Description of Procedures

Breast augmentation (augmentation mammoplasty) enlarges the size of the breasts to improve their shape. Women wish to do this for various reasons: small breasts, lost breast volume after pregnancy, after weight loss, effects of aging, different sized breasts, and those who seek breast reconstruction after breast cancer surgery.

Salt-water solution implants (saline implants) are being used today. The silicone gel-filled implants are not used except in very special circumstances. Soya-Bean oil filled implants are used in Europe but not approved yet in the USA.

Breast augmentation is relatively a safe procedure, but as with any surgical procedure, there are certain risks and specific complications known with augmentation that you should discuss with your surgeon. To date, there is no evidence that breast implants will adversely affect your fertility, pregnancy, ability to nurse and no evidence that breast implants cause breast cancer.

Breast implants can make it more difficult to get or read mammograms, and special mammogram views or ultrasound tests may be needed. Soya-bean oil filled implants do not interfere with mammogram. They are not available yet in the USA.

Breast augmentation is usually performed in an office facility, an outpatient surgery center, or a hospital outpatient facility. Local or general anesthesia are used for this procedure. Several well concealed incisions are used: around the areola (periareolar), in the armpit (transaxillary), under the breast (inframammary) or by using an endoscope to place the implant through a minimal incision through the armpit or the belly button. The surgery usually takes 1-2 hours. Most patients will be able to return to work in a few days.

BREAST LIFT
Breastlift, or mastopexy, is a procedure to raise and reshape sagging breasts. Sagging breasts may results from many factors; pregnancy, nursing, aging and gravity over time, are just a few. During a mastopexy, the plastic surgeon can also reduce the size of the areola (the darker skin around the nipple) or insert implants to increase breast firmness and size.

A breast lift is normally safe when performed by a qualified plastic surgeon. However, as with any surgery, there is some risk involved. Check with your surgeon about the details of any risk or complication involved with this procedure.

Breast lift is performed as an outpatient procedure, in an outpatient surgery center, a surgeon's office or a hospital.

Breast lifts are usually performed under general anesthesia. Some surgeons using a small incision may prefer local anesthesia with intravenous sedation. A mastopexy procedure usually takes 1 1/2 - 3 hours.

Some patients will be able to return to work in 2 weeks but should avoid lifting anything over their head for about 4 weeks.

BREAST RECONSTRUCTION
Reconstruction of the breast is usually needed after a mastectomy other disease such as severe fibrocystic disease, or from distortion of the breast due to trauma or burns. It is possible to create a breast that can closely resembles and feels like the natural breast.

With the rising awareness of possible immediate breast reconstruction, more patients are now requesting this procedure. This option is not the best for every patient but you should discuss it with your plastic surgeon.

Breast reconstruction has no known adverse effects on detection of breast cancer recurrence. It should not interfere with either chemotherapy or radiation treatment. If you have an implant as part of your reconstruction, there may be some interference with the reading of your mammogram that may require that you take special views or extra procedures like ultrasound, to examine your breasts.

Breast reconstruction is usually performed in a hospital. General anesthesia is usually used for this procedure.
Like any surgical procedure, there is some risk and possible complications involved. Discuss these risks and complications in details with your plastic surgeon.

There are many options for breast reconstruction:

(1) Skin Expansion: Skin expansion and insertion of an implant. This is a two stage procedure which requires placement of an expander at the first stage followed by serial expansions with saline injections. The second stage is removal of the expander and placement of a permanent implant;
(2) Flap reconstruction: This procedure involves creation of a skin flap using your own tissue taken from the back, abdomen, or buttocks,...etc. In many cases, placement of an implant will not be necessary as the tissue will provide enough bulk by itself for the newly constructed breast;
(3) Follow-up procedures: If desired, these may be needed to reconstruct the nipple and the areola, modify the shape or size of the other breast, or replace a tissue expander with an implant. Your surgeon will explain to you the details of these follow up procedures.

Your hospital stay will vary from 1-5 days. You may need about six weeks of recovery before going back to work.

BREAST REDUCTION
Breast reduction, also known as reduction mammaplasty, is designed for women with very large breasts causing them medical or psychological problems.

Women with very large breasts may experience various medical problems. Common complaints are back and neck pain, breathing problems and irritation/maceration of the skin under the breasts. Breast reduction will reduce or cure most of these symptoms by reducing breast size. Breast reduction can also reduce anxiety in women with very large breasts. The procedure removes skin and breast tissue which makes the breasts smaller and firmer.

