How Soon Can You Wear Makeup After Eyelid Surgery?

Makeup can be extremely irritating to a fresh surgical incision. Furthermore, the cleansing agents used to remove makeup are even more irritating. For these reasons, we generally don’t allow patients to wear makeup for at least one week following suture removal. Hopefully at this point the edges of the wound are sealed.

What Type of Implant is Best For a Breast Augmentation?

Several questions need to be answered before proceeding with breast augmentation surgery.  These pertain to the following issues: 1) Implant size, 2) Implant type, 3) Incision location, 4) Under or over the muscle, and 5) With or without a breast lift.

Depending on the answers to these questions, a large variety of treatment options potentially exist.  Each patient should be considered individually since no two patients are the same. Patients may have unique anatomic findings and specific aesthetic goals that impact their treatment plan.

In general terms, data shows that the majority of implants are placed under the muscle through an inframammary approach.  There is a greater tendency to use silicone gel implants than saline implants, but saline implants are still used frequently.  When breast sag is present, most surgeons perform a breast lift but occasionally plastic surgeons place the implants on top of the muscles to avoid scarring.

There’s no best breast implant. Silicone breast implants tend to feel more natural than saline breast implants and offer a distinct advantage in patients with minimal amounts of soft tissue coverage.  The advantages of saline breast implants include smaller incisions and less expense.

Mommy Makeover: Inpatient vs. Outpatient Surgery

The mommy makeover is an extensive procedure that combines cosmetic breast surgery, liposuction, and abdominoplasty. In the vast majority of cases, we’ve performed the procedure on an outpatient basis in an ambulatory surgery center. Patients typically return home after surgery and are seen in follow up the next morning.

When cosmetic surgery is performed on an outpatient basis, certain criteria must be met. Patients need to be in good health otherwise and they must have a support system in place. Many mommy makeover patients have small children at home. This potentially complicates after care because both the patient and her children need care givers.

Safety should always be a priority. When patients have co-existing medical problems, they should undergo a comprehensive medical evaluation before surgery. Depending upon the results of these studies, inpatient surgery may be indicated.

Pregnancy After a Tummy Tuck

The vast majority of women who undergo tummy tuck surgery are done having children. Rarely, women who have undergone abdominoplasty change their minds about additional pregnancies or accidentally become pregnant. Under these circumstances, tummy tuck has no negative impact upon the pregnancy. Unfortunately, pregnancy has a negative impact upon the patient’s previous abdominoplasty. Pregnancy recreates many of the patient’s original problems, including loose, saggy skin, weakened abdominal muscles, and stretch marks.

Plastic Surgery Financing

For many patients, cosmetic surgery would not be possible without some type of financing. For this reason, the vast majority of plastic surgeons offer some type of financing program.

In our practice, we almost exclusively utilize Care Credit. This is currently the most commonly used source of plastic surgery financing in the United States. Care Credit is run by GE Capital Financing. It’s reputable and you can apply for a loan online. It takes approximately thirty minutes to get a response. In some cases, you may be able to get a twelve-month interest free loan.

The Management of Breast Asymmetry

Breast asymmetry is an extremely common problem amongst women. In most cases, this is relatively minor and women aren’t bothered by it. Occasionally, it can be severe and treatment is necessary.

A multitude of options can be used to treat this problem. These may include breast reduction, breast lift, breast augmentation, or various combinations of these procedures.

It’s important to realize every patient is unique. They have specific aesthetic goals and unique anatomic findings. The specific treatment for any individual patient will depend entirely upon these issues.

Liposuction for Men

Liposuction is one of the most commonly performed cosmetic surgical procedures in men. The flanks, abdomen, chest, and neck appear to be the most commonly treated areas. This procedure is
associated with high satisfaction rates when patients are near their ideal body weight.

Liposuction in men has limitations because the fat tends to be more fibrous. In addition, a large amount of the abdominal fat is located within the abdominal cavity where it can’t be reached by a liposuction canula. These characteristics can limit the amount of fat that can be removed with this procedure. Men generally have thicker skin than women and as a result, skin sag is less likely to occur in this group.In some cases, ultrasonic liposuction has been found to be helpful when performing liposuction on men. In theory, this procedure results in skin tightening as well.

