| Abdominoplasty Brachioplasty (arm lift) Breast Augmentation Breast Lift and/or reduction |
Browlift Eyelid Surgery(Blepharoplasty) Facelift |
Gynecomastia Lipoplasty Rhinoplasty Scar Revision |
Abdominoplasty (tummy tuck) is a procedure in which excessive skin and fat are removed from the middle or lower part of the abdomen in order to improve abdominal contour. The skin is separated from the muscles of the abdomen and any weakness in the muscles is repaired/tightened, the umbilicus (belly button) is repositioned, and the skin pulled tight. Distended skin and excess fat is removed with an incision that typically runs hip-to-hip, sitting low in the bikini line.
Patients are placed in a post-operative binder (garment) to support abdominal muscles for the first 7-10 days after surgery. Drainage tubes are usually inserted during the surgery, and these will be emptied as needed for several days following your surgery. Drains are monitored over this period and, once output is at a minimum, the drains are removed. Once drains are removed, patients are then placed in a lighter, more comfortable garment, which is worn for another 4-5 weeks.
During this first week, patients are not allowed to stand upright but, rather, are asked to walk hunched over, looking at the floor. This helps to decrease tension on the abdominal incision. Patients are usually up and about in the first week post-operatively, and activity increases as tolerated. A full return to all activities can be anticipated by 4-6 weeks.
Dr. Smith's nursing staff sees patients following abdominoplasty with 2-4 visits in our office to assess incisions, remove abdominal drains and umbilical sutures, and fit patients for appropriate garments. This procedure requires a consistent level of homecare support and patients need to be sure to have this organized and in place prior to booking their surgery.
In terms of followup with Dr. Smith, patients are to book an appointment approximately 6 months post-op for long-term evaluation of their surgical result. Post-operative pictures are usually taken at this visit.
Blepharoplasty (Eyelid Surgery)
The eyes are the most expressive elements of the face. They can transmit a person's inner feelings, and are a means of silent communication.
Blepharoplasty is an operation whose aim is to correct heavy, wrinkled or baggy eyelids, and restore a fresher, more youthful look to the eyes. The operation consists of the removal of excess eyelid skin as well as removal of bags under the eyes when needed, while preserving the natural expression. Upper eyelid blepharoplasty can often be done under a local anaesthetic, however, lower eyelid blepharoplasty will require a monitored IV sedation.
Results may last for many years.
Brachioplasty is a surgical procedure for reducing arm circumference and tissue redundancy/excess. This soft tissue laxity of the upper arm often occurs with obesity, following massive weight loss, and with natural aging. This procedure improves the contour of the upper arms, in exchange for scars.
This procedure is done under a general anaesthetic. Patients may be asked to stay overnight at the surgical clinic and will be discharged with bulky arm dressings in place. A moderate amount of pain may be experienced post-operatively and, therefore, pain medication is prescribed as needed.
One of Dr. Smith's homecare nurses will visit your home on day 2 and day 3 post-op to assist with dressing changes. Often, drains are placed in the incision and these will be assessed and emptied during those visits. The nurse will also provide teaching to the patient regarding drain management.
The incisions for brachioplasty typically run from armpit to elbow. Most patients are up and about the day of surgery, but will have limited arm use for approximately 10 days. Return to full activity is appropriate at approximately 4-6 weeks after surgery.
Long term followup with Dr. Smith should be booked at 4 months post-op.
Breast augmentation is a cosmetic operation to increase the size of the breasts by introducing a synthetic implant behind the mammary gland or behind the pectoral muscle supporting the mammary gland. The introduction of breast implants can make the breasts more proportionate to ones body frame, reshape breasts that have lost their contour or shape due to childbirth and breast feeding and/or correct problems with asymmetry where one breast is larger than the other.
There are many options available for women who have made the decision to proceed with breast augmentation.
Breast implants currently used consist of a silicone bag containing either saline or cohesive silicone gel. The breast prosthesis (implant) is inserted through an incision around the lower border of the areola (brown area surrounding nipple), or in the skin fold below the breast. Choice of incision is largely a matter of preference of the patient and plastic surgeon and is also dependent on the implant style and size chosen.
