Salem Plastic Surgery

Dr. Tucker, Dr. Howell and Salem Plastic Surgery provide treatment for a variety of conditions both cosmetic and reconstructive. Some of the procedures we frequently perform include, but are not limited to: FACE DiamondGlow AquaGold Blepharoplasty (Eyelid Surgery) Chin Surgery Facelift Forehead Lift (Browlift) Otoplasty (Ear Surgery) PrecisionTx Rhinoplasty (Nose Surgery) BREAST Breast Augmentation Breast Lift Breast Reconstruction Breast Reduction BODY Abdominoplasty (Tummy Tuck) Body Lift Cellulaze CoolSculpting® Emsculpt Liposuction Laser Hair Removal Smartlipo TriPlex™ Thigh Lift SKIN Chemical Peels (Alpha Hydroxy Acid Peels) Chemical Skin Resurfacing Dermaplaning Laser Skin Resurfacing (CO2 Laser) Obagi® Skin Care Rejuvapen Icon Laser ThreeForMe iS Clinical SkinMedica Jane Iredale INJECTABLES BOTOX® Cosmetic Juvéderm® Juvéderm Voluma™ Juvéderm Volbella® Juvéderm Vollure® MALE BOTOX® for Men CoolSculpting® Facial Rejuvenation for Men Gynecomastia (Male Breast Reduction) Liposuction for Men Male Facelift Smartlipo TriPlex™ EMSCULPT

A facelift is one of the most common plastic surgery procedures available, designed to treat wrinkles, sagging and skin laxity within the face resulting in a more youthful and refreshed appearance. The effects of time, gravity, sun exposure and stress inevitably take their toll on our faces, producing the wrinkles, folds, fat deposits, and loose skin. Who is a good candidate for a facelift? Patients unhappy with the changing appearance of their face may pursue a facelift to reverse the early signs of aging. This time-tested procedure targets the mid – to lower face, including the cheeks, mouth, chin and neck. Ideal candidates are generally healthy with realistic expectations for surgery, and usually in their 40s, 50s or 60s, and 70s or 80s, if there are no medical contraindications What should a patient expect during a facelift? During the facelift procedure, an incision is made around the ear, extending sometimes under, yet very close to the lower ear, and back into the scalp area. The surgeon generally considers the patient’s individual facial anatomy to camouflage these incisions as much as possible so that after healing they are less visible, and sometimes not noticeable at all. There are several different techniques and approaches that may be options for the patients, depending on their ultimate goals and facial structures, but most may include sculpting, lifting and repositioning the underlying fat, muscles and deep tissues, while also trimming and re-draping the skin for dramatic yet natural-looking results In most cases, a facelift is performed under IV sedation, but may also be performed with general anesthesia for certain patients and procedures. Typically, a facelift will take approximately two to four hours and is performed on an outpatient basis. What should I expect during my facelift recovery? After a facelift, patients may experience mild discomfort controlled with pain medication, as well as bruising and swelling that will subside during the next few weeks. At Salem Plastic Surgery, facelift patients return to the office the next day to have their dressings removed, hair washed, and drains removed, if applicable. Return to work will depend on the type of employment and the patient’s desire for privacy. Strenuous activity and lifting should be avoided for four to six weeks after surgery. What results can I expect after my facelift? The results of the facelift will be immediately noticeable and will continue to improve for up to three months, as swelling and other side effects begin to fade. While results are not permanent and do not make patients immune to the effects of aging, you will continue to look younger than if you had never undergone any treatment.

One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but not for cosmetic purposes. What should I expect during an rhinoplasty procedure? Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done. Surgeons use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an “open” procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed. What should I expect during my rhinoplasty recovery? For a short time after surgery you may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks. Complications are rare and, when they occur, typically minor. These may include infection, nosebleed, or a reaction to the anesthesia.

