Many patients nowadays are seeking removal of their breast implants because of what is referred to as breast implant illness. Such a term is referred to a variety of signs and symptoms related to be caused by breast implants. These symptoms may include weakness, chronic pain, fatigue, neurological disorders, endocrine problems, allergies, anxiety, rash and autoimmune disorders.
A recent article published by the Plastic and Reconstructive Surgery Journal in September 2017, discusses a survey of over 340 posts and comments, on patients that required explantation for symptoms related to breast implant illness and no patients expressed regret after explantation.
One of the most important factors regarding the outcomes of procedures is patient-doctor communication. Over many years, we at the Rosenstock Lieberman Center for Plastic Surgery have stressed the importance of taking the time to listen to the patient’s personal needs and concerns. When we understand your expectations, we can better discuss which surgical options are best for you to achieve the results you desire.
Our goal on breast implant explantation procedures is to assure the patient that we will perform the following process:
Perform Enbloc when possible with total capsulectomy to ensure 100 percent of the capsule is removed.
Take pictures of the implant, capsule and clean out of any and all residual implant, capsule, silicone or saline within the chest cavity.
Perform a Breast Lift, if necessary, with the patients own tissues and/or perform enhancement of the breasts by structural fat grafting (transfer) to achieve a better fullness of the breast.
Not only do we perform fat grafting on breasts that is cosmetically required at the moment of explantation, but also store the patient’s own fat in case a revision is needed later during the next 12 months after the primary procedure . We have been performing fat grafting on different areas of the body for the last 30 years ago with great success.
The surgeons at Rosenstock Lieberman Center are committed to creating individualized patient care and realistic expectations that will ensure your satisfaction.
The process of losing hair is a natural occurrence. We normally lose about 40-200 hairs daily. Our hair starts to thin out when the lost hairs outnumber the regrowth of the follicles. There are multiple causes of hair loss, the most important being hereditary (genetic). This means that every hair follicle has its life course predicted from the time we are in the womb. Other causes are hormonal, stress, scarring after scalp trauma, bad nutrition and medications.
Male pattern baldness starts at different ages and areas of our head, most commonly in the crown and/or temples and frontal hair line. A female's hair loss is more of a generalized thinning of the hair affecting the whole scalp. All persons are possible candidates for hair restoration. The one important factor is the donor area, Occipital (back) and temporal areas (sides) of each candidate. The reason why the hair is taken from the Occipital or temporal areas of the scalp are these hairs will not fall in our lifetime. If you see persons in their eighties or nineties, they usually have hair in the occipital and temporal areas. It is very rare to see complete baldness unless there is some type of medication or illness behind it. Transplanted hair is for life. We have been doing hair transplants for 25 years and have gone through the evolution form large (3-3.5 millimeters) plugs (7-10 hairs per grafts) to the present mini (3-4 hairs) and micro grafts (1-2 hairs), (1-1.75 millimeters). Presently we place several hundred to over a thousand grafts per session. Our vast experience and the usage of mini and micro grafts provide each patient with a natural look, which is the most important aspect of this procedure.
Hair transplants are done in our surgical suites as an out-patient procedure with local anesthesia. The session takes an average of 2-4 hours depending on the number of grafts used. The first consultation involves a complete history of the medical and hair condition of the patient. Each patient is evaluated in a unique way. All aspects of hisher hair are evaluated donor area, recipient area, combing styles, how many grafts and/or sessions are needed to achieve each patient's goals. What is transplanted is the follicle, which is from where the hair grows; this is inside the skin of our scalp. It is the follicle that has the genetic information of not to fall. We could transplant this follicle to any place in the same patient's body and it will grow. The procedure involves harvesting the grafts from the donor area (strip of hair) and placing them was they are needed (frontal hairline, crown area).
The donor area is washed, outline and trimmed. Next the local anesthesia is applied and the grafts are harvested. After harvesting, the donor area is sutured. The donor area is invisible since it is covered by your hair; and the suture line is very thin.
The next step is the cleaning and preparing of the mini-micro grafts for insertion into the recipient sites. The recipient area is anesthetized and then the grafts are placed in the normal direction that hair grows.
After the grafts are inserted a bandage is placed over the scalp. This dressing is removed on the morning after the procedure. The dressing is to keep the area clean and all the grafts in place for a few hours.
