Facelift surgery, medically referred to as rhytidectomy, can help reverse various signs of aging that may develop over time due to the natural aging process, sun exposure, stress, the effects of gravity, and a number of other factors.

The surgery varies in range from minimally invasive ‘lunchtime lifts’ to more extensive, sophisticated surgery. A facelift removes excess skin, while sculpting and tightening the soft, underlying tissues of the face and neck.

When to Consider a Facelift

• If you feel that your face does not reflect your youthful spirit and energy level
• If you determine that your facial sagging and excess skin is a social or career obstacle
• If you show signs of facial aging but still have some skin elasticity
• One day you look in the mirror and realize that time, gravity, sun exposure and heredity have taken a toll and you simply do not look like yourself any more.

Understanding the Surgery

Dr. STEPHAN begins the incision in the area of the temple hair, just above and in front of the ear. Next it continues under the earlobe and follows the back of the ear and blends into the hairline. The skin is gently lifted as Dr. STEPHAN repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incisions are placed where they will fall in a natural crease of the skin for camouflage. After trimming the excess skin, Dr. STEPHAN closes the incisions with fine sutures and/or metal clips. This will permit precise surgery and avoid shaving hair in the incision sites. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia (“twilight sleep”), the patient will experience little discomfort.

What to Expect After the Surgery

Even though most patients experience minimal pain after surgery, Dr. STEPHAN will still prescribe medication and will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Although there are few complications in facelift surgery (thousands are performed each year), some risk exists in any surgery. In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery. All sutures and staples are usually removed within five to 10 days following surgery.

Patients should avoid vigorous activity and prearrange for post-surgery support from family and friends. Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature. In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred. Since surgery does not stop the aging process some relaxation of tissues can occur over the first few weeks. The goal of an artistic facelift is natural beauty without the revealing signs of being “overdone”.

What Are the Benefits

Facial plastic /cosmetic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic facial surgery can help change how you feel about yourself. 

Surgery to reshape the nose is a common cosmetic procedure that can have profound results on your appearance and self-confidence. Rhinoplasty may include any number of changes, including increasing or decreasing the size of your nose, narrowing the nostrils, changing the bridge or tip of your nose, or altering the angle of your nose. Through rhinoplasty, Dr. Stephan can create a more contoured and shapely nose that looks completely natural.

When to Consider a Nose Surgery

• If you are unhappy with the shape, size or angle of your nose
• If your nose is too large, too small or not in proportion to the rest of your face
• If you have breathing problems resulting from irregularities inside your nose
• If you have a nasal hump or a nasal tip that is drooping, too elevated or wide

Understanding the Surgery

The technique involves first accessing the bone and cartilage support of the nose. This is achieved through incisions made inside the nose, where they are invisible. In some cases, an incision is made in the area of skin separating the nostrils. Next, the underlying bone and cartilage is reduced, augmented or rearranged to create a newly shaped structure. For example, if the tip of the nose is too large, Dr. Stephan can sculpt the cartilage in this area to reduce it in size. If the bridge of the nose has a prominence, this can be reduced to yield a more pleasing profile. If any portion of the nose appears disproportionately small, cartilage or soft tissue grafts can be placed to create better harmony. The angles of the nose in relation to the upper lip or the forehead can also be altered by further sculpting the nasal support structure.

The tissues are then redraped over the new frame and the incisions are closed. A small plastic splint is applied to the outside of the nose to minimize swelling and to help maintain the new shape while the nose heals. Soft, absorbent material may be used inside the nose to maintain stability along the dividing wall of the air passages called the septum. Alternatively, soft nasal supports that permit nasal breathing post-operatively can be placed

What to Expect After the Surgery

It is imperative that you follow your surgeon’s post operative instructions. Keeping your head elevated will minimize swelling. It is important not to blow your nose and to avoid any impact to the nose while the structures inside and out are healing. Activities such as heavy lifting, excessive exertion, sun exposure or any activity that would increase the risk of injury should be avoided. If you wear glasses, you must be careful not to exert excess pressure on the bridge of the nose. Tape and other devices are sometimes used to permit wearing glasses without stressing the area during healing.

What Are the Benefits

As the nose occupies a central position on the face, the size and shape of the nose has a great impact on an individual’s appearance. Some patients have nasal respiratory problems; here is the additional benefit of improving breathing.

Aging around the eyes can often be more noticeable than on other areas of your face. Typically, upper eyelid muscles lose elasticity over time and begin to droop, often resulting in a “tired” look. Additionally, fat tissues below your eyelids can also become more pronounced which may result in puffiness. Dr. STEPHAN’s procedure is to tighten the muscles around your eyelids and remove the excess fat tissue, thereby opening your eyes and creating a younger appearance that looks completely natural.

When to Consider Eyelid Surgery

• If you have excess, hanging skin covering the natural fold of the upper eyelids
• If you have loose skin hanging down from the upper eyelids over the eyelashes
• If your upper and lower eyelids appear puffy, making your eyes look tired and aged
• If you have deep grooves under your eyes

Understanding the Surgery

In upper eyelid surgery, Dr. STEPHAN first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat is removed or repositioned, and then the loose muscle and skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.

In lower eyelid surgery, Dr. STEPHAN makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also commonly self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.

