Tanasbourne Plastic Surgery: Cober Sheldon R MD

Also known as a forehead lift, a brow lift is a surgical procedure performed to reduce signs of aging in the forehead area. It aims to remove or minimize deep horizontal creases across the forehead and bridge of the nose, and the frown lines between the eyebrows. It also lifts the eyebrows, making the eyes look more open. Common Techniques There are two techniques used for performing brow lifts. The classic lift uses an incision that runs across the top of the head. This incision can be placed in the hairline or within the hair. The endoscopic lift requires three to five small incisions that are made across the forehead, at the hairline. These shorter incisions mean a shorter recovery time and less scarring than those from a traditional brow lift. Which technique is chosen depends on the thickness, texture and elasticity of the skin, the bone structure of the face, the overall appearance of eyebrows and eyelids, and the position of the eyebrows. The Procedure Brow-lift surgery usually takes about one to two hours to perform, and takes place at the surgery center. General anesthesia is used. Depending on the surgical technique used, one long incision or a series of small incisions are made. Tissue and muscle underneath the skin are moved or repositioned as necessary. At the end of the procedure, the incision(s) is closed with sutures; a drain may be put in to collect excess blood and fluid. Recovery & Results A patient typically returns home on the day of the brow-lift surgery. Swelling may be pronounced for the first day or two after surgery, although most swelling goes away within 2 weeks. To prevent post-operative bleeding, bending and heavy lifting should be avoided for a few days. It can take several for swelling to fully subside and scars to fade. Depending on the patient's presurgical appearance and goals, a brow lift's results, which can be seen immediately, can be either subtle or dramatic. Eyes will appear more "open," and creases across the forehead, bridge of the nose, and between the eyes will be less prominent. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340

Blepharoplasty, also known as eyelid surgery, is a procedure that improves the appearance of the upper and lower eyelids by tightening muscles and tissue or removing excess fat and skin. This procedure can be performed on men and women alike and offers a younger, more refreshed look that reflects across the whole face. A blepharoplasty may be combined with other procedures such as a browlift. Browlifts can revitalize drooping or lined foreheads, helping you to look less angry, sad or tired. Using either traditional or minimally invasive (endoscopic) methods, the muscles above the eyes are altered to smooth lines and raise the eyebrows for a more youthful appearance. Candidates The best candidates for blepharoplasty are individuals who are in good overall health and who do not smoke or have any serious eye conditions. If you have loose, sagging skin or puffy bags around your eyes, this procedure can help reduce these unwanted effects and leave the eyes looking young and fresh. The Procedure The blepharoplasty procedure can be performed under local anesthesia with sedation or general anesthesia. Patients may choose to have this procedure on their upper or lower eyelids, or both. Depending on these choices, the procedure can take anywhere from 45 minutes to two hours. If the upper eyelid is being treated, an incision is made along the natural crease of the eyelid. Once the incision is made, your doctor may remove fat deposits and remove excess skin in order to leave the eye looking younger and refreshed. For the lower eyelid, an incision is made just below the lash line in order for excess skin to be removed. An incision made within the lower eyelid (transconjunctival) is used to remove excess fat within the low lid. After the procedure is performed, the incisions are closed with sutures. Recovery & Results After the blepharoplasty procedure, your doctor may recommend applying lubricating ointment and cold compresses to aid the healing process and minimize side effects such as swelling, bruising, irritation or dry eyes. Patients can usually return to work within two days, but should avoid exercise and strenuous activities for at least two weeks. Swelling and bruising usually subside within two weeks after surgery. Your doctor will give you specific instructions on how to care for your eyes are surgery. Results of a blepharoplasty procedure are visible as swelling and bruising subside and will continue to improve for up to a year after surgery. This procedure is designed to produce long-lasting results. While surgery cannot prevent your eyes from aging, most patients are happy with their results and do not seek repeat procedures. The scars from the blepharoplasty procedure are usually well concealed and will fade with time until they are virtually unnoticeable. The incision is hidden in the crease of the eyelid in an upper blepharoplasty, and just below the lashes in a lower blepharoplasty. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340

