body_small2Body Procedures

Learn how body cosmetic surgery can help you improve your shape, refine your proportions, and experience the benefits of having a body that you’re proud to show off.

Brachioplasty (Arm Lift)

There several techniques available to shape the upper arm. Using liposuction alone, the contour can be improved but sometimes it is necessary to remove excess skin. There are two basic types of brachioplasty or arm lift.   The most common involves an incision down the length of the upper arm: from the armpit to the elbow. This incision is designed to hide underneath the arms when they are resting at your sides. This traditional arm lift may include liposuction of the upper arm to thin its overall appearance. This is followed by removal of the excess and hanging skin. A different procedure involves a much shorter incision near the armpit to “tuck and lift” the loose skin so it doesn’t hang. Massive weight loss and post-bariatric surgery patients may need additional and more aggressive areas of excision.

Good Candidates

A good candidate for the traditional “long incision” brachioplasty is someone with pronounced loose and hanging tissue of the upper arm. This tissue has been comically referred to as “Bat Wings” or “Arm Hammocks”. As we age the loss of skin tone, elasticity and changes in weighty can make this area sag and look out of proportion, especially in those patients who have lost significant weight. The “short scar” brachioplasty is appropriate for patients with less significant hanging skin. Your cosmetic surgeon can help you determine which procedure is right for you.

Dressings

After surgery, the upper arm incision will likely have sutures and either tape or surgical glue. A compression garment will be worn for several weeks after surgery. This typically looks like a jacket with tight sleeves.

Recovery

Most patients will receive antibiotics and pain medication for surgery. The compression garment is necessary and helps support the surgical area. It can be worn under normal clothing. There will be limits to full range of motion of the arms during the early days after the procedure. It is suggested that you have someone available to help after surgery for a few days. Depending on the type of work you do, one to three weeks of recovery time is recommended. You may not be back to full activities for six weeks.

Possible Complications

As with any surgical procedure, there is a risk of bleeding, infection, poor wound healing and visible scarring. Your cosmetic surgeon can suggest available treatments to improve your healing and final scar results. Fluid accumulation (seroma), numbness or other sensation changes, and damage to deeper structures (like nerves, vessels or muscles) are less likely but may occur. Possible need for revision surgery. Other risks associated with anesthesia and any health conditions you may have will be discussed with your doctor.

Body Lift or a Belt Lipectomy: 

Patients that have lost a significant amount of weight either by diet and exercise or after weight loss surgery are often faced with loose skin and loss of skin elasticity in their body, breast and extremities. A body lift is procedures that combine tummy tuck with a mons lift, outer thigh lift and a buttock or back lift at the same time.

A patient considering a body lift procedure needs to be stable with their weight and nutritionally optimized before undergoing such a procedure. The incision usually starts in the bikini line but it goes all the way around the thigh and buttock as well. The body lift removes loose skin and bulges in the abdomen, waist, and lower back and lifts the buttocks.

After the procedure the patient is placed in an elastic compression garment, which they wear for a few weeks. Drainage tubes are usually left in place to collect the excess fluid and blood that can collect. The tubes usually come out in a few days to weeks.

The initial recovery time can be four to six weeks but final results can be seen up to two years later. Risk and complications include infection, bleeding, swelling, fluid collection, numbness, scarring, deep vein thrombosis (DVT), pulmonary embolism, residual skin laxity or contour irregularity and need for additional surgery.

The cosmetic surgeon usually does prescribe antibiotics, pain medication, sleeping medicine and muscle relaxants as necessary. It is important that you discuss all the risk and complications as well as recovery with your cosmetic surgeon during the consultation.

