Is cosmetic eyelid surgery right for me?

Eyelid surgery is performed on men and women of all ages who want to improve their self-image. Most people have eyelid surgery to minimize the effects of aging.
However, many people in their 20s or 30s may also benefit from the procedure.
You may be a good candidate for eyelid surgery if you have any of the following conditions:

Upper eyelids

• excess skin that hides the natural fold of the upper eyelids
• loose skin that hangs down from the upper eyelids
• puffiness in the upper eyelids that creates a tired look.

Lower eyelids

• excess skin and fine wrinkles of the lower eyelids
• puffy "bags" and, in some cases, dark circles.

Eyelid surgery needs to be approached with extra caution if you have any of the following medical conditions:

• thyroid problems, such as hypothyroidism or Graves' disease
• lower eyelids that droop significantly and reveal the white beneath the iris (the eye's colored portion)
• eye problems, such as "dry eye," a detached retina or glaucoma
• high blood pressure or other circulatory disorders
• cardiovascular disease
• diabetes.

It's important to let your plastic surgeon know if you have any of these problems.

Some of the most visible signs of aging first appear on the face. Although the changes appear gradually, there may come a day when you look in the mirror and decide that the face you see doesn't reflect the way you feel about yourself. If you'd like to look as good as you feel, a facelift can help. Also known as rhytidectomy, a facelift smooths the loose skin onyour face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer and fresher.
The best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by The American Board of Plastic Surgery.

Is a facelift right for me?

Facelifts are most commonly performed on patients in the 40-60 age range. However, the procedure can produce good results for people in their 60s, 70s and 80s as well. You may be a good candidate for a facelift if you have any of the following types of conditions:

• a deep line that runs from the corner of your nose to the corner of your mouth .
• loss of a well-defined jawline. deep wrinkles in the cheeks and sagging skin near the cheekbones
• loose skin, wrinkles or excess fatty tissue in the neck.

Facelift surgery needs to be approached with extra caution if you have any of the following medical conditions:

• uncontrolled high blood pressure
• blood-clotting problems
• the tendency to form excessive scars.

Be sure to alert your plastic surgeon if you are affected by any of these conditions.

How is a facelift performed?

The technique chosen for your surgery depends on rour features, your surgeon's preferences and your iesired results.
There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your thin.
Working through these incisions, your plastic surgeon frees the facial skin from its underlying tissues and pulls It upward and back. The excess skin is then removed. In some cases, the deeper issues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows your surgeon to remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.

How will I learn about the safety of facelift surgery?

Each year, thousands of people have facelifts and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits.
One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of facelift surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions you may have about the safety of the procedure.
By carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. A bandage may have been wrapped around your face to help control swelling. Sometimes, small drainage tubes are placed beneath the skin to drain away fluids that might otherwise accumulate. Discomfort is usually minimal, but any pain you feel can be controlled with medication prescribed by your surgeon. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

• In this early stage of healing, you should rest with your head elevated to help minimize bruising and swelling.

Within the first week

• Swelling reaches its peak, and then begins to subside.
• Bandages will be removed and you may shower.
• Stitches will dissolve or be removed.
• You may return to light activity, but continue to sleep with your head elevated.
• You can wear makeup to conceal any discoloration.

Within two weeks

• Most of the bruising will disappear.
• You may resume many of your normal activities, including non-strenuous work.

After several weeks

• You may resume exercise.
• Swelling and puffiness will continue to subside.
• Numbness in the facial area will diminish; however, some numbness may persist for several months.

Throughout the healing period, you should avoid exposure to direct sunlight and, for the long term, be conscientious about using sun block preparations to protect your skin.

What should I know about my results?

If you're like most people who have the procedure, you'll be very pleased with your refreshed and rejuvenated appearance. Although the healing may take some time, you can expect the end result to be worth the wait.
A number of factors, including your heredity and your lifestyle, playa role in how long the results of your facelift will last. Even though the aging process continues, patients are usually happy with their appearance for many years following a facelift. Some patients find that they want to make additional improvements at a later time.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

What is an attractive nose? Quite simply it is a nose that fits your face. It is a natural-looking nose that achieves a harmonious balance with your other facial features. If you feel that your nose is not a good fit, you may benefit from cosmetic surgery of the nose, also called rhinoplasty. Rhinoplasty can enhance the shape, size and general appearance of your nose.
The best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Is rhinoplasty right for me?

Rhinoplasty can be performed on men and women of almost any age. However, it's usually recommended that young people wait until facial growth is complete - about age 13 or 14 for girls and 14 or 15 for boys. If you are a teenager, having the procedure should be your own idea.
You may be a good candidate for rhinoplasty if you have any of the following conditions:

• your nose appears too large for your face
• there is a bump or depression on the nasal bridge when viewed in profile
• the nose seems too wide when viewed from the front
• the nasal tip droops or plunges
• the tip is thickened or enlarged
• the nostrils are excessively flared
• your nose is off-center or crooked
• a previous injury has made your nose asymmetrical
• you have an airway obstruction that impairs breathing.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering rhinoplasty. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.
You should arrive at the consultation prepared to provide complete information about:

• previous surgeries
• past and present medical conditions
• medical treatments you have received
• medications that you take, including nutritional supplements and herbal remedies
• any allergies that cause congestion or conditions that cause breathing difficulties
• how often you use nasal sprays to relieve congestion.

