Aesthetic (Plastic) Surgery Procedures offered by Dr. Tumi
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Breast Surgery
Face & Neck
Other parts of the body
Breast Augmentation or Enhancement
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:
- To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
- To restore breast volume lost due to weight loss or following pregnancy
- To achieve better symmetry when breasts are moderately disproportionate in size and shape
- To improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure
- To provide the foundation of a breast contour when a breast has been removed or disfigured by surgery to treat breast cancer
- To improve breast appearance or create the appearance of a breast that is missing or disfigured due to trauma, heredity, or congenital abnormalities
By inserting an implant behind each breast, surgeons are able to increase a woman's bust line by one or more bra cup sizes. If you're considering breast augmentation, this will give you a basic understanding of the procedure—when it can help, how it's performed and what results you can expect. Please ask Dr. Tumi if there is anything you don't understand about the procedure.
The Best Candidates For Breast Augmentation
Breast augmentation can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Tumi.
The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate.
Types of Implants
The choice of implant filler, implant size, shape and other features will be determined based on your breast anatomy, body type and your desired increase in size. Your lifestyle, goals and personal preferences, as well Dr. Tumi's recommendations and sound surgical judgment are also determining factors. Implant manufacturers occasionally introduce new styles and types of implants, and therefore there may be additional options available to you.
Breast implants are medical devices with a solid silicone, rubber shell. The implant shell may be filled with either saline solution (sterile salt water) or elastic silicone gel. Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an implant has been rigorously researched, tested and reviewed by an independent panel of physicians for safety.
The size of a breast implant is measured in cubic centimeters (cc's) based on the volume of the saline or silicone filler. Breast implants vary both by filler and in size, but there are additional features to consider:
- Texture: the implant shell may be smooth or textured
- Shape: the implant may have a round profile or one that is anatomic (teardrop or tapered shape)
- Profile: the implant may have a low, medium or high projection (the depth of the implant from the base to the highest point of the implant curve)
- Diameter: the width of the implant measured across it's base (the side of the implant that will be positioned over the chest wall)
Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a woman's breasts are fully developed prior to placement of breast implants. Saline implants are FDA approved for augmentation in women 18 years of age and older. Silicone implants are FDA approved for augmentation in women age 22 and older. Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.
You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Regular examinations for breast health and to evaluate the condition of your implants are important whether you have chosen saline or silicone breast implants.
All Surgery Carries Some Uncertainty and Risk
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.
As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.
A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.
Some women report that their nipples become oversensitive, under sensitive or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.
Breast implants do not generally interfere with a woman's ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman's body may alter the results of any breast surgery, including surgery to place breast implants. Therefore, it is important to discuss the options of breast implant surgery with your plastic surgeon if you are interested in becoming pregnant and breast feeding in the future.
Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak.
If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be absorbed and naturally expelled by the body.
If a silicone-gel filled implant leaks or breaks, the elastic silicone gel may remain within the implant shell, or may escape into the breast implant pocket (a capsule of tissue that surrounds the implant). A leaking implant filled with silicone gel may not deflate and may not be noticeable except through imaging techniques such as an MRI. For this reason, a woman with silicone breast implants is advised to visit her plastic surgeon annually to assess that her implants are functioning well. An ultrasound exam or MRI screening can assess the condition of breast implants; after 3 years it is recommended that all silicone implants be properly screened.
Following the placement of breast implants mammography is technically more difficult. Obtaining the best possible results requires specialized techniques and additional views. In many cases, an ultrasound exam or MRI may be recommended in addition to mammography.
While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.
Planning Your Surgery
In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift.
Be sure to discuss your expectations frankly with your surgeon. You may want to ask your surgeon for a copy of the manufacturer's insert that comes with the implant he or she will use—just so you are fully informed about it. And, be sure to tell your surgeon if you smoke and if you're taking any medications, vitamins, or other drugs.
Your surgeon should also explain the type of anesthesia to be used, the type of facility where the surgery will be performed and the costs involved. Because most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure.
Preparing For Your Surgery
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison.