A facelift is one of the most common plastic surgery procedures available, designed to treat wrinkles, sagging and skin laxity within the face for a younger, more refreshed appearance. As we age, the effects of time, gravity, and sun exposure inevitably age our faces, producing wrinkles, folds, fat deposits and loose skin. Patients unhappy with the changing appearance of their face may seek improvement with a facelift. This time-tested procedure targets the mid- to lower face, including the cheeks, mouth, chin and neck. Ideal candidates are usually those in their 40s, 50s or 60s looking to reverse the early signs of aging in the face, are generally healthy. The Procedure During the facelift procedure, an incision is made around the ear, sometimes extending into the scalp. There are several different techniques that may be used depending on each patient's facial structure and desired goals, but most include sculpting, lifting and repositioning the underlying fat, muscle and deep tissues, while also trimming and redraping the skin for dramatic yet natural-looking results. A facelift is performed under general anesthesia. The entire procedure usually takes two to four hours to perform on an outpatient basis. Recovery & Results After a facelift, patients may experience mild discomfort, bruising, swelling and drainage for a few days. You can wash your hair after two days and can likely return to work within a week. It is recommended that patients avoid strenuous activity for four to six weeks after surgery until swelling has completely subsided. The results of the facelift will be immediately noticeable and will continue to improve for up to three months, as swelling decreases. 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. The results of a well-done facelift typically last 10 years. Lower Face Lift A lower face lift restores youthful vitality to the lower face, lifting the cheeks and smoothing smile lines to achieve a natural rejuvenated look without the need to undergo a full facelift. Lower face lifts are ideal for reducing puffiness under the eyes, improving the contour of the upper cheeks, and correcting nasolabial folds. Incisions are small and hidden in the eyelids or in the mouth. Mid-face lifts are often performed in conjunction with lower-lid blepharoplasty to rejuvenate the area around the eyes or with implants to accentuate the cheeks. Neck Lift A neck lift is a surgical procedure that smooths and tightens the neck’s skin, which can sag from aging or weight loss. There are usually two components to a neck lift: cervicoplasty, which removes excess skin, and platysmaplasty, which removes or tightens muscles in the neck. A neck lift can be performed alone or as part of a facelift. A neck lift candidate is in good physical health, and has realistic expectations about the outcome of surgery. The results of a neck lift can last up to 10 years. The Procedure A neck lift begins with a small, inconspicuous incision directly below the chin (platysmaplasty) and/or in front of the ear lobes, looping behind the ears and ending in the scalp near the back of the neck (cervicoplasty). Sagging skin is trimmed away and lifted during cervicoplasty; loose muscles that cause the “bands” around the neck to be prominent are tightened during platysmaplasty. In some cases, it is necessary to perform only one of the two procedures. Liposuction is sometimes used to remove excess fat; if so, it is performed before the neck lift. Incisions are sutured closed. A neck lift usually takes 2 to 4 hours to perform, and the patient is given either general anesthesia or local anesthesia with sedation. Most neck lifts are performed on an outpatient basis. Bandages covering incisions are removed after a few days; sutures are typically removed after 7 to 10 days. Recovery Swelling and bruising from a neck lift can last up to 10 days. Applying cold compresses and keeping the head elevated for the first 48 hours following surgery minimizes swelling. Keeping the head still, and avoiding turning or twisting it for the first few days post-surgery, is recommended. Medication is prescribed to help alleviate discomfort. Most people return to work and other normal daily activities within 2 weeks, after which bruising and swelling have subsided. More strenuous activities should be avoided for 4 to 6 weeks.

