Surgeries

Breast augmentation or enlargement

Breast augmentation, or augmentation mammoplasty, or is a surgical procedure that aims to increase the size, shape, or fullness of the breast.

The surgeon places silicone, saline, or alternative composite breast implants under the chest muscles or breast tissue. Implants last from 7 to 12 years on average.

Breast augmentation is done to:

  • Enlarge breasts that are naturally small
  • Restore breast size and shape after pregnancy, weight loss or breastfeeding
  • Restore symmetry when the breasts are asymmetrical
  • Restore the breast or breasts after surgery

Plastic surgery includes reconstructive surgery and cosmetic surgery.

Reconstructive breast surgery may be done as a part of the treatment for breast cancer. Cosmetic breast surgery is done for esthetic purposes. Breast augmentation is normally cosmetic surgery.

There are three main types of breast implants:

Saline implants are filled with a sterile saline solution, like salt water. The solution is held within an elastomer silicone shell. These implants can be filled with different amounts of saline solution. This affects the feel, firmness, and shape of the breast.

If a saline implant leaks, the solution will be absorbed and expelled by the body naturally.

Silicone gel-filled implants consist of a silicone outer shell filled with a silicone gel. If a silicone-filled implant leaks, the gel will either stay in the shell or escape into the breast implant pocket. A leaking silicone-filled implant may or may not collapse.

Patients choosing this type of implant should carry out more regular checks with their doctor compared with those on saline solution implants. An MRI or ultrasound scan can check the condition of the implants.

Alternative composite implants may be filled with polypropylene string, soy oil, or some other material.

Breast implant removal

The goal of breast implant removal surgery is to remove breast implants from breast augmentation or breast reconstruction patients. During these procedures, the surgeon may also remove silicone material from implant leaks and the breast capsule, which is the scar tissue that formes after the placement of a breast implant.

Often, the scar tissue that forms after the placement of an implant is soft and does not need to be removed, but it may harden, causing pain and discomfort. This is often a reason to have the implants and scar tissue removed.

Breast implants are not lifelong devices and it is important to have them exchanged or removed approximately every 10-15 years. This decision is typically based on the individual and the patient's needs and desires.

In some cases, the outside shell of the implant breaks down causing silicone to leak and the scar tissue around the implant to harden. It is important to understand that your implants should be removed for this reason.

Breast lift mastopexy with or without the placement of an implant

When a patient’s nipple falls at or below the level that the fold of the breast makes with the chest wall (a condition referred to as breast ptosis), a breast lift may be required in order to obtain a better appearance. The medical term for this procedure is Mastopexy. A mastopexy is performed to elevate, and often center the position of the nipple and areola in relation to the breast mound. Mastopexy may be performed with or without implant placement, and the use of an implant depends on a patient’s desires for fuller or larger breasts. Often, the shape of the breast is improved; and this is accomplished by removing lower breast tissue which falls beneath the fold the breast makes with the upper abdomen. The incisions may be around the areola only (Periareolar Mastopexy) for smaller breast lifts with minimal ptosis where the breast does not require significant reshaping. In larger breasts with greater degrees of ptosis, the incisions are made around the areola and from the 6 o’clock position of the areola to the inframammary fold (Vertical Mastopexy) in order to elevate the nipple areola and reshape the breast. There are few indications for the traditional "anchor" incision in most patients seeking mastopexy procedures. However, patients with extreme ptosis may require a horizontal incision in the breast fold to eliminate excess skin.

Buttock lift

A buttock lift is a cosmetic surgical procedure to improve the appearance of the buttocks. It may be done as part of a tummy tuck (belt lipectomy) or lower body lift to contour the buttocks, groin, thighs and abdomen.

A buttock lift alone won't add any volume to the buttocks. But sometimes, a buttock lift is combined with an augmentation procedure to alter the shape or size of the buttocks with implants or fat grafts.

During a buttock lift, excess skin and fat are removed from the buttocks. The remaining skin is then repositioned to create a more toned look.

Chin, Cheek, or Jaw Reshaping/Facial Implants

Plastic surgery to change the shape of the chin, cheek, or jaw may be done. This procedure is typically done to enhance certain facial features, or to bring a certain aspect of the face into proportion with the rest of the face. It may also be done to address a defect present since birth, or as a result of an injury.

For the reshaping of the chin, cheek, or jaw, the surgeon may insert an implant into the area to redefine its appearance.