What to Expect After the Surgery

Immediately after the surgery has been completed, Dr. STEPHAN may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort.

For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eyedrops may be recommended. Dr. STEPHAN will also list activities and environments to avoid in the weeks immediately following surgery. Stitches will be removed in three to five days after surgery.

The risks of blepharoplasty are fairly minimal but include poor healing, persistent fat or loose skin and muscle, dry eyes, and very rarely, visual changes.

What Are the Benefits

Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. 

Neck lift surgery is one of the most rejuvenative procedures in cosmetic surgery. By removing excess skin and fat deposits from the neck area, and possibly restructuring the underlying muscle, Dr. Stephan can dramatically rejuvenate his patient's appearance. The procedure, itself, is one of the safest and most reliable in plastic surgery. Indeed, with the advances made in surgical technology over the past decade, modern neck lift surgery can be performed with minimal incisions and scarring while producing exceptionally natural-looking results.

When to Consider a Neck Lift

• If you have a turkey wattle that makes you look much older than your age
• If you feel your neck is too fat
• If you have lost the distinct jawline of your youth and want to restore it
• If you have excess skin and wrinkles on your neck

Understanding the Surgery

If only minimal contouring is needed, this procedure can be done with liposuction alone leaving a tiny, invisible scar under the chin.

The procedure for a full neck lift is as follows:

• Incisions are made under the chin and/or behind the ears depending on the procedure that has been chosen
• The platysma muscle is tightened and sewn together (corset platysmaplasty) similar to the way shoelaces are cinched.
• Excess skin and fat are carefully trimmed away
• Tissue and skin are repositioned and secured with sutures
• Incisions are closed and drains may be placed before the wounds are bandaged

What to Expect After the Surgery

Immediately after surgery, your neck will be bruised and it will feel tight and numb. The bruising will resolve over the next four to five days but the feelings of tightness and numbness may remain for several months.

Dr. Stephan will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

What Are the Benefits

• Can significantly improve your neck and jawline
• Can be done as a stand-alone procedure if other facial surgery is not needed or desired
• Can provide you with a more youthful profile

This procedure is ideal for patients who want to lift the eyebrows and forehead. It lifts everything from the hairline down to the eyebrows and can address eyebrow shape and asymmetry. The scar from the incision, once healed, is virtually undetectable.

Alternatively, a minimal brow lift can also be achieved with Botulinum toxin injections.

When to Consider a Brow and Forehead Lift

• Sagging or low eyebrow position creates a tired, sad or grumpy appearance
• You have deep horizontal creases across the forehead
• You have frown lines or furrows between the eyebrows or across the top of your nose
• You have excess skin or fatty tissue hanging over your eyes

Understanding the Surgery

Brow-lift procedures have evolved from open techniques with long incisions to techniques with short incisions. A brow lift usually involves incisions in the hair-bearing scalp, but sometimes incisions are made in the forehead and/or the upper eyelids.

• Open brow lift. Dr. Stephan makes a long incision across the hair bearing area and lifts the skin away from the underlying tissues. Dr. Stephan then loosens muscles and removes fat. He removes any excess skin, pulls the remaining skin down, and stitches the brow into its new position. Other names sometimes used to describe open brow lift include classic, coronal or trichophytic brow lift.
• Temporal brow lift.  It uses a 4 cm incision that results in scars that are hidden in the temporal hairline, even in balding men who have little temporal hair remaining. While this procedure does not address the center area of the brow, it can reduce wrinkles at the corners of the eyes, commonly referred to as 'crow's feet.' Most brow lift procedures are performed with an upper blepharoplasty (upper eye lid surgery).

The type of brow lift you undergo will be based on your facial features and aesthetic preferences. The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.

What to Expect After the Surgery

• A Certain degree of swelling is normal after the surgery and should resolve within one to two weeks. 
• Your sutures or staples will be removed approximately one week after surgery.
• During the first week of recovery, you should move and be mildly active. However, do not attempt heavy lifting or strenuous activity.
• You can resume driving when you are able to drive as well as you did before surgery. You need to be able to brake, respond, and turn quickly. When these conditions are met, you may resume driving, typically in the first or second week after surgery.
• You may be able to return to work within a week and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.
• Sensation in your scalp may be temporarily reduced. The feeling will begin to return over the first few weeks after surgery and your scalp will begin to feel 'itchy' as the nerves reawaken. Total numbness behind the incision in an open brow lift will usually persist for nine to twelve months post-surgery, sometimes longer in rare instances.

What Are the Benefits

• Repositions a low or sagging brow that hangs over the upper eyelid
• Raises the eyebrows to a more alert and youthful position
• Makes you look happier, friendlier and more approachable

During a thread facelift, Dr. Stephan inserts thin threads into the face through tiny incisions made in the targeted area. These threads attach to the skin tissue and are then pulled back to lift and smooth the face. Almost immediately, treated areas will be raised slightly, eliminating sagging and giving patients a rejuvenated appearance.

When to Consider a Thread Lift

As we age, the effects of gravity become more noticeable on our faces. The supporting tissue of the cheeks weakens, facial fat is lost, the jawline that used to be firm and tight forms jowls, the edges of the mouth drift down towards the chin, and the lower face and neck sags. Suitable candidates for a thread lift procedure are those who are experiencing mild to moderate sagging of facial tissues, usually those in their mid-thirties to fifties.

