Procedures | Permanent Makeup | Skin Care

PROCEDURES - please select a procedure below

• Breast Augmentation
  
• Breast Lift
  
• Breast Reconstruction
  
• Breast Reduction
  
• Brow/Forehead Lift
  
• CO₂ Laser Resurfacing
  
• Cosmetic Non-Surgical
  
• Ear Surgery
  
• Eyelid Surgery
  
• Facelift
  
• Genioplasty
  
• Liposuction / Ultrasonic-Assisted Liposuction
  
• Malar Lift
  
• Male Breast Reduction
  
• Nose Surgery
  

Breast Lift Procedure: Raise and reshape sagging breasts by removing excess skin and breast tissue and repositioning remaining tissue and nipples. Length: 1 to 3 hours. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Sometimes inpatient. Side Effects: Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars. Risks: Potential risks are widely variable. These will be discussed with Dr. Clark on your initial visit. Possible risks include scars; skin loss; infection. Unevenly positioned nipples. Possible loss of sensation in nipples/breast. Recovery: Back to work: 1 week or more. Strenuous activities: 1 month. Fading of scars: several months to a year. Duration of Results: Variable; gravity, pregnancy, aging, and weight changes may cause new sagging. Results may last longer or be enhanced when breast implants are inserted as part of the procedure.

Back to top

Breast Reconstruction The comprehensive surgical treatment of breast cancer is a very important part of our practice. Autogenous tissue reconstruction (TRAM, Latissimus) and Expander/Implant reconstruction are the foundations for re-establishing the breast shape. New developments and techniques have occurred just in the past few years. These can be discussed at length at a private consultation. Expander/Implant: A pocket is created between the chest wall and the chest muscle to hold the balloon expander. The expander is gradually filled over a period of 3 - 6 months by injecting saline through a small port, which gradually stretches the skin and muscle. Once the breast mound is to the size the patient and doctor want, the expander is removed and replaced with an implant filled with either saline or silicone. This procedure would be a good option for a person who prefers minimal surgery or who lacks excess tissue for a flap procedure. TRAM: This procedure takes a section of abdominal muscle, fat, and skin that is still attached to its blood supply and tunnels it up to the chest area. It is sewn in place to build a "breast mound". The nipple/areola area is reconstructed by using tattooing and pieces of skin. A patient may prefer this procedure it they want to use their own body tissue instead of an implant. There must be sufficient skin and fat in the abdominal area for this to be an option. The patient usually stays in the hospital for 4 - 6 days, with recovery taking 4 - 6 weeks. Latissimus: This procedure takes a section of muscle, fat and skin that remains attached from the back and tunnels it through the armpit. The flap is attached over the chest wall muscle making a pocket in which an implant can be placed. Again, there must be sufficient skin and fat in the latissimus area for this to be an option. The patient usually stays in the hospital for 3 - 5 days, with recovery taking 3 - 4 weeks. Free flap: In this procedure, a section of muscle, fat, and skin from either the abdomen, buttocks, or thigh, is excised from the area and reattached in the breast area using microsurgical techniques. The patient stays in the hospital 5 - 6 days, with recovery taking 4 - 6 weeks.

Back to top

Breast Reduction Procedure: Reduces the size and fullness of the breasts in patients with symptoms of bra-strap grooving, rashes, hindrance of activity, and large breasts. This procedure is frequently covered by insurance. Length: 3-5 hours. Anesthesia: General, Local-sedation. In/Outpatient: Outpatient. Side Effects: Swelling, edema, transient altered nipple sensation, bruising. Risks: Bleeding, infection, risks of anesthesia, scarring. Recovery: May shower the following day, often back to non-strenuous work activity within a week, active exercise usually after two weeks. Duration of Results: Usually permanent, in unusual cases of younger women (18 years of age) may require additional procedure if breast tissue continues to grow.

Back to top

Brow/Forehead Lift (Endoscopic Approach) Procedure: Minimize forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the forehead skin. Done with the use of an endoscope, which requires 3 to 5 short incisions. Most commonly performed on people over 40. Length: 1-2 hours. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Side Effects: Temporary swelling, numbness, headaches, bruising. Risks: Bleeding, infection, nerve injury. Injury to facial nerve could cause loss of motion, muscle weakness, or asymmetrical look. Recovery: Back to work: 2 to 3 days or sooner. More strenuous activity: several weeks. Full recovery from bruising: 2 to 3 weeks. Limit sun exposure for several months. Duration of Results: Usually 5 to 10 years.