Dermabrasion

Dermabrasion removes damaged outer layers of skin. This exposes new layers of skin that appear younger and smoother.

In addition to providing a more youthful appearance, dermabrasion can also help treat:
  • acne scars
  • age spots
  • fine wrinkles
  • precancerous skin patches
  • rhinophyma, or redness and thick skin on the nose
  • scars from surgery or injury
  • sun damage
  • tattoos
  • uneven skin tone

Dermabrasion is only one of many treatments for these conditions. For instance, advances in laser technology make laser tattoo removal quicker and easier. Talk to your dermatologist about all of the treatment options for your specific condition.

Eyelid lift (blepharoplasty)

Blepharoplasty is a kind of surgery performed on the eyelids. It’s done toremove excess skin from the upper eyelids and reduce bagginess from the lower eyelids. It’s also called an eye lift.

This surgery is usually done for cosmetic reasons. It's also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision.

An eye lift won’t get rid of dark circles under the eyes, crow's feet, or other facial wrinkles. It’s often done along with other procedures such as laser resurfacing, filler injections, or forehead lifts.

The eyelid aging process

As skin ages, it gradually loses its elasticity. A lack of elasticity plus the constant pull from gravity causes excess skin to collect on the upper and lower eyelids.

Excess skin on the lower eyelid causes wrinkles and bulges. On the upper eyelids, an extra fold of skin can hang over the eyelashes and get in the way of seeing.

The fat that cushions the eyeball from the skull can also cause bulges in the upper and lower eyelids. The thin membrane that holds the fat in place weakens with age, letting the fat come forward into the lids like a hernia.

Facelift (rhytidectomy)

A facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck, such as:
  • Relaxation of the skin of the face causing sagging
  • Deepening of the fold lines between the nose and corner of the mouth
  • Fat that has fallen or has disappeared
  • Jowls developing in the cheeks and jaw
  • Loose skin and excess fat of the neck that can appear as a double chin or "turkey neck"

The loss of youthful contours in the face can be due to variety of factors, including thinning of the skin, loss of facial fat, gravity, sun damage, smoking, as well as heredity and stress.

Other procedures that might be performed in conjunction with a facelift are brow lift and eyelid surgery to rejuvenate aging eyes. Fat transfer or fillers may be suggested to replace the lost fatty volume. Skin treatments such as IPL, dermabrasion, peels or laser may be offered to improve the quality and texture of the skin.

Forehead lift

A forehead lift is a surgical procedure to correct sagging of the forehead skin, eyebrows, and upper eyelids. It may also improve the look of wrinkles in the forehead and between the eyes.

A forehead lift removes or changes the muscles and skin that cause signs of aging as drooping eyebrows, "hooding" eyelids, forehead furrows, and frown lines.

The surgery may be done alone or with other procedures such as a facelift, eyelid surgery, or nose reshaping. The surgery can be done in a surgeon's office, an outpatient surgery center, or a hospital. It is usually done on an outpatient basis, without an overnight stay.

You will be awake, but will be given local anesthesia so that you will not feel pain. You might also get medicine to relax you. In some cases, general anesthesia will be used. During the procedure, you will feel some stretching of the forehead skin and possibly some discomfort. During the surgery:
  • Sections of hair will be held away from the surgery area. Hair right in front of the cut line may need to be trimmed, but large areas of hair will not be shaved.
  • The surgeon will make a surgical cut (incision) at ear level. That cut will continue across the top of the forehead at the hairline so that the forehead does not look too high.
  • If you are bald or balding, the surgeon may use a cut in the middle of the scalp to avoid a visible scar.
  • Some surgeons will use several small cuts and perform the surgery using an endoscope (a long thin instrument that has a small camera on the end). Dissolvable implants may be used to hold the lifted skin in place.
  • After removing excess tissue, skin, and muscle, the surgeon will close the cut with stitches or staples. Before dressings are applied, your hair and face will be washed so the scalp skin does not get irritated.

Hair replacement or transplantation

What causes hair loss?
Hair loss is believed to be caused by a combination of the following:
  • Aging
  • Change in hormones
  • Illness
  • Family history of baldness
  • Burns
  • Trauma

There are a number of hair replacement techniques available, although hair replacement surgery can't help those who are totally bald. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.