Understanding the Procedure

 During surgery, small 1-2mm incisions will be made at various points on the face. A hollow needle will then be inserted into the skin to put the threads in place. The threads are attached to the fat underneath the skin, and will then be adjusted to tighten and smooth the contours of your face. The excess thread is trimmed so it does not appear above the skin surface. A thread lift procedure takes approximately 30 minutes to 2 hours depending on the number of areas being treated and the type of threads used.

What to Expect After the Procedure

Post-procedure you may experience some slight bruising and swelling, which usually settle within few days. Recovery is generally quick, with most patients returning to work the next day or after a few days’ rest, although you may find that your facial movement is limited for the first week or two..

What are the Benefits

A thread lift procedure uses various different types of suture threads to help lift and tighten the skin. This process helps to raise the outer brow area, reduce jowling along the jawline, and reduce sagging in the cheeks, naso-labial (nose to mouth) folds and the lower eye areas.

Cheek augmentation is a cosmetic procedure that is intended to emphasize the cheeks on a person's face. To augment the cheeks, Dr. Stephan may sometimes place a solid implant over the cheekbones. However, Injections with the patients' own fat (lipofilling) or a soft tissue filler (Hyaluronic acid) are performed much more frequently. (Refer to injectables section for more details). 

When to Consider Cheek Augmentation

• Flat, deflated-looking cheeks
• Cheeks that lack definition
• Hollows in the cheeks or temples
• Under-eye bags or lines and wrinkles on the cheeks
• Desire a lifting effect

Understanding the Surgery

To place the implant, Dr. Stephan creates a pocket between the cheekbones and its overlying soft tissues where the implants are then placed. How and where the incisions are made will be determined by area of placement and other combined procedures.

What to Expect After the Surgery

Strenuous activities will be prohibited for two weeks after the surgery. This procedure is performed as an out-patient and is completed within a couple of hours. There will most likely be bruising, swelling and possible temporary numbness.

Recovery period is usually 7-10 days initially with about six weeks for complete healing and reduction of swelling.
 

What Are the Benefits

• Corrects facial asymmetry and deficiencies
• Procedures are relatively quick to perform and have permanent results

Lip augmentation with dermal fillers plumps up lips and enhances the look of the entire face. Those who have thin lips can especially benefit from lip enhancement.

When to Consider a Lip Augmentation

• Your lips have always been thin and disappear when you smile
• As you age, your lips have become thinner and less full
• You feel self-conscious about how your lips look
• Having fuller lips will help balance out your face

Understanding the Procedure

There are many methods for lip enhancement. Your surgeon will offer you options depending on your aesthetic goals and recovery time frame. It might be appropriate to have two or more of these procedures to achieve the right look for you.

Injections - fat transfer
In fat transfer, autologous fat (fat from your own body) can be taken via liposuction from another area of your body and injected into your lips. Injections may need to be repeated until you get the desired result.

Injections - fillers
Fillers made from natural or synthetic biocompatible material acts as a fat substitute to plump up the lip. One treatment is usually sufficient to produce the desired result. The results, however, may be temporary and require repeat injections.

Surgery - VY advancment
A permanent method of augmenting the lips is accomplished by surgically advancing the lip forward, with incisions in the form of a W placed inside the mouth. 

Surgery - lip lift
Removing extra skin and lifting the lips will help those with loose skin or those who have a downward sloping mouth. To increase the upper lip, an incision is made under the nose and the skin is shortened to pull up the lips. Other lift techniques can shorten the upper lip to expose more teeth.Very small sutures are used for this procedure and removed four to five days later.

What to Expect After Injections 

You may experience mild to moderate swelling of the lips for a day or two. The amount of swelling depends on patients characteristics, amount of fillers injected and the technique used. Bruising, though less often, may take a few days to subside. In most cases, you can get back to work the next day with lipstick camouflage. 

What to Expect After the Surgery

You will experience postoperative bruising and swelling, with mild to moderate discomfort for a day or two. A cold compress can be applied to the operative site to reduce swelling, bruising and pain. You may be restricted to a liquid-only diet for one or two days. You will most likely be mobile the day of your surgery, but your activities will be restricted.

What Are the Benefits

• Some lip injections are temporary and can be modified to your preference
• Surgical enhancement provide a permanent solution
• Quick one-day recovery for injections and a week for most lip surgery

• Chin Augmentation

Chin augmentation surgery whether by the placement of a small implant or by advancing your own bone (genioplasty) enhances the chin and creates a stronger profile and more balanced facial features. For mild augmentation, filler injections of hyaluronic acid, is an alternative nonsurgical solution.

• Chin Reduction

Chin reduction surgery involves the removal of some of the patient's natural jaw bone to reduce the appearance of a prominent chin and create more harmony among all of the patients's facial features.

When to Consider a Chin Surgery

• Asymmetry in the shape of your face
• When the size of the chin may magnify or minimize the perceived size of the nose
• For a more balanced facial profile
• To decrease an existing double chin

Understanding the Surgery

Reshaping the chin can be accomplished either by using chin implants, or by repositioning the bone supporting the chin. There are many types of implants available, manufactured from a variety of materials, including silicone or other substances. A small incision under the chin is used under local or general anesthesia. Dr. Stephan will consult with you, and discuss recommendations for the type of implant to use.

