Abdominoplasty (Tummy Tuck)

Abdominoplasty is a surgical procedure to remove the excess skin and fatty tissue from the middle and lower abdomen and to tighten muscles of the abdominal wall. Abdominoplasty is not a surgical treatment for being overweight. Obese individuals who intend to lose weight should postpone all forms of body contouring surgery until their weight loss has been maintained. There are a variety of techniques for abdominoplasty, such as combining abdominoplasty with suction-assisted lipectomy (liposuction) or other elective surgical procedures.

Augmentation Mammaplasty (Breast Augmentation)

Augmentation mammaplasty is a surgical procedure performed to enlarge the breasts for a number of reasons. These reasons include:

  • To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
  • To correct a loss in breast volume after pregnancy
  • To balance breast size when there exists a significant difference between the size of the breasts
  • As a reconstructive technique for various conditions
  • Replacement of breast implants for medical or cosmetic reasons

The shape and size of the breasts prior to the surgery influence the recommended treatment and the final results. If the breasts are not the same size or shape before the surgery, it is unlikely that they will be completely symmetrical after the surgery.

Breast augmentation is accomplished by inserting a breast implant either behind the breast tissue or under the chest muscles. Incisions are made to keep scars as inconspicuous as possible, usually under the breast, around the lower part of the areola, or in the armpit. The method of inserting and positioning the breast implants will depend on your preferences, your anatomy, and Dr. Holland’s recommendation. There are two basic types of implants: silicone gel filled and saline filled. All breast implants are subject to device tracking according to federal law.

Patients undergoing augmentation mammaplasty surgery must consider the possibility of future revisionary surgery. Breast implants cannot be expected to last forever as they are medical devices.

Breast Reduction

Women who have large breast may experience a variety of problems from the weight and size of their breasts, including possible skin irritation, back, neck, and shoulder pain. Breast reduction is usually performed for the relief of these symptoms rather than to enhance the appearance of the breasts. The ideal candidates for reduction mammaplasty are healthy, emotionally stable women who have realistic expectations about what reduction mammaplasty surgery can accomplish. There are a variety of different surgical techniques available for the reshaping and lifting the female breast. Reduction mammaplasty does leave permanent, noticeable scars on the breasts. There are both risks and complications associated with reduction mammaplasty surgery.

Mastopexy (Breast Lift)

Mastopexy, or breast lift is a surgical procedure performed to raise and reshape sagging breasts. There are a variety of different surgical techniques available for the reshaping and lifting the female breast. Factors such as pregnancy, nursing, weight changes, aging and gravity result in changes in the appearance of women’s breasts. As the skin loses elasticity, the breasts often lose their shape and begin to sag. Mastopexy (breast lift) can raise, reshape, and also reduce the size of areola, the darker skin around the nipple. Mastopexy does leave permanent, noticeable scars on the breasts.

The ideal candidates for mastopexy are healthy, emotionally stable women who have realistic expectations about what mastopexy surgery can accomplish. Breasts of any size can be lifted, but the results may not last as long in women with heavy, large breasts. Small breasts or breasts that have lost volume due to pregnancy or nursing may benefit from the insertion of breast implants in conjunction with or after the mastopexy. A separate consent form for the use of breast implants is necessary.

Lipectomy (Liposuction)

Suction-assisted lipectomy (“liposuction”) is a surgical procedure to remove unwanted deposits of fat from specific areas of the body, including the face, neck, upper arms, trunk, abdomen, buttocks, hips and thighs, knees, calves, and ankles. Liposuction is not a substitute for weight reduction, but a method for removing localized deposits of fatty tissue that does not respond to diet and exercise. Suction-assisted lipectomy may be performed as a primary procedure for body contouring or combined with other surgical techniques such as facelift, abdominoplasty, or thigh lift procedures to tighten loose skin and supporting structures.

The best candidates for liposuction are individuals of relatively normal weight who have excess fat in particular body areas. Having firm, elastic skin will result in a better final contour after liposuction. Hanging skin will not reshape itself to the new contours and may require additional surgical techniques to remove and tighten excess skin. Body contour irregularities due to structures other than fat cannot be improved by suction-assisted lipectomy. Suction-assisted lipectomy by itself will not improve areas of dimpled skin known as “cellulite”.