By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes, but the procedure can be combined with others such as a facelift or browlift and BOTOX® Cosmetic treatments to achieve these results. What can i expect during a blepharoplasty procedure? The procedure is usually performed in an office with either local anesthesia or IV sedation and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars. What can i expect with my blepharoplasty recovery? Stitches are removed after four to seven days and most people return to work in ten. Contact lenses may not be worn for two weeks. Eyes can be sensitive to light and wind and may be slightly irritated for a short while; your surgeon may prescribe eye drops and cool compresses to counteract these discomforts. Complications from the procedure are uncommon, and can include: infection, reaction to anesthesia, double or blurred vision for a few days, temporary swelling of the eyelids, tiny whiteheads, and difficulty closing eyes when going to sleep. Uneven healing and scarring, and ectropion (pulling down of the lower lids) are very rare and may require surgical correction. Patients with thyroid problems, dry eye, high blood pressure, diabetes, detached retina, glaucoma or other health problems should consult with an ophthalmologist about eligibility.

Breast Augmentation | Breast Enhancement | Breast Surgery | Winston Salem NC | Greensboro NCBreast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. and one of our most popular services. Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast. Who is a good candidate for breast augmentation? Patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under our doctors’ expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation. What can I expect from my pre-operative consultation? We know that every woman is unique in both her desires and her body shape. With that in mind, we take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which type and implant placement is best. In this way, every one of our patients enjoys a completely customized treatment, designed with her specific goals in mind. Breast augmentation can achieve dramatic and beautiful results on its own, as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. What is the difference between saline and silicone gel breast implants? Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. We will help you decide which kind is right for you. During surgery, implants will be placed above or below the pectoralis muscle depending on your anatomy and wishes. After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants. What should I expect during breast augmentation surgery? The breast augmentation procedure lasts one to two hours and is typically performed with IV sedation. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located: In the crease on the underside of the breast (inframammary), or Around the areola, the dark skin around the nipple (periareolar). The breast is then lifted, creating a pocket into which the implant is inserted. After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed, then taped and bandaged. What are the different placement options for breast augmentation surgery? Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and, less interference with mammogram examinations. We will discuss which options may be best for you. What can I expect during my breast augmentation recovery? Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. Your stitches are removed in a week to 10 days after breast augmentation and any post operative pain, swelling and sensitivity will diminish over the first few weeks. The scars from your breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. What are some of the possible complications from breast augmentation surgery? Complications following breast augmentation surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast. If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. If a silicone implant ruptures, you will need to see a doctor immediately. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health.

Mastopexy (or Breast Lift) reshapes the breasts and repositions the areolas. This procedure is usually performed on women who have been pregnant multiple times and breastfed their babies, or on bariatric surgery patients who have lost a significant amount of weight. In either case, the deflated look or excess skin in the breast area can be disconcerting to the individual, who may desire aesthetic improvement. When performed on bariatric surgery patients, the procedure is usually combined with breast augmentation (enlargement) to better fill the empty space vacated by the fat loss. What should I expect during a breast lift procedure? The breast lift operation is performed under general anesthesia or heavy sedation combined with a local anesthetic. The skin below the breast is generally removed to excise excess skin from the area. The nipple is then moved higher up on the breast to better situate it in relation to the new breast positioning. The skin above the breast is pulled around to create a swell and to tighten the remaining area of skin around the glands and fatty tissue of the breast for a more youthful appearance. The areolas can also be resized if necessary. Some doctors may also place small drains to help reduce swelling for the first day or so following surgery; these drains will be removed soon after in a follow-up visit less than three days after surgery. What should I expect during my breast lift recovery? The full recovery time of this procedure is usually around a month, but patients can generally return to desk jobs within 10 to 14 days. A supportive bra must be worn everyday for the full recovery period to ensure proper healing. Pain medication is prescribed for the week following surgery. Although scarring is likely, most of the scars associated with breast lift surgery are readily hidden by a normal bra. These scars will fade over time. To schedule an appointment, online consultation or learn more about Breast Lift please Contact Us or call us at 336-768-8483.