There are 4 different types of hair replacement methods:
  1. Hair transplant. During a hair transplant, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then moved to a bald or thinning area.
  2. Tissue expansion. In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
  3. Flap surgery. Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
  4. Scalp reduction. Scalp reduction is done to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area.

Lip augmentation

Having full, plump lips is often considered a sign of good health, beauty and youth. Whether you were born with thin lips or your lips are thinning due to the natural aging process, there are many ways to enhance them or restore soft tissue loss. Lip injections using natural or synthetic fillers can keep your lips plump for months at a time. Lip implants and other surgical procedures can also be performed for a more permanent solution. Other options include lip lifts, vermillion border (lip) advancement and permanent makeup. Every year, thousands of people undergo successful lip enhancement and are pleased with the results.

When to Consider Lip Enhancement:
  • Your lips have always been thin and disappear when you smile
  • As you age, your lips have become thinner and less full
  • You feel self-conscious about how your lips look
  • Having fuller lips will help balance out your face
  • If your self-confidence would improve from such a procedure

Liposuction

Liposuction, sometimes referred to as "lipo" by patients, slims and reshapes specific areas of the body by removing excess fat deposits and improving your body contours and proportion.

What liposuction can treat:
  • Thighs
  • Hips and buttocks
  • Abdomen and waist
  • Upper arms
  • Back
  • Inner knee
  • Chest area
  • Cheeks, chin and neck
  • Calves and ankles

Liposuction can be performed alone or along with other plastic surgery procedures, such as a facelift, breast reduction or a tummy tuck.

Lower body lift

A lower body lift is a comprehensive procedure designed to sculpt, tighten, and ultimately improve the appearance of the region from the midsection to the upper thighs. A common effect of undergoing significant weight loss, as well as withstanding the aging process, is extensive skin laxity in the mid to lower body that can cause skin irritation and chafing in addition to aesthetic concerns. A lower body lift is designed to remove excess skin and tighten the remaining tissue in the targeted areas for a smoother and leaner lower body contour. The procedure can also target isolated fatty deposits that have remained resistant to dieting and exercise. Following a lower body lift, many patients experience a dramatic transformation in their lower body appearance and achieve a sleeker and more defined silhouette.

A lower body lift is performed under general anesthesia and may be classified as an outpatient procedure, depending on the extent of surgical work to be done.

Nose reshaping

Rhinoplasty, sometimes referred to as a "nose job" or "nose reshaping" by patients, enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose.

What rhinoplasty can treat:
  • Nose size in relation to facial balance
  • Nose width at the bridge or in the size and position of the nostrils
  • Nose profile with visible humps or depressions on the bridge
  • Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry

If you desire a more symmetrical nose, keep in mind that everyone's face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.

Rhinoplasty to correct a deviated septum

Nose surgery that's done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing.

Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

Thigh lift

Thigh lift surgery reshapes the thighs by reducing excess skin and fat, resulting in smoother skin and better-proportioned contours of the thighs and lower body.

If fitness and weight control efforts have not achieved your goals for a body that is firmer, more youthful-looking and more proportionate to your overall body image, a surgical lift may be right for you.

What thigh lift surgery can't do

Thigh lifts are not intended strictly for the removal of excess fat. Liposuction alone can remove excess fat deposits where skin has good elasticity and is able to naturally conform to new body contours.

In cases where skin elasticity is poor, a thigh lift along with liposuction may be recommended.

Tummy tuck

Tummy tuck surgery, also known as abdominoplasty, removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.

A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals.

Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:
  • Aging
  • Heredity
  • Pregnancy
  • Prior surgery
  • Significant fluctuations in weight
What tummy tuck surgery can't do

A tummy tuck is not a substitute for weight loss or an appropriate exercise program.

Although the results of a tummy tuck are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies would be advised to postpone a tummy tuck.

A tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised.

Upper arm lift

An arm lift, or brachioplasty, is a surgical procedure that:
  • Reduces excess sagging skin that droops downward
  • Tightens and smoothes the underlying supportive tissue that defines the shape of the upper arm
  • Reduces localized pockets of fat in the upper arm region

Fluctuations in weight, growing older and heredity can cause your upper arms to have a drooping, sagging appearance. This is a condition that cannot be corrected through exercise.

Arm lift surgery may be right for you if the underside of your upper arms are sagging or appear loose and full due to excess skin and fat.