How is rhinoplasty performed?

The technique used for your surgery depends not only on your surgeon's preferences, but also on your desired results. Alterations may be made to increase or decrease the nasal bridge, reduce the size or width of the nose, narrow the nostrils, reshape the tip, or change the angle between the nose and the upper lip.
Plastic surgeons may perform rhinoplasty from within the nose, making the incision inside the nostrils. This is called a "closed rhinoplasty." Other times, a surgeon prefers an "open" procedure, in which a small incision is made across the columella, the vertical strip of tissue separating the nostrils, as well as within the nose.
Working through these incisions, the nose's framework of bone and cartilage is sculpted to the desired shape. Your surgeon may reshape or reposition the bones in your nose, or build up certain areas, using either nasal cartilage or bones and cartilage from another body site, or other materials. The skin and soft tissues are then redraped over the reshaped framework. If the lower part of the nose is being narrowed or the nostrils are
being reduced, small wedges of skin at the base of the nostrils may be removed through incisions that are hidden in the nose's natural creases.

How will I look and feel right after surgery?

When the surgery is completed, you'll be taken to a recovery area. Any discomfort that you feel will be controlled with medication prescribed by your surgeon. A splint may be applied to the bridge of your nose to protect the nose and hold the tissues in place until they have stabilized. You may also have a small, triangular bandage beneath the tip of your nose and packing inside the nostrils, especially if work has been done to improve your breathing.
Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day:

• In this early stage of healing, you should rest with your head elevated to help minimize swelling
• Activity must be kept to a minimum
• You may experience a small amount of bleeding and stuffiness.

Within 10 days:

• Swelling reaches its peak and then begins to subside
• Bruising will begin to diminish
• You can safely use makeup to conceal any discoloration
• Stitches and packing will dissolve or be removed
• You may discontinue wearing the splint (near the week's end)
• You may return to school or a nonstrenuous job.

After several weeks:

• You may resume exercise and most of your normal activities
• Most of the swelling will subside
• Numbness will diminish; however, some loss of sensation may persist for several months
• You may resume wearing eyeglasses normally. (In the early stages of healing, patients often use tape to keep their glasses from resting on their healing noses.)

In the months following surgery, it is important to keep your nose shielded from direct sunlight. Wearing sun block lotion is essential for protecting your skin.

If you're considering ear surgery...
Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. For the most part, the operation is done on children between the ages of 4 and 14. Ears are almost fully grown by age 4, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.
If you're considering ear surgery for your self or your child, this brochure will give you a basic understanding of the procedure- when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything you don't understand about the procedure.

All surgery carries some uncertainty and risk when ear surgery is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
A small percentage of patients may develop a blood clot on the ear. It may
dissolve naturally or can be drawn out with a needle. Occasionally, patients develop an infection in the cartilage, which can cause scar tissue to form. Such infections are usually treated with antibiotics; rarely, surgery may be required to drain the infected area.

Planning for surgery

Most surgeons recommend that parents stay alert to their child's feelings about protruding ears; don't insist on the surgery until your child wants the change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.
In the initial meeting, your surgeon will evaluate your child's condition, or yours if you are considering surgery for yourself, and recommend the most effective technique. He or she will also give you specific instructions on how to prepare for surgery.

Where the surgery will be performed

Ear surgery is usually performed as an outpatient procedure in a hospital, a doctor's office-based surgical facility, or a freestanding surgery center. Occasionally, your doctor may recommend that the procedure be done as an inpatient procedure, in which case you can plan on staying overnight in the hospital.

Types of anesthesia

If your child is young, your surgeon may recommend general anesthesia, so the child will sleep through the operation. For older children or adults, the surgeon may prefer to use local anesthesia, combined with a sedative, so you or your child will be awake but relaxed.

The surgery

Ear surgery usually takes about two to three hours, although complicated procedures may take longer. The technique will depend on the problem.
With one of the more common techniques, the surgeon makes a small incision in the back of the ear to expose the ear cartilage. He or she will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.
Another technique involves a similar incision in the back of the ear. Skin is removed and stitches are used to fold the cartilage back on itself to reshape the ear without removing cartilage.
In most cases, ear surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.

Getting back to normal

Adults and children are usually up and around within a few hours of surgery, although you may prefer to stay overnight in the hospital with a child until all the effects of general anesthesia wear off.
The patient's head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. The ears may throb or ache a little for a few days, but this can be relieved by medication.
Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Be sure to follow your surgeon's directions for wearing this dressing, especially at night.
Stitches are usually removed, or will dissolve, in about a week.
Any activity in which the ear might be bent should be avoided for a month or so. Most adults can go back to work about five days after surgery. Children can go back to school after seven days or so, if they're careful about playground activity. You may want to ask your child's teacher to keep an eye on the child for a few weeks.

Other ear problems

Besides protruding ears, there are a variety of other ear problems that can be helped with surgery. These include: "lop ear," when the top seems to fold down and forward; "cupped ear," which is usually a very small ear; and, "shell ear," when the curve in the outer rim, as well as the natural folds and creases, are missing. Surgery can also improve large or stretched earlobes, or lobes with large creases and wrinkles. Surgeons can even build new ears for those who were born without them or who lost them through injury.
Sometimes, however, the correction can leave a scar that's worse than the original problem. Ask your surgeon about the effectiveness of surgery for your specific case.