Abdominoplasty is a surgical procedure that helps flatten and shape the abdomen and waist by removing excess fat and skin and tightening muscles. Who is a good candidate for abdominoplasty? The best candidates are in good physical condition with pockets of fat or loose skin that haven’t responded well to diet and exercise. Older, slightly obese people whose skin has lost some of its elasticity can be helped. Abdominoplasty can also be useful for women with stretched skin and muscles from pregnancy, although results from the procedure will diminish if they continue to bear children. For this reason, women who plan to have children again are advised to delay abdominoplasty. Patients who intend to lose a lot of weight are also encouraged to wait before undergoing the procedure, since skin in that area typically loosens after substantial weight loss. What should I expect during an abdominoplasty procedure? The procedure takes approximately two to three hours and can be performed with general anesthesia or local anesthesia. Your surgeon will make two incisions: one from hipbone to hipbone close to the pubic area, and one around the navel. Skin is separated from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. The skin flap is stretched down and over the newly tightened muscles, excess skin is removed, and the navel is reattached. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. What should I expect during my abdominoplasty recovery? Recovery time ranges from two weeks to a few months, but with a balanced diet and regular exercise results are long-lasting. Abdominoplasty will likely leave a permanent, but inconspicuous scar, stretching between the hips, although it should be low enough for even a bikini to conceal it. Patients who have had previous abdominal surgery should know that their old scars could be raised, stretched or generally more noticeable after the procedure. Other, rare post-operative complications include infection, blood clots, and poor healing, which may require further surgery.

Liposuction sculpts the body by removing undesirable fat from areas of the body such as the abdomen, waist, hips, buttocks, knees, chin, cheeks, neck, and upper arms that have not responded to diet and exercise. Local anesthesia or general anesthesia may be used and can last anywhere from one to five hours or more depending on the amount of fat being removed. What should I expect during a liposuction procedure? There are several different methods surgeons use when performing liposuction, including tumescent liposuction, the super-wet technique, and ultrasound-assisted liposuction (UAL), as well as SmartLipo. In all types a tiny incision is made in as inconspicuous a place as possible. A cannula (small tube) is inserted and moved back-and-forth beneath the skin, breaking up the fat layer and suctioning it out. Tumescent liposuction and super-wet liposuction use fluid injection, which facilitates fat removal, reduces blood loss, provides anesthesia during and after surgery, and helps to reduce the amount of bruising after surgery. UAL liquefies fat with ultrasonic energy and is highly precise. What can I expect during my liposuction procedure recovery? After surgery, compression garments are generally used to facilitate the healing process. Patients are encouraged to walk as soon as they are able and many return to work within a few days, although strenuous activity should be avoided for about a month. Results are visible immediately, though improvement is expected to continue as swelling subsides during the first three months. Scars are small and inconspicuous. Other irregularities in appearance are possible, such as asymmetric or “baggy” skin, numbness and pigmentation changes.

WHAT IS LASER HAIR REMOVAL? Laser Hair Removal is a laser treatment that targets hair follicles at the designated area with intense laser light energy for thermal destruction, this is done safely and professionally without any damage to the surrounding tissue. HOW DOES LASER HAIR REMOVAL WORK? Laser Hair Removal works by targeting the hair follicles designated in a certain area, with a beam of intense laser light energy. This causes thermal destruction to the hair follicles which will build up to permanent hair reduction over the course of a few treatments. WHAT RESULTS CAN I EXPECT FROM MY LASER HAIR REMOVAL TREATMENT? The overall results of the treatment will vary from patient to patient, most patients can expect up to 80% permanent hair reduction after three treatments.

