DERMAL FILLER & NASOLABIAL FILLLER

What are cosmetic fillers?

We offer non-surgical options to soften these facial lines and restore volume and fullness in the face with the latest techniques in cosmetic injectable fillers. The use of cosmetic injectable fillers, also known as soft tissue augmentation, can plump thin lips, enhance shallow facial contours, soften facial creases and wrinkles, or improve the appearance of recessed scars.

NASOLABIAL FILLER

Nasolabial filler, the active ingredient of which is hyaluronic acid, is applied to the smile lines. Thanks to its ability to absorb water, Hyaluronic acid provides plumping of the applied area. The deep lines formed in the nasolabial region are filled, the skin is revitalized, stretched and looks younger.

Reasons for needing filling;

• Genetic causes
• Facial anatomy
• Sagging of the face due to aging
• Lying on the cheek, wrong sleeping positions and using the wrong pillow
• Nasolabial filling is a temporary filling application and is permanent for 8-16 months.

WHAT TO EXPECT

How is a cosmetic injectable filler procedure performed?

The filler is injected with a fine needle into strategic points on your face in combination with topical or local anesthesia.

The injection sites are cleansed with an antibacterial agent, followed by icing or a topical numbing agent to make more sensitive patients comfortable. The filler itself may contain an anesthetic agent, or you may receive a local anesthetic or combination of local anesthesia and conscious sedation (also known as “twilight sleep”).

Multiple injections are often needed to fill wrinkles or recessed scars. Enhancing your lips with fillers also requires multiple injections to distribute the filler for enhanced lip fullness and to raise or define a cupid’s bow or vermillion border.

Cosmetic injectable fillers for the face are often used to:

• Address nasolabial folds (facial creases between the nose and mouth)
• Improve marionette lines (lines or wrinkles that extend from the outer corners of the mouth down toward the chin)
• Correct “lipstick lines” around the mouth
• Restore fuller cheeks
• Create fullness in the lips
• Improve forehead frown lines, when used in conjunction

HOW TO PREPARE

Am I a candidate for cosmetic injectable fillers?

Tissue fillers are a good option if you:

Are physically healthy

Have mild or moderate degree of facial aging

Have specific, but realistic goals in mind for the improvement of your appearance.

How do I prepare for a cosmetic injectable filler procedure?

Discussing why you want the procedure, your expectations and desired outcome

Review of your medical conditions, drug allergies and medical treatments

Review of your current medications, vitamins, herbal supplements, alcohol, tobacco and drugs

Discussing any past treatment with injectable fillers, facial shaping or Botox®therapy, or other facial rejuvenation procedures.

Your cosmetic surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Discuss options available to you for facial rejuvenation
• Examine and measure your face
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of injectable fillers and any risks or potential complications.

What are the different types of injectable fillers?

Collagen

Is a natural protein that is the primary component of the second layer of the skin, the dermis. Collagen acts as the support structure of the skin for the growth of cells and blood vessels.

Injectable collagen formulas derived from human dermis including Cosmoderm® or Cosmoplast®. Alternatively, Zyderm® and Zyplast® are forms of purified bovine collagen that, unlike human-derived collagen, require allergy testing. Results from collagen injections generally last three months.

Collagen injections historically were the first of the tissue fillers, but, because of their short-lived effectiveness, they have largely been replaced by newer types of fillers.

Hyaluronic Acid

A natural substance found in your body that is effective for plumping thin lips and filling facial creases between the nose and mouth (nasolabial folds) and the jowl area (marionette lines). Hyaluronic acid may also be effective for some surface wrinkles and concave scars, under the eyes (nasojugal grooves) and in the forehead region and elsewhere.

Common hyaluronic acid products include Juvederm®, Restylane® and Perlane®with results from these injectables lasting six months or longer depending on both the individual patient and location of injection. Hyaluronic acids are currently the most popular of the cosmetic injectable fillers.

Hydroxylapatite (Radiesse®)

A mineral-like compound found naturally in human bones, which is suspended within a gel-like formation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds and marionette lines, as well as to enhance fullness of the cheeks and other facial contours. Radiesse’s® results last from six months to one year.

What is involved in recovery?

Injectable filler procedures are performed on an outpatient basis. Your initial appearance after treatment with any filler may include:

• Mild swelling or bruising
• Temporary numbness or redness
• Temporary irregularity to touch in the soft tissue or skin.
• These side effects are easily managed with topical icing and will improve within hours or just a few days.

Results

What results can I expect?

Injectable fillers offer immediate results, but your results will vary depending on which filler is used. A filler’s effectiveness can range from six months (such as hyaluronic acids) to over one year (with the use of PMMAs).

In some cases, the length of your results or effectiveness of correction depends on the filler used, the area treated and the individual patient. Because injectable fillers are not permanent, the best way to ensure results is through repeated treatments with your cosmetic surgeon. In general, less filler is required on subsequent injections. View our injectable fillers before and after photos to see results from actual patients.