Breast reduction is normally safe when performed by a qualified plastic surgeon. However, as with any surgery, there is some risk involved and possible complications. Please check with your surgeon regarding the details of these risks and complications.

Breast reduction is usually done as an outpatient procedure in a hospital, surgery center or office. The surgery usually takes 2-4 hours. Breast reduction surgery is usually performed under general anesthesia.

Some women can return to work in about 2 weeks and others may take as long as 4-6 weeks depending on their job requirements.

Most patients are very satisfied with their operation and most are symptom free compared to their preoperative condition.

CHEMICAL PEELS
A chemical peel is used to improve and smooth the texture of the skin of the face by removing its damaged outer layers. It will not correct loose skin. It uses a chemical solution, e.g. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs). AHAs produce the light peel used for minor cases. TCA is used for medium depth peeling while Phenol is used for deep peeling. Chemical peel can help those individuals with fine to coarse wrinkles, facial blemishes, sun-damaged skin areas, pre-cancerous skin growth, acne and uneven skin pigmentation. Chemical peel can be used alone or in conjunction with a facelift or a forehead lift.

Chemical peel is normally a safe procedure when it is performed by a qualified and experienced plastic surgeon. However, like many other procedures it carries some risks and possible complications. Please check with your surgeon about the risks and complications of Chemical peel.

Most chemical peels are performed safely in an outpatient facility, e.g., in a plastic surgeon's office, or outpatient surgical center.

No anesthesia is required for phenol or TCA peels. Sedatives may be given before and during the procedure to keep you relaxed and comfortable. No anesthesia is needed for AHA peels.

A chemical peel using AHAs or TCA usually takes 10-15 minutes to apply. After care treatment and repeat of the peel may be needed, Check with your surgeon.

A phenol peel generally takes 1-2 hours to perform for the whole face. Smaller areas of the face will need less time. A single treatment usually suffices.

Most of the time, with lighter peels, it takes about two weeks before you may return to work and resume some of your normal activities. You may be able then to use make up. With deeper peels you will need longer period.

DERMABRASION
Dermabrasion and dermaplaning use surgical scraping to "refinish" the skin's top layers. This is in contrast to chemical peel which uses a caustic solution for refinishing of the skin. Both dermabrasion and dermaplaning can be performed on small areas of skin or on the entire face. They can be used alone, or in conjunction with other procedures such as chemical peel or facelift.

Dermabrasion is most often used to improve the look of facial scars caused by accidents or previous surgery, or to smooth out fine facial wrinkles. It is used sometimes to remove pre-cancerous skin growths. Dermaplaning is commonly used to treat deep acne scars.
While chemical peel is used more often to treat fine wrinkles, dermabrasion and dermaplaning are used to treat deeper scars.

Dermabrasion and dermaplaning are usually done on an outpatient basis, in a surgeon'office, an outpatient surgery center, or a hospital.

Dermabrasion and dermaplaning may be performed under local anesthesia. In more severe cases, general anesthesia are used.

Dermabrasion and dermaplaning usually take from a few minutes to an hour and a half, depending on the area involved. These procedure may be done more than once.

In dermabrasion, the surgeon scrapes away the outermost layer of skin until he reaches a safe level that will make the scar or wrinkle less visible.

In dermaplaning, the surgeon uses a hand-held instrument to evenly "skim" off the surface layers of skin until the lowest point of the acne scar becomes even with the surrounding skin.

Most of the patients will be back at work in about two weeks.

Dermabrasion and dermaplaning are normally safe when they're performed by a qualified, experienced physician.

EAR SURGERY
Ear surgery (otoplasty) is usually done on children, age 4-14, to set protruding ears back closer to the head or to reduce the size of large ears. Ear surgery can also be done to correct the ears in adults. Many other ear procedures are available to correct the different problems in the shape of the ears. Surgeons can also build new ears for those who were born without ears or those who lost them through injury or disease.

Ear surgery is usually performed as an outpatient procedure. General anesthesia for young children and local for older children or adults is usually the norm.

Ear surgery may take 2-3 hours. Recovery is usually uneventful and most children will be return to school in 7-10 days.

As with any surgical procedure, there are some risks and possible complications which should be discussed with your surgeon.

ENDOSCOPIC PLASTIC SURGERY
Endoscopy is a type of surgical technique that involves the use of an endoscope, a pencil-like lighted camera, that allows a surgeon to use very small incisions made in inconspicuous areas to see the internal structure of the body and perform the surgical procedure.