Laser Skin Resurfacing | Microdermabrasion | Skin Rejuvenation | Winston Salem NC | Greensboro NCWe offer fractionated CO2 laser resurfacing with Lumenis UltraPulse Active, Deep and Total FX technology for our patients. Traditional CO2 laser resurfacing has proven itself to be one of the most effective treatments for skin tightening and general improvement of skin appearance. Newer, fractionated technology delivers the CO2 laser energy in a manner that allows for reduced downtime for the patient and dramatic results. WHAT ARE THE BENEFITS OF LASER SKIN RESURFACING? The procedure removes areas of damaged or wrinkled skin often caused by prolonged sun exposure. Laser resurfacing can minimize the appearance of fine lines around the mouth and eyes, as well as throughout the face and neck, and is also effective in treating facial scars and skin areas with uneven pigmentation. Total FX can reduce the appearance of acne scars. ActiveFX is the combination of these two modalities, customized for each patient to optimize their result. WHAT CAN I EXPECT DURING A LASER SKIN RESURFACING PROCEDURE? Laser skin resurfacing usually takes less than an hour (sometimes just a few minutes) depending on the size of the area being treated. Treatment is performed in our office, typically with IV sedation for the comfort of our patients, but it can also be done using both a topical anesthetic cream and oral medication. The sedation type depends on the patient’s desires regarding level of improvement and sedation preference. The procedure uses a carbon dioxide (CO2) laser beam which vaporizes the upper layers of damaged skin at controlled levels of penetration. As the body heals, the treated area’s skin remodels, resulting in improvements of fine lines, wrinkles, texture, tone, areas of discoloration, and scars, giving the skin an overall less aged and nice appearance. We typically recommend one treatment, but this can be followed up with future treatments if desired. To schedule an appointment, online consultation or learn more about Laser Skin Resurfacing (CO2 Laser) please Contact Us or call us at 336-768-8483.

An alpha hydroxy acid (AHA) peel is the most common and gentlest type of chemical peel that rejuvenates the skin by peeling away layers of old, sun-damaged cells on the surface of the skin. Chemical peels are ideal for patients who want to fight the signs of aging, including fine lines, age spots and dry spots. What should I expect during an alpha hydroxy acid peel? An AHA peel can be performed using glycolic, lactic or fruit acid, depending on the patient’s individual skin condition and desired results. During the procedure, the skin is cleaned and the peel solution is applied to remove layers of dead and damaged skin and encourage the growth of new, healthy skin cells. This procedure can be performed in less than 20 minutes with minimal downtime, making it ideal for patients who cannot take much time off from work. Patients can usually achieve their desired results after a short series of peels performed, in anywhere from one to four week intervals. An AHA peel can also be combined with other procedures, such as a facelift, for maximum results. What should I expect after my alpha hydroxy acid peel? Some pinkness and peeling may occur for a few days after the peel, but these side effects can be concealed with moisturizer and makeup.

BOTOX® Cosmetic is a highly purified protein injected into the muscles underneath the skin to relax the muscles that cause some kinds of wrinkles. While BOTOX® can treat certain medical conditions, such as excessive sweating, it is most commonly used for cosmetic purposes, primarily to reduce wrinkles on the face and neck. BOTOX® injections are relatively painless, as the needle used is significantly smaller than those used for other injectable fillers. Who is a good candidate for BOTOX®? The best candidates for BOTOX® are men and women seeking an enhanced appearance with fewer wrinkles. In addition, it is important that those seeking treatment are in good physical health, are not pregnant or nursing, and do not have a neuromuscular disorder. People seeking BOTOX® injections should have realistic expectations regarding this procedure’s abilities and should discuss their desired goals with their doctor or a certified nurse injector beforehand. What should I expect during a BOTOX® procedure? BOTOX® injections are administered by a qualified physician or certified nurse injector using a very fine needle. The procedure only takes a few minutes and required no anesthetic. Day-to-day activities can be resumed immediately afterwards. Wrinkles begin to fade within 5-7 days, with continued improvement over the next several weeks. What are the possible side effects of BOTOX® Side effects of BOTOX® Cosmetic are rare and are usually mild and temporary. The most common side effects are headaches and temporary redness or bruising of the skin at the site of injection. Any risk of complication can be reduced by choosing a qualified and experienced physician or certified nurse injector.