A buttock lift improves sagging buttock and thigh skin that has developed as a result of weight loss, aging and gravity, or genetics. The buttock lift procedure is the back part of the body lift or what we call belt lipectomy. This procedure is suitable for a person that has lost a lot of weight or has had multiple pregnancies that have led to weight gain and weight loss and therefore resulted in loss of skin elasticity in the back and buttock region. The buttock lift involves an incision in the lower back that extends over the hip bones to the waist line. This operation improves the appearance of the buttocks, lower back and possibly outer thighs. The recovery is generally easier than a tummy tuck and may take 2-3 weeks. Risks and complications include bleeding, scarring, infection, pain, loss of sensation, wound healing problems and deep vein thrombosis. You surgeon will discuss recovery, possible risks and complications with you during the consultation.

Butt Augmentation using Fat Transfer

A butt augmentation using fat transfer is just like it sounds. Your cosmetic surgeon collects fat using liposuction from your abdomen, flanks, outer thighs, inner thighs, and arms if needed; then carefully prepares your fat for injection and transfer into your buttocks. A bonus to this procedure is that you lose fat from the areas of your body that you don’t want, which gives your body a more contoured look.

Butt augmentation with liposuction and fat transfer became very popular in Brazil, and as a result, this procedure has become known as a “Brazilian Butt Lift”. Even though it’s not really a lifting procedure, filling the butt with a patient’s own fat gives the advantage of augmenting the size and fullness of the butt, and also lifts the butt.

Cosmetic surgeons continue to refine the fat transfer techniques to minimize the amount of fat graft lost after fat transfer, thereby ensuring that patients get the most beautiful result possible with the amount of donor fat available. Typically, patients can expect a 65-75% fat graft survival or “take”. This means that what you have remaining once the post-surgical swelling subsides and after the fat takes at three months will be your permanent result. Patients are advised to ask about their cosmetic surgeon’s injection techniques and processing systems to minimize their risks for infection or any lumpy-bumpy results. Patients are also reminded that fat transfer to the butt is not a treatment for cellulite.

Obviously, patients must have enough fat for a good fat transfer result. There are unscrupulous practitioners who will offer “fat transfer” procedures for butt augmentation to beautiful and thin patients, who simply are not candidates for this procedure. For these patients, gluteal implants provide the most beautiful and consistent results.

Who are candidates for gluteal implants?
Gluteal implants provide beautiful results for gluteal augmentation especially for thinner or more athletic women who may not have enough fat for a good fat transfer result. The advantage of gluteal implants is that they provide extremely consistent results, without the risk of fat graft loss or not enough fat. Modern gluteal implants are FDA approved, and are designed to create a beautiful and natural gluteal contour. Gluteal contour enhancement is not just gluteal augmentation. By combining the implant procedure with liposuction of the upper outer part of the buttock or flanks, a tremendous change in the contour and shape of the buttock can be achieved. It is very important that your surgeon is an expert in the modern surgical procedure and has the experience for gluteal implants surgery.

Gluteal implant placement
Gluteal implants are placed within the thick gluteus maximus muscle. This provides excellent coverage for the implant, prevents the implant from sagging over time, and protects the sciatic nerve from injury. The intramuscular placement gives an extra layer of coverage, so the implant feels more natural to the touch and has a nicer shape. In addition, the additional tissue coverage protects the implant from infection. The modern, highly cohesive silicone implants used for gluteal augmentation are designed to feel like a muscle, and properly sized implants placed in the intramuscular position are almost impossible to feel. Another advantage is that the highly cohesive silicone implants cannot leak. You do not want gluteal implants placed above the muscle, since this will result in a visible, palpable implant that will quickly sag over time. Patients also want to know what gluteal implants feel like after healing. The augmented buttock has a firm, but natural feel.

Risks:
Delayed Healing, Damage to Deeper Structures, Fat Necrosis, Seroma, Surgical Anesthesia, Shock, Pain, Bleeding, Infection, Scarring, Firmness, Swelling,Skin Sensitivity, Major Wound, Separation, Persistent Swelling (Lymphedema), Unsatisfactory Result, Sutures, Allergic Reactions, Asymmetry., Surgical Wetting Solutions, Skin Discoloration,

Recovery:
Most surgeons will require for you to wear a compression garment or binder that should remain on. You may have drains that evacuate fluid from under your skin. These drain bulbs will collect fluid your body makes as part of the healing process. It will be blood-colored at first and will gradually become lighter in color. The drains will be removed when no longer needed. You will not be able to sit on buttocks immediately after surgery unless absolutely necessary. You will continue to wear the garment for 4-6 weeks, removing it only to shower and replacing it immediately.