Facelift Surgery for Rejuvenation of the Neck

It’s not unusual to see women who have significant changes in their neck area as a result of facial aging. In many cases, this may be the primary manifestation of aging, with the face itself being relatively unaffected. These changes may include loss of definition of the jaw line, loss of the sharp angle between the neck and jaw, laxity of the underlying neck muscles with the formation of bands called turkey gobblers, fat accumulation, and of course excess skin. To obtain an excellent result, all of these issues need to be addressed. With this in mind it’s important to remember that all patients have unique facial anatomy and specific aesthetic goals. Therefore, treatment plans may vary from patient to patient depending upon their underlying anatomic deformity.

The procedure that is most likely to accomplish these goals is a facelift. This procedure corrects the abnormalities of the underlying muscles which ultimately defines the jaw line, removes the neck bands, and improves the angle between the jaw and neck. It also addresses fat accumulation and excess skin to further accentuate these improvements.

Capsular Contracture Following Breast Augmentation

It’s normal for your body to react to a foreign material such as a breast implant by forming a scar. This scar surrounds the breast implant and is known as a capsule. Capsule formation occurs in every patient to some degree following breast augmentation. In most cases, this represents a normal response to a foreign material being placed inside your body.

Without capsule formation, implants don’t stay in one place. When this happens, implants migrate and secondary pocket revision may be necessary. In some cases, capsule formation occurs in an aggressive form, which results in a capsular contracture. In severe cases of capsular contracture, the breast implants become hard, distorted, displaced, and painful. The majority of capsular contractures develop within six months of surgery, but they can develop at any time.

There’s no laboratory or radiology test that makes the diagnosis. The diagnosis is entirely based on physical examination.

Teen Breast Reduction

When younger patients have significant breast enlargement with associated symptoms, we don’t feel that they should be denied the benefits of this procedure because of an arbitrary age cutoff. Before proceeding, there are several unique considerations in this group that must be considered.

One of these is the issue of breast growth. We would prefer stabilization of breast growth for at least six months prior to proceeding with surgery. Another issue is the age of consent. Because of this, parents should be involved in every step of the decision- making process.

Choosing a Plastic Surgeon

It’s important for patients to be comfortable with their choice of plastic surgeon before proceeding with cosmetic surgery. When choosing a surgeon, several issues should be considered. These include the surgeon’s training, certification, and experience.

Completion of a plastic surgery residency is an essential requirement when picking a surgeon. Although it seems obvious that cosmetic surgery is a procedure that should be performed by someone trained in plastic surgery, this is not always the case. There are many physicians who perform cosmetic surgery who haven’t completed plastic surgery training. They frequently refer to themselves as cosmetic surgeons and have trained in a variety of other areas.

Board-certification is also extremely important. This means that your surgeon has undergone testing and peer review. He or she has satisfied certain criteria that are associated with surgical excellence.

One of the most important factors is your surgeon’s level of experience. Surgeons who have extensive experience with aesthetic surgery tend to have higher success rates.

Breast Augmentation Options

Several questions need to be answered before proceeding with breast augmentation surgery.  These pertain to the following issues: 1) Implant size, 2) Implant type, 3) Incision location, 4) Under or the over muscle, and 5) With or without a breast lift.

Depending upon the answers to these questions, a large variety of treatment options potentially exist. Each patient should be considered individually since no two patients are the same. Patients may have unique anatomic findings and specific aesthetic goals that impact their treatment plan.

In general terms, data shows that the majority of implants are placed under the muscle through an inframammary approach.  There is a greater tendency to use silicone gel implants than saline implants, but saline implants are still frequently used.

Keep Calm & Fight On!

Aesthetic Surgical Images’ Staff Members Attend Race for the Cure

This past Sunday, October 6th 2013, Aesthetic Surgical Images’ staff members participated in the Susan G. Komen Race for the Cure. The annual event helps raise funds to support breast cancer research. The event honors those who have lost their battle with breast cancer while celebrating those who have survived breast cancer. In addition to supporting research, the event also promotes breast cancer awareness, education, and early breast cancer detection.

We Have A "BOO"-Tox Special, Now Through October 31st!

 We Have A "BOO"-Tox Special, Now Through October 31st!

The Ideal Age for Rhinoplasty

Several variables should be considered when determining the appropriate age for rhinoplasty surgery. These variables tend to make each patient’s situation unique. As a general rule, it’s important for patients to reach both physical and emotional maturity before proceeding with surgery.

Physical maturity is important for several reasons. Operating on the nose before growth has stabilized can have significant consequences. Under these circumstances, continued growth following rhinoplasty surgery can result in nasal changes that may alter the appearance of the nose. In addition, rhinoplasty surgery performed at an early age has the potential to disrupt facial growth. This can result in flattened cheekbones and even malocclusion.