In addition to explaining your surgical procedure, you plastic surgeon will discuss anesthesia, the recovery process and your obligations as a patient. You will also discuss where your procedure will be performed. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications of your surgery. There may be a waiting period of several days to weeks from the time of your consent to the day of surgery.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Types of Anesthesia
Breast augmentation can be performed with a general anesthesia, so you'll sleep through the entire operation. Some surgeons may use a local anesthesia combined with a sedative to make you drowsy, so you'll be relaxed but awake and may feel some discomfort.
The Surgery
The method of inserting and positioning your implant will depend on your anatomy. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple) or in the armpit. In addition, a saline implant may be placed through an incision at the navel. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Working through the incision the surgeon will lift your breast tissue and skin to create a pocket either directly behind the breast tissue (sub mammary or sub glandular placement) or beneath the pectoral muscle and on top of the chest wall (sub muscular placement). Once the implant is positioned within this pocket, the incisions are closed with sutures, skin adhesive and/or surgical tape. A gauze bandage may be applied over your breasts to help with healing.
The surgery usually takes one to two hours to complete. You'll want to discuss the pros and cons of these alternatives with your doctor before surgery to make sure you fully understand the implications of the procedure he or she recommends for you.
After Your Surgery
You're likely to feel tired and sore for a few days following your surgery but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication.
Within several days the gauze dressings, if you have them, will be removed. You may be given a surgical bra. You should wear it as directed. You may also experience a burning sensation in your nipples for about two weeks but this will subside as bruising fades. Your stitches will come out in a week to 10 days but the swelling in your breasts may take three to five weeks to disappear.
Getting Back to Normal
You should be able to return to work within a few days depending on the level of activity required for your job. Follow the advice given on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks. Breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
Routine mammogram's should be continued after breast augmentation for women who are in the appropriate age group although the technician should use a special technique to assure that you get a reliable reading.
Your New Look
For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance. Even if you believe your implants are functioning well, it is important that you follow-up as directed with your plastic surgeon to assess the condition of your breast implants. In addition, whether you choose to have breast implants or not, it is essential to your health that you practice a monthly breast self-exam and schedule regular diagnostic breast screenings.
For further information about breast augmentation or enhancement, please visit ASPS and/or www.plasticsurgery.ca
BREAST Mastopexy or lift
Over the years, factors such as pregnancy, nursing and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity the breasts often lose their shape and firmness and begin to sag. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts--at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you're considering a breast lift, this information will give you a basic understanding of the procedure--when it can help, how it's performed, and what results you can expect. Please be sure to ask if there is anything about the procedure you don't understand.
The Best Candidates For Breast Lift
A breast lift can enhance your appearance and your self-confidence but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.
Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.
All Surgery Carries Some Uncertainty and Risk
A breast lift is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon but they can cause scars to widen. You can reduce your risks by closely following your physician's advice both before and after surgery.
Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.
Planning Your Surgery
In your initial consultation, it's important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient--and every physician, as well--has a different view of what is a desirable size and shape for breasts.
The surgeon will examine your breasts and measure them while you're sitting or standing. He or she will discuss the variables that may affect the procedure--such as your age, the size and shape of your breasts, and the condition of your skin--and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned; they'll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.
Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He or she should also explain the anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.
Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing For Your Surgery
Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Types of Anesthesia
Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. In selected patients--particularly when a smaller incision is being made--the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort.
The Surgery
Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.
The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy," in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.
If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.
After Your Surgery
After surgery, you'll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon.
Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.
If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.
Getting Back to Normal
Healing is a gradual process. Although you may be up and about in a day or two, don't plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don't hesitate to call your surgeon.
Your surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
Your New Look
Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.
You should also keep in mind that a breast lift won't keep you firm forever--the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer. Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.
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Face Lift
As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck.
A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and re draping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
If you're considering a facelift, this information will give you a basic understanding of the procedure, when it can help, how it's performed and what results you can expect. Please ask about anything you don't understand.