During the procedure of bone repositioning, an incision is made inside the lower lip. The chin bone is repositioned, advanced or reduced through this incision.

What to Expect After the Surgery

You will experience postoperative bruising and swelling, with mild to moderate discomfort for a day or two. A cold compress can be applied to the operative site to reduce swelling, bruising and pain. You may be restricted to a liquid-only diet for one or two days.

It is vitally important that you follow all patient care instructions provided by Dr. Stephan.  He will provide detailed instructions about the normal symptoms you will experience, any potential signs of complications and antibiotic and pain medications required. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

What Are the Benefits

• Corrects facial asymmetry and deficiencies especially in the chin, cheek or jaw
• Procedures are relatively quick to perform and have permanent results

This type of facial plastic surgery can alleviate much of the social anxiety experienced by those with overly large or protruding ears and can also be used to correct deformed ears.

When to Consider Otoplasty or Ear Surgery

·        Protruding ears occurring on one or both sides in varying degrees — not associated with hearing loss

·        Kids with protruding ears to avoid teasing from other children at school

·        Adult dissatisfaction with previous ear surgery

Understanding the Surgery

Medications are administered for your comfort during the surgical procedure. The choices include local, intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

Correction of protruding ears uses surgical techniques to create or increase the antihelical fold (just inside the rim of the ear) and to reduce enlarged conchal cartilage (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within its folds to hide them. Internal, non-removable sutures are used to create and secure the newly shaped cartilage in place.

External stitches close the incision. Techniques are individualized, taking care not to distort other structures and to avoid an unnatural “pinned back” appearance.

What to Expect After the Surgery

Temporary throbbing, aching, swelling, redness and numbness are normal postoperatively. Large pressure dressings and bandages are applied around the ears and head for 2 days. Some swelling and bruising may last 1-14 days. Some numbness may exist around the operative areas. Tenderness could last up to 3 months. A headband should be worn at night for 4 to 6 weeks. You may resume full social activities with 5 to 10 days.

Ear surgery offers near immediate results in cases of protruding ears, visible once the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

What Are the Benefits

·        Better shape of your face

·        Normal ears shape

·        Alleviates social pressure for young kids 

Breast augmentation is a surgical procedure designed to improve the shape and increase the size of a woman’s breasts through the use of breast implants. Dr. Stephan’s patients typically undergo this procedure to achieve a greater proportional balance, address asymmetrical concerns, or restore volume lost over time.

A less common method of breast augmentation is Autologous fat transfer to the breasts. This method is still undergoing clinical studies and research for safety and effectiveness.

When to Consider a Breast Augmentation

• If you want a better proportioned or more appealing figure
• If you wish your clothes fit better
• When pregnancy, weight loss or aging has affected the size and shape of your breasts
• To restore symmetry if one of your breasts is smaller than the other

Understanding the Surgery 

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Stephan will recommend the best choice for you.

Incisions are made in inconspicuous areas to minimize visible scarring (inframammary, periareolar or transaxillary). You and Dr. Stephan will discuss which incision options are appropriate for your desired outcome.

Incisions vary based on the type of breast implant (Round or Anatomical Teardrop shape), degree of enlargement desired, your particular anatomy and patient-surgeon preference.

After the incision is made, a breast implant is inserted into a pocket either:

A. Partially under the pectoral muscle (dual plane placement), or

B. Directly behind the breast tissue, over the pectoral muscle (submammary/ subglandular placement)

Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade.

What to Expect After the Surgery

After your breast augmentation procedure, you may be placed in a surgical dressing that can include a support bra.

Breast augmentation surgery stretches the breast tissue and can be painful—especially when implants have been placed under the chest muscle. Typically, the most pain is experienced within the first 48 hours after breast augmentation surgery. Your level of pain will typically decrease each day and may be effectively treated with various pain medications.

Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy. You may experience difficulty raising your arms.

Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.

What Are the Benefits

You will look better in clothes and swimwear. You will have a more youthful-looking figure. Satisfaction with your new image should continue to grow as you fully recover from surgery.

Over time, the natural aging process can cause your breasts to sag and lose their shape. Pregnancy can also have similar effects on your breast tissue. A breast lift, or mastopexy, is a surgical procedure that reshapes and cosmetically alters your breasts. After a breast lift procedure you can expect improved shape, contour and lift to your breasts that restores a more youthful appearance.

When to Consider a Breast Lift

• Pregnancy, nursing, gravity, weight gain or loss, normal aging, and heredity have taken a toll on the shape of your breasts, resulting in sagging
• If your surgeon thinks that breast implants alone are unlikely to achieve the contour you desire
• If the tissue surrounding the nipple or areola has become stretched

Understanding the Surgery

There are different incision patterns and techniques that Dr. Stephan will choose from to operate a breast lift:

• The "anchor" incision, made around the perimeter of the areola, vertically down from the areola to the breast crease and horizontally along the breast crease, produces the most scarring. It is for women with a severe degree of sagging who will not be helped sufficiently by less invasive techniques. This incision, which is the oldest technique, is often used for a breast lift in conjunction with a breast reduction.
• The "lollipop" lift, also known as a "keyhole" incision, made around the perimeter of the areola and vertically down from the areola to the breast crease, is suitable for women with a moderate degree of sagging who will not be helped sufficiently by the periareolar technique and who do not want breast implants.
• The "donut" lift, also known as the "periareolar incision," made around the perimeter of the areola only, is suitable for women with a mild-to-moderate degree of sagging. When used by a skilled surgeon in conjunction with the placement of implants, it can produce a satisfactory result for patients with more pronounced sagging.
• The "crescent" lift, which is less commonly used, is an incision that lies just along the upper half of the areola. A crescent-shaped piece of skin is removed above that line, and the surrounding skin is reattached to the areola. This type of lift is usually done in conjunction with breast augmentation in women with minor sagging. It cannot accomplish the same degree of lifting as the other incision techniques.
• The "scarless" lift. For a select few women concerned more about volume loss than actual sagging, there are procedures to lift the appearance of the breast that are touted as scarless.

Incisions follow your breasts' natural contour defining the area of excision and the new location for the nipple.

What to Expect After the Surgery

Generally, you can expect to be bandaged and wearing a support bra.

Other common recovery side effects include bruising, numbness, or changes in nipple sensitivity, itching around incision sites and increased firmness or fullness in the breast tissue. These side effects should subside over the next few weeks, with some residual effects lasting up to three months following the surgery.

It is vitally important that you follow all patient care instructions provided by Dr. Stephan. This will include information about wearing your support bra, taking an antibiotic if prescribed and the level and type of activity that is safe. Dr. Stephan will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

What Are the Benefits

• You will have improved breast shape, projection, and symmetry.
• Your breasts will have a more youthful appearance.
• You will look better in and out of clothes and feel more self-confident.

This procedure combines a breast lift with a breast augmentation in a single operative session (Augmentation Mastopexy). The lift is used to reposition the breast higher on the chest while the implant is used to give, or restore, upper pole fullness at the top of the breast. This procedure may be performed for cosmetic purposes, or as part of a reconstructive procedure. 

When to Consider a Breast Lift and Augmentation

• Sagging or 'hanging' breasts
• Loss of fullness in the top portion of breasts
• Loss of shape and volume
• Stretch marks on the breasts
• Asymmetry of one or both breasts

Understanding the Surgery

The breast implant fills up the extra skin of the breast. Breast implants work well to restore the fullness that was in the upper aspect of the breasts.

In most cases, the implant is placed beneath the pectoral muscle and the breast lift is then performed. The shape of the breast mound is usually better when both breast augmentation and breast lift are performed together.

The placement of an implant (even a small one) will fill out the top part of the breast and improve the projection.  This additional weight on the chest may accelerate the rate of ongoing breast ptosis if the implant is placed above the muscle. For this reason, the implant is usually placed below the muscle.

There are different incision patterns and techniques that Dr. Stephan will choose from to operate a breast lift and augmentation:

• Around the areolas (Donut)
• Extending downward from the areolas to the breast creases (Lollipop)
• Horizontally along the breast creases (Anchor)

​The choice of the incision pattern depends mostly on the degree of breast ptosis and the augmentation desired by the patient.

What to Expect After the Surgery

After your  procedure, you may be placed in a surgical dressing that can include a support bra.

Augmentation mastopexy  stretches the breast tissue and can be painful—especially when implants have been placed under the chest muscle. Typically, the most pain is experienced within the first 48 hours after breast augmentation surgery. Your level of pain will typically decrease each day and may be effectively treated with various pain medications.

Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy. You may experience difficulty raising your arms.

Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.

What Are the Benefits

• You will have improved breast shape, projection, and symmetry.
• Your breasts will have a more youthful appearance.
• You will look better in and out of clothes and feel more self-confident.

The goal of breast reduction surgery is to reduce the size of your breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts.           

When to Consider a Breast Reduction

• If your breasts are too large for your body frame and create neck, back, or shoulder pain
• If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
• If one breast is much larger than the other
• If you are unhappy and self-conscious about the large appearance of your breasts

Understanding the Surgery

Breast reduction surgery, which usually takes from two to four hours, is performed in a hospital. An overnight stay is not usually required. The surgery commonly involves three incisions in an inverted T pattern. In some cases, incisions may be smaller. Some patients, may benefit from liposuction only without any incisions. After Dr. Stephan removes excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areolas may be reduced in size. Skin that was located above the nipple is brought down andtogether to reshape the breast. Liposuction may be used to improve the contour under the arm.

What to Expect After the Surgery

• You will have a surgical dressing over your upper chest and will probably have drains coming from each breast.
• You may have compression sleeves on your legs to help with circulation
• You will feel discomfort, but your medication will keep you from feeling pain.
• After the hospital staff observes you for a few hours it is likely that you will be allowed to go home, where you will need someone to care for you for the next few days.
• Before your discharge from hospital, you will be shown how to care for your incisions, instructing you on how frequently to change the bandages and how to empty your drainage tubes. Drainage tubes are usually removed within 24 hours.
• When the anesthesia wears off, you may have some pain. Any discomfort can be controlled with pain medication..
• You might notice a change in breast size, but at this point you will have significant swelling. In most cases, this swelling will remain for weeks or even months.

What Are the Benefits

• Your breasts will be in better proportion with your body and will feel firmer.
• Surgery will alleviate neck, back, and shoulder pain and make it easier to breathe and exercise.
• Your clothes will fit better and you will feel more confident about your appearance.