The patient is seen in our center the day after the procedure to remove the dressing and have a shampoo. After combing their hair they are ready to go home or work. The first 6-7 days after the procedure the patients are asked to restrain from strenuous physical activities (jogging, playing sports), they are not allowed to go to swimming pools or the ocean for 15 days. He/She can start to do all hisher desk work, or light activity the second day. On the 8th postoperative day the sutures are removed. A scab will form over each transplanted graft. All the scabs will fall off by themselves around the 10th postoperative day. Transplanted hair starts to grow around the second month after the procedure at 1 centimeter per month for the rest of the patient's life. Once the hair starts to grow it can be treated as your normal hair; cut, wash, and comb it. This is for life.
As people age, the effects of gravity, exposure to the sun and stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck. These changes occur at different rates in different people, and are unavoidable.
Not long ago, a facelift was considered by many to be reserved for movie stars and celebrities. Today, a facelift, or rhytidectomy, is not just for the rich and famous. It is one of the most well-accepted and most frequently performed cosmetic procedures in the world. Early facelift operations tightened only the skin, placing all the tension on the suture line. This stress frequently widened the scars, making them and, indeed, the facelift operation very obvious. Since the skin has an amazing capacity for expansion, results were not only less than optimal, they were also short lived and many times with the appearance of an overdone mask.
With a better understanding of anatomy, the tension in a facelift operation has been transferred to the deeper anatomical layers. Therefore, no excessive tension is applied to the skin leaving the natural beauty of the individual.
Today the main goal of a facelift procedure is to give a younger and fresher look preserving the natural characteristics of the patient.
Additional procedures, such as sub mental liposuction, forehead lifting, eyelid surgery, or fat transfer can be performed at the same time to effect a more complete facial rejuvenation.
The operation is performed by making incisions within the hairline above and behind the ear, and in the natural creases area just in front of the ear. By making the incisions in these locations, healing occurs with virtually undetectable scars. The skin is lifted outward and the underlying muscles and tissues are red raped and tightened.
Excess skin is removed, and if required excess fat is aspirated from the neck and jawline areas to define these areas better. The skin is sutured without tension, to ensure the finest scars possible that would lead to a virtually undetectable scar.
The operation is done under local anesthesia and sedation. In most of the cases you'll spend the night at our center, being discharged the following day with professional nursing care.
The bandage is removed the following day and patients are then allowed to shower and wash the hair. Then another bandage is applied for 24hrs more to minimize swelling.
Patients usually feel and look okay surprisingly quickly after a facelift. There is usually very little pain. Bruises are usually gone by the end of the first week.
Although most of swelling disappears within the first two weeks, final results are seen at about 3 months after the surgery. Most people are able to return to their job by the second week with the help of camouflage.
If you are coming from abroad we advise you to stay for 8-10 days in our country.
The eyes, commonly referred to as the windows of the soul, say a great deal about a person. We evaluate people's moods or attitudes by the light in their eyes or its absence. The loose skin over your eyes and the fat bags under them make you look more tired and older than you feel inside.
Contrary to the perception that you have to be a certain age before you need to have your eyes done, young adults may also benefit from removing bags under the eyes or lifting heavy lids. The average person as early as age 25 may have enough laxity in the upper eyelid that they can obtain significant improvement and at age approximately 25-30 for the lower eyelid.
Operations on the eyelids are not only among the most commonly performed plastic surgery procedures but also the ones that give you a high degree of improvement, and satisfaction. It may be performed alone or in conjunction with other facial surgery procedures such as a facelift or a brow lift.
The goal of eyelid surgery is to rejuvenate the face by restoring the shape of the eye. Blepharoplasty is usually performed under local anesthesia and sedation. Fine incisions are placed in the crease above each eye to correct problems of the upper eyelids. Then a thin crescent of excess skin and muscle is removed.
Excess fatty tissue from the middle most portion of the eyelid is also removed. Sometimes there is also excess fatty tissue at the region over the eyebrow that can be removed in the same procedure. The incisions are closed with very fine sutures. The lower eyelid has two surgical approaches. The one we use the most is through a transconjuntival approach which is an incision where the scar is hidden inside the eyelid and is performed in patients that have only excess fatty tissue.
When excess skin and muscle needs to be removed, there is an incision placed in the natural simple crease below the lash line. Skin and muscle are repositioned and excess skin is removed. Neither incision requires any contact with the eyeball itself. When the surgery is finished a lubricating ointment is frequently placed on the eyeball. The whole procedure takes usually between one and a half to two hours.
During the first 24 hours, cold compresses are applied to the eyelids to reduce swelling and bruising. This surgery is done as an outpatient procedure, so if the operation is performed in the morning, you will be discharged in the afternoon after resting in your suite and feel comfortable to go.