Labiaplasty

Is a cosmetic procedure on the female genital tract designed to improve the function or the appearance of the labia of the woman. The surgery may involve the small lips or labia minora or the larger lips outside the vagina called labia majora or both. It can be a separate procedure or combined with other female genital tract procedures such as vaginoplasty or perineoplasty.

Who are the candidates?

Some women may have inborn deformities to be corrected and some others aquire changes in the labia after pregnancy that may require surgical correction.

Aging or changes of the body causing enlargement or uneven asymmetry of the labia can be distressing beyond reassurance and surgery to restore the original size or shape may be desired. Surgical correction for all cases is controversial and not endorsed by some medical authorities. Women are advised to seek expert opinion regarding their body image and whether the labia are truly out of proportion or fall within the normal anatomical variation for the woman body. At times loss of self-confidence is present when the woman perceives herself outside the norm, and restoration of this feeling is achieved after successful restoration of her anatomy.

Who performs the operation?

Board certified cosmetic surgeons and Board certified Gynecological surgeons with training in cosmetic gynecology are usually the one to perform these procedures.

What kind of anesthesia used?

Local, intravenous sedation, conscious sedation, spinal or epidural anesthesia or general anesthesia can be used. Tumescent anesthesia has been used successfully as it reduces blood loss with the epinephrine content.

Complications:

May include infection, bleeding or hematoma, scarring, acute or chronic pain, dyspareunia or pain with intercourse, dissatisfaction with result or poor scar healing. Overaggressive dissection may remove more tissues as well as under dissection may leave unsatisfactory result.

Recovery is dependent on the extent of the surgical procedure and may range from few days to one week. Surgery is done as outpatient. Swelling is present for few days and increase with early activity. Modified rest for one week helps to reduce the swelling and associated pain. Pain and swelling tend to subside after one week on average, however full return to exercise and all activities take about 4 to 6 weeks. Intercourse can resume after healing in 4 to 6 weeks.

What is Gynecomastia?
Women are not the only ones who suffer from enlarged breasts. In men, enlargement of the breast tissue is known as gynecomastia, and this can be an equivalent source of discomfort and mbarrassment. Gynecomastia may result from hormonal changes, heredity, disease, or the use of certain drugs, and can present unilaterally (one breast) or bilaterally (both breasts).

Treatments:
Gynecomastia is graded based on the severity of the presentation. Mild to moderate enlargement of the breast with primarily fatty tissue (pseudogynecomastia) and minimal skin excess (Grade I or II gynecomastia) can often be treated with vaser liposuction alone. Sometimes, a small peri-areolar incision is needed to remove any hard or firm breast tissue that may be present. For men with more severe breast enlargement with drooping excess skin (Grade III or IV gynecomastia) vaser liposuctions is combined with more formal excisional procedures to remove the excess skin and reshape the chest.

Alternative treatments:

Alternative forms of management consist of not undergoing the surgical procedure or wearing undergarments to help mask the appearance of large breasts. In selected patients, liposuction has been used to reduce the size of large breasts. Risks and potential complications are also associated with alternative forms of treatments.

