Plastic & Reconstructive Surgery

Reconstructive 3D nipple tattoing is for those having undergone mastectomies. 3D Nipple pigment may be used to recreate an image of a natural nipple on the breast skin following breast reconstruction. 3D Nipple image application is appropriate for women who wish to have a finishing touch applied to their breast reconstruction but prefer not to undergo nipple reconstruction surgery.

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Breast Augmentation uses an implant to give the breast added volume and improved shape. Whether the reason is to regain your previous fullness or to just enhance your existing breast volume, breast augmentation can be tailored to meet your desired outcome.

Reasons to Consider Breast Augmentation

• Breasts are too small/not proportional to the rest of the body.
• Improve symmetry by resolving a difference in breast size.
• Post-mastectomy reconstruction.

Breast Augmentation FAQ

1. How will my surgeon evaluate me for breast augmentation surgery?
   Your surgeon will examine your breasts and perhaps take photographs for your medical record. He will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). If your breasts are sagging, a breast lift may be recommended in conjunction with augmentation.
   
   You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information
   
   There is no scientific evidence that breast augmentation increases the risk of breast cancer. The presence of breast implants, however, makes it more technically difficult to take and read mammograms. This may be a special consideration for women who perhaps are at higher risk for breast cancer because of their family history or other reasons. Placement of the implant underneath the pectoral muscle may interfere less with mammographic examination, but other factors may also need to be considered with regard to implant placement. Your plastic surgeon will discuss this with you.
   
   If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. He may recommend that you stabilize your weight prior to undergoing surgery.
   
   If you think that you may want to become pregnant in the future, you should mention this to your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask your surgeon.
2. What should I expect on the day of the breast implant surgery?
   Medications are administered for your comfort during the surgical procedure. General anesthesia will be administered by an anesthesiologist and a pain pump may be inserted for your post-operative comfort.
   
   When surgery is completed, you will be taken to a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings or a surgical bra.
   
   You may be permitted to go home after a few hours, unless you and your plastic surgeon have determined that you will stay in the hospital or surgical facility overnight.
3. Are breast implants safe?
   It is extremely unlikely that an implant will rupture. Should this occur, saline implants do not pose any risk to your health. The saline is absorbed by the body. Under most circumstances the manufacturer will pay for new implants and contribute toward the surgery replacement costs.
4. How will my breasts look and feel after the breast implants have been placed?
   A day or two after surgery, you should be up and about. Any dressings will be removed within several days, and you may be instructed to wear a support bra. Your surgeon will probably permit you to shower between three and seven days following surgery—this will depend on the specifics of your surgery. Sutures will be removed in about a week.
   
   Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.
5. When can I resume my normal activities after my breast augmentation?
   After breast augmentation surgery, it is often possible to return to work within just a few days or a week, depending on your job. Vigorous activities, especially arm movement, may be restricted for two to three weeks.
   
   Sexual activity should be avoided for at least the first week following surgery. After that, care must be taken to be extremely gentle with your breasts for at least the next month.
6. How long will the results last after a breast augmentation?
   Except in the event of implant deflation requiring surgical replacement with a new implant, the results of your breast augmentation surgery will be long lasting. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift to restore their more youthful contour.

Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other disease. Reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance, and size following masectomy. It can begin at the same time as masectomy or may be delayed until a patient has healed from masectomy and recovered from any additional cancer treatments that might be necessary. It is important that a woman feels ready for the emotional adjustment involved; like losing a breast, it takes some time for a woman to accept the results of breast reconstruction.

Breast reconstruction is considered a highly individualized procedure. Techniques offer varying advantages and choosing the appropriate course of treatment requires careful consideration of patient anatomy, patient and surgeon preference, and desired realistic outcomes.

Breast reconstruction is achieved through several reconstructive plastic surgery techniques that attempt to restore a breast to near normal shape, appearance, and size following masectomy and may include:

• Flap techniques that reposition a woman's own muscle, fat, and skin to create or cover the breast mound
• Tissue expansion that stretches healthy skin to provide coverage for a breast implant
• Surgical placement of a breast implant to create a breast mound
• Grafting and other specialized techniques to create a nipple and areola

Flap techniques may result in a more natural feeling breast and are necessary when little tissue or muscle remains following mastectomy. Incision lines appear at both the donor and reconstruction sites and a lengthy recovery follows. There is also a remote chance of partial or full loss of the flap due to poor healing. Sometimes a masectomy initially leaves insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion. Reconstruction with tissue expansion allows for an easier recovery flap procedure, but it is a more lengthy reconstruction process.  Many office visits over 4-6 months after placement of the expander are necessary to slowly fill the device through an internal valve to expand the skin and create adequate healthy tissue.

Breast reconstruction is completed through techniques that reconstruct the nipple and areola (the darker skin surrounding the nipple). Breast reconstruction may be performed at one time or over an extended period, depending on the techniques used, your breast cancer treatment, and the pace at which you wish to achieve your results. Complete reconstruction generally occurs in multiple procedures occurring over several months time.