More natural-looking ears

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don't expect both ears to match perfectly- perfect symmetry is both unlikely and unnatural in ears. If you've discussed the procedure and your expectations with the surgeon before the operation, chances are, you'll be quite pleased with the result.

If you are a woman with overly large breasts, breast reduction surgery can be a tremendously lifeenhancing option. Having the procedure will give you far more than just smaller, firmer breasts. You'll also get significant relief from many physical and emotional discomforts, a new sense of freedom in your exercise and physical activity, and the ability to wear a greater variety of clothing styles. In fact, of all the procedures that plastic surgeons perform, breast reduction ranks among the highest in patient satisfaction.
Breast reduction, also called reduction mammaplasty, is a procedure that removes excess breast tissue and skin, making your breasts more proportional to the rest of your body. The areola (the pigmented skin surrounding the nipple) may be reduced and repositioned as well.
You'll find basic information about breast reduction surgery in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by The American Board of Plastic Surgery.

Is breast reduction right for me?

Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may affect the size and shape of your breasts. If you plan to breast-feed in the future, you should discuss this with your surgeon.
You may be a good candidate for breast reduction if you have any of the following conditions:

• back, neck or shoulder pain caused by the weight of your breasts
• heavy, sagging breasts with very low nipples and areolas
• breasts that are too large in proportion to your body frame
• skin irritation beneath the breasts
• indentations in your shoulders caused by tight bra straps
• restriction of physical activity due to the size and weight of your breasts
• feelings of self-consciousness about the large size of your breasts
• one breast that is much larger than the other.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering breast reduction. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific goals for the surgical procedure.
You should arrive at the consultation prepared to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements
• past experience with weight loss and the effect it had on your breast size.

When examining your breasts, your plastic surgeon will consider their size and shape, the quality of your skin and the placement of the nipples. Measurements and photographs may be taken for your medical record.
Some insurance companies will pay for breast reduction to relieve medical symptoms; however, coverage may depend on a significant amount of breast tissue being removed. A letter of predetermination may be required by your insurance company prior to surgery. Your surgeon's office staff will help you with insurance matters related to the procedure. If you are seeking a purely cosmetic change in your breast size, you will pay for the procedure yourself.

How is breast reduction performed?

The specific method chosen for your breast reduction will be determined by your anatomy, your surgeon's preferences and your desired results.
The most common method uses a three-part incision. One part of the incision is made around the areola (nipple area). Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third part is a horizontal incision beneath the breast, which follows the natural curve of the breast crease.
After the surgeon has removed the excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areola, which is usually larger than ideal, is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour, especially on the sides of the breasts.
The nipples and areolas usually remain attached to their underlying tissue as they are moved to their higher position - much like a button being moved to a higher buttonhole - and this may allow for the preservation of sensation. This method may also preserve the ability to breast-feed, although it is not guaranteed.
The type of incision used for your breast reduction may vary, depending on the size and shape of your breasts and the desired amount of reduction. Women who seek a smaller reduction in size may be able to avoid the horizontal incision that runs underneath the breast. Other incisional techniques may be used in some instances. Women whose breasts contain a significant amount of fatty tissue may find that liposuction alone can be used to reduce breast size with only minimal scars.

How will I learn about the safety of breast reduction?

Each year, thousands of women undergo breast reduction and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of breast reduction surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.
Remember, by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. In some cases, small drainage tubes will have been placed beneath the breast skin to help prevent fluids from accumulating. Gauze dressings will be placed on your breasts and covered with an elastic bandage or surgical bra.
On the day of surgery, you'll be encouraged to get out of bed for short periods of time. Most of the discomfort you feel in the days following the procedure can be controlled with medication prescribed by your plastic surgeon.
Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week:

• You will begin to move about more comfortably and perhaps even return to (nonstrenuous) work.
• Surgical drains will be removed and dressings will be changed.

After several weeks:

• Bruising, swelling and normal periodic discomfort will diminish.
• You can discontinue wearing a support bra.
• Sensation within the nipple and areola area will gradually improve.
• You may return to most of your normal activities, including mild exercise.

After a few months:

• Your breasts will start settling into a more natural shape.
• Incision lines will begin to fade.
• If you haven't felt it sooner, you will notice relief from neck, back and shoulder pain.

What should I know about my results?

Without the excessive weight of large breasts, you may find that you enjoy life more. Your body will look better proportioned, clothes will fit you better and you'll have greater freedom to enjoy physical activities.
Although the incision lines will be permanently visible, they will fade over time and are easily concealed by clothing - even most swimsuits and tops with low-cut necklines.
Breast reduction typically makes a dramatic change in your body image, and it may take some time to adjust to your new appearance. However, most women soon become comfortable with their smaller, more proportional breasts and feel very pleased with the results of surgery.
You can expect to maintain your new breast size, unless you gain or lose a significant amount of weight or become pregnant. If, over time, the effects of gravity and aging cause your breasts to lose their shape or firmness, you may choose to undergo a cosmetic breast lift to help restore a more youthful contour.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

If you often wish that your breasts were larger, fuller or more shapely, breast augmentation surgery may be the right choice for you. Breast augmentation
(also called augmentation mammaplasty) is a cosmetic procedure that uses implants to enlarge and shape the breasts. Your new look will bring you greater freedom with fashion and may give your self image a boost as well.
You'll find basic information about breast augmentation in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by The American Board of Plastic Surgery.