Risks:

Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. It is important that your discuss these risk with your cosmetic plastic surgeon to make sure you understand all possible consequences of gynecomastia surgery:

Delayed Healing, Damage to Deeper Structures, Fat Necrosis, Seroma, Surgical Anesthesia, Shock, Pain, Bleeding, Infection, Scarring, Firmness, Swelling, Skin Sensitivity, Major Wound, Separation, Persistent Swelling (Lymphedema), Unsatisfactory Result, Sutures, Allergic Reactions, Asymmetry., Surgical Wetting Solutions, Skin Discoloration,

Recovery:
A mild amount of swelling and bruising is normal after surgery. Most surgeons will request for you to wear a comfortably fitting compression garment that provides support and helps to minimize swelling. This garment is should be used 24 hours a day for 6 weeks and should remove it only when showering. You will be restricted to light activities for the first 7 to 10 days after surgery while your body heals. The speed of recovery depends on your physical condition prior to surgery. Straining, bending, and lifting must be avoided, since these activities might cause increased swelling. Allow at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for at least two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery for It may take several weeks (6-12 weeks) for all of the swelling to subside. You may experience prolonged soreness or numbness over portions of your surgical areas, which may persist for several months but will ultimately resolve.

Mons Lift also known, as the Pubic Lift is a surgical procedure used to reduce and tighten the Mons Pubis and it is performed for both cosmetic and functional reasons. Good candidates for this procedure are woman that have lost a lot of weight or have had multiple pregnancies and have sagging skin in the Mons Pubis. This is often performed in combination with Tummy Tuck and Body Lift to achieve maximum satisfaction, or at the same time as Labiaplasty and Vaginaplasty to rejuvenate the entire female genitalia area. The Pubic Mons often becomes overly large with weight gain, childbirth or normal aging, and it can interfere with normal function and appearance. Mons lift reduces the sagging skin and restores normal function and appearance to the Mons Pubis.

Recovery may vary from two to six weeks depending on it being combined with other procedures or a stand-alone procedure. Risk and complications may include bleeding, swelling, infection, pain, temporary numbness and scarring. You surgeon will discuss the risk and complications associated with the procedure during your consultation.

A panniculectomy is when excess abdominal skin is surgically removed. The excess abdominal skin and adipose tissue is called a pannus and in severe cases hangs down over the genitals or thighs. It is often associated with massive weight loss or obesity. This excess tissue can make it difficult to maintain good hygiene along the folds in the skin. It can also make it difficult to walk and perform other physical activities. The difference between a panniculectomy and abdominoplasty is a panniculectomy only removes the apron of the skin and there is no undermining of tissue or tightening of muscles. It is often considered medically necessary and can be covered by most insurance policies.

Recovery from a panniculectomy can vary from 2-4 weeks depending on the size of pannus being removed. The risks and possible complications may include bleeding, swelling, infection, pain, loss of sensation, hematoma, seroma, wound healing difficulty, scarring, blood clots in deep veins that can lead to pulmonary embolism. Your surgeon will discuss all risks and complications related to the procedure in detail during the consultation.

Pectoral Implants:
Many men find that they are unable to develop their chest muscles even with a regular weight lifting regimen. Some men are also self-conscious if they were born with a prominent pectus excavatum (sunken sternum) congenital defect. The pectoral implant procedure helps improve the look of the chest by placing a special implant below the existing chest muscle. The result is a much firmer, more muscular feel.

Good candidates:
Men in good physical health who aim to enhance the chest area by adding masculine definition that appears naturally sculpted through exercise. Ideally, men should be non-smokers or cease smoking for two weeks prior to and two weeks following the healing process.

How is surgery done?
Pectoral implant surgery is performed under light general anesthesia in an outpatient surgery center. The operation lasts about 1-2 hours, and the implant is placed through the armpit (trans-axillary) under the muscle to help hide the implant. The scar is almost invisible, hidden in the armpit.

Risks:
Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. It is important that your discuss these risk with your cosmetic plastic surgeon to make sure you understand all possible consequences of pectoral implant surgery. In order to reduce the incidence of complications, it is important that you select an experienced cosmetic plastic surgeon that has a proven track record of success with minimal problems.