Reconstruction with Implants
Tissue expansion is a method of breast reconstruction that involves the use of a tissue expander and a breast implant. A tissue expander is a balloon-like device made from elastic silicone rubber. During a masectomy, the surgeon removes skin and breast tissue, leaving the chest tissues flat and tight. To create a breast-shaped space for the breast implant, a tissue expander is placed under the remaining chest tissues. The tissue expander is inserted unfilled, and over time sterile saline fluid is added by inserting a small needle through the skin and into the tissue expander's filling port. As the tissue expander filles, the tissues over the expander begin to stretch, similar to the gradual expansion of a woman's abdomen during pregnancy. The tissue expander creates a new breast-shaped pocket for a breast implant.

After the tissue expander is removed, the breast implant is placed in the pocket. In reconstruction following a masectomy, a breast implant is often placed sub-muscularly. The surgery to replace the tissue expander with a breast implant is usually done under general anesthesia in an operating room. It may require a brief hospital stay or be done on an outpatient basis.

A note about symmetry:
If only one breast is affected, it alone may be reconstructed. In addition, a breast lift or breast augmentation may be recommeneded for the opposite breast to improve symmetry of the size and position of both breasts.

Good candidates for breast reconstruction are women who are:

• Able to cope well with their diagnosis and treatment
• Do not have medical conditions or other illnesses that may impair healing
• Non-smokers
• Individuals with a positive outlook and realistic goals for restoring their breast and body image

Information courtesy of PlasticSurgery.org.

Poor skin elasticity, gravity and other factors such as weight loss, pregnancy and breast feeding can lead to a loss of breast firmness and shape. A breast lift corrects these changes, giving the breast a more youthful appearance and texture. This procedure can be performed alone or in combination with an augmentation to improve shape and volume.

Reasons to Consider Mastopexy

• Elevate the sagging breasts caused by the effects of aging and gravity.
• Restore firmness to the breasts after weight loss, pregnancy or breast-feeding.
• Reposition nipples that point downward or to the side.

1. Breast Lift FAQ
   1. How will my surgeon evaluate me for breast lift surgery?
   Your plastic surgeon will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.
   
   You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.
   
   You should tell your surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts sag or become smaller with weight loss. Your surgeon may recommend that you stabilize your weight before having surgery.
   
   
2. What will the day of surgery be like?
   Medications are administered for your comfort during the surgical procedure. Often, a general anesthetic is administered, so that you will be asleep throughout the procedure.
   
   When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Sometimes, small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze or other dressings may be placed on your breasts and covered with an elastic bandage or surgical bra.
   
   You may be permitted to go home after a few hours, unless you and your plastic surgeon have determined that you will stay in the hospital or surgical facility overnight.
   
   
3. How long will the results last?
   Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift to restore their more youthful contour and appearance.

Breast Reduction is designed to relieve the physical discomfort associated with large breasts while improving overall breast appearance. Elevating the breast and reducing nipple size is an integral portion of this procedure. This procedure is frequently covered by insurance if certain criteria are met.

Reasons to Consider Breast Reduction

• Back, neck or shoulder pain caused by heavy breasts.
• Sagging, painful bra strap marks and restricted movement due to large, heavy breasts.
• Breasts are not proportional to the rest of the body.

Breast Reduction FAQ

1. How will my surgeon evaluate me for breast reduction surgery?
   Your plastic surgeon will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.
   
   You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.
   
   You should tell your plastic surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. Your surgeon may recommend that you stabilize your weight before having surgery.
   
   
2. What will the day of surgery be like?
   A general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. In many instances, small drain tubes will have been placed in your breasts to help avoid the accumulation of fluids. Gauze dressings will be placed on your breasts and covered with an elastic bandage or surgical bra. You should plan on staying overnight for observation.
   
   
3. When can I resume my normal activities?
   After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor.
   
   Any sexual activity should be avoided for a minimum of one week, and your plastic surgeon may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.
   
   
4. How long will the results last?
   Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast "lifting" procedure to restore their more youthful contour.

Pregnancy, weight loss, and the effects of time can all lead to loss of skin elasticity and abdominal muscle weakness. This leaves the body with a lower abdominal bulge and sagging skin that no amount of exercise can correct. A tummy tuck addresses these issues by removing excess abdominal skin and fat as well as tightening the muscles.  A tummy tuck is frequently combined with other procedures, such as liposuction or breast procedures.

Reasons to Consider Abdominoplasty

• Exercise and diet do not improve the shape of the torso.
• Weight loss leaves large amounts of loose skin.
• General desire for a more pleasing body contour.
• Loss of skin tightness after pregnancy

FAQ
1. How will my surgeon evaluate me for abdominoplasty?
Your surgeon may examine your abdomen while you are standing as well as lying down. Your skin tone and the amount of loose skin in the abdominal region will be assessed. Your surgeon also will evaluate the amount of excess fat in your abdomen and the condition of your abdominal muscles.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries and medications that you currently take. It is important for you to provide complete information.

2. What will the day of surgery be like?
Medications are administered for your comfort during the surgical procedure. A general anesthetic is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. In most instances, small drain tubes will have been placed within the abdominal tissues to help avoid accumulation of fluids. Gauze or other dressings may be applied to your abdomen and covered with tape or an elastic bandage.

You can expect to stay overnight and possibly up to two days in an overnight facility or in the hospital.

3. When can I resume my normal activities?
It is important to realize that the amount of time it takes for recovery varies greatly among individuals. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from two to four weeks after surgery. In many instances, you can resume most of your normal activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. Severe pain should be reported to your doctor.