Is breast augmentation right for me?

Women who choose to have breast augmentation surgery do so to improve their self image. Some feel dissatisfied because their breasts never developed to a size that meets their expectations. Others want to bring balance to a breast that is somewhat smaller than the other. Often, women want the procedure to restore their natural breast volume, which may have decreased as a result of pregnancy, weight loss or aging.
Anyone of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:

• you are bothered by the feeling that your breasts are too small
• weight loss has changed the size and shape of your breasts
• after having children, your breasts have become smaller and have lost their firmness
• dresses that fit well around your hips are often too large at the bustline
• one of your breasts is noticeably smaller than the other
• you feel self-conscious wearing a swimsuit or form-fitting top.

In addition, there are several "musts" for anyone considering breast augmentation:

• if you are a young woman, your breast development must be complete
• you must be emotionally mature and fully understand your own motivations for wanting the procedure (the best reason is to feel better about yourself)
• you must have realistic expectations, knowing that the procedure can bring improvement, but not perfection.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering breast augmentation. During this meeting, your plastic surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.
You should arrive at the consultation ready to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements
• the results of mammograms you have had
• any history of breast cancer in your family

Your surgeon will help you understand the factors that may affect your results. For example, gaining or losing a significant amount of weight may change your breast size. Pregnancy can also alter breast size in an unpredictable way.
As part of the consultation, your breasts will be examined and perhaps photographed for your medical record. During this exam, your surgeon will consider 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). Your surgeon may recommend that you have a baseline mammogram before surgery to assist in detecting any future changes in your breast tissue. After surgery, your mammograms will be done differently because special imaging techniques must be used to visualize the breast tissue.
Your plastic surgeon may suggest additional cosmetic procedures to improve your results. For example, if your breasts are sagging, your surgeon may suggest that a breast lift procedure be performed in conjunction with your breast augmentation surgery.

How is breast augmentation performed?

The technique used for your surgery depends not only on your surgeon's preferences, but also on your desired results. The incision is small and is usually made in one of three locations: underneath the breast just above the crease; around the lower edge of the areola; or within the armpit.
Once the incision is made, the surgeon creates a pocket into which the implant is inserted. This pocket is made either directly behind the breast tissue or beneath the pectoral muscle located below the breast tissue and above the chest wall.

How will I learn about the safety of breast implants?

Most women having breast augmentation surgery today receive saline-filled implants-silicone rubber shells that are filled with sterile salrwater. In the unlikely event that a saline implant leaks, the salrwater is harmlessly absorbed by the body. Silicone gel or alternative filler implants may become available in the future. Your surgeon can provide you with information on the latest implant research.
Each year, thousands of women undergo breast augmentation surgery and experience no major complications. However, you must fully understand the risks as well as the benefits of the procedure. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of breast augmentation surgery. Be sure to raise any questions or concerns that you may have about the safety of the procedure.
Remember that by carefully following your surgeon's advice and instructions-both before and after surgery-you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgery has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery.

How will I be cared for on the day of my surgery?

Breast augmentation may be performed in a hospital, an outpatient surgery center or an officebased surgical suite. If you are admitted to the hospital or surgical facility, your stay will be a short one, perhaps just one night.
For some patients, local anesthesia with intravenous sedation is used. For others, general anesthesia may be the best choice. With either type, you'll remain very comfortable throughout the procedure. You will emerge from surgery wearing a support bra, gauze wrappings or other dressings. Upon leaving the operating room, you'll be taken to a recovery area where you'll be closely monitored.

How will I look and feel right after surgery?

Within a day or two after surgery, you should be up and around. Most of the discomfort that you feel can be controlled with medication prescribed by your plastic surgeon.
Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within one week

• you'll be permitted to shower
• your stitches will be removed (unless dissolving sutures were used)
• you may feel able to return to non strenuous work
• you can resume sexual relations (as long as the breasts are treated gently).

After several weeks

• most of the swelling will subside and you'll start to see your final result
• you may discontinue wearing the support bra . you may resume vigorous exercise and arm movements.

What should I know about my results?

If you're like most women who have the procedure, you'll be very pleased with the results of your breast augmentation. You will no longer need padded bras or other bust-enlarging undergarments. Your new, natural curves will let you wear a greater variety of fashions-even dresses with low-cut necklines and form-fitting tops. Many women find that their new figure gives them a greater sense of self-confidence-whether they're on the beach or in the boardroom.
You are likely to be happy with your results for many years. However, keep in mind that your breasts are not immune to the effects of weight fluctuations or aging.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to return for these checkups so that your surgeon can assess your long-term results and address any questions or concerns you may have.

The goal of breast reconstruction is to create a soft, natural-looking breast for a woman who must undergo breast removal due to cancer or other disease. Whether it is performed immediately following mastectomy or at a later time, breast reconstruction can dramatically improve a woman's appearance, self-confidence and overall quality of life.
You will find basic information about breast reconstruction in this brochure. However, the only way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Is a breast reconstruction right for me?

Almost every woman who has lost a breast to cancer can have her body restored with breast reconstruction. However, the followmg conditions are desirable:

You clearly understand that although your figure will be markedly improved, your reconstructed breast will not look or feel exactly the same as the breast that was removed.