The Best Candidates For a Facelift
The best candidate for a facelift is a man or woman whose face and neck have begun to sag but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties but facelifts can be done successfully on people in their seventies or eighties as well.
A facelift can make you look younger and fresher, and it may enhance your self-confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery think carefully about your expectations and discuss them with your surgeon.
All Surgery Carries Some Uncertainty and Risk
When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.
You can reduce your risks by closely following your surgeon's advice both before and after surgery.
Planning Your Surgery
Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone and discuss your goals for the surgery.
Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems or the tendency to form excessive scars. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
If you decide to have a facelift, your surgeon will explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing For Your Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it's especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas. If your hair is very short, you might want to let it grow out before surgery, so that it's long enough to hide the scars while they heal.
Whether your facelift is being done on an outpatient or inpatient basis you should arrange for someone to drive you home after your surgery and to help you out for a day or two, if needed.
Types of Anesthesia
Most facelifts are performed under local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your face will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)
Some surgeons prefer a general anesthesia. In that case, you'll sleep through the operation.
The Surgery
A facelift usually takes several hours-or somewhat longer if you're having more than one procedure done. For extensive procedures some surgeons may schedule two separate sessions.
Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time and others move back and forth between the sides. The exact placement of incisions and the sequence of events depends on your facial structure and your surgeon's technique.
Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear) and continue behind the earlobe to the lower scalp. If the neck needs work a small incision may also be made under the chin.
In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.
Following surgery a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. The surgeon may also wrap your head loosely in bandages to minimize bruising and swelling.
After Your Surgery
There isn't usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.
Your doctor may tell you to keep your head elevated and as still as possible for a couple of days after surgery to keep the swelling down. If you've had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don't be surprised at the pale, bruised and puffy face you see. Just keep in mind that in a few weeks you'll be looking normal. Most of your stitches will be removed after about five days. Your scalp may take longer to heal and the stitches or metal clips in your hairline could be left in a few days longer.
Getting Back to Normal
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair since your skin will be both tender and numb.
Your surgeon will give specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks and you may tire easily. It's not surprising that some patients are disappointed and depressed at first.
By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Your New Look
The chances are excellent that you'll be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places-behind the neck and ears-where areas of beard- growing skin have been repositioned.
You'll have some scars from your facelift, but they're usually hidden by your hair or in the natural creases of your face and ears. In any case, they'll fade within time and should be scarcely visible.
Having a facelift doesn't stop the clock. Your face will continue to age with time and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you'll continue to look better than if you'd never had a facelift at all.
For further information please visit ASPS and www.plasticsurgery.ca.
Botox
Botox Cosmetic® is a purified protein produced by the Clostridium Botulinum bacteria. It has been used for wrinkle therapy since the early 1990's with no serious side effects documented.
A small amount of Botulinum toxin is injected right into the muscles that are responsible for creating wrinkles or undesirable facial muscle effects. This treatment is quick and results usually last for three to six months. The toxin temporarily inactivates the muscles that produce wrinkles, thereby causing lines to disappear or diminish dramatically. It usually takes a few days after the injection to notice the wrinkle smoothing effect.
Some of the common areas treated with botox include crow's feet, frown lines, laugh lines and forehead wrinkles. The toxin can also be injected to weaken the muscles responsible for a "gummy smile", which can improve this appearance dramatically. Injections into muscles that lower the eyebrow or corners of the mouth can produce a form of temporary brow lift or lip lift.
After the first treatment you may return for follow-up injections. Some doctors report that after several treatments, the effect of Botox Cosmetic® appears to last longer, often up to several months.
Complications from botox injections to the upper eyelid include occasional bruising from the injection and a temporary drooping of the eyelid, which rarely occurs after frown line injection. The injected medication is used in extremely small amounts and does not spread throughout the body so you can return to full activity immediately.
Botox Cosmetic® can be used by almost anyone, however, patients who are pregnant, breastfeeding or who have a neurological disease should not use it.
New uses for Botulinum toxin include reduction in sweating of hands and armpits (hyperhydrosis) and relief of headaches.