Human fat

Which is harvested from your own body and can be reinjected to enhance facial fullness, fill deep creases and to build up shallow contours. Augmentation through fat injections requires a more extensive procedure than other injectable fillers because it involves the use of liposuction techniques to extract the fat prior to injection. Fat injections are somewhat unpredictable in how long they last. Length of action varies from patient to patient and location of injection.

Poly-L-lactic Acid (Sculptra®)

Developed to treat facial wasting, a condition commonly resulting from HIV. FDA-approved for this purpose, it also has recently been approved for facial aging. It functions similarly to human fat injections by enhancing facial volume in patients who appear to have lost facial fat. Studies have shown results from Sculptra® lasting up to two years.

PMMA (polymethylmethacrylate) fillers

(Artecoll®, ArteFill®, Artesense™, Artes Medical) are a type of permanent filler. Unlike temporary fillers, the immediate filling effect of PMMAs disappears rather quickly and, over time, gradual, but long-lasting correction is established. The Food and Drug Administration (FDA) approved PMMA fillers for the correction of facial wrinkles, such as smile lines.

Note: The FDA reviews and approves pharmaceutical fillers. However, some fillers may be used on an off-label basis, which means they have been approved for wrinkle correction in a given area only, or for some other medical indication, but not directly reviewed for a specific application. For a more detailed discussion of off-label uses of fillers, consult your plastic surgeon or dermatologist.

Are cosmetic injectable fillers safe?

All surgical procedures carry some risk, but complications from filler procedures are uncommon. Possible risks and considerations regarding injectable fillers include:

• Fillers derived from non-human sources may require a pre-treatment allergy test
• Certain fillers may lead to an infection at the injection site
• Fillers that are not completely fluid and contain microscopic granular substances (PMMAs) carry a risk of “clumping” as a result of facial movement and the natural aging process. Over time, these can result in lumps or nodules that may require surgery to treat
• Acne-like skin eruptions
• Antibodies to filler material may reduce the effectiveness of future injections
• Asymmetry
• Bleeding, bruising and swelling
• Skin death, also called skin necrosis (extremely rare)
• Skin rash, itching and swelling
• Skin redness
• Skin sensitivity
• Under or over correction of wrinkles.

TUMMY TUCK PROCEDURE

When diet and exercise fail to achieve the waistline you desire, we offer the expertise of plastic surgeons who have perfected procedures to help you attain a flat, well-toned abdomen.

Why Choose Us

When considering a tummy tuck, always look for a board-certified cosmetic surgeon with specialized training and significant experience.

TUMMY TUCK VARIATIONS

Standard tummy tuck

• Addresses the loose, sagging abdominal skin common after pregnancy and weight loss
• Surgically removes excess fat and skin from abdomen
• Tightens weakened or separated muscles above and below the belly button, creating an abdominal profile that is smoother and firmer
• The scar is horizontal, situated above the pubis
• Mini-abdominoplasty
• Surgical removal of fat and skin; specifically the area below the belly button
• Tightens the weakened muscles below the belly button
• The scar is horizontal, situated above the pubis

Lipo-abdominoplasty

• This procedure combines the benefits of an abdominoplasty with liposuction
• Addresses the fat or fullness of the upper abdomen with liposuction that a standard tummy tuck will not address
• Extended abdominoplasty or Fluer-De-Lis
• Addresses the excess skin and fat above the belly button often a result of massive weight loss
• The scar orientation is both vertical and horizontal

HOW TO PREPARE

What is a tummy tuck (abdominoplasty)? What is panniculectomy?

A tummy tuck, also known as abdominoplasty surgery, is a type of abdominal plastic surgery that removes excess fat, skin, and in most cases, can reestablish weakened or separated muscles – creating an abdominal profile that is smoother and firmer.

Panniculectomy, which can be performed alone or in combination with tummy tuck surgery, removes any overhanging “apron” of skin and tissue from below the belly button. This excess skin is most typically a result of significant weight loss (100 pounds or more) through diet and exercise.

The hanging skin of the abdomen, called the pannus or “apron” can cause a variety of problems, including the inability to fit comfortably into clothing, difficulty in daily hygiene, yeast infections or cysts in the folds of skin, and lower back pain. Different from a tummy tuck, which tightens the underlying stomach muscles, a panniculectomy only removes excess skin and fat.

Many people who have achieved significant weight loss can be left with large amounts of heavy, loose folds of skin around the abdomen, which can sag and lose elasticity as a result of being stretched for a long period of time. This excess skin can lead to rashes above the pubic area and along the groin and hips. As a result, skin removal after weight loss is a crucial next step to take. A panniculectomy can offer relief of these symptoms to enhance your health and appearance.

Am I a candidate for a tummy tuck (abdominoplasty)? Am I a candidate for a panniculectomy?

The ideal candidates for tummy tuck surgery are those who have a combination of loose or excess skin on their abdomen and/or excess abdominal fat. Almost all women who have had children will also have some degree of abdominal muscle laxity. Any of these conditions, or all three, can be corrected by a tummy tuck.

Tummy tuck surgery is a good option for you if:

• You are physically healthy and at a stable weight
• You have realistic expectations
• You are a non-smoker
• You are bothered by the feeling that your stomach is too large.
• Panniculectomy candidates typically suffer from obesity, have recently experienced significant weight loss or suffer post-pregnancy issues with excessive fat located below the belly button.