Lip augmentation is a cosmetic procedure that, either surgically or with injections, increases lip size. Either the upper or lower lip, or both, can be augmented. Whether the results are temporary or permanent depends on the type of augmentation performed. There are several different techniques for augmenting lips. Most involve injecting a facial filler, which usually contain a hyaluronic-acid material. The Procedure Lip augmentation with injectables is performed in a doctor’s office, and typically requires only a topical anesthetic. An allergy test may be performed if the filler contains synthetic materials. The filler is injected directly into the lips; proper placement is important to achieve optimal results. Results & Recovery After lip augmentation with injectables, patients typically experience mild discomfort and swelling for a few days; they usually subside on their own. Most patients can return to work and other normal activities within 1 to 2 days after the procedure, although exercise and other strenuous activities should be avoided for a bit longer. With injectables, patients require multiple treatments (usually every 3 to 4 months) to maintain results. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340

Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. Breast augmentation can give women a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast. Our patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, increasing size after pregnancy or surgery, or correcting a congenital breast issue. Under our doctors' expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation. Fully Customized Enhancement 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 implant type and implant placement is best. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind. Complementary Procedures 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 result. Saline & Silicone Gel 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, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle. 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 softer and feel more natural than saline-filled breast implants. Incision Techniques The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. 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. Placement Options 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), another layer of camouflage for the implant, and less interference with mammogram examinations. After the implants have been inserted and positioned beneath the nipples, the incisions are sewn closed. Recovery Most patients feel sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. Any post-operative discomfort, swelling and sensitivity will diminish over the first few weeks. Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340

A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with augmentation mammaplasty (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging. Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, breast lift should not affect your ability to breast-feed. The Procedure Breast lift is performed at an outpatient surgery center. It is done on an outpatient basis under general anesthesia, and lasts from 1-½ to 3-½ hours. The pre-operative consultation focuses on discussing your goals for the size and shape of your breasts. Based on your goals and anatomy an individualized surgical plan will be made. During the procedure incisions are made to lift the nipple and areola into a more youthful position. Excess skin is removed to reshaped the breast. Incisions are closed with absorbable sutures that are placed under the skin. Incision types vary and may include an incision around the areola ("doughnut") mastopexy, an incision from the areola to the crease ("lollipop"), or in certain situations an incision within the crease of the breast ("anchor"). Recovery & Results After breast lift surgery the breasts are wrapped with gauze dressings, over which an elastic bandage or a surgical bra is placed. After a few days this is replaced with a soft support bra which is worn 24 hours a day for about a month. Most patients return to work in 1-2 weeks. You will be able to see the results of your breast lift immediately after surgery, and you may become even more satisfied as swelling goes down and incision lines fade. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340.

Large breasts can cause pain, improper posture, rashes, breathing problems, and low self-esteem. Breast reduction surgery, also known as reduction mammaplasty, is usually done to provide relief from these symptoms. Performed under general anesthesia, this procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body. Benefits Large, heavy breasts can also cause strain on a woman's body. The extra weight of heavy breasts can be harmful to posture and may lead to spinal problems. In addition to causing back, neck, and shoulder pain, excessively heavy breasts may also lead to breathing problems and other health issues. Breast reduction surgery can help a woman correct her posture and remove strain on the back, neck, and shoulders, reducing overall pain. In addition to seeking relief from the pain caused by heavy breasts, many women seek breast reduction surgery because they are uncomfortable with the unwanted attention that their breast size draws. This unwanted attention may cause a woman to become uncomfortable with her appearance. Breast reduction surgery can help a woman regain her self-confidence and positive self-image, as well as provide the motivation to participate in a wide range of physical and social activities. The Procedure & Incision Techniques Breast reduction surgery generally takes two to four hours, depending on the patient's specific case, and is performed under general anesthesia. The size and shape of your breasts, as well as the desired amount of reduction, helps determine which type of incision is right for you. The Different Types Of Incisions For A Breast Reduction Include: Traditional Breast Reduction Surgery The traditional approach to breast reduction surgery is a very effective method for alleviating discomfort caused by large, heavy breasts. The traditional method, also called an anchor pattern or Wise pattern reduction, is often the best choice for women requiring a large amount of tissue removal. In the traditional breast reduction surgery technique, incisions are