Brachioplasty and Scarring

It’s not unusual for massive weight loss patients to develop redundant upper arm tissue. When this occurs it can represent a significant aesthetic deformity that can adversely impact self-esteem and self- image. When sag of this magnitude is present, the majority of patients require a full brachioplasty.

This procedure involves making an incision that extends from the axilla to the elbow. This approach removes excess skin in the vertical and transverse dimensions. Unfortunately, it’s virtually impossible to hide scars in this location. For this reason, brachioplasty patients are often dependent upon their wound healing characteristics for a good result. In other words, when wounds heal nicely, scars can be imperceptible; conversely, some patients will  have notable scars

                

The vast majority of patients tend to heal these incisions nicely, and the aesthetic results are excellent. Unfortunately, some patients form exuberant scar tissue, which can be very noticeable. When this situation occurs, these scars represent a significant aesthetic deformity which is difficult to hide. Under these circumstances, scar revision and long sleeve shirts may be the only options available for patients.

              

In the post-operative period, various maneuvers can minimize scarring. These include massage, topical creams, and silastic. If you’re considering this procedure it’s important to understand the potential for scarring and its irreversible nature. The majority of patients have excellent results, but occasionally patients are unhappy with scarring and request scar revision. 

What Is Coolsculpting?

Coolsculpting represents a significant advance in the treatment of problem fat collections. The technique has been clinically proven and has FDA approval.

The procedure involves placing an applicator over the involved area. Suction is then applied, which draws the soft tissue into the device where it’s held in place. The skin and fat are then cooled in a controlled manner. Upon completion of treatment, the involved area is gently massaged to smooth contour irregularities that have been created by the device.

When single anatomic areas are treated, the procedure typically lasts about an hour. Depending on the magnitude of the problem, multiple treatments may be necessary.

Commonly treated areas include the abdomen, flanks, hips, bra strap area, inner thighs, outer thighs, saddle bags and banana rolls.

In the vast majority of patients who undergo coolsculpting the results are excellent. The procedure is very safe and there appears to be no long term problems associated with the procedure.

Unfortunately, the procedure isn't for everyone. Patients with large amounts of fat or loose skin may need more aggressive procedures. In this group, liposuction or skin resections may be more appropriate. It is important to remember that the best results occur when there’s appropriate patient selection and expectations are realistic.

Can Skin Sag Result From Abdominal Liposuction?

Every patient has the potential to develop loose skin following liposuction surgery. It’s therefore important that this topic be a part of the preoperative discussion and informed consent process.

The potential to develop loose skin varies from patient to patient. This determination is based on physical examination alone. Some patients have excellent skin tone with minimal laxity and aren’t likely to have difficulty with skin sag. These patients are often younger and are close to their ideal body weight. In this group, liposuction is an excellent treatment option with high satisfaction rates.

There are also patients who are clearly at risk for developing skin sag. This group is often older and their skin has more laxity. They have experienced greater fluctuations in their weight and have had multiple pregnancies. In many cases, they are not within 10% of their ideal body weight. They may also have associated weakness of their underlying abdominal muscles.

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.

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.

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.

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.

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.

Mommy Makeover

Most women, today, take pride in their appearance. They work hard to maintain a proper lifestyle by eating mostly healthy foods, exercising, and keeping fit. When motherhood occurs, however, everything changes. Pregnancy, childbirth, and breast feeding all take their toll on every part of the body. Before a woman knows it, a lifetime of her efforts have been undone.

Computer Imaging for your Cosmetic Surgical Procedures

Once you’ve chosen your board certified plastic surgeon for your cosmetic surgical procedure, the next step is to schedule a consultation. At this stage, all your questions about your procedure will be answered. How long does surgery take? Will there be pain and swelling? Is there noticeable scarring from the procedure? What are the risks involved? How soon can I return to work?

Patients often ask, “What type of results can I expect after surgery?” During your initial consultation at Surgical Images, your physician can simulate a “post-op” blueprint of your surgical results. Imaging is most commonly used with the following procedures:

Welcome to Our NEW Cosmetic Surgery Video Blog! - "What Are The Benefits of Combination Procedures?"

If you are considering improving your appearance through plastic surgery, you may also be considering more than one procedure. Today, there is no need to undergo multiple surgeries to achieve your new, more youthful look. Multiple procedures done in combination offer you the ability to have one surgery with only one recovery time and one affordable fee.

The benefits to having more than one type of surgery at a time are twofold – Money and time. In fact, this approach is the perfect option for you to achieve the look you want with a smaller overall recovery time and less of a financial obligation.


Combination Procedures Save You Money

Whether we like to admit it or not, cost is a consideration for many plastic surgery patients. Good medical care with the highest standards does not come cheap. Saving money when it comes to medical procedures does not lower the quality of care. In fact, by performing several procedures at once, you will have the attention of several board certified plastic surgeons to help you achieve your optimal look and “you get more bang for your buck.”

With Surgical Image’s no interest 12 month financing for patients who qualify, a new look at an affordable price is easy and allows you some financial flexibility.

Combination Procedures Save You Time

Most of our patients are just like you …busy and have little time for multiple surgeries and recoveries. That is why combination procedures are so popular– they cater to the hectic pace of life in today’s society.

Consider the time efficiency this service offers:

• Time in surgery is reduced. Doing a few things at once is much quicker than doing them separately.

• You only need to recover from anesthesia one time; especially important for some patients whose anesthesia recovery can take days.

• No one likes pain. Certainly no one likes being in pain any longer than necessary. With a combination procedure, the extent of gain is about the same that it would be for only one surgery.

• You can obtain the look you desire in just one day.

Combination Procedures – The Options

There are a number of cosmetic procedures that can be combined to save you both time and money. Combination procedures frequently requested to achieve a maximum benefit at one time include:

• A Facelift in combination with Upper and Lower Eyelid surgery, along with a Browlift to reverse the signs of aging.

• The “Mommy Makeover” is one of the most popular combinations. This option gives moms the ability to recapture their pre-pregnancy figure. With a surgical program that involves a breast lift or enhancement, a tummy tuck, and liposuction, any mom will look stunning with a restored body and a new sense of confidence.

• Facial contouring rises to the next level when you choose a Rhinoplasty along with a Chin augmentation (a Genioplasty) and cheek implants.

• Other combinations are available depending on a patient’s goals. Make an appointment with one of our Board Certified plastic surgeons to see which procedures are best for your new look.

With the savings of both time and money that combination plastic surgery provides, it just makes good sense to have multiple surgeries at one time. Imagine, a dramatic new look in just one day!