Any sexual activity should be avoided for a minimum of two to three weeks, and your plastic surgeon may advise you to wait longer.

4. How long will the results last?
Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.

Liposuction removes deposits of excess fat, creating a more pleasing contour. It can be used to slim hips and thighs, flatten tummies, remove love handles and improve double chins, and can be used in many other areas. Liposuction can be performed under a local anesthetic with IV sedation or under a general anesthetic and is frequently combined with other procedures.

Reasons to Consider Liposuction:

• Desire for a smoother, more proportional figure.
• Target specific fat deposits in many areas of the body.

FAQ
1. What areas can be treated with Liposuction?
Common treatment areas include:

• Chin and Neckline
• Back
• Upper Arms
• Stomach and Waistline
• Hips and Buttocks
• Thighs and Knees
• Calves and Ankles

2. How will my surgeon evaluate me for liposuction?
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, such as diabetes, high blood pressure or heart disease. Your surgeon will want to know about previous surgeries, medical treatments and medications that you currently take. It is important for you to provide complete information.

How much you currently weigh and whether you plan to lose or gain weight in the future will be factors in evaluating you for liposuction. Your surgeon may ask you about the effects of prior weight loss on the appearance of those areas which you have indicated for contouring. He will assess the elasticity of your skin and estimate the amount of fat to be removed for optimal results.

3. What will the day of surgery be like?
Medications are administered for your comfort during the surgical procedure. You and your surgeon will have decided in advance whether intravenous sedation or general anesthesia will be used. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication that you may continue taking at home. A compressive dressing such as an elasticized bandage, sponge or specially designed garment may have been placed over the areas that were suctioned. Your surgeon will tell you how long you should wear the garment and will instruct you on how to remove it so that you may shower or bathe.

You most likely will be permitted to go home after a few hours, although some patients may stay overnight in the hospital or surgical facility.

4. When can I resume my normal activities?
You may be able to return to work in just a few days. In many instances, you can resume most of your normal activities within one or two weeks and begin some form of exercise soon after. The timing of your recovery depends largely on the extent of your surgery.

5. How long will the results last?
The results of liposuction will be permanent, as long as you maintain your post-operative weight. Even if you gain a few extra pounds, you may find that the weight is distributed more evenly instead of accumulating in the areas that were problematic for you in the past.

Occasionally, a touchup may be desired to further improve an area that has been suctioned. The additional treatment will require a return to the operating room.

A brachioplasty smoothes the arms by tightening the skin and removing excess tissue. Brachioplasty is sometimes performed in conjunction with liposuction; typically, liposuction will be performed first, with brachioplasty following after a sufficient healing period.

Reasons to Consider Brachioplasty

• Skin of the arm sags after weight loss.
• Arm skin has become loose or flabby.
• When it is not possible to tighten the skin on the arms with exercise alone.

FAQ
1. How will my surgeon evaluate me for brachioplasty?
You should come to your initial consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, such as diabetes, high blood pressure or heart disease. Your surgeon will want to know about previous surgeries, medical treatments and medications that you currently take. It is important for you to provide complete information.

How much you currently weigh and whether you plan to lose or gain weight in the future will be factors in evaluating you for a thigh lift. Your surgeon may ask you about the effects of prior weight loss on the appearance of your arms. He will assess the elasticity of your skin and determine the amount of tissue to be removed.

2. What will the surgery be like?
Medications are administered for your comfort during the surgical procedure. You and your surgeon will have decided in advance whether intravenous sedation or general anesthesia will be used. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication that you may continue taking at home.

You most likely will be permitted to go home after a few hours, although some patients may stay overnight in the surgical facility.

Arm lifts are sometimes combined with other procedures, and this can affect the amount of time the surgery takes. The incision used during an arm lift will leave some visible scarring along the inner arm. Aspirus Plastic Surgery uses the most up-to-date techniques to ensure the absolute minimum amount of scarring.

3. When can I resume normal activities?
You should be able to return to work around two weeks after surgery, but it will likely be necessary to restrict the movement of your arms for a longer period. It is important to follow the instructions of your surgeon in order to ensure a quick recovery. A compression garment will generally be worn for up to six weeks after the procedure.

4. How long will the results last?
The results of an arm lift should be permanent, as long as you maintain your post-operative weight.

Thigh lift reduces sagging of the skin on the outer and inner thigh. Tightening the skin smoothes the contour of the upper leg. A thigh lift can be performed alone or in concert with other procedures, such as a tummy tuck.

Reasons to Consider a Thigh Lift

• Skin of the thigh sags after weight loss.
• Skin of the thigh has become loose and rumpled.
• When it is not possible to tighten the skin on the legs with exercise alone.

FAQ
1. How will my surgeon evaluate me for a thigh lift?
You should come to your initial consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, such as diabetes, high blood pressure or heart disease. Your surgeon will want to know about previous surgeries, medical treatments and medications that you currently take. It is important for you to provide complete information.

How much you currently weigh and whether you plan to lose or gain weight in the future will be factors in evaluating you for a thigh lift. Your surgeon may ask you about the effects of prior weight loss on the appearance of your thighs. He will assess the elasticity of your skin and determine the amount of tissue to be removed.

2. What will the day of surgery be like?
Medications are administered for your comfort during the surgical procedure. You and your surgeon will have decided in advance whether intravenous sedation or general anesthesia will be used. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. There may be some discomfort, but this can be controlled by medication that you may continue taking at home.