made horizontally under the breast in the crease and extend vertically up to and around the nipple, creating an anchor pattern. Because traditional breast reduction surgery allows for excess skin removal both vertically and horizontally, it is typically the best method for women with extremely large breasts. The anchor shaped incision also allows surgeons to remove more tissue than other methods, maximizing breast reduction results. Vertical Incision Surgery The vertical incision technique, also known as the short scar or LeJour breast reduction, typically results in shapelier breasts and less scarring than traditional breast reduction surgery. Vertical incision breast reduction is a popular alternative to the traditional method, especially for women who do not require extensive tissue removal. Incisions in this technique extend around the areola and vertically down to the breast crease, making a lollipop pattern. Vertical incision breast reduction eliminates the need for the horizontal incision along the breast crease that is used in traditional breast reduction surgery, resulting in much less scarring. Women with moderately large breasts are the ideal candidates for vertical incision breast reduction. Vertical incision breast reduction surgery may not be a good choice for women requiring the removal of excessive amounts of fat and breast tissue. Recovery Initially after breast reduction surgery, your breasts will be sore, swollen, and bruised. You can expect to wear bandages for about two days after surgery. Activity should be kept to a minimum for one to two weeks. You should also avoid heavy lifting and refrain from exercise and other strenuous activities for at least four weeks following the procedure. For extra support, a special soft surgical bra or athletic bra may be recommended. Most women will be able to return to work and other normal activities about two weeks after undergoing a breast reduction.

Liposuction is a minimally invasive cosmetic procedure that uses a thin, hollow tube called a cannula to remove localized areas of body fat. The cannula is inserted through extremely small incisions, and then moved back and forth to loosen excess fat, which is suctioned out using a vacuum or a cannula-attached syringe. Treated areas look slimmer and more contoured, and in better overall proportion to the rest of the body. However, liposuction is not a method for losing weight, and is not effective in eliminating cellulite, or tightening loose and sagging skin. The ideal candidate for liposuction is in good overall health, but has one or more areas of fat that do not respond to diet or exercise. Areas that are often treated with liposuction include the thighs, abdomen, arms, back, hips, buttocks, chest, face, calves and ankles. Liposuction can be performed alone, or in conjunction with other cosmetic procedures, such as thighplasty and abdominoplasty. The Procedure One of the most common liposuction techniques is tumescent liposuction, which may get an assist from ultrasound or laser. It is performed on an outpatient basis. During tumescent liposuction, a solution comprising saline solution, lidocaine (an anesthetic) and epinephrine (a blood-vessel contractor) is injected into the area being treated. The solution causes the targeted tissue swell and become firm, which makes it easier to remove via the cannula. The advantages to this technique are that the anesthetic is built in, so there is no need for general or IV sedation, and blood loss is minimized because the epinephrine constricts blood vessels. In laser-assisted tumescent liposuction, a laser is used to liquefy the fat, which makes removing it easier. The laser can also be used to tighten treatment-area skin after fat is removed. Similarly, ultrasound-assisted liposuction uses ultrasound energy to liquefy fat. Recovery & Results After liposuction, patients experience mild swelling, bruising and discomfort in the treated area. Compression garments or elastic bandages are typically worn to help reduce these symptoms as the area heals. Patients can return to work and other regular activities as soon as they feel comfortable, which is usually after a few days. Exercise and other strenuous activities should be avoided for a few weeks. Results of the liposuction procedure may not be apparent until swelling and bruising subside, which usually takes a week; swelling should completely subside within a few months. Incisions are rarely sutured, and scarring is almost nonexistent, because the incisions used for the cannula are so small. The results of liposuction are long-lasting, unless a substantial amount of weight is gained. Fat Transfer Fat transfer, also known as autologous fat transfer or liposculpture, is a surgical procedure that involves restoring lost volume in the face with the patient's own fat, taken from the abdomen, thighs or other areas. This procedure is effective in treating sunken cheeks, facial lines, acne scars and other areas of lost volume that have developed as a result of aging, sun damage and other conditions. Unlike fillers and other volume-enhancing treatments, fat grafts are taken from the patient's own body, and as a result cannot cause an allergic reaction. The fat is naturally accepted by the body. Autologous fat grafts also last longer than synthetic materials. The Procedure During the fat transfer procedure, fat is harvested from the donor area by inserting a cannula and suctioning out the fat, similar to liposuction. This is done under local anesthesia to minimize any potential discomfort. The harvested fat is then purified so that only the fat cells are grafted. Once the fat is ready to be placed, it is injected into the targeted area through a cannula until the desired appearance is achieved. This procedure is performed on an outpatient basis in your doctor's office or a surgical facility. Because of the different aspects involved, treatment time can vary significantly depending on each patient's individual procedure. Results & Recovery Patients may experience mild swelling and bruising after the fat grafting procedure, which can be minimized by icing the area. Fat transfers usually last longer than fillers and other volumizing treatments, and are considered safe for most patients since no foreign material is being injected into the body. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340.