Back to top

Cosmetic Non-Surgical Bluewater Plastic Surgery and Cosmetic Center provides a variety of non-surgical solutions that achieve dramatic improvements in many skin problems. With little or no recovery periods, these treatments don't disrupt your lifestyle, nor do they make you wait for results. To help reduce or eliminate the appearance of facial contour defects, such as skin creases, laugh or frown lines, and scars, we offer the following non-surgical cosmetic procedures: Botox: This cosmetic treatment involves injecting Botox in liquid form, into areas such as worry lines, frown lines, laugh lines, and crow's feet to block impulses from the nerve to the facial muscles that contribute to these expression lines. Botox relaxes the muscles so they do not contract, which helps to soften these lines. Botox injections are a temporary solution and results may last from three to six months. Collagen: This procedure injects highly purified bovine collagen into any of the above listed facial contour defect areas to supplement the body's own collagen. A test dose of collagen is usually given to see if any allergic reaction may result. The results of these injections are temporary and vary from person to person. Fat Injections: This procedure takes fat from an area like the abdomen and then injects it into areas where recontouring is desired. The procedure may need to be repeated to achieve desired results. Future Treatments: Restylane: This is a new gel based on a natural substance found in the body, hyaluronic acid, which has been stabilized for a long duration, usually lasting 6-12 months. Its use ranges from treating fine lines to reshaping facial contours and lip augmentation. Currently used in Europe, Canada, and Australia, Restylane is not yet FDA approved for use in the U.S., but it is expected to be approved soon and available at Bluewater Plastic Surgery. Artecoll: This injectable solution consists of microscopic beads suspended in collagen. When the collagen is absorbed, the body produces its own collagen to envelop the tiny beads, making Artecoll permanent. Widely used in Canada, Artecoll is in the process of being FDA approved for use in the U.S. These non-surgical cosmetic procedures can be used alone or in conjunction with our wide range of skin care products and procedures to correct flawed or damaged skin.

Back to top

Ear Surgery (OTOPLASTY) Procedure: Commonly performed to set prominent ears back closer to the head or to reduce the size of large ears. Usually performed on children between the ages of 4 and 14, but ear surgery on adults is also common, and there are generally no additional risks associated with ear surgery on an older patient. Also done to correct various ear and lobe deformities. Length: 2-3 hours. Anesthesia: Local with sedation, or general. In/Outpatient: Outpatient. Side Effects: Ears may ache for a few days-usually relieved by medication. Risks: A small percentage of patients may develop a blood clot on the ear, which may dissolve naturally or can be drawn out with a needle. Rarely, a patient may develop an infection in the ear cartilage, which is usually treated with antibiotics. Recovery: Patient is usually up and around within a few hours of surgery. The patient's head will be wrapped in a bulky bandage immediately following surgery to promote the best molding and healing. Within a few days, a lighter dressing similar to a headband will replace the bulky bandages. 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, but must remain careful about playground activity. Duration of Results: Usually permanent.

Back to top

Eyelid Surgery Procedure: Correct drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. Can be performed on upper lids only or lower lids only. (Upper-eyelid surgery may be covered by insurance if used to correct visual field defects) Length: 60-90 minutes. Anesthesia: Usually local with sedation. In/Outpatient: Usually outpatient. Side Effects: Temporary discomfort, tightness of lids, swelling, and bruising. Temporary dryness, burning, itching of eyes, excessive tearing, and possible sensitivity to light for first few weeks. Risks: Temporary blurred or double vision. Infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Recovery: Reading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol: about 3 weeks. Bruising and swelling gone: several weeks. Duration of Results: Several years. Sometimes permanent.

Back to top

Chin Surgery (Genioplasty) Procedure: Surgery of the chin is performed to correct the size, shape, and appearance of the chin. The operation, also known as a genioplasty, is performed most commonly to enlarge, or bring forward the chin. In a person with a receded chin, it would improve the projection of the chin and bring it in better balance with the remainder of the face. The facial profile can be balanced by extending the chin in relationship to the nose. Reconstructive mandibular sliding surgery to correct bite dysfunction can be performed in conjunction with chin surgery. On occasion, the operation may also be performed to reduce the size of an enlarged chin. Length: 1-2 hours. Anesthesia: Local sedation or general anesthesia. In/Outpatient: Outpatient. Side Effects: Temporary numbness of gums and lower lips, sensation gradually returns. Risks: Bruising and swelling of the chin are the most common complications. Infection and blood clots are rare postoperative problems. Possible temporary or permanent numbness of gums and lips. Recovery: Return to work and usual activity is allowed within 7 to 10 days. Within a week of surgery, the external dressing is usually removed. Duration of Results: One surgical approach is to make an incision inside the mouth along the inferior sulcus (a "landmark" inside the lower gum) to gain access to the chin bone. A horizontal cut (called an osteotomy) is made through the jaw bone (mandible) with a bone saw or chisel. The lower portion of the separated bone is moved forward to the desired position and wired or screwed in with titanium plates. The mental nerves are carefully protected. The incision is closed with sutures and an external pressure dressing is applied. There is no visible scarring since the surgery is performed through an incision inside the mouth.

Back to top

Facelift Procedure: Improves sagging facial skin, jowls, and loose neck skin by removing excess fat, tightening muscles, and redraping skin. Most commonly done on men and women over 40. Length: 3-4 hours. Anesthesia: Usually general. In/Outpatient: Usually outpatient. Some patients may require short inpatient stay. Side Effects: Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men, could involve permanent need to shave behind ears, where beard-growing skin is repositioned. Risks: Possible injury to the nerves that control facial muscles or feeling (usually temporary, but may be permanent). Infection, bleeding, poor healing, excessive scarring. Recovery: Back to work: 10 to 14 days. More strenuous activity: 2 weeks or more. Bruising: 2 to 3 weeks. Must limit exposure to sun for several months. Duration of Results: Usually 5 to 10 years.