Breast reconstruction includes a variety of procedures performed to restore the form and shape of the breast, following mastectomy or lumpectomy surgery. Factors such as individual anatomy, aesthetic goals and the need for any postsurgical chemotherapy or radiation will determine your options. Discussing your cancer surgery with Dr. Stephan before undergoing mastectomy is crucial, because the proposed cancer removal surgery may significantly affect the choices and the results of any type of breast reconstruction.

When to Consider a Breast Reconstruction

• If you think reconstruction will give you a sense of psychological well-being or a feeling of “wholeness”
• To help restore your feelings of femininity and confidence in your appearance
• To improve symmetry if only one of your breasts is affected
• To allow you to wear low-cut necklines and normal swimwear

Understanding the Surgery

The three basic options for breast reconstruction:

• Using breast implants (saline or silicone).
• Reconstructing the breast using your own skin, fat and muscle.
• A combination of these methods.

Most breast reconstruction methods involve several steps. The majority of breast reconstruction procedures are done as outpatient surgery; however, some may require a hospital stay for the initial procedure (especially if it is done in conjunction with the initial mastectomy). Implant or expander insertion may not require extra hospital time if it can be done at the time of the mastectomy.

Dr. Stephan will help you weigh the pros and cons and select the method to benefit you the most.

What to Expect After the Surgery

It is vitally important that you follow all patient care instructions provided by Dr. Stephan. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. Dr. Stephan will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

Implant-based reconstruction is the simplest and least painful and has the shortest recuperation time. Typically, most women are able to do most routine activities within two to three weeks. Flap-based procedures, which require surgery in two areas, are more demanding and recuperation varies, depending on which flap procedure was performed.

What Are the Benefits

• You will not have to cope with wearing external breast forms or pads.
• This is a way of removing any reminders of your mastectomy and cancer experience.
• It can help you feel better about how you look and restore confidence in your sexuality.

This cosmetic surgery procedure removes excess fat and glandular tissue to restore a flatter, firmer and more masculine contour to the chest.  With the help of Dr. Stephan you can restore a naturally masculine appearance to your chest.

When to Consider a Male Breast Reduction

• If you are reluctant to remove your shirt in public, to swim, to participate in sports or to exercise at a gym.
• If you want to improve your overall body proportions.
• If you experience psychological discomfort associated with large breasts.
• If you want to increase your social confidence.

Understanding the Surgery

The goal of gynecomastia surgery is to restore a normal male breast contour and to correct deformities of the breast, nipple or areola. Surgical options include liposuction, excision (surgical removal of tissue) or a combination of both approaches. Glandular breast tissue is denser than fatty tissue and is not appropriate for liposuction.

• The choice of surgical technique depends on the likelihood of skin redundancy after surgery. Skin shrinkage is greater in younger than older patients.
• The most common approach is the intra-areolar incision, or Webster incision, which extends along the circumference of the bottom half of the areola in the pigmented portion.
• The length of your incision will be based on your anatomy.
• In severe gynecomastia, skin resection (surgical removal of part of an organ or structure) and moving the nipple (nipple transposition) may be necessary.
• Minimally invasive gynecomastia surgical procedures have gained popularity. In the "pull-through technique," a very small incision (approximately 5 mm) is made at the areolar edge. Following liposuction, the glandular tissue from the overlying areola is pulled through the incision. The major advantage of this procedure is the smaller incision. This technique is used in well-selected patients.
• Ultrasonic liposuction (VASER) has improved the results of gynecomastia correction. In liposuction-assisted breast reduction, there is less compromise of blood supply, nipple distortion and areola slough. In addition, postoperative complications are fewer with this technique than with open surgical resection; however, liposuction-assisted breast reduction is not effective for correcting glandular gynecomastia. The fatty and glandular components of your breast must be assessed before surgery. Few patients can be sufficiently treated with liposuction only.

What to Expect After the Surgery

Generally, you can expect to be bandaged, wearing a compression garment, and you may have a surgical drain.

The first three postoperative days are critical in your recovery. You must be at full rest at home, but not necessarily in bed; sitting and watching TV or having meals in the kitchen or living room is permissible.

Movements of the waist and elbow are acceptable, but you should curtail vigorous shoulder movement for the first few days. Lateral arm movements are generally permitted, but do not lift your arms up vertically. There are many variables; consult your plastic surgeon for more details.

What Are the Benefits

• You can feel comfortable revealing your chest contours, clothed or unclothed.
• You can gain more social confidence.
• You can enjoy permanent results.

Liposuction is designed to remove stubborn fat buildup throughout different areas of your body. Following the liposuction procedure you can often expect a slimmer, more defined figure that looks completely natural.

Liposuction is designed to remove stubborn fat buildup throughout different areas of your body. Following the liposuction procedure you can often expect a slimmer, more defined figure that looks completely natural.

When to Consider a Liposuction

• If you have localized areas of fat deposits that are disproportionate with the rest of your body.
• If you would like more definition or a sleeker contour in certain areas of your body.
• If your skin elasticity is good (Liposuction removes fat, but does not tighten skin).

