Your doctor makes a cut (incision) in the bottom crease of the breast, the armpit, or along the lower edge of the nipple and the areola (the colored area around the nipple). Then your doctor makes a pocket under the muscle or breast tissue. He or she puts in the implant and adjusts it to the correct shape, size, and position. Your doctor then closes the incision with stitches.Breast enlargement surgery is done to increase the size of the breasts and enhance their shape. You may decide to get breast implants to:

• Enhance breasts you consider too small. The definition of what is “too small” (or too large, for that matter) varies from woman to woman. There is no universal standard below which breasts are considered too small. If you are content with the size of your breasts, then they are not too small.
• Restore the size or shape of the breasts after significant weight loss or pregnancy. A breast lift may be done at the same time as the enlargement in these cases.
• Make the breasts more evenly proportioned. In many women, one breast may be larger or sit higher than the other.

A breast lift may be done at the same time as the breast enlargement. A breast lift can raise sagging or drooping breasts and elevate the nipple and areola. To lift the breasts, excess skin from the bottom of the breast and the area around the areola is removed. The remaining skin is then brought together, which tightens and raises the breast. A breast lift requires larger incisions than a breast enlargement alone. Incisions may extend from the areola down to the crease where the bottom of the breast meets the chest.

Breast enlargements and lifts are usually done as outpatient procedures in a hospital or outpatient surgery center. An overnight stay in the hospital is not needed unless there are complications during surgery. The surgery takes 1 to 2 hours. General anesthesia is usually used, although local anesthesia or an epidural may be used in some cases.

Depending on your personal situation, breast reduction surgery can be done in an outpatient facility, or you may have to stay at least one night in the hospital. In either case, you will get general anesthesia, which means you will be put to “sleep” during the procedure.

Breast reduction surgery will take about two to five hours, sometimes longer. Your surgeon will make a cut around your nipple then downward on the breast in the form of a keyhole. The operating team will remove extra skin tissue, and fat from your breasts and reposition your nipple. Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in special gauze. You may also need to wear a surgical bra.

Men with large or sagging breasts can be both physically and emotionally uncomfortable, often restricting themselves from certain activities because they feel self-conscious about their breast size. Male breast reduction is an excellent way to decrease the size of a man’s breast, helping him feel more comfortable and confident. The procedure can be performed on men of all ages who are in good health, both physically and emotionally.

Male breast reduction surgery is usually performed under general anesthesia on an outpatient basis. The surgery typically takes one to three hours. Several techniques can be utilized in male breast reduction, depending on the extent of the procedure.

If the enlarged breasts are primarily caused by excessive fatty tissue, liposuction can be performed through tiny incisions to remove the excess fat. The incision may be made around the edge of the areola (the area around the nipple) or in the underarm. If excess glandular tissue is the primary cause of the enlarged breast, the tissue will be excised, or cut out, in addition to liposuction.

In more extreme instances when large amounts of fat or glandular tissue have been removed, excess skin may have remained that has not reshaped well to the new contour of the breast. In these cases, the excess skin may have to be removed as well. The incisions are then closed using sutures and are usually covered with a dressing. The chest may be wrapped to keep the skin firmly in place.

A facelift can considerably reduce these signs of aging by removing excess fat, tightening the underlying muscles, and redraping the skin around the neck and face. Facelifts can be done alone, or are frequently performed in conjunction with another procedure such as a browlift, eyelid surgery, or nose reshaping. In some cases, a facelift can reduce the outward signs of aging by ten or fifteen years.

The incisions are usually made inside the nose so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may beadded (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is redraped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals.

Rhinoplasty may be done using general or local anesthesia. It is usually done as an outpatient procedure but sometimes requires a 1-night stay in the hospital.

Blepharoplasty is ideal for the correction of:

• Loose, sagging and/or folded upper eyelids that may limit vision
• Puffy fat deposits in the upper eyelids o Under-eye bags
• Sagging lower eyelids that may show the white of the eyes below the iris
• Excess skin in the lower eyelids
• Fine wrinkles in the lower eyelids

Eyelid surgery is performed in the doctor’s clinic, usually with local anesthesia and IV sedation. The procedure can take less than 45 minutes.

Aesthetic cheek surgery can be performed alone, or in combination with other surgical procedures. Multiple shapes and sizes of implants are available to fit your particular anatomy and desired change. Depending on the areas that are being addressed, the implants can be placed through the mouth with a small incision at the gum line, or through a lower eyelid incision if eyelid rejuvenation is being performed at the same time. Depending on the approach and your doctor’s preference, the cheek implants can be made of solid silicone or other non-reactive materials. Surgically, a pocket is made for the implant directly over the cheek bone, and the implant placed. The implant is secured either by designing a well-fitting pocket, or affixing it to soft tissue or bone. The incision is closed, completing the cheek augmentation. Usually the whole operation takes about 30 to 45 minutes to complete, unless other procedures are being performed in addition to the cheek augmentation.

Cheek augmentation surgery can be performed under sedation anesthesia, or general anesthesia, depending on the technique utilized.

• Large or protruding ears
• Lop ear (top of the ear folds downward or inward)
• Cupped ear (a small ear)
• Shell ear (no outer curve in the cartilage)
• Large, stretched, or torn earlobes
• Earlobes with large creases and wrinkles

Torn earlobes can be repaired with a quick in-office procedure performed under local anesthesia.

Torn earlobe repair first involves “freshening” the edges of the torn lobe by removing a small amount of skin. Then, using fine sutures, the earlobe is meticulously repaired to reconstruct a normal, rounded earlobe that matches your natural ear shape.

You will be able to return home immediately after the procedure, with only a small bandage covering the stitches. The stitches will be removed after one to two weeks. When the earlobe has healed and the scar has softened, you may re-pierce the repaired earlobe.

Any one or combination of the following conditions may indicate that you are a good candidate for a Forehead Lift:

• Sagging or low position of the eyebrows, creating a tired or sad appearance
• Deep horizontal creases across the forehead
• Frown lines, or furrows, between the eyebrows and sometimes across the top of the nose

There are many different variations of the Forehead Lift procedure. The Forehead Lift procedure usually involves incisions in the hair-bearing scalp. Occasionally, incisions may be performed in the forehead, and/ or the upper eyelids. Once the incisions are made, various degrees of undermining of the skin are performed, and the deeper layers of the forehead are “lifted.” The skin and deeper layers are often then “fixed” or attached to the bone. The results are a reversal of the effects of gravity and tightening of soft tissues of the forehead to restore a more youthful contour to the upper face.

The incision is made across the top of the scalp, beginning above the ears and hidden within the hair. Sometimes, the incision may be placed at the front of the hairline or, in some cases, toward the middle of the scalp. The incision is designed to be inconspicuous when healed.

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