Giving birth can be one of the most rewarding experiences of a woman's life. Unfortunately, pregnancy and breast-feeding often result in unwanted changes in a woman's body, such as drooping breasts, enlarged areolas, a straighter waist, pockets of fat in the abdomen, stretch marks, and a sagging tummy that no amount of exercise and dieting seems to fix. The loose muscles and stretched skin improve somewhat over time, but the body never completely returns to the way it was before pregnancy. It used to be that women were resigned to living with these natural changes in their bodies. Now, however, more and more women are seeking out plastic surgeons to rejuvenate their breasts and tummies to the youthful firmness they enjoyed before having children. These procedures are collectively called "mommy makeovers" or post-maternity breast and body reshaping. Breast Lift The aftermath of pregnancy can leave you with sagging breasts, uneven breasts, lost breast volume, drooping nipples and stretched areolas (the dark skin surrounding the nipple). A breast lift, or mastopexy, is performed to reverse these changes and return a youthful shape and lift to your breasts. This is accomplished by trimming excess skin and tightening supporting tissues to achieve an uplifted, youthful contour. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts after pregnancy can also reduce areolar size and reposition downward-pointing nipples. Your post-maternity breast lift will be tailored to you, depending on your individual case and goals. Breast size does not change after a breast lift, nor does the fullness or roundness in the upper part of the breasts. Women who desire larger, smaller or more rounded breasts may want to consider a breast augmentation or breast reduction together with a breast lift. Breast Reduction Most women find that their breasts swell to a fuller size and shape while they are pregnant. Afterwards, a natural reduction in breast size leaves some women with the empty-looking, drooping breasts discussed above in the breast lift section. For many other women, however, the breasts remain larger than desired after childbirth. Breast reduction surgery may be the solution in these cases. One reason women may seek breast reduction after giving birth is to return the breasts to the smaller size they had before becoming pregnant. In addition, breast reduction can relieve the common symptoms of large breasts, such as pain, improper posture, rashes, breathing problems, skeletal deformities and low self-esteem. Breast reduction achieves these goals by removing fat and glandular tissue and tightening skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body. Tummy Tuck Perhaps nowhere else on the body is pregnancy more unforgiving than in the abdomen. By stretching and weakening the skin and muscles of the tummy and waist, pregnancy can leave you with loose skin, stretch marks and a straighter waistline that no amount of exercise will correct. A tummy tuck, also known as abdominoplasty, can help. Tummy tucks help to flatten and shape the abdomen and waist by removing excess skin and tightening muscles. The result is a firmer tummy and more defined waistline. Our doctors have been performing abdominoplasties with excellent cosmetic results for many years. Women who also suffer from areas of fat in the abdomen or flanks after pregnancy may benefit from liposuction. Note: Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to delay abdominoplasty. Liposuctiontummy Tuck New mothers may find that they have pockets of fat in the lower abdomen that don’t respond to diet or exercise. They may also find that they have lost definition in their waistline. Women who had C-sections may also suffer from areas of fat hanging over their surgical scar. Each of these post-maternity body changes can be improved through liposuction. Liposuction sculpts the body after pregnancy by removing undesirable, resistant fat from the abdomen, waist, hips, buttocks and/or thighs. It offers the opportunity to slim and contour areas of the body that did not “spring back” to their pre-baby tone. With liposuction, you can minimize areas of fat caused by pregnancy and enhance the curve of the waistline. There are several different methods surgeons use when performing liposuction, including ultrasound-assisted lipectomy (UAL) and suction-assisted lipectomy (SAL). In both types, fluid is injected into the area to be treated. Then a tiny incision is made in as inconspicuous a place as possible, and a cannula (small tube) breaks up the fat layer and suctions it out. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340.