Back to top

CO2 Laser Resurfacing Procedure: Smooth the face and smooth fine wrinkles using a carbon dioxide (C02) laser that treats layers of damaged skin. Softens lines around the eyes and mouth and minimizes facial scars and unevenly pigmented areas. Patient Selection: Dr. Clark will determine if you are a candidate based on a clinical exam. Length: A few minutes to 1 hour, depending on the size of area to be treated. May require more than 1 session. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient, unless combined with other surgical procedures that require hospitalization. Side Effects: Temporary swelling, discomfort. Lightening of treated skin. Acute sun sensitivity. Increased sensitivity to makeup. Pinkness or redness in skin that may persist for up to 6 months. Risks: Burns or injuries caused by laser heat, scarring, abnormal changes in skin color. Possible flare-up of viral infections ("cold sores") or other infections (rare). Recovery: Back to work: 2 weeks. More strenuous activities: 4-6 weeks. Complete fading of redness: 6 months or less. Return of pigmentation/light sun exposure: 6-12 months. Duration of Results: Long-lasting, but does not stop aging. New wrinkles, expression lines may form as skin ages.

Back to top

Liposuction / Ultrasonic-Assisted Liposuction Procedure: Improve body shape by removing exercise-resistant fat deposits with a tube and vacuum device. Can be performed using the tumescent technique, in which targeted fat cells are infused with saline containing solution with a local anesthetic before liposuction to reduce post-operative bruising and swelling. Common locations for liposuction include chin, neck, upper arms, abdomen, buttocks, hips, thighs, knees, calves, ankles. For larger volumes of fat or for fibrous body areas, ultrasound-assisted lipoplasty (UAL) may be used. UAL is a technique in which an ultrasound probe is inserted beneath the skin to "liquefy" the fat before it is suctioned. Length: 1 to 2 hours or more. UAL: 20-40 percent longer than traditional liposuction. Anesthesia: Local with sedation. In/Outpatient: Usually outpatient. Side Effects: Temporary bruising, swelling, numbness, soreness, and burning sensation. Tumescent: Temporary fluid drainage from incision sites. UAL: Larger incisions for cannula. Risks: Asymmetry. Rippling or bagginess of skin. Pigmentation changes. Skin injury. Fluid retention. Excessive fluid loss leading to shock. Infection. UAL: thermal burn injury caused by the heat from the ultrasound device. Recovery: Back to work: 1 to 3 days. More strenuous activity: 2 to 4 weeks. Full recovery from swelling and bruising: 1 to 6 months or more. Use of tumescent technique or UAL may decrease post-operative bruising and swelling. Duration of Results: Permanent, with sensible diet and exercise.

Back to top

Malar Lift Procedure: As we age, the supporting ligaments of the cheek pads give way to the effects of gravity. As the cheek pads sag, angularity in the face is lost and the sagging deepens the nasolabial folds (smile lines) around the mouth, making one appear older and tired. A malar lift restores the cheek pads to their uplifted position, resulting in a more youthful look. Usually is done in conjunction with a brow lift or face lift Length: 1 to 2 hours, longer if done with another procedure. Anesthesia: Usually general. In/Outpatient: Usually outpatient. Side Effects: Temporary bruising, swelling, numbness and tenderness of skin. Risks: Possible injury to the nerves that affect facial muscles and feeling; infection; bleeding. Recovery: Back to work: one week. More strenuous activity: two weeks. Duration of Results: Usually 4 to 8 years.

Back to top

Male Breast Reduction (GYNECOMASTIA) Procedure: In young males or middle-age men, breast tissue can hypertrophy or become larger. This may result in similarity to a woman's breast shape. Can be alleviated with ultrasonic-assisted liposuction and/or cutting out excess tissue. (Some cases may be covered by medical insurance). Length: 1-2 hours. Anesthesia: Local with sedation. In/Outpatient: Outpatient. Side Effects: Discomfort, swelling, temporarily altered nipple sensitivity. Risks: Bleeding, infection, risks of anesthesia, permanent nipple insensitivity, and scarring. Recovery: Usually able to resume work after 3 to 7 days. Duration of Results: Can be permanent.

Back to top

Nose Surgery Procedure: Reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May also relieve some breathing problems. (May be covered by insurance.) Length: 1 to 2 hours or more. Anesthesia: Local with sedation, or general. In/Outpatient: Usually outpatient. Side Effects: Temporary swelling, bruising around eyes, nose and headaches. Possibly some bleeding and stiffness. Risks: Infection. Small burst blood vessels resulting in tiny, permanent red spots. Incomplete improvement, requiring additional surgery. Recovery: Back to work: 1 to 2 weeks. More strenuous activities: 2 to 3 weeks. Avoid hitting nose or sunburn: 8 weeks. Final appearance outcome: 1 year or more. Duration of Results: Permanent.

Back to top