You may be a candidate for panniculectomy if:

• Excess fat causes health issues, including back problems, breakdown of skin, rashes, ulcers or skin disorders
• Your weight has been stabilized for at least one year
• You are participating in a proper dietary and exercise plan
• You are a non-smoker
• You have a positive outlook and realistic goals for what panniculectomy can achieve
• You are committed to leading a healthy lifestyle, including proper nutrition and exercise.

WHAT TO EXPECT

How do I prepare for a tummy tuck (abdominoplasty) and/or panniculectomy?

• Preparing for your tummy tuck (abdominoplasty procedure) and/or panniculectomy procedure will include a discussion with your plastic surgeon about your health, desires and lifestyle.
• To ensure the best results from your tummy tuck surgery or panniculectomy procedure, be prepared to discuss:
• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries.

Your plastic surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of the tummy tuck and any risks or potential complications
• Order bloodwork, an EKG and obtain surgical clearance (for panniculectomy)
• Ask you to stop taking aspirin-containing products for two weeks before surgery.

What results can I expect?

After a tummy tuck procedure (abdominoplasty)

Whether you’re having a partial or complete tummy tuck & the overall result will be a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Your final results after the abdominal plastic surgery may be initially hidden by swelling and the inability to stand fully upright until internal healing is complete. Your new slimmer profile should be will begin to be apparent within a week or two following surgery. It might take several weeks or even months to appreciate the final result.

After a panniculectomy

Most patients are very pleased with the results of the panniculectomy. The majority lose approximately five to 10 pounds in weight. You will notice that your clothing fits more comfortably. Some patients also find personal hygiene and physical activity easier.

While it will take a few months after surgery to realize final results, your body’s new contour will be permanent, providing your weight remains stable. An additional benefit for most patients is that changes in their weight do not result in accumulation in the waist as it did before the procedure.

What is involved in recovery?

After a tummy tuck procedure (abdominoplasty)

Following your tummy tuck procedure, the incision site will be stitched and bandaged. Your plastic surgeon may have you wear either an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals.

It’s very important that you follow all of your surgeon’s instructions on wearing this garment (if you are given one) and caring for the bandage in the days following surgery. Your surgeon will also instruct you on how to best position yourself while sitting or lying down to help ease pain.

Tummy tuck procedures are often performed as an outpatient procedure or with a one-night stay at hospital. If your tummy tuck is completed as an outpatient procedure, make certain you bring someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

You will have to severely limit strenuous exercise for four to six weeks as you go through the healing process, in addition to possibly needing to take up to one month off work after surgery to ensure the recovery and results. Your cosmetic surgeon will help you determine a recovery based on your personal situation.

After a panniculectomy

Following panniculectomy, your surgeon will instruct you regarding showering and bathing. Use a supportive abdominal garment only if your surgeon recommends it.

You will need to avoid strenuous activities for a few weeks, but most people can usually return to work within two weeks of the procedure. Any stitches in the skin are generally removed in about a week. You will also have deeper sutures that dissolve on their own.

How is a tummy tuck (abdominoplasty) performed?

In a traditional tummy tuck (abdominoplasty procedure), a horizontal incision is made just above the pubic hairline. The length of this lower abdominal incision is determined by the amount of excess skin.

The skin is then dissected up toward the rib cage, the muscle is tightened, the belly button is repositioned and excess skin is removed. Your cosmetic surgeon may also recommend combining liposuction with your tummy tuck surgery for the best results.

In those cases where loose skin extends towards the back, the incision can be lengthened into the back area performing a so-called “circumferential abdominoplasty.”

The tummy tuck procedure is generally performed under general anesthesia and can often be performed as an outpatient or with a one-night stay. The procedure itself requires anywhere from two to four hours to perform. Drains are most often used and are removed several days following the procedure.

How is panniculectomy performed?

Panniculectomy may be performed as a single procedure or combined with a tummy tuck. The procedure may also be performed with another abdominal surgery, such as a hysterectomy, repair of the abdominal wall, or hernia repair. When done alone the panniculectomy is intended to only to remove the overhanging skin and fat and is not a cosmetic procedure.

The procedure takes approximately three to five hours and involves an incision just above the pubic area extending outward toward the hips.The length of your incision depends upon the amount of skin to be removed. Depending on the size of the pannus, the naval might get pulled down or completely removed with the panniculectomy. Your surgeon will be able advise you of this in your pre-operative consult.

Panniculectomy may be an outpatient procedure or require an overnight stay, depending on the particular circumstances of your procedure.

What are the different types of tummy tuck (abdominoplasty) procedures?

There are three different types of tummy tuck procedures. The degree of loose skin, excess fat or laxity of the stomach muscle, in addition to a full consultation with your plastic surgeon, will determine whether a traditional or complete abdominoplasty, a partial mini abdominoplasty or circumferential abdominoplasty is right for you.