This is as close to pain free plastic surgery as you can get. You may be given prescription pain medication, but it is unlikely that you would need to use it for more than a day, if at all. Sutures are removed usually at 48-72 hours. You will be allowed to return to work in three to four days, but most people would wait a week to allow bruising to resolve.
Otoplasty (ear surgery)
The nose is one of the most dominant and distinctive features of the human body. Its central location only serves to confirm its importance. However, when it is the center of attention as well, you can be relatively certain that something is out of balance.
The cosmetic procedure of recon touring the nose is one of the most popular procedures sought by plastic surgery patients today. Reasons for such requests range from recon touring or reshaping the external nose, to straightening a previously injured nose and or improving the patient's ability to breathe.
The ideal nose varies from face to face depending on skin type, ethnic background, age, and other variables. The most important matter sought today by plastic surgeons is to provide a natural looking nose that goes accordingly to the patient's own facial appearance. The patient may elect also to have chin or cheek implants at the same time to enhance and balance their facial features.
Most of the incisions for reducing or recon touring the external nose are made inside the nose. Occasionally a small external incision is necessary, depending on the complexity of the problem. The nasal skin is lifted away from the cartilage and bone and excess tissue is removed. Then the cartilages at the tip of the nose are sculpted to refine the nasal tip.
Sometimes instead of resecting tissues, it is necessary to place grafts that may have been harvested from the patient's own septum or ear.
The procedure is sometimes combined with septum surgery to correct deviations of the nose. Finally, the skin is red raped over the new framework. When the surgery is complete, a splint will be applied to help your nose maintain its new shape and an internal packing is applied for 24-48 hours depending on the extent of the procedure.
This surgery is done as an outpatient procedure, so if the operation is performed in the morning, you will be discharged in the afternoon after resting in your suite and feel comfortable to go. Cold compresses are generally applied at frequent intervals for the first twenty-four hours to minimize bruising and swelling.
You will need to keep your head elevated at all times for the first week, as this will reduce bruising and swelling. You will be able to shower and wash your hair but keep the dressing dry. After the first week of surgery the splint is removed and a much lighter external dressing is applied if necessary.
Patients are usually able to return to desk jobs 3-4 days after the surgery, but most wait a full week to do so to allow for splint removal.
Autologous fat (adipose tissue) transfer is today's number one filling agent for wrinkles and creases on our faces.
Adipose (fat) is a very abundant tissue which we all have in our body. The fat cell has the capacity to increase and decrease in size; this depends on our physical activity. When we lose weight the fat cells decrease in size when we gain weight they increase. We do not get rid of them; for this we have liposuction.
As we age the appearance of wrinkles on our face is inevitable. Even though wrinkles are part of our aging process and there is nothing we can do to stop it, we can attenuate the wrinkles or creases with fat.
Also, the older we get we start to lose our fat from our upper face (cheeks). This fat with loose skin starts to show up in the jowls area, giving us a sad, gloomy look. By placing the fat in the upper third of our face we produce an uplift effect; thereby we reshape the face to the more youthful years.
This procedure can be used alone or in combination with other facial rejuvenation procedures like face lifting, chemical peels, and eyelid surgery to treat wrinkles. It is also used to rejuvenate the dorsum of the hands, nasal labial fold or anybody depression as well as lip enhancement.
Since it is the patient's own fat there is no risk of rejection. No possibility of allergies. It is mainly used to produce a more youthful look and recon touring of the face.
Frequently the fat is taken at the time of a liposuction, even though both methods are totally different regarding the way fat has to be harvested.
We have been using fat grafting for 12 years now with excellent and long lasting results. Since fat is just below the skin the plastic surgeon has easy accessibility to it.
This safe procedure has rare complications. It is the patient’s own fat; local anesthesia is used, and all cannulas are blunt, to harvest and to place the fat into the face (so there is no sharp or cutting instruments during the procedure).
It is done with local anesthesia in our surgical suite as an outpatient procedure. No sutures are needed.
Once the harvesting site is determined (abdomen, hips, thighs) the area is anesthetized. Next the fat is harvested with blunt 1-2 millimeter cannulas. Then the fat is washed and prepared to be placed in the area that needs the improvement. The recipient site is anesthetized and the fat is placed with a blunt cannula.
The amount of fat put in each area is always more than needed. The reason for this is that we know that 50-60% will be absorbed by the body, the rest will stay. We always keep some of the patient's fat in our Fat Bank, Freezer. If in the future you need more grafting to an area we already have it (fat) ready to apply. Most patients need two sessions; but by having the fat in the Bank there is no need to harvest it again. Our own pathological studies have shown that we can still use the fat 12-13 months after harvesting. The cells of the adipose tissue (fat) maintain all their anatomical and physiological properties.