Your oncologist has advised you that reconstruction is appropriate for you with regard to your stage of cancer or treatment. (Should cancer recur, your reconstructed breast will not interfere with further treatment. However, such treatment may affect the appearance of your reconstructed breast.)

You feel that you are able to handle the period of emotional adjustment that may accompany breast reconstruction. Just as it takes time to get used to the loss of a breast, it may take some time before you begin to think of the reconstructed breast as your own.

You have no additional health concerns that may complicate the procedure, such as obesity or heart disease.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering breast reconstruction. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific goals for the procedure. You should arrive at the consultation prepared to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including dietary or herbal supplements
• past experience with weight loss and the effect it had on your breast size

To help you determine which reconstruction method will give you the best results, your surgeon will perform a physical exam. Measurements and photographs may be taken for your medical record.
Thanks to the advocacy efforts of the American Society of Plastic Surgeons (ASPS) and several breast cancer support groups, insurance companies are now required by law to cover the cost of reconstructive surgery for women who have undergone a mastectomy. The law also requires coverage for procedures to restore and achieve symmetry on the opposite breast.
Because regulations related to the law are not yet final, coverage denials still occur. It's best to let your plastic surgeon know if you are having difficulty getting coverage. Many insurance companies require a letter of predetermination. Your surgeon's office staff will help you with this and any other insurance matters related to the procedure.

How is breast reconstruction performed?

There are many options available in breast reconstruction. Your anatomy, your surgeon's preferences and your desired results will help determine which method is best for you.

Skin expansion with a breast implant. This is the most common method of reconstructing a breast. Following mastectomy, a balloon expander is inserted beneath the skin and chest muscle. Over several weeks, the expander balloon is gradually filled with a salt-water solution in the doctor's office, causing the overlying skin to stretch. When the skin has stretched sufficiently, the expander is surgically replaced with a more permanent implant. Some expanders are designed to be left in place as the final implant. The nipple and the skin surrounding it, called the areola, are reconstructed in a later procedure.
In rare cases, when a sufficient amount of skin is available, an implant can be placed without the preliminary skin-expansion step.

Flap reconstruction. Although flap reconstruction is more involved at the initial procedure than reconstruction with an implant, many women prefer it because it may allow the breast to be rebuilt with natural tissue. Also, unlike the tissueexpander method, the breast mound is completed at the initial operation, without the need for expansion over an extended time period.
In one method, the breast is reconstructed using a tissue flap - consisting of a portion of skin, fat and muscle - that is taken from the back, or abdomen. The flap, still tethered to its original blood supply, is tunneled beneath the skin to the front of the chest wall. The transported tissue may be bulky enough to create a new breast mound itself. However, sometimes an implant will be inserted as well.
In a more complex flap technique, tissue that is removed from the abdomen, is surgically transplanted to the chest by reconnecting the flap's blood vessels to vessels in the chest region. Although more complicated, this microsurgical reconstruction may provide a more natural and less traumatic reconstruction in many women.
Although recovery from flap reconstruction may take longer than with implant reconstruction at the initial procedure, it does not require a secondary procedure for placing a permanent implant, nor does it require the weekly office visits needed for tissue expansion. Additionally, a flap procedure may improve the contour of the site from which the borrowed tissue was taken. For example, a protruding abdomen may appear trimmer after tissue is taken from the area and used to rebuild the breast.
All of these procedures have advantages and disadvantages, and many times the choice of procedures is limited by other health factors, such as weight, other medical conditions and previous cancer therapy. Your plastic surgeon will help you to determine which is the best procedure for you.

Follow-up procedures. Once the breast mound is restored in the initial procedure, one or more follow-up procedures will be performed to replace a tissue expander with a permanent implant or to reconstruct the nipple and areola. Your surgeon may also recommend an additional operation to lift or reduce the opposite breast to match the appearance of the reconstructed breast.

What are the risks associated with breast reconstruction?

Each year, thousands of women undergo breast reconstruction and experience no major complications. However, one of the most important parts of your consultation with your plastic surgeon is discussing the risks as well as the potential benefits of surgery. Certain complications are possible in any type of surgery including; blood loss, infection and others. Your specific risk should be discussed with your surgeon.
Potential complications specific to breast reconstruction vary with the type of reconstruction you and your surgeon choose. For instance, with flap reconstruction, there is a small risk of partial or, very rarely, complete flap loss. Reconstruction with an implant has the potential for breast firmness (capsular contracture) and implant rupture. The probability of having one of these or other complications must be thoroughly discussed with your surgeon.
Remember, by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your procedure has been set, your oncologist and plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points will be covered, including:

• avoiding medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery

What can I expect on the day of my surgery?

Breast reconstruction usually involves more than one operation. The first stage, whether performed at the same time as the mastectomy or later on, is typically performed in a hospital.
Follow-up procedures may be performed in a hospital, an outpatient surgery center or an officebased surgical suite.
Medications are administered to keep you comfortable during the procedure. Usually a general anesthetic is used in the first procedure to reconstruct the breast mound so that you will sleep throughout the entire surgical procedure. Followup procedures may require only local anesthesia. You and your surgeon will discuss the types of comfort measures that will work best for you.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. Small drainage tubes may have been placed beneath the skin near the surgical sites to help prevent fluids from accumulating.
On the day of surgery, you will be encouraged to get out of bed for short periods of time. Most of the discomfort you feel in the days following the procedure can be controlled with medication prescribed by your plastic surgeon.
Recovering from a combined mastectomy and reconstruction or from a flap reconstruction typically takes longer than recovery from an implant reconstruction or a reconstruction performed apart from the mastectomy. Although everyone heals at a different rate, your recovery may follow this general time line:

Within the first week

• Surgical drains (if used) will be removed and dressings will be changed.
• Your stitches will be removed.