Abdominoplasty (tummy tuck) helps flatten the abdomen by removing excess fat and skin, and tightening muscles. The best candidates for abdominoplasty are in good physical condition, with pockets of fat or loose skin that have not responded well to diet and exercise. Abdominoplasty can also be appropriate for slightly obese people whose skin has lost some of its elasticity, and for women with skin and muscles stretched from pregnancy. Anyone planning on losing a significant amount of weight, and women planning on having (more) children, should wait before undergoing abdominoplasty. The Procedure Abdominoplasty takes approximately 2 to 5 hours to perform; the patient is placed under general anesthesia. Two incisions are made: one from hipbone to hipbone close to the pubic area, and another 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 then stretched down over the newly tightened muscles, excess skin is removed, and the navel is reattached where it looks natural. The incisions are then closed, and sterile surgical dressings are applied over the sutured areas. Recovery After surgery, a temporary tube may be inserted to drain excess fluid from the surgical site. An overnight hospital stay may be necessary. Recovery time ranges from 2 weeks to 2 months. Abdominoplasty leaves a scar spanning the lower abdomen from hip to hip, although it is low enough to be concealed by a bikini. Maintaining weight with a balanced diet and regular exercise provides long-lasting results. Mini Tummy Tuck Partial abdominoplasty, or "mini tummy tuck", is similar to the regular tummy tuck procedure, except it involves a shorter incision and the skin is only lifted to the navel, which does not have to be moved. The "mini" procedure is ideal for patients who need just a little improvement in order to reach their desired results, such as those within 10% of their ideal body weight. It offers patients many benefits, including less scarring, shorter recovery times and an overall less invasive procedure. You can discuss the differences between these procedures, as well as weigh their benefits and risks with your doctor in order to decide which procedure is best for you. Candidates Ideal candidates for partial abdominoplasty include those patients who do not have enough excess fat and skin for a full abdominoplasty procedure, yet too much for liposuction alone. It is especially effective for those with a localized fullness within the lower abdomen that can be easily removed through the smaller incision. The Procedure The partial abdominoplasty procedure is performed on an outpatient basis under either general anesthesia or local anesthesia with sedation, depending on the amount of fat and skin being removed, as well as the overall health and preference of the patient. During the procedure, your doctor will create a small incision above the pubic area, instead of the hip-to-hip incision needed for a full abdominoplasty. This procedure also eliminates the need for an incision around the navel. The skin is lifted up to the navel to remove localized fat and tighten muscles in the lower abdominal area. Depending on the amount of fat removal needed, liposuction may be used for a less invasive removal. The navel does not have to be repositioned with this less invasive procedure. The incisions are then closed with sutures, and small drains may be inserted to reduce the risk of fluid buildup in the area. The entire procedure usually takes one to two hours to perform, which is much shorter than a full abdominoplasty. Recovery After the partial abdominoplasty procedure, patients can return home the same day after a few hours of monitoring. The recovery period is substantially shorter than that of a full abdominoplasty procedure. Compression garments will be needed to ensure proper healing for two to three weeks, although most patients will be able to return to work after a week or two. Heavy lifting and strenuous activity should be avoided for about a month. The results of the partial abdominoplasty procedure will be visible right away, allowing patients to enjoy a flatter, more toned abdominal area that more appropriately matches the natural contours of your body. Many patients experience improved self-confidence after this procedure and are able to maintain their results with a balanced diet and regular exercise. Tummy Tuck Revision Tummy tuck revision reduces the prominence of scars that result from previous surgery. Although many scars fade over time and become barely noticeable, disruptions to the healing process can cause them to become red, raised, indented or otherwise deformed.