You most likely will be permitted to go home after a few hours, although some patients may stay overnight in the surgical facility.

Thigh lifts are sometimes combined with other procedures, and this can affect the amount of time the surgery takes.

3. When can I resume my normal activities?
Recovery generally takes around two to three weeks, though you will likely have to refrain from strenuous activity for a longer period. It is important to follow the instructions of your surgeon in order to ensure a quick recovery.

4. How long will the results last?
The results of a thigh lift should be permanent, as long as you maintain your post-operative weight.

Lipotransfer is a procedure in which fat is harvested or removed from other areas on the body and then placed in areas of the body where an increase of volume or better shape is desired. With age, skin changes and becomes less elastic, collagen production slows down, and there is a reduction in natural fatty tissue that helps the body and face maintain a youthful appearance. Lipotransfer can be used to fill deep wrinkles around the nose, mouth and temple, fill out the buttocks, or to add volume to the breast.

1. How will my Plastic Surgery Group surgeon evaluate me for lipotransfer?
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, such as diabetes, high blood pressure or heart disease. Your surgeon will want to know about previous surgeries, medical treatments and medications that you currently take. It is important for you to provide complete information.

How much you currently weigh and whether you plan to lose or gain weight in the future will be factors in evaluating you for lipotransfer. Your surgeon may ask you about the effects of prior weight loss on the appearance of those areas which you have indicated for contouring. He will assess the elasticity of your skin and estimate the amount of fat to be removed for optimal results.

2. What will the day of the procedure be like?
Medications are administered for your comfort during the procedure. There is no need for general anesthesia.

3. When can I resume my normal activities?
Recovery is based on multiple factors, including how much fat is removed and which parts of the body are treated. For most patients, recovery time in minimal. You may be able to return to work a few days after your procedure.

4. What kind of results can I expect?
Results can vary based on many factors, including the amount of fat available from donor sits and the amount of breast and buttocks volume you desire. You doctor will meet with you about your expectations before your procedure.

Lighten unwanted pigmentation, even out skin tone, lighten acne blemishes, smooth out rough skin and more.

The objective of external ear surgery is typically to set prominent or flared ears closer to the head or to reduce the size of overly large ears. Though this procedure is most commonly performed on children, many adults who desire more proportional ears choose to have the procedure as well. It is generally performed on an outpatient basis under local anesthesia, though for very young children, general anesthesia may be recommended.

Reasons to Consider Otoplasty

• Ears appear to stick out.
• Ears are overly large.

Otoplasty FAQ
1. How will my surgeon evaluate me or my child for external ear surgery?
You should be prepared to discuss your medical history or your child’s medical history with the surgeon. It is important to provide complete information. The ears will be examined by the surgeon, and an open, honest discussion of your goals for yourself or your child will follow. It is important to have realistic expectations for what an otoplasty can achieve. If you are considering the procedure for your child, the child’s opinions and feelings on the matter are as important as your own. If your child is uncomfortable with having the procedure, a satisfying emotional outcome is far less likely, regardless of the physical outcome.

2. What will the day of surgery be like?
With some exceptions for very young children, local anesthetic with intravenous sedation is used, and the patient will remain awake during the procedure. An otoplasty typically takes between one and two hours to complete. After a brief period of observation, you will be allowed to return home.

Bandages are usually worn on the head for one to two weeks after the surgery. It is very important to follow the instructions you receive from your surgeon in order to speed recovery. Recovery times will vary based on the individual. Smokers invariably encounter longer recovery times, and should consider stopping before surgery. Most patients will be instructed to avoid strenuous exercise for 6-8 weeks. This presents a unique problem when the patient is a child, as much childhood play requires physical exertion. If your child has a procedure, you must monitor your child’s activities as much as possible to ensure that surgical results are not compromised.

3. What are the possible side effects or complications?
All surgery carries some risk of complication, though the risks are relatively low for ear surgery. Some post-operative bleeding or bruising is possible, and on rare occasions a set-back ear may protrude again, requiring a follow-up procedure. Visible scarring is generally negligible, as most of the incisions are made behind the ear. Most scarring that does occur will fade with time, especially in children, though healing times will vary greatly from person to person.

Aspirus Plastic Surgery offers two types of eyebrow procedures:

• Micoblading - Also known as 3D brows or Eyebrow Embroidery, Microblading is a form of permanent makeup. A manual tool is used to create feather like hair strokes with color pigment to the dermal layer of the skin in the eyebrow region. Microblading is semi-permanent and results can last 12-18 months.
• Ombre (Powder Brow) - The Ombre brow involves the use of our high quality tattoo machine to create a soft, misty, powder filled brow. The results are similar to the look of makeup application to the brow. The tails of the brow are darker, and fade into a light start at the beginning of the brow, giving it a very subtle natural look.

View brochure for more details on both

A facelift is performed to improve facial wrinkles, sagging of the facial skin and fullness of the neck. There are many techniques used to obtain these changes and no two facelifts are the same. Techniques like mini-facelifts, short scar facelifts and full face lifts, many times in conjunction with liposuction, can all be used to obtain an individual result for you. Results of a facelift can be dramatic or subtle depending on the patient and the desired goals of the procedure. This procedure can be combined with other facial procedures under a single anesthetic.