After two weeks

• Any lingering soreness at the surgical sites will diminish.
• You will feel less fatigued and have more energy.

After several weeks

• You may return to most of your normal activities, including sports and sexual activity.
• You may begin stretching exercises recommended by your plastic surgeon.
• Your scars will begin to fade, although it may take many months to see substantial fading.

Sensation may return to some areas of the breast. However, a reconstructed breast will never feel completely normal or have normal sensation.

What should I know about my results?

If you are like most women who undergo breast reconstruction, you will find that the procedure provides both physical and emotional rewards. For many women, breast reconstruction represents a new start, the chance to put breast cancer behind them and get on with their lives.
You should expect to go through a period of adjustment to your new look. However, any concerns about your new shape are likely to pass within a few months as you begin to think of the reconstructed breast as your own.

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a post-operative follow-up visit so that your healing and progress can be evaluated. In the following months, you will see your surgeon to schedule your follow-up procedures and for check-ups to monitor your recovery. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

If you have ever stood in front of a mirror and wished that your breasts were firmer, higher and more youthful-looking, breast lift surgery may be a good option for you. A breast lift can rejuvenate your figure by restoring the lift and shape that is often lost as gravity takes its toll.
In breast lift surgery, also called mastopexy, the breasts are raised, the nipples are repositioned and the areolas (the darker skin around the nipples) may be reduced in size. If you have lost breast volume over the years and you want to add more fullness, implants may be inserted during breast lift surgery to increase breast size.
You will find basic information about breast lift surgery in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by The American Board of Plastic Surgery.

Is a breast lift right for me?

A breast lift can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Pregnancy and breast-feeding may affect the size and shape of your breasts, so you may wish to postpone surgery until after having children. Still, many women elect to go forward with the surgery before having children, knowing that they can address any pregnancyrelated changes later. The milk ducts and nipples typically are not affected during breast lift surgery, so usually the procedure will not alter your ability to breast-feed.
You may be a good candidate for breast lift surgery if you have any of the following conditions:

• breasts are pendulous, but are a size that is satisfactory to you
• breasts lack substance or firmness
• nipples and areolas point downward, especially if they are positioned below the breast crease

In many cases, women seek breast lift surgery to correct inherited traits or asymmetry - one breast may be firm and well-developed while the other is not. Breasts of any size can be lifted. However, the results are more long-lasting for women whose breasts are smaller and lighter.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering a breast lift. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific goals for the surgical procedure.
You should arrive at the consultation prepared to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements
• past experience with weight loss and the effect it had on your breast size

When exammmg your breasts, your plastic surgeon will consider their size and shape, the quality of your skin and the placement of the nipples and areolas. Measurements and photographs may be taken for your medical record.
In most instances, insurance companies won't pay for breast lift surgery. However, coverage may be provided in certain circumstances. For example, if a breast reconstruction is performed after mastectomy, and the newly reconstructed breast doesn't match the opposite breast, an insurance company may pay for a breast lift on the opposite breast to achieve symmetry. Prior to surgery, your insurance company may require a letter of predetermination. Your surgeon's office staff will help you with insurance matters related to the procedure.

How is a breast lift performed?

Your anatomy, your surgeon's preferences and your desired results will determine the specific method chosen for your breast lift. The most common method of breast lift surgery involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third is a horizontal incision beneath the breast that follows the natural curve of the breast crease.
After the surgeon has removed the excess breast skin and shaped the remaining breast tissue, the nipple and areola are shifted to a higher position. The areola, which is usually stretched out in sagging breasts, can also be reduced in size. Skin that was formerly located above the areola is brought down and together to reshape the breast. In some cases, liposuction may be used to improve the contour, especially on the sides of the breasts.
The nipples and areolas remain attached to the underlying mounds of tissue and this usually allows for the preservation of sensation and the ability to breast-feed.

Are there options?

There are many variations in breast lift technique. Your plastic surgeon will determine the best technique for you based on the size and shape of your breasts, the size of your areolas and the extent of the sagging.
In some instances, it may be possible to avoid the horizontal incision that runs beneath the breast. For other women, a technique may be used that avoids both the horizontal incision and the vertical incision that runs from the edge of the areola to the breast crease. If you are a good candidate for one of these modified techniques, your surgeon will discuss this with you.
If you and your surgeon have decided that your breasts will be enlarged at the same time they are lifted, breast implants will be required. If you are considering this option, your surgeon will review the necessary safety information with you and may give you an additional brochure on breast augmentation.

How will I learn about the safety of breast lift surgery?

Each year, thousands of women undergo breast lift surgery and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of breast lift surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the procedure.
Remember, by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgical procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points will be covered, including:

• avoiding medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery
• having a baseline mammogram before surgery, if your surgeon feels it's appropriate

How will I be cared for on the day of my surgery?

Breast lift surgery may be performed in a hospital, an outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one.
Medications are administered to keep you comfortable during the procedure. Usually a general anesthetic is used so that you will sleep throughout the entire surgical procedure.