Delayed Healing, Damage to Deeper Structures, Fat Necrosis, Seroma, Surgical Anesthesia, Shock, Pain, Bleeding, Infection, Scarring, Firmness, Swelling, Skin Sensitivity, Major Wound, Separation, Persistent Swelling (Lymphedema), Unsatisfactory Result, Sutures, Allergic Reactions, Asymmetry., Surgical Wetting Solutions, Skin Discoloration,

Recovery:
A mild amount of swelling and bruising is normal after surgery. Most surgeons will request for you to wear a comfortably fitting compression garment that provides support and helps to minimize swelling. This garment is should be used 24 hours a day for 6 weeks and should remove it only when showering. You will be restricted to light activities for the first 7 to 10 days after surgery while your body heals. The speed of recovery depends on your physical condition prior to surgery. Straining, bending, and lifting must be avoided, since these activities might cause increased swelling. Allow at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for at least two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery for It may take several weeks(6-12 weeks) for all of the swelling to subside. You may experience prolonged soreness or numbness over portions of your surgical areas, which may persist for several months but will ultimately resolve.

Thighplasty
Thigh lift or thighplasty is a surgical procedure to address the front and inner thighs. Liposuction can be performed to improve the overall shape of the upper thighs and loose, hanging skin is lifted and removed. Typically, the incision is placed in the groin area and the scar hides well with most bathing suits.

Good Candidate
A good candidate for thigh lift surgery is someone with loose or “jiggly” upper thighs. The surgery primarily helps with the upper and inner thighs while it does not have a major effect on the outer thighs. The typical patient has had some weight changes that have left the skin loose or have left discrete fatty areas in the upper thighs.

Dressings
A tight, compression garment (similar to a girdle) will be worn after surgery for several weeks. The incision will have sutures and sometimes tapes and/or surgical glue. There will not need to be a lot of dressings or dressing changes.

Recovery
The procedure is usually an outpatient surgery. Most patients are walking the same day. After surgery there will be several days of pain medication and antibiotics. The compression garment is essential to support the area of liposuction but also to protect the incisions for excess tension and pulling. Plan for one to three weeks off from work and up to six weeks before resuming all activities.

Complications
Almost all surgery includes a risk of bleeding, infection and poor healing. Because the incisions are in a location that is constantly being “pulled” with every step, the risk of thicker scars is higher. Talk to your cosmetic surgeon about methods and products to minimize this risk. Seroma (a collection of fluid) is possible as well as damage to the underlying tissue (including nerves, blood vessels and muscle). Any medical problems you have will be considered by your surgeon before determining if you should proceed with a thighplasty.

Tummy Tuck or Abdominoplasty
Tummy tuck or Abdominoplasty is by far one of most common abdominal contouring procedures performed by the CACS members. Patients that have loose skin, stretch marks and loose muscles either due to pregnancy, weight loss or aging are good candidates for a tummy tuck. Tummy tuck is not a weight reduction procedure. In fact, if the patient is overweight it is best that they lose the weight prior to undergoing this procedure.

With this procedure the surgeon usually makes an incision low in the suprapubic area or Bikini line in between the hip bones as well as around the belly button. All the skin below the belly button is removed, the recti muscles are tightened in the middle and the rest of skin is stretched down and the belly button is replanted in the new skin. The incisions are closed carefully in several layers.

After the procedure the patient is placed in an elastic compression garment, which they wear for a few weeks. There is usually drainage tubes left in place that come out in a few days.

The recovery time can be two to four weeks depending on the extent of tummy tuck needed and patient’s pain tolerance. It is important that patients move around after surgery as one of the risks is development of Deep Vein Thrombosis (DVT) or blood clots in the deep veins of the leg that can travel to the lungs. Therefore patients are encouraged to move and walk around early. The first few days they may have to walk slightly bent over but within one to two weeks they can straighten up and walk normally.

A tummy tuck is a gratifying procedure that can lead to a flat well-toned abdomen in the appropriate patient. Patients usually look very good already at three months but their results continue to improve for a whole year.

Mini Tummy Tuck
Mini Tummy tuck is appropriate for patients that have some excess fat and skin in the lower abdomen with minimal to no muscle laxity. This procedure usually involves liposuction combined with skin removal in the lower portion of the abdomen. The belly button usually does not have to be cut or repositioned. The muscles usually are not tightened with this procedure although they could be if necessary at the lower portion of the abdomen.