Understanding the Surgery

Liposuction removes fat from your body using suction. The procedure can be performed under General, epidural or local anesthesia. In this procedure, small, thin, blunt-tipped tubes (cannula) are inserted through very small cuts in the skin. Dr. Stephan moves these tubes under your skin to target fat deposits and then suction them out. There are a variety of techniques that facilitate liposuction:

• Suction-assisted liposuction (SAL), the most traditional form of liposuction, draws fat out with a vacuum.
• Power-assisted liposuction (PAL) is traditional SAL with the addition of a tool to increase the motion of the cannula, which speeds up fat removal.
• Ultrasound-assisted liposuction (UAL) transmits energy through a special hand piece that helps to loosen and melt fat, enabling a greater volume of fat to be removed. This is best for larger areas, dense fat and male patients.
• VASER, a variation of UAL, is an ultrasonic cannula with several grooves that evenly disperse the energy, improving fat disruption and removal.
• Laser-assisted liposuction (LAL), will work like ultrasound to disrupt the fat cells and make fat removal more efficient and less traumatic. It also allows heating of the skin to permit skin retraction.

What to Expect After the Surgery

The incisions where Dr. Stephan inserted the cannula may be leaky or drain fluids for several days.

You will wear special tight garments to keep your skin compressed. Your doctor will tell you how long to wear these, usually for four to six weeks. 

Swelling and bruising are normal in the postoperative period. Bruising will typically subside within three weeks. Swelling may take up to three months to completely subside and allow the skin to retract. 

What Are the Benefits

• Will make your clothes fit better and your body appear slimmer.
• Uses small incisions, which result in small scars.
• Can be done under sedation with less risks and shorter operating times than similar open body contouring procedures.

A A tummy tuck surgery, also known as abdominoplasty, is designed to remove excess fat and tissues located throughout the abdominal area. During the procedure, muscles throughout the abdominal region can often be tightened, as well. Tummy tuck surgery can be especially beneficial for patients who retain excess bulk in their mid-sections despite healthy diets and previous weight loss attempts, as well as for females who have undergone multiple pregnancies.

When to Consider a Tummy Tuck

• If you've got flab, stretch marks or excess skin in your abdomen that does not improve with diet or exercise.
• If the shape of your abdomen has been affected by pregnancy or massive weight loss.
• If you feel that your protruding abdomen is unattractive.
• If your self-confidence is marred by your stomach contour.

Understanding the Surgery

In this surgical procedure, your surgeon will remove your loose abdominal skin and tighten up your abdominal muscles with sutures. In addition, liposuction of the abdomen, waists and back may be performed simultaneously. 

• Dr. Stephan will mark your abdomen to indicate the location of the incisions, the center of your torso and the location of the repositioned navel.
• A solution of lidocaine (a local anesthetic) and epinephrine (a vasoconstrictor that controls bleeding by constricting blood vessels) will be injected.
• The primary tummy tuck incision will be above the pubic mound, from one hipbone to the other. In a full abdominoplasty, another incision is made around your navel. In a mini-tummy tuck, •  Dr. Stephan will use a shorter incision. Incisions are placed low enough to be covered by a low cut bathing suit. 
• Dr. Stephan will loosen the skin from your abdominal wall to your ribcage and then place sutures in the fascia of your abdominal muscles to pull them into a tighter position. This is the muscle repair portion of the surgery.
• After your abdominal muscles have been sutured, your surgeon will remove excess fat by liposuction or other methods. Your abdominal skin is then stretched down over your incision line and the excess skin is removed.
• Next, Dr. Stephan will mark the placement of your navel. Although the skin around your navel has been moved, the navel almost always stays in the same place. He cuts a hole through the redraped skin and sutures it around your navel.
• In a full abdominoplasty, Dr. Stephan will often but not always, insert one or more drains to prevent fluid buildup, which can cause pressure on the incision. The drain is a clear plastic tube placed through a very short incision below the main incision, which leads out of the body to a small oval-shaped bulb. Each time you empty a bulb and before you close it again, you will be asked to squeeze it to help drain the wound.

The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy and comfortable as possible.

What to Expect After the Surgery

In the first couple of days, managing pain and avoiding complications is your top priority. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. Pain in efficiently managed with pain killers. After a few weeks, regaining mobility and fitness becomes important. After several months, you can start evaluating the aesthetic outcome of your surgery. It is important to remember that the time it takes to recover varies greatly among individuals.

An abdominal garment is worn for four to six weeks. 

What Are the Benefits

• Tummy-tuck surgery will restore a flat tummy.
• You will look better in clothes and swimwear.
• You will have a more youthful-looking body.

Arm lift surgery may be a good option if you have recently lost a lot of weight after bariatric surgery or due to diet and exercise. It can also be an effective way to treat signs of aging in your upper arms. There are several surgical techniques that can be used to perform the procedure, including a standard upper arm lift and a mini-arm lift. Sometimes, liposuction alone may be sufficient. Dr. Stephan will help you choose the right solution for you based on your cosmetic goals and the natural contours of your arms.

When to Consider an Arms Lift

• Excess upper-arm skin and fat following significant weight loss
• Loss of upper-arm skin elasticity
• Weakened tissues in the upper arm

Understanding the Surgery

The Arm Lift can be performed at three different levels. The level chosen is a decision that you make with Dr Stephan during your initial consultation and is mainly a function of 1) the amount of skin you have hanging from your armpit and arms and 2) the length of your arm which has the amount of hanging skin.