Your plastic surgeon will discuss the details of this with you. For further information about Botox treatment, please visit www.plasticsurgery.ca.
brow lift
Overhanging skin in the upper eyelids can be
addressed in two ways: an upper eye lid lift
or a brow (forehead) lift. While in the past
surgeons often chose to automatically
perform an upper eyelid lift to correct sagging
of the upper lid, a brow lift is often used
today to create the same result.
A brow lift can be performed alone or it may
be performed at the same time as a facelift
to remove excess skin and tighten muscles
in the middle and lower face.
Younger adults who have a naturally low
brow, or who already have deep frown lines
due to stress or muscle over activity, may
also benefit from a brow lift. Sometimes,
patients may focus their attention on excess
skin in the upper eyelids and not realize that
it is their sagging eyebrows that are the
cause of the problem.
Your plastic surgeon will explain the benefits of both eyelid surgery and brow lift
as each procedure applies to you.
The surgical technique that your plastic surgeon recommends will depend on
things such as the position of your eyebrows, the amount of excess upper eyelid
skin you have and the height of your hairline (the height of your hairline can be
altered a little after surgery).
Often, an incision is made across the top of
the scalp, beginning above the ears and
hidden in the hair. Sometimes, the incision
may be placed in front of the hairline. The
incision is designed to be inconspicuous once
healed. Through these incisions, your plastic
surgeon can modify or remove parts of the
muscles that cause frown lines, remove
excess skin, and lift your eyebrows to a more
youthful level.
Another forehead lift technique uses an
endoscope. This is a long, thin tube with a
light on the end, attached to a video camera.
The endoscope is inserted through a few tiny
incisions in the scalp. It allows your plastic
surgeon to see and work on the inside
structure of the forehead. The endoscopic
technique has the advantage of requiring
minimal incisions, but it may not be
appropriate for all patients.
If your main concern is frown lines between your eyebrows, a limited endoscopic
procedure can be performed to correct these problems. If you are having upper
eyelid surgery performed, it may also be possible to treat frown lines by way of
the incisions that are made in the upper eyelid.
Complications from a brow lift are infrequent, but can include prolonged numbness
and itching, and minor hair loss where the scalp incisions were made which is
usually temporary and is easy to conceal.
Swelling and bruising are usually gone within two weeks. You may use
camouflage makeup almost immediately. You will have an accurate idea of how you will look within a few weeks.
For further information please click here.
blepharoplasty (eye lids)
Some people have eyelid surgery to correct problems that are
a result of aging, while others have inherited traits such as
bags under their eyes that cause them to seek treatment at a
younger age.
If the upper eyelid condition is accompanied by sagging of the
eyebrows, then a forehead (brow) lift may be recommended.
Smoothing of crow's feet may require Botox, chemical peeling
or laser resurfacing procedures. Circles beneath the eyes
caused by dark pigmentation may be treated with a bleaching
solution or chemical peel.
Alternately, sinking around the bony orbit below the eye can
be addressed with fat grafting or a mid face lift.
High blood pressure, thyroid problems or diabetes are some of the conditions that can increase the risks during eyelid surgery. Your plastic surgeon will ask if you have allergies or if you have been told that you have "dry eye" or any other eye problems.
There are two different approaches to lower lid surgery. One
uses an external incision and the other is performed from
inside the lower lid. Your age and the extent of the fatty
deposits you have will determine which approach is preferred.
The incision is hidden within the natural fold of the upper
eyelid for upper eyelid surgery and it is through this incision
that excess skin and fat are removed.
Because the incision follows the natural contour of the upper
eyelid, it will be well camouflaged when it has healed.
For lower lid surgery the incision is usually hidden below the
lower lashes. Through this incision, excess skin, muscle and
fat are removed. Fat may also be redistributed to improve
puffiness or bulges. Other adjustments such as canthopexy
(eyelid tightening) may be done to correct special problems
such as muscle laxity.
You and your plastic surgeon may decide that the best
approach for removing excess fat is a technique that needs no
external incision. This procedure is called trans-conjunctival
lower blepharoplasty. While it is a good approach for younger
patients, it cannot be used to remove excess skin so a laser
may be used in conjunction with this method to tighten the
skin under the eyes.
