The eyes are the window to the soul.

Blepharoplasty commonly referred to as eyelid surgery is one of the most popular plastic surgery procedures for both men and women. The goal of the surgery is to create a more youthful and pleasing appearance to the eyes. Candidates for the procedure include people with:

• excess skin or hooding of the upper lids
• prominent fat deposits of the upper or lower lids
• loose sagging lower lid skin with wrinkles

The procedure can be performed in an office based surgical facility under local anesthesia with sedation in about one and one-half hours. During the procedure an ellipse of excess skin is removed from the upper lid followed by resection of the fat pads. Fine sutures are used to close the incision. The lower lid can be addressed by an incision through the conjunctiva in order to remove the fat from the 3 lower lid fat compartments. With the transconjuntival approach to lower lid surgery no external scars are evident. Lower lid excess skin can be removed if needed to produce a smoother lower lid.

After surgery patients are instructed to apply iced compresses for 48 hours. In addition, head elevation and minimal exertion are helpful in preventing swelling and bruising.
Eyelid surgery can produce a dramatic improvement in facial appearance, while turning back the clock many years.

What you need to know about Rhinoplasty

Rhinoplasty aka nose job is a surgical procedure performed by plastic surgeons to reshape or reconstruct the nose. Current rhinoplasty techniques focus on preserving cartilage and bone in order to produce a balanced and pleasing shape of the nose that compliments the person’s face. Older techniques were more likely to produce a nose that was “overdone” or had that “operated on” look. The open rhinoplasty technique allows the surgeon access to the cartilaginous structures of the nasal tip through a small incision between the nostrils known as the columella. The skin of the nose is then retracted allowing the surgeon direct visualization of the framework of the nose. The delicate nasal structures can then be sculpted, removed, shaped or augmented under direct vision in order to obtain precise results.

The operation is usually performed in the office surgical suite and takes about 1 and 1/2 hours. Twilight anesthesia or general anesthesia can be used. A splint is placed over the nose for 7-10 days. Packing the nostrils is not usually required. Most patients complain of minimal to mild discomfort requiring pain relievers for 2-3 days. Bruising and swelling of the eyes and face may last one week. After the splint is removed the new shape of the nose will be immediately apparent. It will take several months for the subtle changes of the nasal tip to be evident as the edema subsides and the skin of the nasal tip softens and returns to normal.

When performed skillfully cosmetic rhinoplasty has a high satisfaction rate and can produce dramatic improvements in patients’ appearances along with a boost of confidence and self-esteem.

Top 10 questions I am asked about breast augmentation

1. Are the implants safe?
In a word yes. The saline and silicone breast implants used today are safe and approved by the FDA. In addition after years of research the National Institute of Health has determined that silicone gel implants have not been found to cause any diseases or medical illnesses.

2. Can someone tell if I have breast implants?
When the implants are placed under a sufficient amount of breast tissue and muscle it is less able to be seen or felt. A larger implant will obviously be more noticeable.

3. What happens if the implant ruptures?
If a saline breast implant ruptures the fluid will be reabsorbed by the body and the implant will deflate within a few hours or days. The breast will become smaller as the saline is absorbed.
Implant rupture can be treated by replacing the implant. The cost is usually subsidized by the implant manufacturer.

4. Should the implant be placed over or under the muscle?
Studies have shown that submuscular breast implant placement leads to less scar tissue around the implant that can cause capsular contracture or hardening of the breasts. In addition, the chances of wrinkling or feeling the implant shell will be less in the submuscular position.

5. Where should the incision be for implant insertion?
The simplest and easiest approach for breast implant insertion is through the inframammary fold (the crease at the base of the breast). Other incisions include the areola or axilla (armpit). In any case the scar is usually small (3 cm) and while permanent usually improves over time.

6. How big should I go?
The size of the breast implant should be in proportion to the overall size and shape of the body. The base diameter of the breast is measured to determine the width of the implant. The amount of skin available to cover the implant must also be taken into consideration to avoid an unnatural look.

7. Do breast implants last forever?
There is no expiration date associated with breast implants. Some implant will last a lifetime while others may deflate requiring replacement. Generally, if the implants are not causing a problem they do not need to be exchanged.

8. Do I need a lift?
If the breast is droopy oftentimes a breast lift or mastopexy is required at the same time as the breast implants. Inserting breast implants alone may provide a lift to a breast that has lost volume after weight loss or pregnancy if the nipple is not below the breast fold.

9. What are “gummy bear” implants?
Gummy bear implants refer to a cohesive silicone gel implant that when punctured does not leak. The consistency is similar to a gummy bear. The implant is under clinical trials and is not available for general use at this time.

10. Can my breasts look like this picture I brought with me?
While inserting a breast implant will increase the size of the breast and oftentimes improve the shape of the breast it is impossible to guarantee a result from a photo in a magazine.

What you need to know about buttock implants.

The quest for the perfect buttock has long been a desire of both men and women. Until recently there was no permanent predictable technique to produce a fuller and more shapely gluteal region. Fat injections are not permanent and not practical in thin patients. Silicone injections to the buttock can have disastrous consequences including nodularity and deformity. Buttock augmentation with a solid silicone implant is a predictable and permanent way to create a fuller and more pleasing buttock.

The best candidates for buttock augmentation with an implant are patients who lack projection of the gluteal region and have good skin elasticity without significant sagging of the buttocks. In addition, there should be enough skin, fat and muscle to provide good coverage of the implant to allow for proper healing and long term acceptance by the body.

The implant is inserted through a single incision in the crease between the buttocks. A pocket is made either within the muscle or in the muscle lining known as the fascia depending on the needs of the patient. The solid implants which have a soft feel similar to muscle are then inserted. A drain is often placed around the implant to collect any fluid that may accumulate. Vigorous exercise and exertion should be avoided for at least 6 weeks. Some of the complications that may occur include bleeding, infection and fluid retention around the implant requiring drainage or implant removal in some cases. Liposuction of the lower back can be combined with buttock augmentation to produce the perfect hip to waist ratio.

The result is a buttock that is rounder, more projecting and more attractive. POW!