliomyelitis or after a surgical muscle release procedure as in club-foot, there is asymmetry between left and right sides and only one leg needs augmentation. In keeping with the anatomy of the main calf muscle which has two heads, two implants are usually required in each calf to achieve maximum enlargement, but occasionally only inner side implants are required such as in "bow legged" patients.

Silicone elastomer implants are available in at least four sizes. With few exceptions, most men require an extra large, large, or medium size implant, and most women require a medium or small implant.

Gynecomastia

Liposuction — Liposculpture

Liposuction, commonly known as liposculpture, involves removing unwanted subcutaneous fat while simultaneously recontouring to create a more aesthetically appealing body.

While not a treatment for obesity, liposuction- liposculpture selectively removes persistent and unwanted subcutaneous fat.

Bothersome fatty deposits are found in areas that are resistant to diet and exercise, such as the face, neck, breast, abdomen, upper arm, hips, thighs, knees, and ankles. Liposuction-liposculpture can be performed on multiple areas at one time - your surgeon will follow accepted guidelines regarding safe volumes which may be removed in one session.

While goals include size improvement, this procedure is not for weight loss. Final results may not be evident for 6 months following your procedure. During this time your body balances fluids and the skin and remodels underlying tissues. Final results also depend on proper nutrition, exercise and decreasing your caloric intake.

Small incisions are made in hair bearing areas or natural skin folds. A special tumescent solution is next placed within the fatty areas to be removed. This solution provides anesthesia to the areas, while limiting the usual blood loss. Fat is then carefully removed from the areas of concern to the patient using a surgical instrument called a cannula, which is attached with tubing to a suction machine.

The time for completion of the procedure depends upon the total amount of fatty tissue removed. At the end of the procedure, the skin openings may be sutured or left open to heal, depending on the size of the openings. The patient may be placed in a compression garment that is worn for certain amount of time afterwards.

While recovery is easy, you should expect some initial drainage along with swelling, bruising and discomfort. Your compression garment will minimize the swelling, bruising, discomfort and assist in the retraction of any loose skin.

While some results are noted immediately, your final shape and form will continue to improve as your swelling subsides. You will be encouraged to be up and about the night of your surgery and progressively increase your activities. Usually light work duties may be resumed within three to five days and vigorous exercise within two to four weeks.

Who Is A Candidate?

Women and men desiring an improved facial, neck, breast, body or leg shape.

Patients of most ages who are healthy.

Patients who realize that this is not a weight loss procedure.

Procedure Description

• Liposuction-liposculpture is usually performed under local or conscious sedation, in an approved outpatient facility.
• The incisions are small and heal with minimal scars.
• Patients may be placed in a special support (compression) garment at the end of the procedure.

Recuperation And Healing

• You will be discharged home to the care of a responsible adult.
• You are encouraged to be up and about the first night.
• Some blood tinged drainage is expected for usually the first several days.
• Light household duties may be resumed in several days.
• Most patients resume standard pre-operative activities with 2 to 4 weeks after their surgery.

Other Options

• Laser assisted liposcuction-liposculpture.
• Vaser and ultrasonic assisted liposcuction-liposculpture.

Notes

• The specific risks and suitability of this procedure for a given individual can only be fully determined at the time of consultation with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications which do not affect the overall cosmetic results occur occasionally. Major complications are rare.

Thigh Lift

Thigh lift is surgery that removes excess skin and fat from your thighs. The goal of the procedure is to improve the appearance of your thighs by removing the "dimpled look" produced by cellulite. Some surgeons say the procedure is more effective for the front and side thigh areas, less effective for the back and inside areas. The incision does leave a scar at the hip, but it fades in time and can be hidden by a bathing suit.

A thigh lift usually lasts several hours and can be an outpatient procedure or require a short hospital stay. You may be given local or general anesthesia depending on the surgical plan you and your doctor have developed. The surgery begins with an incision in the groin area, near the hip. After the incision is made, your surgeon separates the skin on your thigh from the fat and muscle below by pulling the flap of skin upwards. Then, your surgeon removes the excess skin and stretches the remaining skin back in place.

When the procedure is complete, your surgeon closes the incisions with small stitches and covers them with bandages. A small drainage tube may be inserted in your skin for several days to drain excess fluid from the surgery.

Upper Arm Lift

Over time, gravity gets the best of all of us. Skin that becomes droopy and unattractive can be enhanced through a series of lifts. Lifts can be utilized on most areas of the body from head to toe. Arm, thigh and face are the most common areas while buttocks lifts are growing in popularity. Lifts are also beneficial to stomach-staple patients who lose a large amount of weight and are looking to remove the excess skin that many patients develop. Liposuction can be used in place of an arm lift in special instances where there is excess fat but the skin is still tight. If the skin is loose, however, the only method for correction is the arm lift. The drawback to the lift procedure is the noticeable scarring. Scarring therefore is the trade-off. Many people find that they prefer the scarring over the excess tissue and also find that the scarring can fade over time.

Normal activity can be resumed within 7 - 10 days. No lifting should be performed for the first 3 - 5 days and no heavy lifting for 2 weeks. Swelling is typical and there may be some mild to moderate discomfort over the first few days. Medication may be prescribed as needed.