Reasons to Consider a Facelift

• Sagging skin, muscles and fat in the face, jawline and neck.
• Creases, lines and wrinkles around the nose, mouth and chin.

Facelift FAQ
How will my surgeon evaluate me for a facelift?
In evaluating you for a facelift, your surgeon will assess the thickness, texture and elasticity of your skin, and the severity of wrinkles and folds. Your hairline will be examined to determine where incisions can be discreetly placed. All of these factors, as well as your bone structure and underlying tissues, will be considered in developing an individual surgical plan.

Your surgeon may discuss with you additional procedures that can be performed along with a facelift in order to address all the concerns you have identified. For example, a facelift is frequently combined with a forehead lift, eyelid surgery, nose reshaping or skin treatments such as a chemical peel, laser resurfacing or injectable fillers.

What will the day of surgery be like?
Medications are administered for your comfort during the procedure. You and your surgeon will have decided in advance whether intravenous sedation or general anesthesia will be used. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the level of oxygen in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You may have a bandage around your face. Sometimes small tubes are inserted beneath the skin to drain away fluids that might otherwise accumulate, but you will not feel these at all. In fact, there is usually little discomfort from the surgery.

When can I resume my normal activities?
Straining, bending, and lifting should be avoided during the early post-operative period. In many instances, you will be able to resume most of your normal activities within two to four weeks and begin to exercise three to four weeks after surgery. You will be instructed to temporarily avoid exposure to direct sunlight and, for the long-term, to be conscientious about the use of a sunblock to protect your skin.

How long will my results last?
The results of your facelift may be dramatic or subtle, depending on how you look before surgery as well as the specific goals that you and your plastic surgeon have established. Since the healing process is gradual, you should expect to wait at least several weeks for an accurate picture of your new look. Additional minor changes, or settling, may occur over several months.

KYBELLA® may be right for you if:

• You’re bothered (unhappy, self-conscious, embarrassed) by fat under the chin.
• You feel the condition makes you look older or heavier than you actually are.
• You don’t want to have surgery.
• You eat well and exercise, but the fat under your chin does not go away.

How does KYBELLA® work?
The active ingredient in KYBELLA® is synthetic deoxycholic acid. Deoxycholic acid is a naturally occurring molecule in the body that aids in the breakdown and absorption of dietary fat. When injected into the fat beneath the chin, KYBELLA® destroys fat cells, resulting in a noticeable reduction in fullness under the chin. Once destroyed, these cells can no longer store or accumulate fat, so further treatment is not expected once you reach your desired aesthetic goal.

How is KYBELLA® administered?
Treatment can only be administered by a KYBELLA®-trained healthcare specialist. At each treatment, you will receive multiple small injections under your chin, and the injection process takes about 15 to 20 minutes. The exact number of injections will depend on the amount of fat you have under your chin and your desired profile.

How many KYBELLA® treatment sessions will I need?
Since everyone’s chin profile is different, the number of treatments varies from patient to patient. Your healthcare specialist will help determine how many treatment sessions you need based on the amount and distribution of your submental fat and your personal treatment goals. Each KYBELLA® treatment session is given at least 1 month apart, and you should not receive more than 6 treatments. In clinical studies, 59% of patients received 6 treatments.

Will I need time to recover?
After KYBELLA® treatment, you will likely have some swelling, bruising, or numbness under your chin. Be sure to inform your healthcare professional if you develop an uneven smile, facial muscle weakness, or difficulty swallowing.

Information courtesy of mykybella.com

Some women may wish to add subtly volume to their lips; other may want to soften the appearance of the vertical lines above them.  Lines such as these are often caused by factors such as sun exposure or repeated muscle movement.

Juvederm Volbella® XC may be right for you if:

• You would like to add subtle volume to your lips.
• You would like to soften the appearance of your vertical lip lines.
• You want natural-looking, long-lasting results.

There are a number of procedures available to enhance the appearance of the neck. They range from very minimal in-office treatments with no down time, to more invasive procedures requiring anesthesia and time off for recovery. Aging of the neck is usually a combination of loose skin and muscle and some excess fat. To decide what is best for you, start by consulting a board-certified plastic surgeon to address your concerns.

We’ve included basic information below on ways to address the most common concerns. These procedures can be performed alone or in combination to give you the best possible result. This general overview should not serve as a replacement for your doctor’s advice, however. You also should write down your thoughts on what you’d like to correct, and have that with you at the time of your pre-operative consultation.

Treatment options

• Neck Liposuction for Fat Removal - During liposuction, your surgeon will make a small incision below the chin, and the excess fat will be removed. This procedure is often done alone or may be performed as part of a neck lift or facelift. If this is the only procedure you’ll need, you should plan to spend approximately an hour undergoing the operation. Your incisions will be stitched and bandaged. This procedure requires an anesthetic and you should allow five to ten days for recovery. It’s very important to follow your doctor’s instructions on properly caring for any stitches and bandages in the days following surgery.

• Neck Lift Procedure - Sometimes called a cervicoplasty or neck lift with platysmaplasty, the procedure will last two to three hours. Of course, if you are having a neck lift in conjunction with liposuction, facelift, forehead lift, or other surgeries, the time will vary accordingly. Your exact procedure will depend on your desired results and your own personal circumstances. In order to undergo a neck lift, you must be in good general health, both physically and mentally.
  