After your surgery, you may have a feeling of dryness or
irritation in the eye. This may require treatment. There is
also a chance of a temporary reduction in eyelid sensation
or impaired eyelid function.
Impaired lid function may be treated with additional surgery.
Mild swelling persists for several weeks in some cases while
others see swelling resolve in just seven days. Bruising is gone
in most people in seven to ten days and you may use makeup within the first week to hide discoloration.
You may find your eyes are temporarily sensitive to light. You may also experience some excess tearing or dryness. Your plastic surgeon may recommend eye drops to relieve burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from the wind and sun.
The incision lines will fade over several months until they become barely visible.
For further information about brow lift, please click here.
Abdominoplasty (tummy tuck)
People are sometimes left with empty, hanging folds of skin after pregnancy, serious weight loss or sometimes just with aging. When this loose skin is surgically removed from the belly, it is called abdominoplasty or tummy tuck or body contouring. When the skin is removed around the whole waist to raise the buttock, lateral thighs and trim the tummy, it is called body lifting. From the upper arms, we call it brachioplasty. Thigh lifting is for loose inner thigh skin or posterior thigh skin.
This surgery is designed to tighten loose and flabby skin. Body
contouring surgery changes the texture of the skin by stretching
it thereby making the looseness and wrinkling less apparent.
Body contouring surgery may be combined with liposuction.
Liposuction is designed to improve fat bulges, not to tighten
loose skin. In fact, liposuction alone can make the appearance
of the skin worse in patients with poor skin elasticity.
As with liposuction, body contouring surgery is not intended
to correct obesity; patients should be at normal or near-normal
weight before surgery.
Although abdominoplasty is sometimes done under local
anesthesia, most other body contouring surgery requires
general anesthesia.
Loose skin cannot be removed without leaving scars, and
body contouring often means long incisions that result in long
scars. Your plastic surgeon will make every effort to give you
the best scars possible and to conceal them in the least visible
areas.
Although scars will fade over time, you should know that the
scars will be permanent and that their final width, height and
color are not entirely predictable.
The most common complications of body contouring surgery
are hematoma (an accumulation of blood under the skin),
seroma (fluid accumulation under then skin) and numbness
of the skin. Most of the feeling usually comes back. Hematoma and seroma may require intervention to drain the blood or serum that has accumulated if it is a large amount. Problems with healing after surgery are also possible, especially if you are a smoker.
Normal activities can usually be resumed within a couple of weeks and many people return to work the third week after surgery.
It can take 6-12 months to see the final result of body contouring surgery.
For further information about abdominoplasty, please click here.
liposuction
Women and men who are not overweight but
have isolated areas of fat that they cannot get
rid of through diet and exercise are good
candidates for liposuction. Liposuction is not
effective for cellulite. Liposuction can be effective on many areas
of the body: arms, abdomen, hips, thighs,
calves, ankles, and under the chin. You are more likely to get good results from
this procedure if your skin has good tone
and elasticity which helps to achieve a
smooth result following fat suctioning.
Your plastic surgeon will assess the quality of your skin and may ask you how
your areas of localized fat were affected by weight loss in the past.
Fat is removed by first inserting a small tube
(a cannula) through tiny incisions close to the
area to be suctioned. Incisions are very small
- usually under a quarter inch.
Though infrequent, some complications
include bleeding, infection and reaction to
anesthesia. Skin numbness is to be expected
and is usually only temporary. It is possible,
however, for some numbness to persist or
even be permanent. Occasionally, there is
skin discoloration in the areas that have been
treated. Irregularities of the skin surface,
including depressions or wrinkling, can occur.
You may be asked to wear a compression garment for the first several days after
surgery so that the tissue can "learn" its new shape.
You can usually return to work in just a few days, though you may still have some
swelling and bruising which usually subsides within a couple of weeks. It is not uncommon for a touch up to be required later to further improve an area
that has been treated.
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