Similar to the full tummy tuck the patients are placed in an elastic compression garment for a few weeks. Usually drainage tubes are not necessary with a mini tuck procedure.

One of the main advantages of a mini tummy tuck is that the recovery is shorter, usually less than two weeks and patients can return to their normal routine faster.

An upper body lift is a procedure that removes sagging skin from the upper torso, back and bra rolls. It can also involve skin removal from the upper arm and chest area. This procedure is suitable for patients that have lost a significant amount of weight and skin elasticity in the upper portion of their body. The upper body lift involves an incision that extends from the back and bra line area to the front under the breast crease. This operation improves the appearance of the upper back, lateral chest wall as well as the arm and breast. Recovery may take 2-4 weeks. Risk and complications include bleeding, swelling, infection, pain, scarring, and loss of sensation.

The best way to determine if you are a candidate for an upper body lift is through a consultation with an experienced surgeon. You surgeon will examine and discuss treatment options as well as recovery, possible risks and complications with you during the consultation.

Vaginoplasty is a cosmetic procedure designed to correct a congenital deformity or an acquired condition or deformity of the vagina in the female patient.

Vaginoplasty for congenital or inborn anomalies are aimed to produce a functional vaginal canal when it was partly or completely absent.

Acquired conditions or deformity of the vagina can occur after trauma of childbirth, non-childbirth trauma or simply as result of aging process. Pregnancy and childbirth produce changes in the vagina that may lead to enlargement, weakening of the vaginal muscles and lining or mucus membrane. Vaginoplasty to improve these conditions will involve tightening the loose entrance and tightening the muscles involved with the vaginal canal.

Surgery for cosmetic vaginal improvement is aimed at correcting the opening if it was unduly stretched or enlarged following childbirth trauma, and rendering it tighter as well for better sexual stimulation and friction during intercourse. Vaginoplasty is not designed for more sexual arousal or desire as these are multifactorial in origin and treatment may not be surgically successful.

Vaginoplasty may be carried out with other procedures such as labiaplasty or perineoplasty, and may be carried out as a single stand-alone procedure.

Anesthesia may be local, regional or general depending on the particular situation.

Who would be a good candidate?
Women presenting for vaginoplasty are often mothers who had some trauma during parturition or delivery. They may notice the opening of the vagina to have enlarged or they may feel the vagina to have become looser and less friction and sensitivity thereafter. Their sexual experience and vaginal sensation may have altered after the trauma of childbirth or aging tissues. The vagina had become looser, larger and less sensitive to friction and sensation during intercourse.

Cosmetic surgeons trained in vaginal surgery carry out Vaginoplasty, as well as highly trained Gynecologist.

Recovery
Surgery is usually carried out with dissolvable sutures and recovery is related to the complexity of the repair and varies from 2 weeks to 6 weeks.

Patients are advised to maintain low-key activities in the recovery time to allow for healing without complications. Pelvic rest is advised till healing is complete.

Patients may complaint of pain and swelling that ultimately responds to rest and feet elevation. The use of vaginal tampon is discouraged during the immediate postoperative period.

Possible complications
Surgery on the vagina and the vaginal muscles and surrounding tissues should only be performed by an expert in the field of Gynecology and cosmetic surgery to minimize possible complications. Complications may result secondary to excessive tightening of the area and its muscular layers, the result would lead to pain and painful sexual penetration or pain during intercourse. On the other hand insufficient repair may lead to insufficient correction of the relaxed tissues. Bleeding, infection, difficult scarring, and chronic pain may result as complications.

Varicose veins are more than a cosmetic concern! Although varicose veins can be embarrassing and painful, they may also underlie a more serious medical condition. Damaged veins take many different forms, from small surface veins to large, grape-like clusters. No matter what size or shape, these are signs of vein disease and may be caused by faulty valves inside the veins. Varicose vein treatment is important because, without treatment, they may lead to more serious complications, such as ulcerations, blood clots or spontaneous venous rupture. Many people inherit vein disorders, and the incidence is higher in women than men.