Learn more about these tummy tuck options:

Complete Abdominoplasty

A complete abdominoplasty procedure requires an incision above the pubic hairline, an incision around the umbilicus, or belly button, and a tightening of the rectus abdominis muscles (the pair of muscles that run vertically on each side of the stomach’s front wall). Muscle tightening, as well as skin removal, is the most important step in improving the stomach’s contour. Liposuction may also be performed at the same time of a complete tummy tuck

Partial or Mini Abdominoplasty

The mini abdominoplasty is performed on those patients with mild to moderate tummy contour changes, relatively little skin excess and little weakness of the abdominal wall. In the mini abdominoplasty procedure, the navel incision is avoided. Liposuction may also be performed at the time of mini abdominoplasty surgery.

Circumferential Abdominoplasty

Skin laxity or skin excess is a three-dimensional issue and involves not only the abdominal area, but also the back region. When there is significant excess fat in the back area as well, abdominoplasty can be performed with liposuction of the back region or circumferential abdominoplasty can be performed. The benefit of the circumferential abdominoplasty procedure is that both skin and fat can be removed in the hip and back region, improving your body contour three dimensionally.Results

Is a tummy tuck (abdominoplasty) and panniculectomy safe?

• All surgical procedures carry some risk.
• Possible risks of tummy tuck and panniculectomy procedures include:
• Bleeding (hematoma)
• Infection
• Fluid accumulation
• Poor wound healing
• Skin loss
• Unfavorable scarring
• Anesthesia risks
• Numbness or other changes in skin sensation
• Skin discoloration and/or prolonged swelling
• Fatty tissue found deep in the skin might die (fat necrosis)
• Major wound separation
• Asymmetry
• Recurrent looseness of skin
• Pain (possibly persistent)
• Deep vein thrombosis, (Blood Clots) cardiac and pulmonary complications
• Persistent swelling in the legs
• Nerve damage
• Possibility of revisional surgery.

Monsplasty

Monsplasty, also known as mons pubis reduction, is a procedure that removes excess bulk, and lifts and tightens the skin of your mon pubis (the fatty area right above your labia). Some patients combine this procedure with a tummy tuck.

Your mons pubis can change with time, weight fluctuations, pregnancy, and injury. If the area above your vagina is enlarged or sags and you wish to reduce the tissue and tighten the skin, monsplasty may be right for you. Below are some of the benefits of monsplasty:

• Reduce the size and protrusion of your mons pubis
• Improve the contour of your upper pubic area with minimal scars
• Feel more confident wearing clothing, such as bikini bottoms, panties, and tight workout pants
• Increase your sexual satisfaction
• Improve your self-image and self-confidence

LABIAPLASTY

Overview

Labiaplasty is a surgical procedure to reduce or increase the size of your labia. The surgery is done to improve the appearance of your labia, to reduce physical discomfort or as part of gender-affirming surgery.

Your labia are the folds of skin around your vagina opening. You have two folds of skin. The outer folds are called the labia majora, which means large lips. These folds are the larger fleshy folds that protect your external genital organs and are covered with pubic hair after puberty. The inner folds are called the labia minora, which means small lips. These skin folds protect the opening of your urethra (where your pee leaves your body) and vagina.

During a labiaplasty and depending on why it’s being done, your surgeon either:

• Removes some tissue from the labia to reduce its size.
• Injects a filler material or fat into the labia to enlarge it.
• Reconstructs a labia from other tissue.

What are the reasons for wanting a labiaplasty?

Medical and physical reasons

To reduce the size of labia minora so it doesn’t protrude beyond the edges of the labia majora. Excess labial tissue can twist, turn, or get pinched or tugged, and cause physical discomfort and irritation during exercise, physical activities (such as bike riding or jogging) and intercourse.

To improve hygiene and health since excess tissue can make cleansing more difficult and can harbor bacteria that can lead to the development of urinary tract infections.

Cosmetic and emotional reasons

To restore a more youthful look after childbirth or aging.

To reduce asymmetry (uneven shape) of the labia minora or labia majora when one side is longer or shaped differently than the other.

To increase self-confidence and eliminate the visual lines, bulges or “camel toe” appearance when wearing body-conforming pants or leggings. Tight-fitting clothing can also cause physical discomfort if there’s excess labia tissue.

To improve comfort, confidence and sexual well-being about the appearance of your genitalia during intimate contact.

Gender-affirming surgery

If surgery is part of a gender-affirming process, labia can be created using existing genital tissue. Labiaplasty may be performed before or after other reconstruction surgeries.

What causes a labia to become oversized?

• Age. Menopause or other hormonal changes can thin the tissue of the labia majora, allowing the labia minora to protrude beyond the labia majora.
• Pregnancy and childbirth.
• Changes in your weight.
• Genetics.

What happens before surgery?

First, you and your surgeon will discuss the reasons why you want to undergo labiaplasty. You’ll discuss your expectations and goals as well as the risks of the surgery.

Next, your surgeon will explain the details of your surgery, including where incisions will be made and what to expect regarding changes to the size and shape of your labia.