Endoscopy has the advantages of minimal scarring, less bleeding and bruising, less chance of nerve damage and quicker recovery.

Most of the endoscopic procedures are performed on an outpatient basis, usually under local anesthesia with IV sedation.

Tummy tuck, forehead lift and brow release, face lift, breast augmentation, flap surgery, carpal tunnel surgery and placement of tissue expanders are some of the procedures done using the endoscope.

Endoscopic procedures performed by experienced plastic surgeon are generally safe. As with any surgical procedure, there are some risks and possible complications which should be discussed with your surgeon.

EYELID SURGERY
Eyelid Surgery (blepharoplasty) is a procedure used to correct loose skin and sagging around the eyes and removing fatty deposits which cause puffy bags beneath the eyes. This is done by removing the excess fat, skin and muscle from the upper and lower eyelids. This procedure can also be used to add a crease to the upper eyelid in Asian patients.

Eyelid surgery can be done alone or in conjunction with other procedures: facelift, browlift, nose or ear surgery.

Eyelid surgery is usually done as an outpatient, in a surgeon's office, an outpatient surgery center, or a hospital. It is usually performed under local anesthesia. Some surgeons prefer to use general anesthesia. The procedure usually takes 1-2 hours, depending on the extent of the surgery.

Eyelid surgery has infrequent and usually minor complications when performed by a qualified surgeon. Most people return to in 7-10 days and are able to wear makeup then.

FACELIFT
Facelift is one of the best known and most satisfying cosmetic procedures. It reverses the effects of the aging face and uplifts an individual's sense of well being by restoring a youthful look to the face.

During a facelift, excess fat and skin is removed and the underlying tissue is tightened, redraping the neck and facial skin. Sometimes, a facelift is also done with other procedures, e.g., forehead lift, eyebrow lift, eyelid surgery, or nose surgery.

Most facelifts are done as outpatient procedures in a surgeon's office, outpatient surgery center or a hospital. Many are done under local anaesthesia. The procedure takes about 3 hours.

Most patients can return to work in 10 to 14 days.

Facelifts are generally safe procedures. As with any surgical procedure of any magnitude, there are some risks and benefits which should be discussed with your surgeon.

LASERS IN PLASTIC SURGERY
Lasers are being used in many plastic surgery procedures. Laser treatment of the damaged or wrinkled skin has proven itself when used for the fine lines around the mouth and the eyes, acne scarring, or other facial scars, sun damaged skin, or areas of uneven pigmentation on the face. Laser resurfacing is one of several methods being used by plastic surgeons to remove damaged skin. Laser surgery of the skin is a bloodless procedure that produces minimal scarring. We now know that laser peel of the skin stimulates new collagen within the skin.

When used for the face, laser peel may be performed on the whole face or in specific regions, either alone or in conjunction with other cosmetic procedures, such as a facelift or eyelid surgery.

After evaluation, your plastic surgeon however may advise you that an alternative skin resurfacing treatment, such as dermabrasion or chemical peel, may be a better choice.

Complications from laser peel are infrequent and usually minor, when performed by a qualified, plastic surgeon.
You will likely be asked to take some antibiotics and antiviral medications just prior to and just after the procedure to help prevent infectious complications. Laser resurfacing is usually done as an outpatient procedure in an outpatient surgery center, a surgeon's office, or in a hospital. It is usually performed under local anesthesia. For more extensive resurfacing, general anesthesia may be used.

Laser resurfacing usually takes anywhere from a few minutes to 1 1/2 hours, depending on the size of the area involved.

Your post operative care will be managed closely by your surgeon who will help you during the postoperative period when your new skin will be pink to red. After about two weeks, most patients can safely apply makeup to conceal this temporary pink to red color change. Following your surgeon's advice and prescribed treatment will ensure you n uneventful recovery and good results.

LIPOSUCTION
Liposuction, fat suction, or suction lipectomy is one of the most popular cosmetic procedures. It is the technique to remove unwanted fat deposits from specific areas of the body.

Liposuction has been used to remove fat from the abdomen, thighs, hips, buttocks, calves, knees, ankles, chin area, jowls, cheeks, neck, chest and the upper arms. It should not be a substitute for weight reduction, but only a method of removing focal fatty tissue that doesn't respond to dieting and exercise.

The best candidates for liposuction are those of normal to slightly above normal weight who have pockets of excess fat in specific areas of their body that didn't respond to dieting or exercise.