The patient leaves after the procedure is done. We always place some ice over the treated areas so there is the least swelling possible. You can expect swelling for the first 48 hours. All patients are seen the next day after the procedure. Occasionally patients develop ecchymosis (black and blue areas) and if they do, the bruising disappears in 5-7 days. Also they are very easy to cover up with makeup.
Fat grafting is a safe ambulatory procedure done under local anesthesia with long lasting results and no risk of rejection or allergies. All of us have plenty of it.
Autologous fat (adipose tissue) transfer is today's number one filling agent for wrinkles and creases on our faces.
Adipose (fat) is a very abundant tissue which we all have in our body. The fat cell has the capacity to increase and decrease in size; this depends on our physical activity. When we lose weight the fat cells decrease in size when we gain weight they increase. We do not get rid of them; for this we have liposuction.
As we age the appearance of wrinkles on our face is inevitable. Even though wrinkles are part of our aging process and there is nothing we can do to stop it, we can attenuate the wrinkles or creases with fat.
Also, the older we get we start to lose our fat form our upper face (cheeks). This fat with loose skin starts to show up in the jowls area; giving us a sad gloomy look. By placing the fat in the upper third of our face we produce an uplift effect, henceforth we reshape the face to the more youthful years.
This procedure can be used alone or in combination with other facial rejuvenation procedures like face lifting, chemical peels, and eyelid surgery to treat wrinkles. It is also use to rejuvenate the dorsum of the hands, nasal labial fold or anybody depression as well as lip enhancement.
Since it is the patient’s own fat there is no risk of rejection. No possibility of allergies. It is mainly use to produce a more youthful look and recon touring of the face.
Frequently the fat is taken at the time of a liposuction, even though both methods are totally different regarding the way fat has to be harvested.
We have been using fat grafting for 12 years now with excellent and long lasting results. Since fat is just below the skin the plastic surgeon has easy accessibility to it.
This is a very safe procedure with rare complications. It is the patient’s own fat; local anesthesia is used, and all cannulas are blunt, to harvest and to place the fat into the face (so there is no sharp or cutting instruments during the procedure).
It is done with local anesthesia in our surgical suit as an outpatient procedure. No sutures are needed.
Once the harvesting site is determined (abdomen, hips, thighs) the area is anesthetized. Next the fat is harvested with blunt 1-2 millimeter cannulas. Then the fat is washed and prepared to be placed in the area that needs the improvement. The recipient site is anesthetized and the fat is place with a blunt cannula.
The amount of fat put in each area is always more than it is needed. The reason for this is that we know that 50-60% will be absorbed by the body, the rest will stay. We always keep some of the patient’s fat in our Fat Bank, Freezer. If in the future you need more grafting to an area we already have it (fat) ready to apply. Most patients need two sessions; but by having the fat in the Bank there is no need to harvest it again. Our own pathological studies have shown that we can still use the fat 12-13 months after harvesting. The cells of the adipose tissue (fat) maintain all its anatomical and physiological properties.
The patients leave after the procedure is done. We always place some ice over the treated areas so there is the least swelling possible. You can expect swelling for the first 48 hours. All patients are seen the next day after the procedure. Rarely patients present with ecchymosis (black and blue areas) and if they do, they disappear in 5-7 days. Also they are very easy to cover up with makeup.
Fat grafting is a safe ambulatory procedure done under local anesthesia with long last results no risk of rejection or allergies. All of us have plenty of it.
A neck lift treats laxity in the sub mental and neck areas. The muscle underneath called the platysma is treated when there are present deep cords or unsightly bands that may form in the neck.
One of the fundamental steps of the procedure is to remove the excess fatty tissue by means of a liposuction with small cannulas to give a better definition of the mandibular and jaw line.
This is the preferred procedure by many young patients that have an excess of fat or localized flaccidly in the area of the neck, but no mid or upper face flaccidly. Additional procedures, such as eyelid surgery, or fat transfer can be performed at the same time to effect a more complete facial rejuvenation.
Neck lifts are usually performed under local anesthesia and sedation. The first step of the procedure is to infiltrate anesthetic solution using the tumescent technique in a similar way to the one described for the other liposuction procedures, so bleeding is minimized.
Two 0, 3 inches incisions are placed behind the crease of the ears and liposuction is carried out with fine non traumatic cannulas. Following this a small incision is placed in the small crease hidden under the chin in order to complete the liposuction and treat the platysma muscle underneath, so it is repositioned and tightened with sutures.