Botox injection

The cosmetic form of botulinum toxin, sometimes referred to as "Botox" by patients, is a popular injectable that temporarily reduces or eliminates facial fine lines and wrinkles. The most commonly treated areas are frown lines, forehead creases, crow's feet near the eyes. Several other areas have been treated such as thick bands in the neck, thick jaw muscles, lip lines and gummy smiles.

Botulinum toxin is a purified substance that's derived from bacteria. Injections of botulinum toxin block the nerve signals to the muscle in which it was injected. Without a signal, the muscle is not able to contract. The end result is diminished unwanted facial wrinkles or appearance. Commonly known types of botulinum toxin type A injections include Botox®, Dysport®, Xeomin® and Jeuveau®.

Botulinum toxin can be used to
  • Smooth crow's feet, forehead furrows, frown lines, lip lines and bunny lines
  • Diminish neck bands
  • Improve the appearance of skin dimpling of the chin
  • Lift the corners of the mouth
  • Soften a square jawline
  • Correct a gummy smile

The FDA has approved the use of Botox® for the frown lines and crow's feet, while Dysport® and Xeomin® are approved for frown lines only. All other uses are considered "off label."

Cellulite treatments

If cellulite bothers you, you’re not alone. Our desire to get rid of — or at least diminish — cellulite has led to many treatment options. With so many treatments out there, it can be hard to know what, if anything, works.

To find out, dermatologists have been conducting research studies. You’ll be happy to know that the research shows some treatments can make cellulite less noticeable — at least for a while. Here’s the lowdown.

Bottom line: Cellulaze™ may reduce the appearance of cellulite. Patients are seeing results that last a year or longer. More research is needed to know for sure how helpful this laser can be.

With other laser treatments, some patients have seen less cellulite. Results can last 6 months or longer; however, a bit of dimpling usually returns.

Called Cellfina™, this medical procedure involves your dermatologist inserting a needle just under the skin to break up the tough bands beneath the skin that cause us to see cellulite.

Bottom line: Cellfina™ has been shown to reduce the skin dimpling that you see with cellulite. In a study of 232 patients, 99% of them said they were satisfied with the results. The results can last 2 years and possibly longer.

Vacuum-assisted precise tissue release

This also breaks up the tough bands that cause us to see cellulite. During this procedure, your dermatologist will use a device that contains small blades to cut the tough bands. After the bands are cut, the tissue moves upward to fill out and eliminate the dimpled skin.

Bottom line: This may be an effective treatment for reducing cellulite. A small study shows that many patients who received this treatment had less cellulite for up to 3 years. It’s too soon to tell, but the results may last even longer.

Carboxytherapy

During this medical procedure, carbon dioxide (CO2) gas is inserted just beneath the skin. CO2 differs from carbon monoxide, which can be deadly. Possible side effects from carboxytherapy are discomfort during treatment and temporary bruising.

Bottom line: Early studies show that women may see less cellulite. In one study, 10 women received 8 treatments. After these treatments, the researchers found that the women had a little less cellulite.

Chemical peel

A chemical peel is a procedure in which a chemical solution is applied to the skin to remove the top layers. The skin that grows back is smoother. With a light or medium peel, you may need to undergo the procedure more than once to get the desired results.

Chemical peels are used to treat wrinkles, discolored skin and scars — usually on the face. They can be done alone or combined with other cosmetic procedures. And they can be done at different depths, from light to deep. Deeper chemical peels offer more-dramatic results but also take longer to recover from.

A chemical peel is a skin-resurfacing procedure. Depending on the issues you're addressing with the procedure, you'll choose a chemical peel in one of three depths:
  • Light chemical peel. A light (superficial) chemical peel removes the outer layer of skin (epidermis). It's used to treat fine wrinkles, acne, uneven skin tone and dryness. You might have a light peel every two to five weeks.
  • Medium chemical peel. A medium chemical peel removes skin cells from the epidermis and from portions of the upper part of your middle layer of skin (dermis). It's used to treat wrinkles, acne scars and uneven skin tone. You might need to repeat the procedure to achieve or maintain the desired result.
  • Deep chemical peel. A deep chemical peel removes skin cells even deeper. Your doctor might recommend one for deeper wrinkles, scars or precancerous growths. You won't need repeat procedures to get the full effect.
  • Chemical peels can't remove deep scars or wrinkles or tighten sagging skin.