After patients complete a thorough consultation with Dr. Smith, an office visit with one of our office nurses will be arranged. This second consultation provides an opportunity for the patient to address any further questions they may have, and to try on breast implant "sizers" in order to establish the implant size they prefer. We believe it is very important that the patient is intimately involved in the choosing of implant size and style. With the great variety of breast implant profiles, the appropriate breast implant for the right patient is key.
As with any surgery, it is important to have a full understanding of the risks and complications inherent. For breast augmentation, these include hematoma, infection, scarring, rippling of implants, rupture of implant, altered or loss of nipple sensation, capsular contracture (hardening of the breast capsule), persistent asymmetries, and double contour.
Breast augmentation is performed under a general anaesthetic and takes about 1 to 1.5 hours. Patients can expect some discomfort post-operatively, and appropriate pain medication will be prescribed to address this. Dressings are placed over the incisions in the operating room and will be left in place for approximately 72 hours. At this point, patients will be encouraged to have a shower and remove dressings. A supportive sports bra will be worn for approximately 4-6 weeks after surgery.
Patients will be seen by office nurse 5-7 days post-op for review of incisions and implant position. Sutures are dissolving, thus suture removal is not required. Patients will visit the office nurse at 10 days post-op to receive teaching and instruction regarding breast massage. Patients are usually able to return to work one week after surgery, but are restricted from heavy lifting for approximately 4-6 weeks post-op.
Patients are to book long term followup with Dr. Smith at approximately 4 months post-op.
For more information click on ALLERGAN or MENTOR.
Breast Lift (Mastopexy) & Breast Reduction
Mastopexy and reduction mammaplasty are somewhat similar. These operations are both aimed at remodeling the breast. The reduction does this by removing a suitable segment of a large breast and reshaping it. The mastopexy does it by removing skin, sometimes with a small amount of breast, or may incorporate the addition of a prosthesis to enlarge it (see Breast Augmentation.)
This type of surgery has been practiced for more that 40 years. Better results are now being achieved through new surgical techniques. Reductions are carried out to relieve back, shoulder and neck pain, skin irritation and problems with clothing which are common in women with large, pendulous breasts, as well as for improvement in appearance. They may also make sports more enjoyable. Mastopexy is done for aesthetic reasons only. With both procedures the surgeon will aim at improving the shape and symmetry of the breasts.
Breast surgery is done under a general anaesthetic and last approximately 2 hours. A certain level of pain and discomfort can be anticipated and appropriate pain medications will be given to address this. Patients will be discharged with dressings in place under their sports bra, and these will be left in place until the first shower at 72 hours post-op. Sutures are usually dissolving, so suture removal is not required.
It is not uncommon to experience small amounts of drainage from the incision lines the first few days after surgery. Patients will be assessed by the office nurse 5-7 days post-op.
As with any surgery, there are some risks. Complications can include infection of the breast or bleeding into the breast (hematoma). Numbness to the nipple (generally temporary) can occur, as can widening of the scars, or slight asymmetry of the breasts (difference in size). More rarely, the circulation to the nipple could be lost, leading to loss of part or the entire nipple.
A browlift procedure elevates the brow position from the upper orbital rim (eyebrow area) and extends into the hairline. Incisions can either be made along the front hairline (anterior approach), or from ear to ear in the hairline (coronal approach).
A browlift can improve ptosis (drooping of the brow). This procedure is often paired with upper or lower eyelid blepharoplasties and facelift. Forehead lines and frown lines can be reduced with a browlift.
Following surgery, patients are placed in a bulky head dressing for 48 hours. Patients are asked to regularly apply cold compresses (icepacks) to eyes and forehead for the first 72 hours post-operatively to minimize swelling and to sleep with their head in an elevated position. Sutures/staples are removed from the incision line at 10 days post-op by one of Dr. Smith's nurses.
The face-lift is a surgical procedure aimed at rejuvenating the face and neck. The operation consists of removing excess skin and fatty tissue and correcting the sagging of specific facial muscles. Plastic surgeons have been performing this type of surgery for many years.
Recent advances in surgical technique have led to significantly improved and longer-lasting results.
The "classic" face-lift is aimed at rejuvenating the face in the areas of the temples, cheeks and neck. Lifting of the forehead and eyebrows may also be done at the same time, as well as eyelid surgery.
Potential risks and complications include facial nerve paresis (temporary), hematoma, infection.