You may undergo some presurgical tests including blood work, urinalysis and chest X-ray. You’ll be given instructions about what to wear to your procedure, when to stop food and drink, when to adjust or temporarily stop certain medications and other information on how to prepare for your surgery.

What happens on the day of surgery?

After you arrive at our hospital, you will change into a surgical gown. A healthcare provider will take your vitals (temperature, pulse, blood pressure, oxygen level, breathing rate). You may have some blood work and urinalysis done again. They’ll place an intravenous line (IV) in your arm or hand and they may place a urinary catheter in your urethra.

Next, your provider will cleanse your labia and the skin around it and shave your pubic area if needed. Then, they’ll start anesthesia. You may have IV sedation with local anesthesia or general anesthesia depending on the procedure you’re having. Your provider will discuss which type of anesthesia is best for you during the planning stage of your surgery.

Your provider chooses which surgical technique according to how your labia (labia majora and/or labia minora) will be resized or reshaped. They usually perform this surgery with a scalpel, scissors or laser.

Reduction procedures

To reduce your labia (labia minora and/or labia majora), there are two general approaches:

Trim procedure. With this approach, your surgeon removes excess tissue from the outer edge of one or both sides of your labia minora so that it’s even with or receded from the edges of your labia majora.

Wedge procedure. With this approach, your surgeon removes a wedge or pie-shaped piece of tissue from the inner areas of one or both sides of your labia minora. They leave the submucosa intact so that when the labia is stitched (sutured), the wrinkled edge of the labia remains intact. This retains a more natural look for the labia minora. Similarly, an inner portion of each labium of your labia majora can also be removed if you’re having surgery to reduce the labia majora.

Your surgeon may have other preferred approaches depending on their surgical expertise or your desired result. You and your surgeon will work together to choose the surgical approach that will best meet your goals and concerns.

How long do the results of labiaplasty last?

Labiaplasty performed as a reduction surgery is meant to be a one-time, long-lasting procedure. Unless complications develop, you may never need this surgery again. Enhancement labiaplasty with injections of fat or fillers may need additional “touch-ups” over time.

You should know that if you choose to have children after your procedure, your labiaplasty may be affected. Many people choose to wait to have their labiaplasty until after they’ve completed their families.

Enlarging procedure

To enlarge your labia majora, your surgeon takes a small amount of fat from another body area, such as your abdomen or thigh (in a liposuction procedure) and injects it into your labia majora. Injecting hyaluronic acid into your labia majora is an alternative option.

Gender-affirming surgery

Tissue from the penis can be used to create your labia. Labiaplasty is one step in the entire gender-affirming reconstructive surgery process.

All incisions in the procedures described above are closed with absorbable stitches (sutures) that dissolve over time and don’t need to be removed. Your surgical site is covered with surgical dressing.

How long does labiaplasty take?

Labiaplasty is an outpatient procedure. Labiaplasty typically takes less than two hours. Gender-affirming surgery would require more time.

What happens after surgery?

After surgery, your provider removes your urinary catheter (if you have one) and you’ll become more alert as the anesthesia wears off. You’ll be checked for bleeding. Before being discharged, you’ll be given instructions about how to care for your wound while it heals. Your providers will also discuss pain control and give you information about activity restrictions and follow-up appointments.

What are the risks and complications of labia surgery?

Complications are infrequent, but can include:

• Too much tissue or not enough tissue is removed.
• Bleeding.
• Bruising (hematoma).
• Infection.
• Wound breakdown.
• Scarring.
• Ongoing pain, pain with sex or loss of sensitivity.

Is the recovery painful?

You will have some swelling, discomfort and pain, but it’s usually easy to manage with over-the-counter medication, such as acetaminophen (Tylenol®), or a limited prescription medication. If your discomfort is not well controlled with the recommended medications, be sure to contact your surgeon. Home remedies, such as a cold compress or icepack, are helpful too. Apply an ice pack to the operative area (on top of a cloth undergarment) on a 20 minutes on/20 minutes off schedule to reduce pain and swelling. Most people report only mild pain or tenderness for a few days.

You may be given an oral antibiotic prescription or topical antibiotic to apply to your surgical wound to prevent infection.

Wear loose-fitting pants and undergarments during the healing period. Tight-fitting clothes or undergarments can cause friction against the wound and prevent or delay healing.

Will there be much bleeding?

You may have some bleeding for days up to a week or so. You can wear a mini-pad to absorb this minor bleeding.

When will results be at their very best?

The initial swelling, soreness and temporary discoloration decrease over the first couple of weeks after surgery. Most swelling is gone after six weeks. However, it may take up to four to six months of healing time for swelling to completely go away before seeing the final results of your labiaplasty. There’s usually little to no scarring.

How do I wash my labia area?

Use lukewarm water only (no soap) to wash your wound. Gently wipe or dab the area dry after peeing; don’t rub the surgical area.

Your surgeon may have you take medication or recommend a diet to prevent constipation so that you do not strain, which could stretch or break your stitches.

Follow all your provider’s post-op instructions for peeing and pooping, for keeping your surgical area clean and free from bacteria, and allowing the surgical area to heal.

When can I return to work, physical activity and sexual activity?

