Procedure: Tighten the belly by removal of skin and fat Length: 2-3 hours Anesthesia: Local-sedation or general In/Outpatient: Usually outpatient Side Effects: Temporary soreness, swelling, bruising, and change of sensation in the lower abdomen Risks: Bleeding, infection, risks of anesthesia, and scarring Recovery: Back to work: seven to ten days. One can shower the following day and resume activities as they feel comfortable. A compression garment is worn for approximately 2 weeks. Duration: If weight is stable, usually permanent.
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Procedure: Enhances the size of breasts using inflatable implants filled with saline solution (silicone gel implants are available and may be used in select cases). Length: 1 to 2 hours. Anesthesia: Primarily performed with general anesthesia. In/Outpatient: Usually outpatient. Side Effects: Temporary soreness and swelling, moderate bruising. Breasts may be sensitive to stimulation for a few weeks. Risks: Bleeding, infection, the formation of scar tissue around the implant (capsular contracture), decreased breast sensation, asymmetry. Recovery: Back to work: a few days or more. Limited exercise can generally begin after two weeks. Duration of Results: Variable. Implants may require removal or replacement later in life.
Procedure: Raise and reshape sagging breasts by removing excess skin and breast tissue and repositioning remaining tissue and nipple. 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.
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 if 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 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.
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 may be 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.
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 to 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.
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 mentoplasty may 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: Usually permanent
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.
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.
Restylane and Juvederm: These gels are based on a natural substance found in the body, hyaluronic acid, which has been stabilized for long duration, usually lasting 6-12 months. Their use ranges from treating fine lines to reshaping facial contours and lip augmentation.
Radiesse: A new dermal filler for facial folds and wrinkles, Radiesse is made of calcium-based microspheres that not only fill and volumize, but work with your body to stimulate new collagen production. Results can last a year or more.
Fat Injections: This procedure harvests fat from an area like the abdomen and then injects it into areas where recontouring is desired, such as lips or cheeks. The procedure may need to be repeated to achieve desired results.
Artefill: The first and only FDA-approved non-resorbable filler for the correction of smile lines. A simple in-office procedure provides immediate, visible results which improve over the course of several months and can last up to five years or more.
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.
Procedure: Commonly performed to set prominent ears 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. 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, local with sedation, or general.
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: Usually permanent
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, 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.
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.
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, 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.
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.
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.
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.
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.
Procedure: Portrait Plasma Skin Regeneration (PSR) by Rhytec is a new technology (not a laser) that improves skin texture, tone, removes discoloration, tightens lax skin, and reduces wrinkles using highly energized, nitrogen-based plasma. Length: Actual procedure can be as short as 10 - 30 minutes depending on size of area treated. (Additional time is required for topical anesthetic to take effect.) Anesthesia: Usually, only a topical anesthetic applied before the procedure is needed. In/Outpatient: Usually an outpatient, in-office procedure, unless combined with other surgical procedures requiring a hospital or surgery center. Side Effects: A local sensation of heat may be experienced during procedure. A short duration pinkness or redness of skin followed by peeling is commonly experienced in the first few days or in the first week. Temporary swelling, mild acne flare up may occur. Risks: Pain or discomfort, possible infection, changes in skin color, scarring. Recovery: Minimal downtime. Lighter treatments require 2-3 days before peeling is complete and makeup can be worn. More intense treatments may require 7-10 days before peeling completes and makeup can be worn. Duration of Results: Improvements continue for up to a year after treatment.
Procedure: Some small tattoos can be removed with local excision if they are in a favorable body area. Another option is removal by micropigmentation technique (see Permanent Makeup) which requires repeated treatments. Length: Depends on the size and location of the tattoo. Anesthesia: Local for excision, topical numbing agent for micropigmentation technique. In/Outpatient: Strictly outpatient. Side Effects: Possible swelling and tenderness at the site. Risks: Possible scarring, infection, and swelling. Recovery: Usually no downtime needed and no limitations. Dependent on size and location of tattoo. Duration of results: Once removed, the tattoo is permanently gone.