  Your surgeon will make a small incision under your chin and possibly in front of and/or behind your ears. These incisions allow access to the platysma (neck muscle) and any fat in the neck. The neck muscles can then be tightened and any excess fat removed. Your surgeon may choose to remove the fat with liposuction or by cutting it out. The incisions near the ears also allow for removal of some excess skin.
  
  Once the muscle has been tightened and any excess fat removed the skin is re-draped over the neck. Any excess skin is removed and the incisions are closed with sutures. Your surgeon will let you know if the sutures will need to be removed or if they will dissolve on their own. It is possible your surgeon may place a drain under the skin on the neck to collect any fluid that would increase your post op swelling and discomfort. If you surgeon chooses to use a drain it might remain in place only a day or two. You would be instructed on how to care for the drain if it needs to stay in for a longer period of time.

Information courtesy of ClevelandClinic.org.

This facial rejuvenation technique can help ease many signs of the passage of time. Selection of appropriate muscles and dosages to achieve optimal results requires thorough knowledge of facial anatomy and function. Botox can be used in many areas and usually requires little, if any, downtime. It is the only treatment of its type approved by the FDA.

Reasons to Consider Botox

• Low-impact method for treating facial wrinkles, furrows, crow’s feet and frown lines.

Botox FAQ
1. How does Botox work?
Botox is a purified protein produced by the bacterium. It temporarily inhibits the movement of the muscles that cause frown lines and wrinkles to form over time. In 2005, nearly 3.3 million Botox cosmetic procedures were performed.

2. Where are Botox injections performed?
Generally, we administer Botox injections in our office. The procedure is quick and patients can typically return to normal activities almost immediately.

3. How long do the results last?
The improvement in facial wrinkles after Botox injections usually lasts for around four months. Re-treatments are needed to maintain long-term results.

Other Fillers
In addition to Botox, the Plastic Surgery Group offers a number of other facial fillers, including Juvederm XC™ and Juvederm Voluma XC™. Juvederm XC smooths lines and wrinkles around the nose and mouth. Juvcderm Voluma adds volume to the cheek area to correct age related volume loss and can last up to two years.

Depending on your specific needs, one of these fillers may be the most appropriate treatment for you. Because of the materials used in these treatments, the chances of adverse or allergic reactions are extremely low, and side effects are typically limited to small amounts of redness or swelling at the injection sites.

Instantly adds subtle volume to lift and contour your cheek area. Proven to last up to two years.

Sun exposure, acne, or just getting older can leave our skin tone uneven, wrinkled, spotted, or scarred. If you want to look smoother and younger, consider a chemical peel, which uses a chemical solution to smooth the texture of your skin by removing outer layers.

A chemical peel, also called chemexfoliation or derma peeling, is one of the least invasive ways to improve the appearance of your skin. Although chemical peels are used mostly on the face, they can also be used to improve the skin on your neck and hands.

You Can Improve:

• Acne or acne scars
• Age and liver spots
• Fine lines and wrinkles
• Freckles
• Irregular skin pigmentation
• Rough skin and scaly patches
• Scars
• Sun-damaged skin

Information courtesy of PlasticSurgery.org.

Cosmetic eyelid surgery removes the excess fat and wrinkled, drooping skin of the upper eyelids that can result in a tired or sad-looking face. A lower lid blepharoplasty tightens the lower eyelid skin and can also eliminate bags under the eyes. Cosmetic eyelid surgery can correct problems resulting from aging, as well as inherited traits that can affect some patients as early as their 20s or 30s. This procedure can be performed under either local anesthetic or, for most patients, intravenous sedation.

Reasons to Consider Blepharoplasty

• Dark circles or large bags below the eyes.
• Excessive skin or wrinkles around the eyelids leading to a puffy appearance.

Blepharoplasty FAQ
1. How will my surgeon evaluate me for aesthetic eyelid surgery?
You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems and diabetes are among the medical conditions that may increase the risks associated with eyelid surgery.

Your surgeon will want to know if you have allergies, especially if they affect your eyes. He may ask whether you have ever tried and were unable to wear contact lenses, you should bring them with you in case your surgeon wants to test your vision.

We will need to know if you have ever been told by an ophthalmologist that you have a condition called "dry eye" or if you have any other problems with your eyes.

One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that your surgeon recommends will depend on may factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of the muscles around your eyelids.

2. What will the day of surgery be like?
Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There is surprisingly little discomfort, however, from the surgery.

You probably will be permitted to go home after a few hours, although some patients may stay overnight in the hospital or surgical facility.

3. How long will the results last?
The results of aesthetic eyelid surgery are long lasting, but they may be affected by your heredity and lifestyle factors.

Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows that mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure.

Even though the aging process continues, patients are happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.

See Breast Reconstruction under the "Breast Procedures" option.

Hearing a diagnosis of "cancer" is very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. At Aspirus Plastic Surgery, we understand your concerns and will guide you through treatment and explain the resulting effect on your health and appearance.

The first step in treating skin cancer is a consultation with your plastic surgeon. The success and safety of your skin cancer surgery depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires, and lifestyle.