If there is an excess of skin it is removed at that time. The incisions are then close and a light stockinet-type dressing is applied.
This surgery is done as an outpatient procedure, so you will be discharged after resting in your suite and feels comfortable to go. It is advised to apply cold compresses and to keep the head elevated during the first 48 hours to minimize the swelling.
You may be given prescription pain medication, but it is unlikely that you would need to use it for more than a day, if at all. Sutures are removed usually after 5 to 7 days.
You will be allowed to return to work in two to four days, but most people would wait a week to allow bruising to resolve.
This procedure is indicated for those persons that want to achieve a more youthful and thin arm. The excess skin and adipose tissue are removed.
All person who undergo weight lose either by surgery or dieting know exactly how the skin on their arms was tight when they were overweight, but as soon as they start losing weight the skin under their arms starts to sag. This sagging skin gets in the way of everyday life; it is not aesthetically pleasing and hard to accommodate, and hide under the cloth.
Candidates Persons who have lost significant weight either by gastric bypass and or dieting commonly ask for this surgical procedure. The goal of this surgery is to have thin-tight and contour arms.
Procedure The only way to get rid of this excess skin is by removing it surgically. The procedure most of the time is done with local anesthesia and sedation and it’s performed as an outpatient procedure.
First a liposuction is done to remove any excess adipose tissue and then an incision is made from the inner aspect of the elbow to the axilla. Then we undermine the excess skin and remove it. All sutures placed are reabsorb able, in other words no suture removal is needed.
The incision (scar) is a fine line. For the first couple of months it will look red and it will slowly start fading away.
Recovery The procedure will not incapacitate you; you need to take it easy with arm movements for two weeks. No drains are used. You can expect some swelling and black and blue for a couple of days and minor discomfort. We prescribe analgesic and antibiotics. You will use a garment; for 2-3 weeks, which we provide.
The arm lift procedure can be done at the same time as other procedures, for example tummy tucks, face-lift, and breast surgery.
Results are seen immediately once we make the first dressing change. Significant difference and an attractive smooth arm is what you will see; you will be able to move your arm freely and will be able to wear any type of shirt or sleeveless dress.
Breast Augmentation
Breast enhancement or augmentation is one of the most frequently performed cosmetic surgeries in the world. It is the procedure of choice for women who consider their breasts to be too small or have undergone a process of weight loss, childbirth's or just normal aging, in which the breasts have lost volume and their shape has changed.
The surgery consists of lifting the breast tissue and placing silicone rubber implants, which are then filled in most of the cases with a saline solution. Depending on the desire of the patient, silicone gel implants can be used safely.
One very important matter to take in account is that after several large studies conducted worldwide, it has been clearly demonstrated that there is no scientific evidence that breast augmentation increases the risk of cancer. Breast augmentation will make your breasts fuller and enhance their shape. Often patients start to feel more comfortable finding easier to wear certain styles of clothing providing them a more proportional figure.
Breast augmentation is performed under general anesthesia in the vast majority of cases. Occasionally local anesthesia and sedation is used A very small incision is used, relative to the size of the implants. There are several options of incisions, which will be discussed thoroughly with you before the surgery.
One of the most frequently incision employed is around the lower half of the areola which results in an inconspicuous, almost invisible scar. Then, a pocket is created behind the breast tissue, where the implant is positioned. Sutures are placed to close the incisions, and a gauze bandage and supporting bra are applied.
In most of the cases surgery is done as an outpatient procedure, meaning you have the surgery done and are discharged the same day after resting in your own suite and feel comfortable to go.
The procedure takes about two to two and a half hours to be performed, depending on each case. Most women after the surgery experience some degree of swelling, bruising and tenderness, but these symptoms subside in a short time and can be controlled with oral medications.
You should wear the surgical bra for about four to five weeks. People are usually able to return to their desk jobs within the first week, although most wait a full week to ten days to do so. Having a breast augmentation procedure can drastically improve the way a woman sees herself giving a boost to own self-esteem.
Breast enhancement or augmentation is one of the most frequently performed cosmetic surgeries in the world. It is the procedure of choice for women who consider their breasts to be too small or have undergone a process of weight loss, childbirth's or just normal aging, in which the breasts have lost volume and their shape has changed.
The surgery consists of lifting the breast tissue and placing silicone rubber implants, which are then filled in most of the cases with a saline solution. Depending on the desire of the patient, silicone gel implants can be used safely.