You should be able to return to work and other light activities after a few days. If your job involves physical activity or lifting, you may need to stay home longer. You should avoid the following for four to six weeks or until cleared by your surgeon:

• Strenuous exercise.
• Physical activities such as cycling, running and swimming.
• Sexual intimacy.
• Returning to these activities too soon can put pressure on the wound, tear stitches and delay healing.

What is blepharoplasty?

Loose skin above the eyes, tired eyes or bags under the eyes can be improved dramatically with eyelid surgery, also known as blepharoplasty. Eyelid surgery improves the appearance of your upper eyelids, lower eyelids or both.

Your surgeon will offer a total care approach to ensure a rejuvenated appearance to the surrounding area of the eyes – resulting in a more rested, alert look.

When considering Eyelid Surgery (blepharoplasty), always look for a board-certified cosmetic surgeon with specialized training and significant experience. For the best results, choose a cosmetic surgeon who is affiliated with a major medical center, make sure to ask your doctor about his or her credentials, training and how many procedures he or she has performed.

HOW TO PREPARE ?

Am I a candidate for eyelid surgery (blepharoplasty)?

• A common cosmetic procedure in patients age 30 and older, eyelid surgery, also known as an eyelid lift, is used primarily to fight the effects of aging skin. As skin ages, it gradually loses its elasticity, and this, combined with the constant pull from gravity, leads to excessive skin collecting in the upper eyelids, causing drooping of the eyelids. The primary cause of lower-lid aging is loosening of skin and the underlying muscle.
• The best candidates for eyelid surgery are adult men and women who have healthy facial tissue and muscles and realistic goals for improving the upper and/or lower eyelids and surrounding area. If improving both upper and lower eyelids, the procedure is called an upper and lower blepharoplasty.
• Candidates for eyelid surgery include:
• Healthy individuals who do not have a life-threatening illness
• Individuals with a positive outlook and specific goals in mind for blepharoplasty
• Individuals without serious eye conditions.
• You should tell your cosmetic surgeon if you have any of the following medical conditions:
• Eye disease, such as glaucoma, dry eye or a detached retina
• Thyroid disorders, such as Graves’ disease and under or overactive thyroid
• Cardiovascular disease, high blood pressure or other circulatory disorders

Diabetes.

How do I prepare for eyelid surgery (blepharoplasty)?

Preparation for your eyelid surgery includes:

• Lab testing or a medical evaluation
• Taking certain medications or adjusting your current medications
• Stopping smoking well in advance of surgery
• Avoiding taking aspirin, anti-inflammatory drugs and herbal supplements due to the risk of increased bleeding.

RESULTS

What results can I expect?

The final results of your eyelid surgery (eyelid lift) will appear within several weeks. While eyelid surgery will not stop your eyes from aging, the procedure is typically very long lasting. The effects of upper eyelid surgery can last many years to an entire lifetime, while lower eyelid surgery rarely needs to be repeated. View our eye lift before and after photos to see results from actual eyelid lift patients.

What is involved in recovery?

• Eyelid surgery is usually performed as an outpatient procedure. If this is the case, be certain to plan for someone to drive you home after surgery and stay with you at least the first night following surgery.
• Initial healing throughout the first one to two weeks following your eyelid surgery may include:
• Swelling
• Bruising
• Irritation or dry eyes
• Irritation at the incision sites.
• It is important that you practice careful sun protection, including using darkly tinted sunglasses until the healing process is fully complete.

WHAT TO EXPECT

How is eyelid surgery (blepharoplasty) performed?

Eyelid surgery can involve the upper eyelids, lower eyelids, or both eyelids depending upon the goals of the surgery and recommendations of your surgeon:

Upper eyelid surgery

involves the placement of incisions in the natural crease of the upper lid, making them well hidden when the eyes are open. The excess skin and protruding fat are removed and the incision is closed. An entire upper eyelid surgery can be completed in approximately 45 minutes to one hour. Your surgeon may combine upper eyelid surgery with an eyebrow lift to achieve optimal rejuvenation results if the eyebrows are too low.

Lower eyelid surgery

can correct conditions with an incision just below the lower lash line. Excess skin in the lower eyelid is removed through this incision. Your surgeon may also use an incision hidden inside the lower eyelid, or a transconjunctival incision, as an alternative technique to correct lower eyelid conditions and redistribute or remove excess fat.

If the transconjunctival approach is used, there is no visible incision. If the lower eyelids are lax, as they are in many middle-aged individuals, your surgeon may recommend tightening the lower lids in addition to removing skin and/or fat (canthopexy or canthoplasty).

Eyelid surgery usually takes about two hours to complete if both upper and lower eyelids are completed at the same time. Typically, a local anesthesia is combined with conscious sedation (also known as “twilight sleep”).

Is eyelid surgery (blepharoplasty) safe?

All surgical procedures carry some risk. Although rare, possible complications from eyelid surgery include:

• Bleeding
• Infection
• Dry eyes
• Abnormal discoloration of the skin of the eyelids
• An inability to fully close the eyes
• Eyelid skin that folds in or out abnormally
• A pulled down lower lid lash line
• Possible loss of vision (extremely rare).