Be prepared to discuss:

• Your type of skin cancer
• Medical conditions, drug allergies, and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco, and drugs
• Previous surgeries
• The likely outcomes of your treatment any any risks or potential complications

Your surgeon may also:

• Evaluate your general health status and any other pre-existing health conditions or risk factors
• Examine your skin
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of surgery and any risks or potential complications

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you will receive cover:

• What to do on the day of surgery
• The use of anesthesia during your skin cancer surgery
• Post-operative care and follow-up

What Happens During Skin Cancer Surgery?

Procedural Steps:

• Step 1 – Anesthesia: Medications are administered for your comfort during the surgical procedures. The choices include local, intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
• Step 2 – Removal: A small or contained lesion may be removed with excision--a simple surgical process to remove the lesion from the skin. Closure is most often performed in conjunction with excision.
• Step 3 – Reconstruction: A large lesion or one that has been removed with frozen sections can be reconstructed with a local flap. A flap may also be necessary where excision may result in a disfiguring appearance. A local flap repositions healthy, adjacent tissue over the wound. A suture line is positioned to follow the natural creases and curves of the face if possible, to minimize the appearance of the resulting scar.
• Step 4 – See the Results: After your skin cancer has been removed and any primary reconstruction is completed, a dressing or bandages will be applied to your incisions.

Quick Facts About Skin Cancer Treatment:

• Treatment of skin cancer, much like any form of cancer, may require surgery to remove cancerous growths.
• Your plastic surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health and your appearance.
• Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance.
• For some people, reconstruction may require more than one procedure to achieve the best results.

Information courtesy of PlasticSurgery.org.

Enhancing Your Appearance with Scar Revision Surgery:
Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly, or disfiguring. Even a wound that heals well can be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to its size, shape, or location.

Your treatment options may vary based on the type and degree of scarring and can include:

• Simple topical treatments
• Minimally invasive procedures
• Surgical revision with advanced techniques in wound closure

Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Is It Right For Me?
Scar revision is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. Scar revision can be performed on people of any age and is a good option if:

• You are bothered by a scar anywhere on your body
• You are physically healthy
• You do not smoke
• You have a positive outlook and realistic goals for your scar revision surgery
• You do not have active acne or other skin diseases in the area to be treated

Information courtesy of PlasticSurgery.org.

If your hand is impaired in any way, surgery can improve your condition. This type of very specialized surgery can treat diseases that cause pain and impair the strength, function, and flexibility of your wrist and fingers. Surgery seeks to restore to near normal the function of fingers and hands injured by trauma or to correct abnormalities that were present at birth.

Specifically, Hand Surgery Can Treat:

• Carpal tunnel syndrome: a condition caused by pressure to the median nerve within the wrist, or carpal tunnel. You might feel pain, a tingling sensation, numbness of the fingers, weakness, or aching. Carpal tunnel syndrome is associated with multiple conditions including: repetitive motion or overuse, fluid retention during pregnancy, injury to the nerve in the carpal tunnel or rheumatoid arthritis.
• Rheumatoid arthritis: a disabling disease that can cause severe inflammation in any joint of the body. In the hand, it can deform fingers and impair movement.
• Trigger finder release: also known as stenosing tenosynovitis, one of your fingers or your thumb gets stuck in a bent position and then straightens with a snap — like a trigger being pulled and released. If trigger finger is severe, your finger may become locked in a bent position.
• Dupuytren's contracture: a disabling hand disorder in which thick, scar-like tissue bands form within the palm and may extend into the fingers. It can cause restricted movement, bending the fingers into an abnormal position.

Is It Right for Me?
Hand surgery is a highly individualized procedure which can be performed on people of any age and is a good option for you if:

• You do not have additional medical conditions or other illnesses that may impair healing.
• You are a non-smoker.
• You have a positive outlook and realistic goals for your hand surgery.
• You are committed to following your plastic surgeon's prescribed course of treatment.
• In some conditions, hand surgery is necessary to treat wounds and to help painful conditions.

Carpal Tunnel Syndrome Repair
Carpal tunnel syndrome (CTS) is a common condition that affects the hand, wrist, and occasionally the entire upper extremity. The tunnel itself is a narrow canal at the base of the palm that is defined by the bones of the wrist and the overlying transverse carpal ligament. The nine flexor tendons to the fingers and thumb, and the median nerve pass through the tunnel. The median nerve provides sensation to the thumb, index, and long fingers, and to part of the ring finger. It also provides strength to the muscles at the base of the thumb. CTS is a constellation of symptoms resulting from compression or adherence of the median nerve at the base of the palm.

What are the symptoms of Carpal Tunnel Syndrome?
Characteristic early symptoms include numbness at night, tingling, or pain in the fingers (especially the thumb, index, and long fingers). The patient will often awaken with these symptoms and attempt to shake the hand or hold it in a dependent position to relieve symptoms. As the problem worsens, the symptoms become more prominent during the daytime, especially while driving, brushing hair and holding the phone or a book. The patient also may begin to experience weakness and may occasionally drop objects, often without realizing they are losing their grip until it is too late.

Surgery for Carpal Tunnel Syndrome
The goal of surgery is to decrease pressure on the nerve by enlarging the carpal canal. This is accomplished by dividing the ligament that covers the carpal tunnel at the base of the palm—the transverse carpal ligament—through an incision approximately one inch in length.