Emotional maturity is also extremely important. For the most part, this procedure is irreversible and young patients must understand the significance of their decision. The nose is located in the center of their face and their appearance will be altered forever.

Vote Aesthetic Surgical Images: Best of Omaha 2014!

It’s that time of year again! Best of Omaha voting for 2014 is underway and Aesthetic Surgical Images would be honored to have your vote in the Breast Augmentation & Cosmetic Surgeon categories.

How to Vote:
Step 1) Click Here.
Step 2) Register to vote (you will need to verify your email address).
Step 3) The Breast Augmentation category will appear. Click on the Submit Vote and Continue box.
Step 4) Click on the Cosmetic Surgeon category, which is in the drop down menu. Please enter the Aesthetic Surgical Images’ surgeon that you think deserves this vote: Dr. John Edney, Dr. Richard Bruneteau, Dr. Marie Montag or Dr. John Heieck.


*Please Note: Make sure to verify your email address & vote for at least 20 categories for your votes for Breast Augmentation & Cosmetic Surgeon to count!


Thank you! The surgeons and staff of Aesthetic Surgical Images truly appreciate your support and are incredibly grateful for your votes!

Mini Tummy Tuck vs. Full Tummy Tuck

Pregnancy has a significant impact on a woman’s body, and nowhere is this more noticeable then the abdomen. This area develops excess, saggy skin, weakened muscles, and stretch marks. Despite diet and exercise, most women are unable to reverse these changes and this ultimately affects their self-image and self-esteem. Treatment options are limited and in most cases involve either abdominoplasty or mini abdominoplasty.

Abdominoplasty is performed by making a lower abdominal skin incision and then lifting the skin and subcutaneous tissue to the level of the rib cage. This typically requires detaching the belly button, which allows more skin to be removed. The muscles are then tightened, excess skin removed, and the belly button re-attached in proper position.

Recovery Following Facelifts

Facelift recovery varies from patient to patient and depends on a large number of variables. Just as every patient is unique, the chosen procedure for he or she is unique as well. The differences in wound-healing characteristics and the type of procedure performed account for variations in facelift recovery.

Most patients feel pretty good in about four to five days, but their primary concerns are when they will look good enough to go out in public. Recovery following facelift surgery may last for months, but most patients feel they can go out in public in about two weeks. At this point, most of the bruising and swelling have resolved. Many patients adjust their hairstyle to hide their incisions and use make-up as well.

Will Pregnancy Ruin My Breast Implants?

Breast implants are not impacted by pregnancy and breast-feeding, but the surrounding breast tissue can be significantly impacted. These changes vary from patient to patient following breast augmentation and pregnancy. Some patients are minimally impacted, while others note sag of their native breast tissue, loss of breast volume, and stretch marks. These changes are probably not related to breast implants, but are instead related to the natural biologic tendencies of the breast tissue. In other words, loss of breast volume, sag, and stretch marks would occur even if breast implants weren't present.

Breast Augmentation & Under Wire Bras

We generally avoid using under wire bras for six to eight weeks following breast augmentation. There are two reasons for this approach. First, when patients undergo sub muscular placement of breast implants, the pectoral major muscle may undergo spasm in the early post-operative period. This may force the implant in an upward direction and lead to malposition. When this situation arises, we utilize compression to force the implant in a downward direction. An under wire bra would have the opposite effect.

Another reason for avoiding under wire bras in the immediate post-operative period is the potential for the bra to irritate a fresh surgical incision.  An infamammary incision would be directly beneath the under wire bra and this might lead to irritation of the incision.

Exercise Following Breast Augmentation

Recovery times following breast augmentation surgery vary from patient to patient. These times are significantly impacted by the nature of the procedure, the patient’s employment, and the patient’s social situation. It’s important to realize that even though breast augmentation is a cosmetic procedure, it’s still a significant operation with associated risk. For this reason, premature return to normal activity can result in an increased incidence of complications.
  
We generally recommend light activity for the first week following the procedure. After one week, patients are allowed to gradually resume normal non- strenuous activities. Strenuous activities and heavy lifting are not allowed for at least six weeks in most cases. At six weeks, most patients are able to resume all of their normal activities.

Insurance Coverage for Blepharoplasty?