Sculptra® | Thermage® | No Recovery Skin Tightening | Tighten Skin | Winston Salem NC | Greensboro NCDeep wrinkles and furrows may be a part of aging, but they don’t have to be permanent. Dermal fillers such as Juvéderm® Injectable Gel are a quick and easy solution. They work to erase these lines and restore a younger, more refreshed appearance. What is Juvéderm®? Juvéderm® is a safe, FDA-approved formula that lasts variable lengths of time, depending on which formulation is used. For instance Juvéderm Voluma®, Juvéderm Vollure®, and Juvéderm Volbella® have different characteristics, which allow for customized treatments. It contains lidocaine, a local anesthetic, to minimize the mild discomfort that is sometimes associated with receiving an injection. The injection of hyaluronic acid-a naturally occurring substance in the skin that adds volume and hydration-is administered directly to targeted areas to reduce the appearance of wrinkles and folds while also smoothing the skin. It is an effective technique for restoring a youthful plumpness to the skin. Where can Juvéderm® be used? Juvéderm® can benefit many problem areas of the skin. On the face, it is an effective treatment for the lips, skin under the eyes, nasolabial folds (also known as smile lines, these run from the nose to the mouth), glabella (the area above the nose between the eyebrows), temples, cheeks, chin and jaw line. In addition, Juvéderm® may be very successful in filling scars, such as select ones formed from acne, that leave a depression in the skin. The formula’s ability to plump the skin can make these scars less noticeable and therefore provide a boost in self-esteem to affected patients. Juvéderm® is also helpful in improving the appearance of other parts of the body that are affected by the signs of aging. Sagging or thinning earlobes can be restored to a more attractive shape and fullness, helping earrings to lay better. The hands and feet are two more areas that can be benefitted by Juvéderm®. Problems such as wrinkles and uneven, veiny skin tend to respond very well to an injection, making the hands and feet look smoother and younger once again What are the results Juvéderm® Most patients achieve their desired results in just a single treatment session, with natural looking improvements to the skin becoming visible immediately. The results are long lasting and may only require yearly touch-up treatments in order to be maintained. What are the Juvéderm® risks? Juvéderm® is considered to be a safe form of treatment that needs only minimal recovery and downtime. However, there are some side effects associated with its use. Some of the most frequently reported occurrences are problems at the injection site, including infection, redness, discomfort or tenderness, swelling, formation of lumps, bruising, itching or discoloration. Any of these that develop are generally short lived and typically resolve within one week of the treatment.

Although rarely discussed, enlarged male breasts is a common condition. Gynecomastia affects approximately 40 to 60 percent of men.There is often no known cause for gynecomastia, although there has been some correlation with various drugs or medical conditions. Men who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.

Male Facelift | Male Breast Reduction | Liposuction for Men | BOTOX® | Winston Salem NC | Greensboro NCOver time, our skin changes as a result of aging and sun damage, causing wrinkles, pigmentation and scarring. Men may experience these changes even more than women because they tend not to be as concerned with skin protection at an earlier age. Many men unhappy with these changes are now seeking nonsurgical cosmetic treatments to restore their appearance safely and effectively. Chemical peels remove damaged outer layers of skin to smooth texture, reduce scarring and remove blemishes and growths. There are three different types, ranging from mild to strong. Laser skin rejuvenation stimulates collagen production for improved aesthetic results. Patients often need several sessions, but this treatment can completely remove unwanted spots on the skin.

BOTOX® Cosmetic is just as helpful for men as it is for women. In fact, hundreds of thousands of BOTOX procedures are performed annually on men. It is effective for reducing lines and wrinkles all over the face, but the most popular areas of treatment for men are between the eyebrows and across the forehead. Men can benefit from BOTOX’s ability to help them look relaxed and younger, whether you want to look your best for business meetings or social purposes. Even men in their 30s and 40s can have noticeable furrows from smiling, frowning and other facial movements. These lines can make you look older, sad, angry or tired. Quick, safe and effective, BOTOX reduces facial lines and wrinkles for up to six months with no downtime and little to no discomfort. Through a series of tiny injections, BOTOX treatments can not only prevent these lines from deepening, they can also erase these marks of aging, leaving you looking refreshed.