DERMAPEN

Overview

It can be used on all skin types to shrink wrinkles, enlarged pores, improve the appearance of scars and acne scars. It stimulates collagen production.

Generally, 4-6 sessions of treatment are recommended at intervals of 4 weeks. After the treatment, with micro needling method using serums suitable for the skin structure, a visible improvement is experienced in the tone and texture of the skin.

PLASMAPEN

Overview

Plasma energy, which provides a direct transition from solid to gas, ionizes the skin surface. The skin surface is evaporated into spots. The skin, which takes action to treat this limited damage, repairs and renews the entire skin with tiny scabs in a short time.

In Which Treatments Is It Used?

• Non-surgical eyelid lift
• Eye area rejuvenation
• Forehead wrinkles treatment
• Skin rejuvenation, tightening and stretching
• Decollete tightening
• Spot treatment
• Erase the wart and me
• Hand rejuvenation
• Treatment of stretch marks in the legs and abdomen
• Plasma Pen results are high performing for the first two years and can be permanent for up to five years.

BREAST LIFT PROCEDURE

Overview

Your breasts often change over time, losing their youthful shape and firmness. Pregnancy, nursing, weight gain and loss, aging and gravity can cause breasts to soften and sag. Women who are unhappy with the shape, volume and/or firmness of their breasts may consider having breast lift surgery, also called mastopexy. A mastopexy raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast. A breast lift is often combined with breast augmentation surgery to increase both the firmness and size of the breasts.

WHAT TO EXPECT

How is breast lift surgery (mastopexy) performed?

Breast lift surgery is performed as an outpatient procedure, usually under general anesthesia and typically takes 1 ½ to 2 hours.

The procedure can be achieved through a variety of incision patterns and techniquesYour physician will determine the appropriate technique for you based on:

Breast size and shape

The size and position of your areolas (small darkened area around the nipples)

The degree of breast sagging

Skin quality and elasticity, as well as the amount of extra skin.

All types of breast lifts require an incision to remove excess skin so that the remaining skin can be repositioned. There are several types of surgery techniques available that differ in the incision made and the procedure used to lift the skin.

Standard Breast Lift Surgery

Uses an anchor or keyhole incision, which starts at the base of the breast in the crease and extends upward around the areola – creating an anchor shape. It is most often used for extensive ptosis (drooping), resulting in the most noticeable scarring.

“Doughnut Mastopexy”

Which is also called a Benelli lift or periareolar lift, is much less invasive than the anchor breast lift procedure because the incision is limited to a circle around the areola. A piece of skin around the areola is removed and the surrounding skin is reattached to create a lifted look with minimal scarring.

Vertical Mastopexy

Is a procedure resulting in an incision around the areola and then vertically down the breast. This avoids the horizontal incision under the breast that results from a standard breast lift.

HOW TO PREPARE

Am I a candidate for breast lift surgery (mastopexy)?

Breast lift surgery, also known as a boob lift, is a highly individualized procedure achieved through a variety of incision patterns and techniques, which involves removing excess skin and relocating the nipple and areola (the pigmented skin surrounding the nipple). Patients with smaller breasts and minimal sagging may be candidates for a mastopexy procedure that involves smaller incisions than a standard breast lift requires. While there are many variations to the procedure, a consultation with the physician is an excellent means of establishing your individualized treatment plan.

How do I prepare for breast lift surgery (mastopexy)?

If you are a smoker, you will be asked to stop smoking well in advance of breast lift surgery. You should avoid aspirin and certain anti-inflammatory drugs that can cause increased bleeding for a period of time before surgery. Your plastic surgeon will provide you with additional preoperative instructions.

RESULTS

What results can I expect?

Though results from your breast lift surgery are immediately visible, breast shape and position continue to settle over the next few months. Incision lines are permanent, but will continue to fade over time.

While the results of your surgery will be long lasting, over time your breasts can continue to change due to aging and gravity. You will be able to retain the results of your mastopexy by maintaining your weight and keeping a healthy lifestyle.

What is involved in recovery?

Breast lift surgery is usually performed as an outpatient procedure. If this is the case, be certain to plan for someone to drive you home after surgery and stay with you at least the first night following surgery.

Following your surgery, your breasts will be bruised, swollen and sore for one to two weeks. You’ll need to wear a surgical bra for the first week after surgery, followed by a support bra for several weeks after that.

Post-surgical swelling will resolve over time and incision lines will fade. You may experience some loss of sensation in your nipples and breasts following mastopexy surgery, with sensation gradually returning over the next weeks and months. However, some patients experience numbness for up to a year. On rare occasions, loss of sensation can be permanent.

Is breast lift surgery safe?

• All surgical procedures carry some risk.
• Although rare, risks associated with breast lift surgery include:
• Bleeding
• Infection
• Unevenly positioned nipples
• Permanent loss of sensation in the nipples or breasts
• Problems with wound healing.

Breast lift surgery incisions do leave scars, but these will fade with time with maximum fading occurring at one year. Scar locations include an incision around the nipples, vertically down the breast and sometimes horizontally in the breast fold.