Surgery for CTS is an outpatient procedure that is usually performed under local anesthesia. Brief surgical discomfort lasts 24 to 72 hours; however, patients often experience complete resolution of their nighttime symptoms even the night after surgery. Sutures are removed 10 to 14 days after surgery, and hand and wrist use for everyday activities is gradually restored using progressive exercise.

Information courtesy of ClevelandClinic.org and PlasticSurgery.org.

Enhancing Your Appearance with Spider Vein Treatment
If you sometimes avoid showing your legs because you have spider veins — those small clusters of red, blue or purple veins that appear on the thighs, calves and ankles — you are not alone. It’s estimated that at least half of all women are bothered by this common cosmetic problem.

If you would like to eliminate your spider veins and improve your appearance, your plastic surgeon can help. Today there are very effective, safe and relatively painless methods available for eradicating spider veins.

In some women, spider veins become noticeable in their early 20s. For others, the veins may not become obvious until they reach their 40s. Men get spider veins, too. However, usually they are concealed by hair growth on the leg.

A number of factors may contribute to the development of spider veins in the legs, including:

• Heredity
• Pregnancy
• Hormonal shifts
• Weight gain
• Occupations or activities that require prolonged sitting or standing

Is It Right For Me?
Spider vein treatment is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Spider vein treatment can be performed on people of any age and is a good option for you if:

• You are bothered by spider veins anywhere on your body
• You have a positive outlook and realistic goals for your spider vein treatment
• You are committed to following your plastic surgeon’s prescribed course of treatment

Sclerotherapy
Sclerotherapy requires no anesthesia and is usually performed in our office. Two or more sessions, each lasting less than 30 minutes are usually required to obtain optical results.

A common method of treating spider veins in the legs and ankles is with sclerotherapy. In this treatment, sclerosing solution is injected into each affected vein, causing the vein to collapse and fade from view. Although everyone is different, you can generally expect to receive one injection for every inch of spider vein that is treated. Bright light and magnification may be used to ensure maximum precision while the skin is held taut to inject sclerosing solution. A cotton ball and compression tape is often applied to each injection site as it is finished. Compression stocking are to be worn for a few days following, as well as a limitation of strenuous activities.

VeinWave™
Veinwave™ is an electrical desktop device which uses a needle holder and a foot pedal. The practitioner identifies the area for treatment and inserts an ultra-fine insulated needle into the needle holder. This is minimally invasive, literally breaching only the top layers of skin, and should not pierce the vessel. The effect of the treatment is 'instant' - you see the veins disappearing immediately. Some patients leave the treatment without any real visible sign on the skin, other than the lack of veins, and some with more sensitive skin may suffer minor reddening which should disappear within a few days, if not hours.

Immediately after the treatment you can resume everyday activities. Avoid the sun for a couple of days or use sun block. After a few days very small micro-crusts, like the marks from a cat scratch, can appear where Veinwave™ has been applied. This is normal and no special care is needed. These will disappear on their own. It is best not to retreat an area for 6 weeks. At that time your practitioner is best able to see if any small veins remain. Once a thread vein has been successfully treated it cannot come back.

A hernia occurs when the inner lining of the abdomen pushes through the weakened inside layers of the abdominal wall, forming a bulge. This bulge often gets bigger over time. If you let it go, you may end up experiencing abdominal pain and discomfort with constipation, nausea and vomiting. It could also lead to other, more serious health problems.

With both types of hernia surgeries, open repair and laparoscopic, you can expect to recuperate within a few days — sometimes even quicker — and get back to normal activities within a few weeks.

Treatment Options:

• Umbilical Hernia Repairs: Umbilical hernia repair is surgery to repair an umbilical hernia. An umbilical hernia is a sac (pouch) formed from the inner lining of your belly (abdominal cavity) that pushes through a hole in the abdominal wall at the belly button.
• Ventral Hernia Repairs: When a ventral hernia occurs, it usually arises in the abdominal wall where a previous surgical incision was made. In this area the abdominal muscles have weakened; this results in a bulge or a tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a balloon-like sac. This can allow a loop of intestines or other abdominal contents to push into the sac. If the abdominal contents get stuck within the sac, they can become trapped or "incarcerated." This could lead to potentially serious problems that might require emergency surgery.
• Groin Hernia Repairs: Inguinal hernia repair is surgery to repair a hernia in the abdominal wall of your groin. A hernia is tissue that bulges out of a weak spot in the abdominal wall. Your intestines may bulge out through this weakened area. During hernia repair, this bulging tissue is pushed back in. Your abdominal wall is strengthened and supported with sutures (stitches), and sometimes mesh.
• Femoral Hernia Repairs: Femoral hernia repair is surgery to repair a hernia near the groin or upper thigh. A femoral hernia is tissue that bulges out of a weak spot in the groin. Usually this tissue is part of the intestine. In surgery to repair the hernia, the tissue is pushed back in, and the weakened area is sewn closed or strengthened. This repair can be done with open or laparoscopic surgery.

Information courtesy of Cleveland Clinic, Society of American Gastrointestinal and Endoscopic Surgeons, and MedlinePlus.

Dramatically reduce signs of gaining in a single treatment, reducing excessive sagging skin in the neck, arms or abdominal area.

Rejuvenate and treat excessive stretching of the vaginal muscles or treat minor urinary incontinence.

Smooth and wrinkle reduction targeting around the yes, mouth, cheek and neck using gentle heat.