One very important matter to take in account is that after several large studies conducted worldwide, it has been clearly demonstrated that there is no scientific evidence that breast augmentation increases the risk of cancer. Breast augmentation will make your breasts fuller and enhance their shape. Often patients start to feel more comfortable finding easier to wear certain styles of clothing providing them a more proportional figure.
Breast augmentation is performed under general anesthesia in the vast majority of cases. Occasionally local anesthesia and sedation is used A very small incision is used, relative to the size of the implants. There are several options of incisions, which will be discussed thoroughly with you before the surgery.
One of the most frequently incision employed is around the lower half of the areola which results in an inconspicuous, almost invisible scar. Then, a pocket is created behind the breast tissue, where the implant is positioned. Sutures are placed to close the incisions, and a gauze bandage and supporting bra are applied.
In most of the cases surgery is done as an outpatient procedure, meaning you have the surgery done and are discharged the same day after resting in your own suite and feel comfortable to go.
The procedure takes about two to two and a half hours to be performed, depending on each case. Most women after the surgery experience some degree of swelling, bruising and tenderness, but these symptoms subside in a short time and can be controlled with oral medications.
You should wear the surgical bra for about four to five weeks. People are usually able to return to their desk jobs within the first week, although most wait a full week to ten days to do so. Having a breast augmentation procedure can drastically improve the way a woman sees herself giving a boost to own self-esteem.
Breast reduction may give women with large pendulous breasts relief from a variety of problems, from back and neck pain and irritated skin to skeletal deformities and breathing difficulties.
These patients often complain of painful grooves in their shoulders produced by their breasts. In these cases the ideal procedure is a reduction mammoplasty in which the surgeon will not only reduce the size of the breast, but will sculpt it to give the best possible shape.
In some patients the problem is mostly stretched skin with looseness of the whole breast in which the problem is confined to the shape and form of the breast. In these cases a breast lift is the ideal procedure and the surgeon will create a better shaped breast without necessary reducing the size of the breast. In fact sometimes this procedure is performed in conjunction with breast augmentation, depending on the size of the breast.
Of all plastic surgery procedures, breast reductions and breast lifts result in the quickest body-images changes. Having a cosmetic breast procedure can greatly improve the way a woman sees herself, resulting in an enhanced self-esteem.
Depending on the size of the breast there are several variations of techniques employed.
The most common technique employed is the classic Pita guy technique which is used for larger andor very flaccid breasts. In these cases incisions are placed circling the areola, extending downward, and following the natural curve of the crease beneath the breasts. The areola is reduced in diameter if needed and excess glandular tissue, fat and skin are removed. Subsequently the areola is placed in the new higher position even
with the inframmamary crease or a little higher. The remaining tissues are reshaped around the areola to achieve the desired contour.
For cases in which there is no or little excess mammary tissue, a variation of the Pita guy technique may be employed. In this case the incisions are placed surrounding the areola extending downward onto the natural crease of the breast without a horizontal extension. A pedicle or tissue base is created from the lower pole of the breast and it is transferred to the upper pole, so the breast adopts a harmonic conical shape. Then the incisions are sutured and a dressing is applied.
One of the most important questions in regard to the technique employed is your goals and expectations of the surgery. Items like size and shape of the breast will be fully discussed prior to your surgery.
Breast reduction and breast lifts surgeries are usually done as an outpatient procedure, but a one night stay may be recommended in individual cases.
These procedures are usually carried out under general anesthesia, especially if associated with other procedures. In certain cases of breast lift local anesthesia and sedation may be utilized. You may feel some discomfort during the first couple of days, but will easily be controlled by the use of analgesics.
For the first few days following breast surgery, you will wear surgical dressings and a special post-surgical bra is worn for several weeks. You should avoid lifting your arms or pushing anything heavy for the first three to four weeks. With the support of your surgical bra, you should be able to increase your activity level at a steady pace.
You will be allowed to return to your desk job work in four to five days if you were submitted into a breast lift or after seven to ten days if a breast reduction was performed
(Correction of male breast excess)
From the Greek words for "womanlike" breasts, gynecomastia is a condition affecting an estimated 40 to 60 percent of men. Because men have such small amounts of breast tissue, most of us rarely give a man's breasts a thought -unless there is something wrong, as in the case of gynecomastia or male breast enlargement.
Breasts, female or male, are primarily composed of fat and glandular tissue, the development of which is governed by hormones. Excessive breast development can be psychologically debilitating at any age, but especially in the teen years, when body image is so important to one's identity. Gynecomastia may be the reason behind difficulty at school and antisocial behavior, and isolation.
