Surgical Procedures

Body Procedures

Arm Lift Surgery (Brachioplasty)
Liposuction
Thigh Lift (thighplasty)
Tummy Tuck (Abdominoplasty)
Skin Cancer
Scar Revision

Arm Lift Surgery (Brachioplasty) View Photos

Procedure Overview:
Arm Lift Surgery (Brachioplasty) - A brachioplasty is a surgical procedure involving the skin and fat on your arms, typically the posterior part. Some people are born with large arms while others develop loose, hanging skin with increasing age or after significant weight loss. In some cases liposuction alone can improve the size and shape of the arms. In others, removal of tissue with a scar is needed for the best improvement. The scar typically runs from the axilla to the elbow. If placed well, this scar is not visible when your arms are at your side. In patients who have loose skin that is located near the under arm area alone, it’s possible to remove skin so that the scar is hidden.

Anesthesia Options:
General Anesthesia, or in some cases IV Sedation or even local.

Risks and Benefits:

The most common problem associated with this surgery is wound healing and final scar appearance. Scars are the greatest drawback to this operation. Smokers are advised to discontinue smoking three weeks prior to surgery, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin.

Complete scar maturation takes about a year and a half. This is when your scar will begin to look its best. Scars will be red and raised at first but typically flatten and lighten over time. The benefits of the procedure is a slender arm that does not “jiggle”. Patients are not so self-conscious about their arms. Patients feel more comfortable wearing clothing that shows their arms.

Recovery:
Your arms will be swollen for several weeks following the procedure. Your hands may swell. Arm elevation is important to prevent excessive swelling. I will see you at the office 2-3 days following surgery to remove dressings, assess your wounds and to possibly remove drains if used. Silicone gel sheeting is recommended to ensure the best scar possible. I recommend the use of compression garments for up to six weeks after the procedure to control swelling and improve post operative skin contour.

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Liposuction View Female Liposuction Photos View Male Liposuction Photos

Procedure Overview:

Liposuction (Suction-Assisted Lipectomy) - Liposuction consists of the removal of excess fatty tissue all over the body and even the face. It is one of the most commonly performed plastic surgery procedures. In well qualified hands, the procedure is safe, reliable and pleasing. Traditional liposuction removes fat with a suction machine and a small cannula that is moved beneath the skin. A number of techniques can be used at the surgeon's discretion. Ultrasound-assisted lipoplasty (UAL) is a technique in which an ultrasound probe is inserted beneath the skin to "liquefy" the fat before it is suctioned. Power assisted liposuction (PAL) is a technique in which the cannula is put in motion with a machine. There are laser based machines that liquefy fat which is subsequently removed with the standard cannula. Ultimately, it is the surgeon who determines the safety and quality of your results and not the machine.

The tumescent technique refers to the infusion of a saline solution containing a local anesthetic into the fat before liposuction to reduce blood loss and post-operative bruising and swelling. Larger volumes of fat removal require special expertise and appropriate staff and facilities. Please review my Article on Liposuction for a more thorough discussion of this popular procedure.

Anesthesia Options:
General recommended, or in some cases Local with IV sedation. Small cases of isolated fatty deposits can be performed with tumescent anesthesia alone.

Risks and Benefits:
Temporary bruising, swelling, numbness, soreness, burning sensation, temporary fluid drainage from incision sites, asymmetry, rippling or bagginess of skin, pigmentation changes. Large volume liposuction is associated with greater risks including shock and even death. The benefits of liposuction range from treatment of relatively small “difficult” areas to complete body reshaping. In appropriately selected patients, liposuction can be a catalyst to beneficial life changes. Liposuction is not performed for weight loss.

Recovery:
Recovery varies greatly depending on the amount of liposuction done. Most people can return to work after several days and be back to exercising in 2 weeks. Full recovery from swelling and bruising can take several months. The use of postoperative homeopathic supplements such as Arnica and Bromelain may decrease post-operative bruising and swelling. Endermology treatments are recommended in most cases to ensure optimal skin retraction. When larger amounts of fat is removed it’s not uncommon to feel less energetic for several weeks. It’s important to move about after liposuction to speed recovery. Compression garments are worn for about four weeks. Areas of skin numbness recovers after a few months.

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Thigh Lift (Thighplasty) View Photos

Procedure Overview:
Thigh Lift (thighplasty) - A thigh lift is a procedure to remove excess skin and fat from the inner or outer thighs. It is a common consideration in patients who have lost significant weight. It only contours the skin in the uppermost region of the medial legs and will not improve the area down the leg (as seen when pulling up on the skin of your legs when demonstrating the look that you desire.)

Anesthesia Options:
General or local with sedation.