BOTOX® Cosmetic BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines. Applications Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. BOTOX Cosmetic is used to treat the following: Forehead furrows Frown lines Crow’s feet Skin bands on the neck Procedure & Results Using a very fine needle, BOTOX Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals. Juvéderm® Juvéderm® is a safe, FDA-approved formula that lasts up to one year. 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. Results 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. Juvéderm Voluma™ Juvéderm Voluma™ is a new, FDA-approved dermal filler formulated specifically to add volume to the face around the cheeks and chin. This is the only injectable gel created to provide a subtle, natural enhancement to the mid-face, addressing changes in definition that occur over time. Juvéderm Voluma can help restore more youthful contours by plumping up the area that so often loses volume as part of the aging process. It can also return a firmer shape to the jaw line when some softening has set in. Juvéderm Voluma is not only an effective treatment method, but it is long lasting as well. In many patients, the results will last for a period of up to 18 months. The active ingredient in Juvéderm Voluma is hyaluronic acid (HA), which is a substance naturally produced within the skin. As we get older, the levels of HA present in the skin begin to decline, resulting in a loss of volume and sunken or sagging cheeks. Juvéderm Voluma integrates into the existing collagen and elastin in the skin tissue to offer greater support and elasticity. This can provide a noticeable smoothing and firming to the skin and lend the facial structure more substantial definition. Juvéderm Voluma is the latest in the Juvederm line of dermal fillers. These various formulas have a successful history of reducing the appearance of wrinkles and folds in the skin and rejuvenating the face. Obagi® Skin Care Obagi® is a brand of skin care products designed to develop and maintain healthy skin through an advanced line of cleansers, toners, eye creams, sunscreens, serums and other beneficial products.These products, available only from a physician, have been used for many years to improve the appearance of the skin, reduce the signs of aging and treat and prevent some of the most common skin conditions, including acne, rosacea and more. With a unique combination of vitamins, minerals and other natural elements, each product is designed with a distinct function to produce healthy, beautiful skin. Obagi Tampa Obagi skin products can also be used in conjunction with Obagi procedures, such as the Blue Peel, for maximum results and especially to repair severely damaged skin. Your doctor will develop a customized treatment plan for you based on a thorough evaluation of your individual skin condition. Skinmedica Your Perfect Skin Care Regimen If you are new to SkinMedica® and want to learn more about our services, give us a call at 503.297.93

Carpal Tunnel The carpal tunnel is a narrow, fibrous passage in the wrist that protects the median nerve, which runs down the length of arm and through the wrist into the hand. It controls some hand movement, and sensation in the thumb, index and middle fingers, and half of the ring finger. Irritation or compression of the median nerve within the carpal tunnel can cause tingling and numbness in the fingers, a condition known as carpal tunnel syndrome (CTS). Treatment Often, CTS can be effectively treated by avoiding or modifying the activity that is causing symptoms. Additional treatments may include the following: Resting the hands Applying cold packs Taking anti-inflammatory medication Getting corticosteroid injections Wearing splints Getting physical therapy More severe cases of CTS, such as those that interfere with normal daily activities or are caused by nerve damage, may be treated surgically by cutting the ligament that is pressing on the median nerve. Either endoscopy or open surgery can be used. Postsurgery, activities known to have caused CTS should be stopped, or performed differently. Trigger Finger Trigger finger is a common and painful disorder of a finger's flexor tendon that causes the finger to "catch" or "lock" when bent or released. Trigger finger can be caused by repetitive motion of the finger, rheumatoid arthritis, diabetes and gout. Grasping something for an extended period of time can also result in trigger finger. The fingers and thumb are able to bend and straighten because of tendons and muscles in the hands and arms. A tendon usually moves smoothly through the sheath (tissue) that covers it. However, when a finger's flexor tendon becomes inflamed, it may not be able to move smoothly through the sheath so that, when an attempt is made to bend or release the finger, the pulling of the enlarged tendon through the sheath results in the tendon's catching or locking. Treatment Applying ice, stretching and taking nonsteroidal anti-inflammatory medications are recommended treatments for trigger finger. However, the quickest and most