How will I look and feel right after surgery?

When surgery is complete, you'll be taken to a recovery area. In some cases, small drainage tubes will have been placed beneath the breast skin to help prevent fluids from accumulating. Gauze dressings will be placed on your breasts and covered with an elastic bandage or supportive bra.
On the day of surgery, you will be encouraged to get out of bed for short periods of time. Most of the discomfort you feel in the days following the procedure can be controlled with medication prescribed by your plastic surgeon.
Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week

• You will begin to move about more comfortably and perhaps even return to (nonstrenuous) work.
• Surgical drains (if used) will be removed and dressings will be changed.

After several weeks

• Bruising, swelling and normal periodic discomfort will diminish.
• The last of the stitches will have been removed.
• You can discontinue wearing a surgical support bra.
• Sensation within the nipple and areola area will gradually improve.
• You may return to most of your normal activities, including mild exercise.

After a few months

• Your breasts will start settling into a more natural shape.
• Incision lines, which initially are red or pink, will begin to fade.

In todays world, looking and feeling good mean having a fit, well-proportioned body. However, for many people, this may seem like an unreachable goal. Sometimes even a strict diet or a disciplined exercise program can't conquer stubborn areas of excess fat. For those who seek a smoother or better-proportioned body contour, liposuction may be the answer. Liposuction, also called lipoplasty, is a surgical procedure that removes deposits of excess fat from specific areas of the body, face or neck. Liposuction can be used to slim the hips and thighs, flatten the abdomen, shape the calves and ankles or eliminate a double chin.
You'll find basic information about liposuction in this brochure. However, the best way to get complete answersto specific fluestions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by The American Board of Plastic Surgery.

Is liposuction right for me?

Liposuction is most commonly recommended for men and women of normal weight who simply want to improve their body contour. The procedure can produce excellent results for people who have deposits of excess fat that make certain body areas appear disproportionately large. Although liposuction is not a treatment for obesity, it can permanently alter body proportion and is sometimes the only way to eliminate fat deposits that do not respond to diet and exercise.
People of almost any age may undergo liposuction; however, patients with good skin elasticity will achieve the smoothest contour after fat is removed. You may be a good candidate for liposuction if you desire fat removal or contouring in any of the following areas:

• cheeks, chin and neck
• upper arms
• breast or chest area
• back
• abdomen and waist
• hips and buttocks
• thighs
• inner knee
• calves and ankles

It's important to be clear about a few "cans and can'ts" related to liposuction.

Liposuction can. . .
- be performed on several areas of the body at the same time or be done in conjunction with other cosmetic surgery procedures, as long as you understand that there is increased risk and your surgeon feels that having multiple procedures is a safe option for you.
- be used to treat some cases of gynecomastia, or male breast enlargement, which occurs in both teenagers and adult men.

Liposuction can't. . .
- serve as a substitute for dieting and exercise
- effectively treat cellulite (a condition that gives the skin a dimpled appearance).

Also, certain medical conditions may complicate liposuction. They include: diabetes, high blood pressure or heart disease and previous surgery near the area to be contoured. It's important to let your plastic surgeon know if you have any of these medical conditions or if you have had surgery in the past.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering liposuction. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the procedure.

You should arrive at the consultation ready to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements

Depending on the parts of your body that you would like to be treated with liposuction, you may be asked to undress. Your surgeon will fully assess the extent of correction needed. You'll also be asked to point out the exact areas where you would like to see improvement. Your surgeon will check the elasticity of your skin and may feel certain areas, to assess the thickness of the underlying layer of fat. Your surgeon will also check your blood pressure and weight, and ask you if you are planning to lose or gain weight in the future.

How is liposuction performed?

To perform liposuction, one or more small incisions are made near the area to be suctioned. Whenever possible, incisions are placed within the natural folds or contour lines of the skin so that they are inconspicuous. The surgeon then places a slim, hollow tube called a cannula through the incision so that its tip penetrates the underlying fat. After the cannula is connected by flexible tubing to a suction pump, the surgeon moves the cannula back and forth through the fat, which is vacuumed into the tube.
Several variations to the basic liposuction technique have been introduced. The fat-removal technique that best meets your needs depends on a number of individual factors that your surgeon will discuss with you.

• Your surgeon may use the tumescent technique, in which the fat is pre-injected with a salt-water solution containing small amounts of adrenaline and sometimes local anesthetic.
• Your surgeon may also use ultrasoundassisted lipoplasty or UAL, a two-step technique that uses the energy from sound waves to liquefy the fat before it is suctioned.
• The type of instrumentation used may also vary. For some areas, a hand-held syringe may be used to provide the vacuum instead of a suction pump.

How will I learn about the safety of liposuction?

Each year thousands of people undergo liposuction and experience no major complications. However, you must fully understand the risks as well as the benefits of the procedure.
One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of liposuction. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.
By carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgery has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery

How will I be cared for on the day of my surgery?

Liposuction may be performed in a hospital, an outpatient surgery center or an office-based surgical suite.
Various types of anesthesia can be used for liposuction. Your surgeon will select the type of anesthesia that provides the safest and most effective level of comfort for your procedure. For some patients, local anesthesia is used (usually with sedation) which numbs only the affected areas. For others, regional anesthesia, such as an epidural block (the kind of anesthesia commonly used in childbirth) or general anesthesia may be the best choice.
Your physical status will be closely monitored throughout the procedure and during your recovery.