Liposuction is usually done as an outpatient procedure. Depending upon the surgeon's evaluation of the patient, general or local anesthesia is required.

The tumescent technique is now commonly used and decreases postoperative recovery time. This technique enables the surgeon to remove larger volumes of fat under local anesthesia.

Liposuction is normally safe, however, as with any surgical procedure, there are some risks which should be discussed with your surgeon.

The costs of liposuction will vary depending upon the extent of the surgery and areas treated.

Depending on the extent of your procedure, it may take you few days to 2-3 weeks to recover from surgery.

MALE PLASTIC SURGERY
More men in our society are requesting cosmetic surgery to look young and fit. They may wish to have a trimmer waistline, a rejuvenated face, more hair on the head or a better shaped nose.

Facial Surgery : Facelift, necklift, forehead lift, eyelid surgery, nose surgery or removing a fatty area beneath the chin, can all be performed on men who should understand that the outcome of their surgery is very much influenced by the hair growth and beard growth. The incisions for such procedures have to be individualized to hide the scars behind a recessing hair line or a balding scalp.

Hair Replacement : This is one of the most common procedures requested by men. Hair replacement using hair transplant usually requires multiple surgical procedures, with long recovery intervals. It can take up to 2 years to complete a full procedure. Other alternatives to hair-transplant options, such as flap surgery or scalp reduction are less time consuming for recovery.

Liposuction and Body Contouring : Liposuction is usually very effective in men to remove the fatty areas that are resistant to diet and exercise. This includes areas around the neck and chin, around the abdomen and flanks (love handles), and the breast (gynecomastia).

Tummy Tuck: Tummy tuck or "Abdominoplasty" removes excess fat, tightens the muscles of the abdominal wall, and trims the waistline. This procedure is especially useful for those who have excess skin from massive weight loss or because of chronic large hernia that stretched their skin or men with loose abdominal muscles.

Cosmetic muscle enhancement : Cosmetic implants and sculpting techniques are now used to improve muscle contours of otherwise healthy men. Pectoral muscle implants (for the chest) and calf implants (for the leg) are just two examples.

NOSE SURGERY
Reshaping of the nose (Rhinoplasty) is one of the most common plastic surgical procedures. Thousands of people every year choose this procedure to change the size or shape of their noses. Rhinoplasty can change the size of your nose, change the angle between your nose and your upper lip, change the shape of the tip or the bridge, or narrow the width of the nostrils. It may also correct birth defects or breathing problems.

Teenagers are best treated after their growth spurt, around age 14-15 for girls and 15-16 for boys.

Rhinoplasty is usually done on an outpatient basis, in the surgeon's office, an outpatient surgical facility or in a hospital. Complex procedures may require an overnight hospital stay. Rhinoplasty can be performed under local or general anesthesia. An external splint on the nose may be required for about one week after the operation.

A rhinoplasty procedure usually takes 1-2 hours, though complicated procedures may take longer. Most rhinoplasty patients return to school or simple work within a week.
As with any surgical procedure, there are some risks which should be discussed with your surgeon.

SPIDER VEINS
Spider veins are small, thin clusters of red, purple or blue veins that lie close to the surface of the skin. They affect millions of women, and commonly appear on the thighs and legs.

Today, many plastic surgeons are treating spider veins by injection treatment of a sclerosing solution or with lasers, which causes them to collapse and fade away. Lasers are particularly useful in treating small ares of veins of the face and legs.

The best candidates for treatment of these spider veins are women of any age whenever these veins become noticeable. Pregnant or breastfeeding women who experience spider veins should know that some of these veins will disappear on their own within three months after the baby is born.

Injection treatment or lasers treatment of spider veins is a relatively simple procedure that requires no anesthesia. It is performed in an outpatient setting, e.g. your doctor's office, an outpatient surgical center or a hospital. It usually takes 15-45 minutes. There is no disability associated with this procedure and most patients can resume their normal work immediately.

Complications from this treatment are extremely rare when the procedure is performed by a qualified practitioner.

TATOO REMOVAL
Tattoo removal has been made easy by the advent of laser treatment. Plastic surgeons use the laser treatment to remove tattoo, leaving minimal scaring. Results vary depending on the depth of the tattoo and the kind of ink used.

Tattoo removal is performed as an outpatient procedure in the surgeon's office, in an outpatient surgical center or a hospital. Usually 3-5 treatments are needed, depending on the size, number and depth of the tattoo.

As with any surgical procedure, there are some risks which should be discussed with your qualified surgeon.