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.

View brochure for more details

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.

Performed in the office, Renuva is an injectable treatment by transferring small amounts of allograft fat tissue into your existing fat tissue. Once transplanted into your body, Renuva forms an adipose matrix which acts as a scaffold system to build and regenerate tissue around. Your body uses this matrix to improve skin tone, texture, volume and appearance. Renuva is an excellent option for men and women who want to achieve a more youthful appearance and can be used to improve everything from restoring volume to your hands and facial skin as well as dimples caused by uneven cellulite, scarring from previous procedures, restore upper breast fullness and uplift the buttocks.

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

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, Aspirus Plastic Surgery 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.

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.

Aspirus Plastic Surgery offers a number of other facial fillers, from the Juvederm family of fillers including Juvederm XC™, Juvederm Voluma XC™, Juvederm VolbellaXC and Juvederm VollureXC.

Juvederm products are a smooth consistency gel, compared to some hyaluronic gel products that have a granular consistency. Juvederm products are developed using the Hylacross technology to allow for a smoother, malleable gel. Hyaluronic acid is a naturally occurring sugar found in the body. Hyaluronic acid works by holding in water at the injection site and acting as a cushioning agent. It adds temporary volume and a smoother appearance to the skin. Juvederm products also contain the local anesthetic lidocaine for more comfortable injections as this numbs the treatment area within seconds. 

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.

• JuvedermXC: An injectable hyaluronic acid dermal filler used to provide 9-12 months of correction for moderate to severe facial wrinkles and folds, such as nasolabial lines.
• VollureXC: Also a suitable hyaluronic acid filler for moderate or severe facial wrinkles of folds but may last longer, up to 18 months.
• VolumaXC: Designed to instantly add subtle volume to lift and contour your cheek area and to treat age related volume loss that causes cheeks to flatten and skin to sag. Lasts up to 24 months.
• VolbellaXC: For those who want to add subtle volume to their lips or soften the appearance of the vertical lines above the lips. Lasts up to 12 months.
• Renuva: A more permanent solution to volume loss in the face, Renuva provides an adipose (fat) alternative designed to address minor aesthetic defects. Renuva is an injectable treatment that transfers small amounts of allograft fat tissue into your existing fat tissue. Once transplanted, Renuva forms an adipose matrix with acts as a scaffold sysytem to build and regenerate tissue. Your body uses this to improve skin tone, texture, volume and appearance.

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.

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

Excessive stretching of the vaginal muscles commonly occurs after vaginal child birth or simply due to aging. Damage can diminish sensation during sexual activity, reduce satisfaction. Laxity of the skin is caused by numerous factors. ThermiVA treatments use radiofrequency energy to gently heat tissue to rejuvenate collagen, without discomfort or downtime. Treats and tightens vaginal muscles, decreases vaginal dryness, helps with minor urinary incontinence and improves sexual satisfaction. Performed in the office setting and requires a series of 3 treatments.