This procedure is typically done under a monitored anaesthetic. Following discharge from the clinic, patients will receive a nursing homecare visit on day 1, day 2, and day 3 post-op.
Patients can expect minimal discomfort and a feeling of "tightness" after surgery. Ice packs will be applied to ease swelling and to provide comfort during the first 72 hours post-op and patients will be asked to sleep with their head in an elevated position. Swelling and bruising typically continue for 1-2 weeks after surgery, although some patients will continue to experience bruising and minimal swelling beyond that period.
Sutures are removed in the office at 5-10 days post-op, over the course of a few visits.
Patients are to book long term followup with Dr. Smith at approximately 4-6 months post-op.
Information coming soon.
This is a surgical technique employed to remove unwanted fat deposits from different areas of the body by suctioning them away. We all have a certain fixed number of fat cells at birth that grow until adulthood. This fixed number of cells can increase if there is excessive food intake at at young age. This predisposes the person to obesity as an adult. By aspirating the fat cells, liposuction appears to be capable of preventing recurrence of fat deposits.
This procedure makes it possible to suction out the fat cells without breaking the attachments that tie the skin to deeper structures. There has been progress lately in lipoplasty. The cannulas and types of equipment used are more sophisticated, while the technique itself has also evolved and minimizes immediate risks and discomfort during convalescence.
The areas that may be improved by this procedure are the cheeks, chin, neck, breasts, fatty areas over the armpits, the trunk, hip areas, buttocks, inner thighs, knees, calves, ankles and sometimes the arms. Fat deposits secondary to surgery or trauma may also be reshaped.
Surgery is usually done under a general anaesthetic. Duration of surgery depends on the number of areas being addressed and the extent of liposuction required. Patients can expect a feeling of "bruising and discomfort" following surgery and appropriate pain medications will be given to address this. Bed rest will be required for the first 24 hours, with a gradual return to activity as tolerated.
Drainage from small puncture incision sites can be expected for the first 24-48 hours post-op and bruising and swelling can last up to 2-3 weeks. All sutures are removed at 10-14 days and patients are asked to wear a pressure garment for 4-6 weeks to help contour and flatten surgical areas.
It is important that patients considering liposuction are insightful regarding expectations. This is one of the surgical procedures whose result will not be fully apparent for many months. The body continues to remodel itself for months following liposuction, so patience is an essential ingredient for a happy patient.
Patients are to book long term followup with Dr. Smith at approximately 4-6 months post-op.
This is a surgical procedure used to correct an overly projected ear, done under a general anaesthetic. The surgery takes approximately 1-2 hours.
The ear will be "tacked" into place in a more natural position and a bulky head dressing will be placed. This dressing remains intact until the first office visit at one week post-op. Sutures are removed at this visit.
A spandex headband or bandana must be worn for 4-6 weeks, 24 hours per day, in order to avoid the complication of ear rebound.
Patients are to book long term followup with Dr. Smith at 4 months post-op.
Surgery on the nose may be done for functional, reconstructive or aesthetic reasons. Functional Rhinoplasty is aimed at improving the physiology of the nose by modifying its malpositioned anatomical structures to relieve a nasal obstruction. Reconstructive Rhinoplasty is aimed at correcting congenital or traumatic malformation of the nose. Aesthetic Rhinoplasty is aimed at modifying the shape of the nose in order to make it more pleasing. Plastic surgeons have the expertise to deal with all these aspects of nasal surgery.
Problems such as a large hump or an overly broad or round tip can be corrected. Most incisions are made inside the nose, although sometimes carefully placed external incisions are needed to correct some problems. Surgery in performed under a general anaesthetic and last approximately 2.5 hours.
Patients can expect moderate pain or discomfort following surgery and pain medication will be given to address this. As well, patients will be instructed to sleep with their head elevated and to apply icepacks on a regular basis for the first week post-op. It is not uncommon to have difficulty breathing through the nose during this period as, most often, nasal support splints are placed inside each nostril during surgery and remain in place for 7 days post-op.
The majority of bruising settles within 1-2 weeks, but patients can experience residual swelling for several months. For this reason, it is difficult to assess the final result from rhinoplasty until 6-9 months post-op. It is not uncommon to require small revisions or "touch-ups" with this type of surgery.
Patients are to book long term followup with Dr. Smith at 4 months post op and will likely see him again at 9-12 months post-op.
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