Risks and benefits:
The risks of the procedure typically involve wound healing issues like wound drainage and delayed healing. There is the distinct possibility of a wound infection because of the location of the incision in a warm, moist area. The benefits are a significant reduction in the fullness in the upper part of your legs, less rubbing of the skin and less skin excess. The contour of your legs is improved.

Recovery:
There will be some pain and tightness associated with this procedure in your upper things. Swelling will last for several weeks. The incision takes a few weeks to heal completely. Compression garments are recommended for several weeks. The incision needs to be kept clean and dry to minimize the potential for would healing problems. Any leg movements that place tension on the wound will be associated with pain and should be minimized. I recommend that you have four or five days to relax after the procedure. Exercise can start about three weeks after surgery. It takes about a year and a half for the scar to look its best.

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Tummy Tuck (Abdominoplasty) View Photos

Procedure Overview:
Tummy Tuck (Abdominoplasty) - Abdominoplasty is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty; also know as a mini-tummy tuck

Anesthesia Options:
General anesthesia or local anesthesia combined with IV sedation for a mini tuck at the discretion of our anesthesiologist.

Side effects/risks:
Temporary pain, swelling, soreness, numbness of abdominal skin, bruising and fatigue for several weeks or months. Blood clots, infection, bleeding under the skin flap, poor healing resulting in conspicuous scarring or skin loss and the need for a second operation are much less common side effects.

Recovery:
For the first few days, your abdomen will be swollen and you're likely to feel some pain and discomfort that can be controlled by oral medication. We also infiltrate numbing medication on the abdominal fascia that helps reduce discomfort considerably. All patients are sent home the day of their procedure. Though you may not be able to stand straight at first, you should start walking as soon as possible and as the tightness softens over the week you will walk normally. In healthy motivated patients, recovery usually lasts two weeks at most. Many patients return to work after one week and resume exercise in three or four weeks depending on their tolerance. It’s important to remain slightly flexed at your waist in order to be most comfortable and reduce the tension on your repair. Mild swelling can persist on the lower abdomen for 6 to 8 weeks. Drains are usually inserted at your procedure and will remain for about 5 days.

Heavy lifting is avoided for the first two weeks (25 pounds or more). Extra help will be beneficial for the first seven to ten days particularly if there are young children around. Sleeping in the flexed position for the first week or so will provide extra comfort. A recliner or hospital bed (rented) has come in quite handy for many patients.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. It is recommended that you use silicone scar strips on your incisions for at least six months afterwards in order to ensure the finest scar result. This must be worn for at least 12 hours a day. We encourage patients to wear store bought compression garments for several months after the procedure for swelling control, general comfort and scar softening.

Scar Improvement Over Time

The following three photos illustrate how the abdominal scars change over time. The first photo is the patient's pre operative abdomen. The second was taken at four months, and the last was taken at 14 months after her abdominoplasty. It actually takes about 2 years or so for a scar to completely mature. During that time the redness deminishes, the scar flattens and minor skin irregularities improve. The scar is real, it goes from one hip to the other but it is rarely a source of concern.

*Please note that abdominoplasty scars always look worse in photographs than in real life. Also, most post operative photos are taken at four months when scars have not yet fully matured. Complaints about an abdominoplasty scar are uncommon.

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Skin Cancer

Procedure Overview:
Skin Cancer on the Body - While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous. Most skin cancers are removed surgically, by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily. The procedure may be a simple excision, which usually leaves a thin, barely visible scar, or curettage (scraping) and electrocautery may be performed. In this procedure the cancer is scraped out, and an electric current is used to control bleeding and kill any remaining cancer cells. This leaves a reddened area for some time, which eventually turns white or skin colored.

Anesthesia Options:
Local.

Duration of Results: variable - recurrences are possible

Side effects/risks:
Depending on the location and severity of the cancer, the consequences may range from a small but unsightly scar to permanent changes in facial structures such as your nose, ear, or lip.

Recovery:
Varies depending on the complexity of the procedure performed.

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Scar Revision View Photos

Procedure Overview:
Scar Revision on the Body - While no scar can be removed completely, plastic surgeons can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as scar revisions. Z-plasty is a surgical technique used to reposition a scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable. It can also relieve the tension caused by contracture. Not all scars lend themselves to Z-plasty, however, and it requires an experienced plastic surgeon to make such judgments. Skin grafts and flaps are more complex forms of scar surgery. Your surgeon decides the need for these.

Anesthesia Options:
Skin grafts and flaps: general anesthesia.

Duration of Results:
Permanent.

Side effects/risks:
These procedures are normally safe, but there is always the possibility of complications. These may include infection, bleeding, a reaction to the anesthesia, or the recurrence of an unsightly scar.

Recovery:
Skin grafts and flaps require several weeks or months for complete healing.

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