When gynecomastia persists in adulthood, the psychological scars are no less significant. There is a reluctance to participate in any activity in which the chest would be exposed and clothing is used to disguise the condition.
There are two basic approaches to gynecomastia correction, both of which are done as outpatient procedures with local anesthesia and sedation. Which method is used depends upon the ratio of fat to glandular tissue.
When the breast is composed primarily of fat (the vast majority of cases)
Liposuction is the procedure of choice. The technique used is similar to the one described for liposuction in general, and the liposuction is carried out inserting a cannula through a small incision at the bottom of the areola. This technique gives excellent results on this specific deformity.
In the infrequent instances where the breast is composed largely of glandular tissue, direct excision is combined with the liposuction technique. Dense glandular tissue is not aspirated as easily as fat through a suction cannula and needs to be removed using a 2-3 inch incision, which is located usually under the areola.
A compression garment is applied after the procedure is finished.
After this surgery you might feel a little bruised and sore as if you would
The body has over exercised. Some swelling is expected, which commonly peaks at three to four days and disappears within four to six weeks.
You may return to work the next day although some patients wait two to three days of rest to return to their work. It is important to begin normal activity as soon as possible. Also you will be recommended a medical massage therapy starting on the next day after the operation. The support garment should be worn for two to three weeks to diminish the possibility of swelling, unevenness or waviness. Your results will be likely visible almost immediately after surgery, but the full effect may not be fully evident for four to six weeks after most of the swelling has subsided. Patients are usually very pleased with the results of the procedure with a more comfortable shape of the body and an enhanced self-esteem.
Today derma to lumpectomy is a procedure usually considered secondary or ancillary to liposuction. Liposuction alone causes skin contraction, which may correct the entire problem or will, at least reduce the extent of any subsequent skin resection. Even though liposuction is the current body contouring procedure of choice, derma lumpectomy still has its place, especially when there is too much skin to respond favorably to
liposuction alone.
The most obvious area to benefit from this type of operation is the abdomen of patients who have lost large amounts of weight (fifty pounds or more). The best candidate for this surgery is a person with relatively normal weight, weak muscles and excess skin.
A Tummy Tuck or abdominoplasty is a surgical procedure designed to flatten a protruding abdomen by tightening the muscles in the abdominal wall and removing excess fatty tissue and skin. Many patients combine their tummy tuck with other cosmetic procedures such as liposuction, breast augmentation or breast reduction surgery.
A transverse incision is made across the lower abdomen and the skin is lifted upward toward the rib cage, saving the belly button by freeing it from the skin. Then the abdomen muscles which were flaccid are pulled together and tightened.
The skin flap is then red raped across these newly repaired muscles and the apron of excess skin and fat is removed. Then the belly button is repositioned and reshaped. Finally the incisions are sutured closed and
Firm elastic dressings are applied.
Abdominoplasty is usually carried either under general anesthesia or spinal anesthesia, although in some cases local anesthesia and sedation may be used. The procedure takes about three hours to be performed, and then you will be transferred into your own private suite, where our professional staff will assist you in all of your needs.
In abdominoplasty a one night stay is recommended, especially if associated with other procedures, although in selected cases the procedure may be carried out as an outpatient procedure, depending on the extent of the surgery and preoperatory conditions of the patient. For the first few days your abdomen will be swollen and you're likely to feel some discomfort, which can easily be controlled with medication.
Physical activity will be limited somehow after the surgery, but with the support garment, you are going to be able to increase your activity at a steady pace. You'll be feeling better with each day passing. We encourage our patients to begin walking as soon as possible although you must refrain from any stannous activity or lifting.
One important matter is that scars usually fade over time and are placed in areas where they will be easily hidden by underwear. Sutures are removed in between 7-10 days and most patients are able to return to their desk jobs after that. Patients who understand well this surgery are usually very satisfied because results are quite dramatic giving them a slimmer, trimmer figure, with a flatter abdomen.
The number of fat cells in the body is established by the time a person reaches puberty. After this period these cells act like balloons, so when we gain weight these cells augment their size, because they're storing more fat. Also when we lose weight these cells tend to shrink because the fat inside diminishes.
What these means is that after puberty these cells stay the same in number, but may get larger and smaller depending on several factors varying from person to person. Liposuction is a procedure that can help sculpt the body by removing these unwanted cells of fat from different areas of the body. When these cells are removed may not form again.
Liposuction today is the most commonly requested cosmetic surgery in the world and can be performed at virtually any age and in any part of the body.