BREAST AUGMENTATION PROCEDURE

Overview

Breast augmentation, often combined with a breast lift, is a highly individualized procedure, which you should do for yourself, not to fulfill anyone else’s desires or to fit a certain type of ideal image. It is the most commonly performed cosmetic surgical procedure throughout the World.

WHAT TO EXPECT

How is breast augmentation performed?

Usually performed under general anesthesia, incisions are made in inconspicuous areas of the breast to minimize visible scarring. There are a variety of incisions used to perform the procedure:

• In the lower crease of the breast (inframammary incision)
• Around the lower portion of the areola, or dark-colored skin around the nipple (periareolar incision)
• In the armpit (transaxillary incision)
• Under the breast fold (sub-mammary incision)
• Through these incisions, the plastic surgeon creates a pocket to place the implant. To maximize the accuracy of future mammograms, implants are generally placed under the muscle (subpectorally).
• Some breast enlargements can be performed in a minimally invasive manner using endoscopes and small incisions made in the armpit, with the major benefit being less scarring for the patient. The procedure, which takes about two hours, is typically performed on an outpatient basis.

Are there different options for breast augmentation?

Breast implants are made up of a silicone shell – we are using the brand Mentor – filled with either saline (a salt water solution) or silicone gel. Silicone gel has a thick, sticky fluid consistency that closely mimics human fat, offering a more ‘natural’ look and feel if capsule contracture (shrinking and tightening of the scar tissue around a breast implant) does not occur. Saline implants have the disadvantage of sometimes feeling like a water balloon to touch, especially in patients with thin, soft tissue.

HOW TO PREPARE

Am I a candidate for breast augmentation?

If you aren’t satisfied with the shape, size or contour of your breasts, you may wish to consider breast augmentation. Also known as augmentation mammoplasty, the procedure involves using implants to enlarge the breasts.

Breast augmentation may also help after pregnancy or weight loss if you are unhappy with the size or droopiness of your breasts. Implants can also correct asymmetry or unevenness in breast size caused by developmental problems or breast cancer surgery performed in the opposite breast.

One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:

• You are worried by the feeling that your breasts are too small
• Clothes that fit well around your hips are often too large at the bustline
• You feel self-conscious wearing a swimsuit or form-fitting top
• Your breasts have become smaller and lost their firmness after childbirth
• Weight loss has changed the size and shape of your breasts
• One of your breasts is noticeably smaller than the other

How do I prepare for breast augmentation?

If you are a smoker, you will be asked to stop smoking well in advance of surgery. You should avoid aspirin and certain anti-inflammatory drugs that can cause increased bleeding for a period of time before surgery. Your plastic surgeon will provide you with additional preoperative instructions.

Breast enlargement is performed with either saline or silicone implants that are placed either under the chest muscle (sub pectoral) or over the chest muscle (sub glandular).

RESULTS

What results can I expect?

Breast augmentation will make your breasts fuller and enhance their shape. Like many women who have had the procedure, you may have a boost in self-confidence. Generally, the results of breast enlargement surgery are long-lasting. Augmentation mammoplasty cannot, however, stop the natural effects of aging that eventually alters the size and shape of virtually every woman’s breasts. Long-term follow-up with your plastic surgeon is strongly recommended. View our breast augmentation before and after photos to see results from actual patients.

What is involved in recovery?

Breast enlargement surgery is usually performed as an outpatient procedure. If this is the case, be certain to plan for someone to drive you home after surgery and stay with you at least the first night following surgery.

You will be given medication to take at home. Stiffness and soreness in the chest for the first two to five days is normal. These side effects, along with some swelling and bruising will subside over two to three weeks. Any surgical dressings will be removed within several days and you may be instructed to wear a support bra.

Physical activity is limited for the first several weeks, with most patients able to return to work and their normal activities within two to three weeks. Each year, thousands of women undergo successful breast augmentation surgery. Yet, all surgical procedures involve some risk.

Is breast augmentation safe?

• Both saline-filled and silicone gel-filled breast implants present potential risks, including:
• Implant rupture
• Need for additional breast surgery
• Breast pain
• Scar tissue that hardens around and distorts the breast implant (capsular contracture)
• Potential for decreased nipple or breast sensation
• Infection

Hymen repair (hymenoplasty) is the cosmetic repair, restoration, or construction of a woman’s hymen, and is often requested by women for physical, psychological, or cultural reasons. Restoration of the hymen is also known as hymenoplasty or revirginization.

Hymen repair is usually a simple outpatient procedure that can be done in our hospital under local anesthesia. Any torn skin around the edges of the hymen is gently and neatly cut away, after which the remaining tissue is stitched together, leaving a small opening. This restores the hymenal ring to a normal size and shape.

If there is not enough skin to restore the hymen, or if a hymen is nonexistent, the surgeon may create one, using either some of the body’s own thin vaginal skin (vaginal mucosa) or a synthetic tissue. A small blood supply may be added, either artificial or the patient’s own taken from a piece of vaginal flap, thus simulating the traditional bleeding upon subsequent penetration.