effective treatment is a cortisone injection into the affected tendon's sheath. If the trigger finger does not go away after two injections, and is not helped by ice, stretching or anti-inflammatories, surgery may be recommended. Arthritis Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is the most common form of arthritis and it commonly affects the hands because of their frequent use. Arthritis of the hand develops as the cartilage protecting the bones of the finger joints wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the hand may cause the joints to lose their normal shape and limits the motion of the joints within the hand. It occurs more frequently in older individuals, as a result of normal wear and tear over time, that causes cartilage to wear away. The definitive symptoms of arthritis of the hand are pain, swelling, stiffness and tenderness, although the pattern and intensity may vary. Some individuals feel that the inflamed joints may feel warm or hot to the touch and others may have cysts that develop on the ends of the joints. Damaged cartilage and bone rubbing together may cause a sensation of grating or grinding when the hand is moved. Treatment for arthritis of the hand focuses on relieving pain and addressing symptoms. It is commonly treated with a combination of methods that may include medication for pain and discomfort such as: Anti-inflammatory medication Prescription pain relievers Corticosteroid injections Splints may also be used to help support the affected joint and to ease the stress placed on it during frequent use and activities. In severe cases, surgery may be required to smooth irregular tissue surfaces, or to reposition or replace joints through arthroscopy. Dupuytren's Disease Dupuytren's contracture is a rare hand deformity in which knots of tissue form under the skin that can pull fingers into a bent position. This makes it difficult for the fingers to straighten and can interfere with normal hand function. Dupuytren's contracture is not usually painful but can lead to other conditions such as plantar fibromatosis. Although the cause of this condition is not known, it may run in families and can be influenced by tobacco and alcohol use. Mild cases of Dupuytren's contracture that do not have much of an effect on hand function may not require any treatment and can simply be monitored through regular checkups. More severe cases may benefit from steroid injections, radiation therapy, needle aponeurotomy or physical therapy. Surgery is also an option for people who may become disabled from this condition and may involve removing tissue or amputating the finger.

Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best. Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma. Effective hand surgery requires the skill and precision of an experienced surgeon, in order to successfully treat the condition and restore full function to the hand. Candidates Hand surgery can be performed on patients of any age to correct conditions and deformities within the hands. The ideal candidates for hand surgery include patients who: Do not smoke Do not have any other serious medical conditions Have made the decision for surgery on their own Have realistic expectations for their surgery The Procedures Hand surgery is usually performed under general anesthesia or local anesthesia with sedation, on an outpatient basis. The surgeon will make an incision to access the targeted area. Many hand procedures can be performed laparoscopically, allowing patients to benefit from smaller incisions, less bleeding and shorter recovery times. The actual procedure will vary depending on the type and severity of each patient's individual condition, but may include: Carpal tunnel surgery – tissue that is causing pressure on the nerve is removed to relieve pressure. Rheumatoid arthritis surgery – damaged tissue is removed from the joint, tendons and ligaments are repositioned, or the entire joint is replaced with a prosthetic. Dupuytren’s contracture surgery – thickened, scar-like tissue is separated to improve range of motion and prevent nerve damage. Grafting – transfers bones, nerves or other tissue from healthy areas of the body to the damaged area, commonly performed after trauma. After the condition is treated, the incision is closed, with or without sutures, depending on each individual patient. Recovery & Results After hand surgery, patients may experience mild to severe pain. Your doctor will provide you with oral medication to manage pain, if needed. The hands will usually need to be immobilized for a few days as they heal. Patients usually require a course of physical therapy in order to restore full function and range of motion to the hand. The results of hand surgery usually appear gradually, as swelling and other side effects subside. Most patients notice significant pain relief almost immediately, while cosmetic results may take several months before they are fully visible. For more information about our facial procedures, or to schedule an appointment, please complete our online form or call 503.297.9340