Although most people think of spider veins as unsightly, they may also signal more serious underlying vein disease and saphenous vein reflux. With varicose veins treatment, your body will re-route blood flow into stronger, healthier veins, reducing vein problems and improving circulation.

Associated symptoms:

  • Swelling
  • Heaviness during the day
  • Restless leg Syndrome at night
  • Pain to legs
  • Cramping
  • Fatigue
  • Itching

Treatment options
Treatment depends on the extent of your vein disease. Minimally invasive treatments for varicose veins are now offered in the office setting by most varicose vein specialist using newer laser technology under local anesthesia.

Endovenous Laser Therapy (EVLT)
Used to treat saphenous vein reflux (venous insufficiency), which is the most important factor underlying varicose vein disease. EVLT has effectively replaced the historic surgical vein stripping procedure for saphenous vein reflux. ELVT eliminates leg aching; swelling; restless legs; and diminishes varicose veins. This procedure is laser therapy ablation under ultrasound guidance with local anesthesia in the office. This procedure has very minimal scarring and no lengthy recovery or side effects. Patients are asked to wear an ACE wrap over night after their EVLT and take Aleve or Tylenol for any mild pain or discomfort. Patients should continue using their compression hose (at lease 15-20mmHg) after their successful EVLT to help slow the progression of their varicose vein disease.

Micro-Phlebectomy
This outpatient surgical procedure is performed under local anesthetic, also in the office setting. The surface varicose veins to be removed from one area of the leg are marked and numbed. Delicate micro punctures are made along the course of the vein, allowing the veins to be removed using custom instruments. Micro-phlebectomy causes minimal scarring (do you have any scars from any prior blood draws or venopunctures). Patients experience tremendous relief from their painful varicose veins. Patients are asked to wear an ACE wrap over night after their phlebectomy procedure and use Aleve or Tylenol for any post-procedure mild pain or discomfort. Patients should continue using their compression hose (at lease 15-20mmHg) after their successful phlebectomy procedures to help slow the progression of their varicose vein disease.

Sclerotherapy
Is a nonsurgical procedure performed to eliminate visible spider veins that are too small for phlebectomy. In sclerotherapy, a concentrated solution is injected through a tiny needle into the spider vein, irritating (i.e. sclerosing) the vein walls, causing the spider vein to collapse and disappear.

What to expect after treatments
Very minimal to no pain. Bruising and some swelling may be experienced as well. Over the counter pain relievers may be used as needed.

What is Vaser Liposuction?
VASER technology supplements traditional liposuction techniques. Vaser liposuction technology helps serve to enhance the results of traditional liposuction when indicated. When traditional liposuction is performed there is a higher risk of residual loose skin. Although there is always some natural skin retraction after traditional liposuction, this is often not enough to achieve the patients’ desired result with ultimate skin tightening – especially for difficult areas such as the “bra fat”, arms, inner thighs, flanks (or “love handles”) and under the chin area. For these specific areas VASER and laser liposuction can be very useful adjuncts to traditional liposuction for enhanced skin tightening.

Although VASER Liposuction sounds like Laser Liposuction, the two technologies are very different. LASER stands for “Light Amplification by Stimulated Emission of Radiation” and uses light energy to burn and destroy fat cells. VASER stands for “Vibration Amplification of Sound Energy at Resonance” and uses high-frequency ultrasound to break up scar tissue and connections between fat cells and generate heat energy to tighten the skin. The skin tightening results from the delivery of the VASER energy under the skin before the liposuction, which triggers collagen remodeling, causing the skin to continue to tighten 4 to 6 months after the procedure. At lower settings, VASER does not destroy fat cells, thereby making VASER very useful for fat transfer. VASER liposuction involves an additional step performed prior to the actual liposuction, wherein the high frequency ultrasound energy (VASER) is used to pretreat the areas of fat to be removed.