Collagen or fat injections

Collagen and other injectable wrinkle fillers give skin a plumper, smoother appearance. Although collagen is the best known wrinkle filler, there are many other substances doctors can use to plump up your skin, including fat from your own body and synthetic materials. Take a look at how collagen and other injectable wrinkle fillers your doctor may recommend work.

What Is Collagen?

Collagen is a key part of your skin's structure. It forms a network of fibers within your skin that acts like a framework.

In young skin, the collagen framework is intact and the skin remains moisturized and elastic. Over time, the support structure weakens and the skin loses its elasticity. The skin begins to lose its tone as the collagen support wears down.

Using your facial muscles -- smiling, frowning, or squinting, for instance -- is part of expressing yourself. That's normal, but it does stress the collagen in your skin. Over time, that stress adds up and contributes to facial lines and wrinkles.

Can Collagen Creams Smooth Wrinkles?

Collagen creams work only on the skin surface and, like other moisturizers, mainly slow the rate of water loss from the skin and help keep the skin supple. A moisturizer with or without collagen cannot penetrate the skin and is not designed to be absorbed. No moisturizer can undo the effect of collagen loss and make wrinkles disappear.

How Do Collagen Injections Fight Wrinkles?

Collagen injections replenish the skin's natural collagen. By supplementing your skin's own collagen, injections help smooth facial lines and some types of scars. The natural beauty of your skin is enhanced as the contour of the support structure is restored. These products can come from cows (bovine) or human cells.

Laser skin resurfacing

Laser skin resurfacing, also known as a laser peel, laser vaporization and lasabrasion, can reduce facial wrinkles, scars and blemishes. Newer laser technologies give your plastic surgeon a new level of control in laser surfacing, permitting extreme precision, especially in delicate areas.

What laser skin resurfacing can improve
  • Fine lines or wrinkles around or under your eyes, forehead or mouth
  • Scars from acne or chickenpox
  • Non-responsive skin after a facelift
  • Aged or sun-damaged skin
  • Liver spots
  • Improve your complexion if you have yellowish or grayish skin tones
  • Warts
  • Birthmarks such as linear epidermal nevi
  • Enlarged oil glands on the nose
How does laser skin resurfacing work?

It's all about using beams of light. Your surgeon uses the laser to send short, concentrated pulsating beams of light at irregular skin. This removes unwanted, damaged skin in a very precise manner one layer at a time.

Laser skin resurfacing's targeted approach means there are fewer problems with hypopigmentation, or a lightening of skin, for procedures such as laser acne scar removal.

The laser beam used in laser resurfacing will remove your outer layer of skin, called the epidermis. It simultaneously heats the underlying skin, called the dermis. This action works to stimulate growth of new collagen fibers. As the treated area heals, the new skin that forms is smoother and firmer.

Laser treatment of leg veins

Public interest in laser and light treatment of leg veins is high, and, under the right circumstances, excellent results can be achieved with this treatment modality. With any laser or light source treatment, reverse pressure from associated reticular or varicose veins must be recognized and eliminated; otherwise, the treatment is doomed to fail.

Many patients benefit from a combination of treatments such as sclerotherapy, ambulatory phlebectomy, and intravascular laser or radiofrequency closure because external lasers and light sources do not effectively treat associated reticular and varicose veins. Lasers can be effective in treating vessels of less than 1-2 mm in diameter that are resistant to sclerotherapy and telangiectatic matting, which can occur postsclerotherapy. However, sclerotherapy remains the criterion standard for the treatment of leg veins and telangiectasias.

Vaginal rejuvenation

Vaginoplasty is a procedure that aims to "tighten up" a vagina that's become slack or loose from vaginal childbirth or aging. Some surgeons claim it can even improve sensitivity -- a claim the American College of Obstetricians and Gynecologists (ACOG) has strongly challenged.

While it's true that vaginal tissues can stretch, surgically tightening the vaginal tissue in itself cannot guarantee a heightened sexual response, since desire, arousal, and orgasm are complex, highly personal responses, conditioned as much by emotional, spiritual, and interpersonal factors as aesthetic ones. In addition, sexual "sensitivity" doesn't automatically lead to more pleasure - it can actually lead to pain.

Labiaplasty, plastic surgery on the labia (the “lips" surrounding the vagina), can be performed alone or with vaginoplasty. Surgery can be performed on the labia major (the larger, outer vaginal lips), or the labia minor (the smaller, inner vaginal lips). Labiaplasty changes the size or shape of the labia, typically making them smaller or correcting an asymmetry between them.