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Blepharoplasty (Eyelid Surgery)

Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision. Blepharoplasty can be combined with BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes.

The procedure is usually performed in an office with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.

Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. The effects of blepharoplasty can last for a long time and are sometimes even permanent.

 

Otoplasty (Ear Surgery)

Ear Close UpEar surgery typically serves two functions: setting prominent ears back closer to the head, and reducing the size of large ears. Surgery may also be helpful for “lop ear," "cupped ear" and "shell ear,” large or stretched earlobes, and lobes with large creases and wrinkles. Surgeons are also able to construct new ears for patients who are missing them from injury or other causes.

Although surgery for adults is available, the operation is most often performed on children aged four to 14 -- ears are almost fully grown by age four, and early surgery can prevent a child from being teased in school.

Otoplasty lasts from two to three hours and may be performed in a hospital, office-based facility or an outpatient surgery center. General anesthesia is recommended for very young patients, while local anesthesia and a sedative are used for older children and adults.

 

Breast Reconstruction

Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman's natural breast as closely as possible in shape, size and position.

Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.

The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.

There are several ways to reconstruct the breast, both with and without implants; your breast surgeon and plastic surgeon should work together with you in deciding which is the best for you.

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Liposuction

Woman measuring her waist

The most popular cosmetic surgery procedure in the U.S. today, liposuction sculpts the body by removing undesirable fat from areas of the body such as the abdomen, waist, hips, buttocks, thighs, knees, chin, cheeks, neck and upper arms that have not responded to diet and exercise. Local anesthesia or general anesthesia may be used and can last anywhere from one to five hours depending on the amount of fat being removed.
There are several different methods surgeons use when performing liposuction, including tumescent liposuction, the super-wet technique, and ultrasound-assisted liposuction (UAL). In all types a tiny incision is made in as inconspicuous a place as possible. A cannula (small tube) is inserted and moved back-and-forth beneath the skin, breaking up the fat layer and suctioning it out. Tumescent liposuction and super-wet liposuction use fluid injection, which facilitates fat removal, reduces blood loss, provides anesthesia during and after surgery, and helps to reduce the amount of bruising after surgery. UAL liquefies fat with ultrasonic energy and is highly precise.

Risks are uncommon when the procedure is performed by a qualified surgeon but may include infection, delays in healing, fat clots or blood clots, shock, fluid accumulation that must be drained, burns, perforation injury, lidocaine toxicity, and unfavorable drug or anesthesia reactions.

After surgery, drainage tubes, compression garments and antibiotics may be needed to facilitate the healing process. Patients are encouraged to walk as soon as they are able and many return to work within a few days, although strenuous activity should be avoided for about a month. Results are visible immediately, though improvement may continue as swelling subsides during the first three months. Scars are small and inconscpicuous. Other irregularities in appearance are possible, such as asymmetric or "baggy" skin, numbness and pigmentation changes.

 

Tummy Tuck (Abdominoplasty)

An abdominoplasty (stomach lift or tummy tuck) tightens the abdominal walls and removes excess skin to create a flatter contour of the abdomen. This procedure is popular with mothers who have passed their child bearing years and is not recommended for women who may get pregnant in the future. Also, people who have undergone bariatric (weight loss) surgery are common subjects of the operation. Anyone who has difficulty reducing abdominal fat and increasing tone despite frequent exercise is a good candidate for this surgery.

The abdominoplasty procedure is performed under local or general anesthesia and begins with an incision along the bikini-line and the removal of the naval. Once the abdominal walls have been strengthened and repositioned, the skin flap is pulled down, stretched and cut for the new naval fixture. Supplemental liposuction can be used to smooth the transition between the new locations of the skin. The belly button is then reattached and all incisions sewn shut.

The procedure is moderately invasive and requires several weeks before returning to work and even more time before exercise can be attempted. For the first week, it is discouraged to lift any weight heavier than ten pounds. It is also advised to wear the compression garment fitted at the end of surgery as much as possible to reduce the swelling.

 

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