Rhytidectomy (Facelift)

Rhytidectomy (facelift) is a surgical procedure to improve visible signs of aging on the face and neck. As individuals age, the skin and muscles of the face region begin to lose tone. Surgical rhytidectomy (facelift) cannot stop the process of aging. It can improve the most visible signs of aging by tightening deeper structures, re-draping the skin of the face and neck, and removing selected areas of fat.

Facelift surgery is individualized for each patient. The best candidates for rhytidectomy (facelift) surgery have a face and neck line that has begun to sag, but whose skin has elasticity and has a well-defined bone structure. A facelift can be performed alone or in conjunction with other procedures, such as a browlift, liposuction, or eyelid surgery.

Blepharoplasty (Eyelid Surgery)

Blepharoplasty is a surgical procedure to remove excess skin and muscle from both the upper and/or lower eyelids along with underlying fatty tissue. Blepharoplasty can improve drooping skin and bagginess. It can help improve vision in older patients who have hooded of the upper eyelids. Although it can add an upper eyelid crease to the Asian eyelid, it will not erase evidence of one’s racial or ethnic heritage. Surgical blepharoplasty cannot stop the process of aging. Blepharoplasty will not remove “crow’s feet” or other wrinkles, eliminate dark under eye circles, or lift sagging eyebrows. It can diminish the look of loose skin and bagginess in the eyelid region.

Blepharoplasty surgery is individualized for each patient. It can be performed alone involving upper, lower or both eyelid regions. A blepharoplasty can also be performed in conjunction with other procedures, such as facelift or browlift surgery.

Breast Reconstruction

There are a variety of surgical techniques for breast reconstruction. The best candidates are women whose cancer, as far as can be determined, seems eliminated by the mastectomy.

Contraindications to tissue expander breast reconstruction procedure exist:

  • Inadequate skin and deeper tissue to cover the tissue expander
  • Local recurrence of breast cancer after mastectomy
  • Skin problems resulting from radiation therapy to the chest
  • A patient who is medically or psychologically unsuitable for breast reconstruction

Most mastectomy patients are medically appropriate for breast reconstruction, either immediately following breast removal or at a later time. There are legitimate reasons to delay breast reconstruction. Some women may be advised by their surgeon or oncologist to wait until other forms of necessary cancer treatments are completed. Other patients may require more complex breast reconstruction procedures. Women who smoke or who have to take tramadol 50mg online may be advised to postpone surgery.

Breast reconstruction has no known effect on altering the natural history of breast cancer or interfering with other forms of breast cancer treatment such as chemotherapy or radiation.

The use of tissue expanders for breast reconstruction involves a two-stage process. A silicone, rubber, balloon-like tissue expander is first inserted beneath the skin and chest muscles. Saline is gradually injected into the tissue expander to fill the tissue expander over a period of weeks or months. This process allows the skin on the chest to be stretched over the expander, creating the breast mound. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent implant. Patients undergoing breast reconstruction surgery with tissue expanders must consider the possibility of future revisionary surgery. Tissue expanders and breast implants cannot be expected to last forever, as they are medical devices.

The shape and size of the breasts prior to the surgery influence both the recommended placement of the tissue expander and the final shape of the reconstructed breast. Tissue expander breast reconstruction cannot produce an exact replica of the removed breast. The nipple and areola may be reconstructed in subsequent procedures after the breast mount is created through tissue expansion.

Use of an acelluar tissue matrix may be required to attain coverage. Acelluar tissue matrix is a pliable, sterile product derived from cadaver porcine dermis processed to remove cells, reducing the risk of rejection.  Tissue Matrices can help to overcome many of the aesthetic challenges associated with breast reconstruction. They may help to:

  • Provide an additional layer of tissue that may help hide implant visibility
  • Provide additional tissue creating a hammock that allows for a natural looking breast
  • Help control the location of the implant and to define the breast fold