SEE A LIST OF THE PRICE OF PROCEDURES HERE

More Information about Procedures

Breast augmentation
Breast augmentation is surgery to enhance the size and shape of a woman's breast. The surgery may be done to enhance breast size, correct a reduction in volume after pregnancy or balance a size difference between the two breasts. Surgeons are able to enlarge the breast by placing a saltwater-filled silicone implant behind it.

During the initial consultation, a thorough evaluation of your skin tone and breasts will determine the most appropriate surgical technique for you. Occasionally, a breast lift (mastopexy) will also be required to reshape and reposition a sagging breast. Breast augmentation is most commonly performed under general anesthesia.

The surgeon will make recommendations about how the implant should be inserted and positioned based on your anatomy. The incision may be made in the crease under the breast (inframammary) or around the areola (the dark skin surrounding the nipple). After the incision is made, the surgeon creates a pocket for the implant directly behind the breast tissue or behind the chest muscle.

The implant is centered behind the nipple and areola and they are available in a round or teardrop shape with a smooth or textured surface.

Breast augmentation surgery requires about two hours to complete. After the procedure, patients are advised regarding wound care, bra selection, suture removal and follow-up. Physical activity will be limited for several weeks after surgery. Scars will remain firm and pink for about six weeks and then begin to fade over several months.

Athough breast augmentation is a relatively straightforward procedure, there are risks. As with any surgical procedure, excessive bleeding may produce swelling and bruising. Infection is rare. However, if it occurs next to the implant, it might be necessary to remove the implant to resolve the infection. In some breasts, firmness develops because scar tissue forms around the implant. This is called a "capsular contracture" and may require secondary surgery to correct. Sensation change around the nipple can occur, but in most cases it is temporary. Occasionally, the breasts will have slightly different shapes. In most cases, these problems can be treated with acceptable results.

Since the implants are made of plastic, they can rupture and their contents leak. When a saline-filled implant ruptures, it deflates and the body harmlessly absorbs the saline. An implant rupture is very unusual and can be easily corrected by replacing it.

Breast implants have never been shown to cause any form of cancer in women. However, implants do make mammography somewhat less accurate and more difficult to interpret. Women who have breast implants should advise their radiologist before having a mammogram so that the mammogram technique can be modified.

Finally, there is no evidence that breast implants will affect breastfeeding, fertility or pregnancy. While most women undergoing breast augmentation do not experience complications, it is important to discuss the risks thoroughly with the surgeon.

Most women after the surgery report feeling better about themselves and having more self-esteem.

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Breast reduction
Women with large, heavy breasts may experience several health concerns related to their breasts: back pain, neck pain, grooves in the shoulders from bra straps, pain in the breasts, and rashes under the breasts.

Some women are bothered by the psychological embarrassment of large breasts. In other situations, athletic, active women and women who are trying to lose weight are inhibited by the size of their breasts. Breast reduction can minimize or eliminate these problems. Excess skin and breast tissues are removed and the breasts reshaped to be smaller and more attractive.

The breast reduction procedure is performed at the hospital with the patient under general anesthesia. When only a small amount of tissue is removed, the procedure can be performed under local anesthesia with intravenous sedation as an outpatient procedure.

The surgeon makes incisions so that scars form around the areola, vertically below the areola, and in the crease beneath the breast. The incisions are designed so the scars will not be visible while wearing normal clothing.

The surgeon then repositions the nipple and areola to a higher position on the breast, and removes excess breast tissue and skin. A drain may be left in place at the time of surgery and removed several days later. The patient can be up and about the day after surgery, and can go home in the next day in most cases. Sutures are removed within the first two weeks following surgery.

Complications of breast reduction can include postoperative bleeding, infection and healing problems. These complications may result in more obvious scars.

Although every attempt is made to obtain symmetry and a natural shape, there may be some irregularities in the final size and shape of the breasts or in the positioning of the areola and nipple. Because separating the nipple from the breast tissue during the procedure disturbs the surface nerves of the nipple, patients may experience a decrease in sensation which basically returns back. Patients also may experience a permanent inability to breast-feed after having the surgery what is actually rare.

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Breast Lift (Mastopexy)
Breast sagging (ptosis) is a common problem following pregnancies, weight loss or aging. Sagging occurs when breast skin stretches, and breast tissue and fat degenerate over time. This results in a less youthful appearance of the breasts. Breast sagging can be corrected with a breast lift (mastopexy).

The mastopexy procedure may be performed under either local anesthesia with intravenous sedation or general anesthesia. The operation takes about two hours, and patients often return home the same day.

During mastopexy, surgeons reposition the nipple and areola to a higher position and remove excess skin from beneath the breast. Closing the remaining skin lifts the breast mound to a higher position and recontours the breast to give it a more projected and youthful appearance.

If there is inadequate breast tissue to fill the skin and achieve the desired size, a saline-filled breast implant may be placed beneath the breast at the same time, achieving the desired size, shape and projection.