Patients commonly request this procedure to be performed in their neck, cheeks, jowls, abdomen, buttocks, thighs, hips, knees, ankles, calves and arms.
Liposuction is also used to correct enlarged male breasts, a condition known as gynecomastia. Liposuction can be performed alone or in conjunction with virtually any other plastic surgery procedure.
In liposuction the area to be treated is injected with a special fluid anesthesia combination prior to suctioning. The fluid constricts the surrounding blood vessels, making the procedure nearly bloodless, while minimizing the pain. It also provides anesthesia during and after surgery.
When the procedure is to be started a thin, hollow tube, or cannula, is inserted through one or more tiny incisions near the designated area. It is attached to a machine that creates a strong vacuum. The cannula is strategically manipulated to contour and sculpt the body. No actual pain is felt during the procedure, although you may feel an occasional stinging sensation.
Multiple areas of the body may be treated at the same time. Depending on the areas to be treated liposuction can take from one to two and a half hours. After the procedure is finished fine sutures are placed in the incisions, and tight fitting garments are worn.
This procedure is done as an outpatient procedure in the overwhelming majority of cases, so you will be discharged after resting in your suite and feels comfortable to go. You may feel a little bruised and sore as if you would have over exercised that part of the body. Some swelling is expected, which commonly peaks at three to four days and disappears within four to six weeks.
Depending on the areas treated you may return to work the next day although some patients wait two to three days of rest to return to their work. It is important to begin normal activity as soon as possible. Also you will be recommended a medical massage therapy starting on the next day after the operation.
The support garment should be worn for four to six weeks to reduce the possibility of swelling, unevenness or waviness. Your results will be likely visible almost immediately after surgery, but the full effect may not be fully evident for four to six weeks after most of the swelling has subsided. Patients are usually very pleased with the results of the procedure with a more comfortable shape of the body and an enhanced self-esteem.
Not only has body contour surgery emerged and increased in numbers, but the age spectrum for both male and female body contour surgery has also been greatly expanded to include much younger patients on one end of the spectrum and much older patients on the other. Lower body lift are performed usually in patients that have undergone massive weight loss as a consequence of surgery in which the tire of hanging skin and tissue is removed from around the entire midbody. These patients usually present with large quantities of abdominal fat and skin excess, a descended or hanging pubic area, back rolls, flat and saggy buttocks, excessive laxity on the lateral thighs, and no waist definition. Usually these patients will also require surgical procedures on the face, arms, breasts, inner thighs, and back.
Surgical procedure
A lower body lift usually requires between 6 to 8 hours of surgery. The patient is marked on the standing position just before the surgery. The excess skin is grasped at the level of the flanks with both hands trying to join each other, putting an important amount of tension. The horizontal lines of resection and the final incision placement are marked. These incisions are continued both anteriorly from hip bone to hip bone and posteriorly until they join with the markings of the contra lateral side. At this time areas that need to be sculpted with liposuction are also marked. These markings will guide us at the time of surgery and will make operative times quicker.
This surgery is carried out under general anesthesia and the patient is placed on the operating bed on one side first and then on the other side. Incisions are made following the previously marked lines. The removal of excess skin and fat is performed at this time. There is a moderate undermining of the tissues inferiorly. Once this is done, liposuction is performed at the level of the upper lateral thigh, flanks, posterior trunk andor other areas previously chosen. Then, the incision is continued at the abdominal area just above the pubic area, running from hipbone to hipbone and a second incision is made around the navel to loosen it from the surrounding tissue. After separating the skin from the abdominal wall up to the sternum and ribs, the separated muscles (rectus abdominus) will be pulled together and sutured from pubis to sternum.
The apron of excess skin and fat in this area is removed and the navel will be repositioned.
The tissues are approximated placing the highest-tension on the wound closure laterally at the level of the flanks, and less medially. Two to Four drains are placed alone the incision lines to evacuate any old blood and prevent fluid accumulation. The incisions are sutured and a dressing is applied.
A one to three night stay at our center is recommended. Expect to be sore for about one week and require prescription medication. After one week any residual discomfort is easily controlled with over-the-counter medications. Sponge baths are mandatory until the drains are removed, which might be up to a week after the procedure. You will continue to wear the support garments night and day for approximately five weeks, and will be removed only to shower. Strenuous body activity is not recommended for the first 4-6 weeks, although walking is encouraged starting on the day after the surgery.
An iron supplement is recommended after the surgery for at least two months to help replenish any blood lost during the operation and will help you regain your preoperative energy levels at a faster pace.