It is extremely important for your cosmetic surgeon to have extensive experience with laser and Vaser technologies, as well as years of experience performing minimally invasive liposuction using micro-cannulas to minimize scarring. VASER liposuction is a powerful tool to enhance the results for redo-liposuction, liposuction for men, harvest liposuction for fat transfer and when additional skin tightening is desired for any areas treated with liposuction. Swelling usually resolves 6-8 weeks after surgery.

Am I a good candidate?
Vaser Liposuction may be used in cases where there is good skin elasticity and where there is only localized excess abdominal fat with no stretched muscles from pregnancy (diastasis recti). Usually used to remove additional unwanted fat deposits and to improve the overall contours of the waistline, hips, and thighs.

Possible Risks
Infection, hematoma, seroma, scarring, visceral puncture, pneumothorax, death, rippling, wrinkling, loss of skin sensation, irregularities, burns, and changes of skin color

Recovery & Results
All liposuction is performed with tumescent local anesthesia. Multiple areas of Vaser liposuction are usually performed under general anesthesia with adjunctive local and tumescent anesthesia. Patients usually awaken from the anesthesia with minimal nausea or pain. Discomfort is usually well controlled with oral pain medication prescribed by your surgeon. You will need someone to drive you to and from the hospital home and highly recommended for adult to stay with you through the first night following your surgery

A mild amount of swelling and bruising is normal after surgery. Most surgeons will request for you to wear a comfortably fitting compression garment that provides support and helps to minimize swelling. This garment should be used full time for 3-6 weeks and should remove it only when showering.

You will be restricted to light activities for the first 7 to 10 days after surgery while your body heals. The speed of recovery depends on your physical condition prior to surgery. Straining, bending, and lifting must be avoided, since these activities might cause increased swelling. Allow at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for at least two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery. It may take several weeks (6-12 weeks) to a year for all of the swelling to subside. You may experience prolonged soreness or numbness over portions of your surgical areas, which may persist for several months but will ultimately resolve. Skin tightening from the Vaser proceeds over the 3-4 months after the procedure.

Laser liposuction is tumescent liposuction whereby after infiltrating the tumescent anesthetic fluid, a small laser fiber is used to disrupt fat cells and tighten skin. Typically, the sequence is: (1) infiltrate the area with tumescent anesthesia, (2) use the laser fiber in the deeper fat to disrupt and melt fat cells, (3) suction fat using manual or power-assisted liposuction, (4) use the laser fiber on the undersurface of the skin to stimulate collagen and create skin tightening.

The laser currently used by most cosmetic surgeons doing laser liposuction is the Cynosure Triplex Smartlipo system that allows the surgeon to use one or a combination of two wavelengths depending on the area of the body.

Smartlipo laser lipolysis in the body and Precision laser lipolysis in the neck help to reduce fatty areas and create skin tightening at the same time. This system is safe when used by an experienced cosmetic surgeon as it incorporates a thermometer at the tip of the laser fiber that enables the surgeon to continuously monitor the temperature in the area being treated.With laser lipolysis (Smartlipo) we can melt and remove fat and achieve skin tightening that is not possible with conventional liposuction.

In all liposuction we use tumescent anesthesia consisting of a solution of saline to which is added Lidocaine to numb the fat compartment, epinephrine, which constricts blood vessels and prevents bleeding and most bruising, and bicarbonate which neutralizes the solution so that it can be infiltrated painlessly. In addition to the above, the tumescent solution aids in hydrodissection of the fat, making it easier to remove.

Power liposuction refers to removal of the fat using a power-assisted cannula. There are multiple power assisted devices on the market, one of which moves a cannula in an out and one that rotates the cannula. These technologies allow for the safe and precise removal of fat from desired areas. This allows for the treatment of small areas and precise sculpting with a higher margin of safety, as there is less movement required by the surgeon’s arm, and in addition, there is less fatigue to the surgeon doing the procedure which is good for both surgeon and patient.