How will I look and feel after surgery?
When the procedure is complete, you will be taken to a recovery area. For some patients, small drainage tubes will have been placed beneath the skin. Any discomfort you may feel can be controlled with medication prescribed by your plastic surgeon. An elastic bandage or specially designed compression garment may have been applied over the treated areas to control swelling and assist healing. Your plastic surgeon will tell you how long you must wear the garment and how you can remove it to bathe.
If only a small amount of liposuction has been done, you will be encouraged to get out of bed very shortly after the surgery. If multiple areas have been treated, you will probably remain in bed for a day or two, getting up to go to the bathroom and for meals.
Keep in mind that the speed of your recovery depends largely on the extent of your surgery. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week

• The swelling will reach its peak and then begin to subside.
• Your stitches will be removed.
• You may return to nonstrenuous work.

After several weeks

• Bruises will fade and eventually disappear.
• Areas that felt numb will regain normal sensation.
• You may resume most of your normal exercise and activities.
• Swelling will continue to subside

What should I know about my results?

Quite soon after surgery you will see a noticeable difference in the shape of your body. However, improvement will become even more apparent after a couple of months, when fluid retention and swelling have subsided. For most patients, the final result is evident after about three months.
After your liposuction surgery, you may notice that clothes fit more comfortably and you feel more confident about your appearance. As long as you maintain your postoperative weight, your new, slimmer contour will be permanent. Many patients who gain a few pounds after surgery find that the weight distributes itself more evenly and does not settle in the same "problem areas."

How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

A flat stomach is important to a physical, fit appearance. However, a healthy diet and regular abdominal workouts can sometimes do little to eliminate accumulations of excess fat and loose, sagging skin in the abdominal area. If you are bothered by these appearance problems, abdominoplasty (also called tummy tuck) may be a good choice for you. Abdominoplasty is designed to firm and smooth the abdomen. This cosmetic procedure removes excess skin and fat from the abdomen and may also tighten the muscles of the abdominal wall. The result is a flatter, tighter abdominal profile.
You'll find basic information about abdominoplasty in this brochure. However, the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Is an abdominoplasty right for me?
Abdominoplasty is best suited to women and men who are in relatively good shape, but have loose abdominal skin and/or a significant amount of fat that won't respond to dieting or abdominal exercise.
You may be a good candidate for abdominoplasty if you have one or more of the following conditions:

• excess or loose, sagging abdominal skin
• an abdomen that protrudes and is out of proportion to the rest of the body
• abdominal muscles that have been weakened by pregnancy or aging
• excess fat that is concentrated beneath the abdominal skin.

If you plan to become pregnant or to lose a significant amount of weight, you should discuss these plans with your surgeon. Scars from previous abdominal surgeries may limit the results of an abdominoplasty. However, in some cases, an existing scar can be used for the new incision, as is often the case for women with Cesarean section scars.

What should I expect from the consultation?

A personal consultation is the first step for every patient considering abdominoplasty. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the surgery.
You should arrive at the consultation prepared to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements.

When examining your abdomen, your plastic surgeon will evaluate:

• the quality of your abdominal skin
• the location of any existing scars
• the amount and location of any excess fat
• the status of the underlying muscles.

Your plastic surgeon may suggest other treatments to better meet your appearance goals. For example, some patients may benefit from liposuction alone or a more limited type of abdominoplasty.

How is abdominoplasty performed?

Generally, a horizontal incision is placed just within or above the pubic area. The length of the incision, which extends outward toward the hip bones, depends largely on the amount of skin to be removed. In other words, the more loose skin that needs to be removed, the longer the incision will be. For women, plastic surgeons keep the incision within swimsuit lines, when it is possible. Working through this incision, your surgeon may tighten the underlying muscles by pulling them together and stitching them in place. Any excess skin from the lower abdomen is trimmed away. Skin that contains stretch marks may be removed as well; however, it may not be possible to remove them all.
In patients with larger amounts of loose skin, a second incision may be made around the navel. This way, the excess skin above the navel is separated from the deeper tissues so it can be pulled downward and removed. Although the navel's position remains unchanged, its appearance may be slightly altered.

Are there other options?

Traditional abdominoplasty isn't the best choice for everyone. Your surgeon will advise you if either of these other options will work well with your anatomy and meet your surgical goals.

The "mini" abdominoplasty - This procedure may benefit you if you are primarily dissatisfied with the appearance of the abdominal area below the navel. A mini abdominoplasty requires only a short horizontal incision and no navel incision. It's important to realize, however, that the mini abdominoplasty will not correct loose skin above the navel.

Liposuction alone - If you have good skin elasticity and muscle tone, liposuction alone may be used to remove abdominal fat. This alternative may appeal to patients who are planning to become pregnant in the future.

How will I learn about the safety of abdominoplasty?

Each year, thousands of people undergo abdominoplasty and experience no major complications. However, abdominoplasty is an extensive procedure and it is essential for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of abdominoplasty. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.
Remember that by carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

What can I do to prepare for my surgery?

When the date for your surgical procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help or special care following surgery.

How will I be cared for on the day of my surgery?

When surgery is complete, you'll be taken to a recovery area. In many cases, small drainage tubes will have been placed beneath the skin to help prevent fluids from accumulating. Any discomfort you may feel can