When redundant upper eyelid skin results in obstruction of vision, it’s more than a cosmetic issue.  Patients often have excess skin, which obstructs vision superiorly and laterally.  Under these circumstances, excess upper eyelid skin can actually cause significant functional problems.  For instance, this can create problems when driving a motor vehicle and this can be potentially dangerous.  When this happens insurance carriers will occasionally view upper lid blepharoplasty as
medically necessary and cover its expense.

Before insurance carriers cover the expense of blepharoplasty they require that certain criteria be met.  These include documentation of symptoms and physical findings associated with visual field obstruction.  In addition, visual field studies that demonstrate visual field obstruction are critical to insurance approval.

Visual field studies are typically performed by an ophthalmologist or optometrist. The study is performed by measuring the patient’s response to a series of flashing lights. The patient’s responses are recorded and a computer- generated report is made. This report will demonstrate any visual field defects that the patient may have. The initial study is followed by a secondary study in which the upper eyelids are taped in an upward direction.  Improvements in the results of visual field studies with the upper lids taped as opposed to untaped would indicate that blepharoplasty would benefit the patient.

Signs of Breast Implant Leakage

In the majority of patients undergoing breast augmentation, implants last a lifetime. Occasionally, implants deflate and need to be replaced.

Current data suggests that implants deflate at a rate of 1% at one year and 3% at three years. Over time, this number can be expected to grow. Implants may deflate with no apparent cause or may deflate secondary to trauma.

When saline implants deflate, the diagnosis is relatively easy to make. These implants lose volume and flatten quickly. Silicone implants present a much more difficult problem when they deflate. Rupture of silicone implants may not be apparent for years.

Signs of deflation include soreness, redness, loss of volume, change in shape, and sometimes, capsular contracture. These signs may be subtle and a history of trauma may be the only early indicator.

Aesthetic Surgical Images Sees 100,000th Patient

When you’re considering cosmetic surgery, the experience of your surgeon is extremely important. In 1970, Aesthetic Surgical Images saw its first patient. We are proud to say that after 43 years, we have seen over 100,000 patients. This is not only a testimony to our longevity, but the support of the community as well.

One of the driving forces behind the achievement of our practice is the strength of our surgical team. Comprised of four, board-certified plastic surgeons, our team members were selected not only for their credentials, but also for how their skills would complement one another for the benefit of our patients. For these reasons, you can count on our surgeons to provide integrity, trust, and excellence from the consultation and surgery to each postoperative visit.

Drs. Heieck, Edney, Bruneteau, and Montag want to thank the community for your continued support and look forward to serving you well into the future. As always, our cosmetic consultations are complimentary. To schedule a day or evening appointment, please call 402.390.0100.

Should I Get Breast Implants If I Plan On Getting Pregnant Later?

The results of breast augmentation surgery are never permanent. Changes in weight, normal aging, pregnancy, and breast-feeding can all be expected to change the breasts. Each patient who is considering breast augmentation and possibly pregnancy should be considered individually based on their personal situation. As a rule, if a patient is planning pregnancy within a year of surgery, we generally recommend postponing surgery until after the pregnancy. Most patients who present for breast augmentation don't have plans for pregnancy in the short term, but realize that it's probably in their future. It's important for this group of patients to realize that pregnancy may impact their final result.

The impact of pregnancy on breast augmentation varies from patient to patient. Some patients are minimally impacted, while others note sag of their native breast tissue, volume loss, and stretch marks. This often results in the need for secondary procedures, such as implant exchange and breast lift.

When is the Best Time to Get a Mommy Makeover?

Pregnancy causes significant changes in a woman’s body.  These changes vary from patient to patient and are permanent in most cases unless surgery is undertaken to reverse them. These changes can affect the breast, abdomen, and lead to fat accumulation in the hips and thighs. Many patients attempt diet and exercise, but this isn’t always helpful.  This problem can ultimately affect self-confidence, self-esteem, self-image, and the quality of day-to-day life. For these reasons, many patients request breast augmentation, tummy tuck, and liposuction.

The timing of surgery following pregnancy is important and several issues should be considered before proceeding with surgery. It takes time for a new post-pregnancy body to reach its new baseline following pregnancy. During this period, stretched skin may contract, a swollen uterus may shrink, and the weight gained during pregnancy may gradually disappear.

The breasts also undergo significant changes with pregnancy and breast-feeding. This results in breast enlargement, which continues with nursing. After nursing is stopped, it takes time for the breasts to return to their new baseline. At this point, the breasts may be smaller and have sag. This process takes three to six months to occur. All of these changes need to occur before a mommy makeover is considered.