Patients may resume limited activities the day after surgery and normal activities in three to four weeks. Pain usually can be controlled with oral pain medication. Sutures are removed one to two weeks after surgery.

When there is marked sagging, the incisions required and resulting scars are similar to those resulting from a breast reduction. In cases of less breast sagging, mastopexy can often be accomplished with smaller scars.

Potential complications of mastopexy include bleeding, infection and healing problems. Patients may experience some decrease in sensation in the nipple. In addition, some patients may notice minor irregularities in the size and shape of the breasts, and in the position of the areola and nipple.

Following mastopexy, patients may be able to breast-feed because the nipple usually is not separated from the milk glands. If an implant is used, however, problems with the implant can occur.

Following the surgery and healing period, the breast will have a more attractive and youthful appearance. With time, however, there may be further sagging that could necessitate a revisional procedure.

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Liposuction
Areas that can be well treated by suction lipectomy include the flanks, buttocks and thighs.

Removing body fat using suction has proven to be a safe and effective surgical alternative that can result in a better body contour with minimal scarring. The procedure gives the best result when used to remove localized areas of unwanted fat after someone has reached a desirable weight through diet and exercise.

Except for removing very small amounts of fat, this procedure must be performed under general anesthesia. However, in most cases, it can be done as an outpatient procedure. When plans are to remove large amounts, it is safer to do the procedure in the hospital. The length of the procedure varies depending on how much fat is removed and it is from 1 to 4 hours.

Liposuction is commonly used to remove excess fat in the abdomen, flanks, buttocks, thighs and knees.

Before the surgeon begins the liposuction, the area to be suctioned is infused with large quantities of a special fluid. This is called the tumescent technique. It has been in widespread use for several years and is a great advance to liposuction. It makes it easier for the surgeon to remove the fat, and there is less bleeding and postoperative bruising and pain. Patients recover faster and are back to their normal activities sooner than after the older technique.

A small, 2 cm incision is made near the area where the fat is to be removed. A thin, blunt-tipped, hollow rod is inserted under the skin and carefully manipulated through the fat tissue. The hollow rod is attached to a high-vacuum hose that suctions out the unwanted fat cells. When the desired fat is removed, the incisions are closed and dressings are applied. Patients wear a pressure garment over the suctioned area. This minimizes swelling and discoloration and helps the healing process. In spite of this, there will be some swelling and discoloration. The discoloration subsides in several weeks, but the swelling may take months to disappear.

Following surgery, oral medication will usually control the pain. Patients should drink plenty of fluids the first few days after surgery. Sport drinks containing electrolytes are recommended. Patients can return to near normal activity in about one week, but it may be several weeks before strenuous exercise can be resumed.

As in any operation, complications can occur but their degree and number are relatively small. Occasionally, antibiotics are required for minor infections. The most common problem is waviness or sagging skin, which is caused by irregular fat removal or inadequate skin shrinkage over the newly contoured areas. In some cases, there may be depressions from too much fat removal. Cellulite (dimpling) and other surface irregularities that were present before surgery will still be present afterward.

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Tummy tuck (Abdominoplasty)
Women often develop excess abdominal skin, fat, and stretched abdominal muscles as a result of pregnancy or weight loss. Abdominoplasty, surgical removal of loose skin and excess fatty tissue, corrects these problems. If the patient's only complaint is excess fat in the abdomen, the problem can sometimes be corrected by liposuction alone.

Abdominoplasty is usually performed under general anesthesia and takes two to three hours. The patient usually must spend one to several nights in the hospital. When discharging the patients, doctors prescribe oral pain medication to control typically mild to moderate pain. The patient also is given an abdominal binder to provide support while healing.

Following surgery, patients should restrict their activities for two to three weeks, and exertion is prohibited for four weeks. The stitches generally are removed in one to two weeks following surgery.

Abdominoplasty is performed through an incision across the lower abdomen. An incision is made around the belly button, leaving it attached to the abdominal wall. The skin and fat are then elevated from the abdominal wall and muscles to the level of the rib cage. Surgeons may remove some fat from the flanks with supplemental liposuction and, if needed, the abdominal muscles are tightened by suturing them together in the midline and shortening them. Surgeons remove excess skin and fat at the upper line of the incision. The belly button is then brought out through a small incision and sutured to the new skin in its normal position.

Drains are sometimes left beneath the skin for several days following surgery. It may be months before all the swelling has completely subsided. Patients often experience reduced sensation in the abdominal area and the upper thighs. This will subside in the months following the procedure. The scars around the belly button and the lower part of the abdomen will gradually fade and become less visible.

Potential complications of abdominoplasty include bleeding, infection and healing problems, which can lead to heavy scars. Some lack of symmetry also may occur. Because the skin is undermined, there is a slight risk of inadequate circulation and loss of some skin. This risk is greater in smokers and in patients with specific kinds of old scars. Patients should quit smoking for 14 days prior to and following surgery, and stop taking aspirin 14 days before surgery.

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