• Invisible Arm Lift

The Invisible Arm Lift removes excess skin at the crease of axilla (armpit) resulting in a short scar and is usually combined with liposuction of the upper arm to remove fatty tissue.

• Traditional Arm Lift

The Traditional Arm Lift removes hanging skin and fatty tissue from your armpit to just above the elbow. The incision is made on the inside of your arm, from the armpit to just above the elbow.

• Extended Arm Lift

The Extended Arm Lift, or Thoracic Lift, removes excess skin and fatty tissue that is on the side of the chest, axilla, and upper arm. This procedure includes the Traditional Arm Lift but adds the removal of skin along the side of your upper chest. The incision goes from your armpit, down the inside of your arm, and extends all the way down the midpoint of the side of your chest.

What to Expect After the Surgery

Having an Arm Lift involves taking 1 to 2 weeks off from work. During this period you should elevate the arms and avoid movement of the arms. If you have an active job where you use your arms to lift or move things, you will need more time off from work.

During week 3 to week 4 you will have a limited range of motion in your arms. By the end of week 6 you should be able to resume normal activities.

What Are the Benefits

You will look better in clothes and swimwear. You will have a more youthful-looking figure. Satisfaction with your new image should continue to grow as you fully recover from surgery.

Thigh lift is an excellent way to achieve firmer and more attractive upper legs. With age or after massive weight loss, the thighs may become loose, sagging with excess skin, fat deposits and cellulite.  While some people achieve good results with diet and exercice or with liposuction alone, others find it difficult or impossible to tone their legs without a surgical thigh lift procedure. Dr. Stephan will work with you to create a personalized surgical plan that suits your unique needs and goals so you can enjoy sexier legs.

When to Consider a Thighs Lift

• Poor skin elasticity, with fat deposits and cellulite on inner thighs
• Dramatic weight loss resulting in excess skin on thighs, extending from the groin to the knees
• Sagging, hanging skin on inner or outer thighs

Understanding the Surgery

• Inner Thigh Lift

Inner thigh Lift techniques can be divided into:

1. Horizontal medial thigh lift:  the skin incision is located in the groin crease where the thighs meet the pubic area. The final scars are covered by the panties. This procedure tightens the excess and sagging skin located in the upper third of the thighs. It may be combined with liposuction of the thighs to give a better contour. 
2. Vertical medial thigh lift: the skin incision is omega shaped located on the inner thigh with a final scar extending from the groin to the knee. This procedure tightens the entire inner thighs in both a horizontal and a vertical direction. It may be combined with liposuction of the thighs to give a better contour.

Immediately before surgery, while you are still awake and standing, Dr Stephan will mark your inner thighs with the incision location. The skin is pinched and elevated towards the groin and an estimate is made for how much skin should be removed. The duration of surgery may range from 1 to 4 hours depending on the extent of liposuction and the amount of skin to be removed. 

• Outer Thigh Lift

The Outer thigh lift is done to remove excess skin that hangs below the hip area. The incision for this procedure is located near your hip bone. If you are having a tummy tuck at the same time, the incision simply extends horizontally from the tummy tuck incision.

On the morning of surgery, while you are still awake, the incision location is discussed with you standing in front of the mirror. We will pinch the area of excess skin and I am careful to place this incision below the panty line. To assist with the surgical markings, we ask you to bring along a favorite bathing suit to help determine the best incision location.

What to Expect After the Surgery

Thigh Lift recovery time is 2 to 3 weeks. A compression garment should be worn for 4 weeks. Good postoperative wound care is imperative to avoid infections or dehiscence. 

What Are the Benefits

You will look better in clothes and swimwear. You will have a more youthful-looking figure. Satisfaction with your new image should continue to grow as you fully recover from surgery.

Patients who are unhappy with the appearance of their buttocks, whether due to their size or shape or the presence of sagging skin, can enhance their figures with butt lift surgery.

When to Consider a Brazilian Butt Lift

• Flat buttocks
• Sagging buttocks
• Asymmetrical buttocks
• Small (disproportionate) buttocks
• Massive weight loss which has changed the buttock's shape

Understanding the Surgery

• Fat Extraction

Suction assisted tumescent liposuction is used to extract the fat which will be later used for the fat graft to the buttocks. First to remove fat from selected areas of your body using slender, 3mm cannulas with 1mm holes. The small cannula holes allow to collect only the smallest fat particles.

During fat extraction, the buttock is first contoured in the areas around the buttocks to make them stand out more. Common areas liposuctioned include the back (directly above the buttocks), the stomach, and the thighs. Note that even the liposuction alone will give your lower body a more attractive look.

• Fat Processing

After liposuction, the fat suctioned from these areas is carefully processed and purified by decanting and centrifugation. Only a fraction of the donor fat removed will qualify for re-injection to the buttocks. In most cases , not more than 25% of the fat cells extracted will be qualified for re-injection.

Only the best donor fat cells are re-injected back into your buttocks for augmentation. In order to get enough qualified fat, I must liposuction at least two areas of your body, and preferably three areas.

• Re-Injection of Fat into the Buttocks

The fat is placed or transferred to the buttocks in hundreds of injections with special cannulas. Dr. Stephan injects small amounts of purified fat into different areas of the buttocks and at various depths so that the patient will get the highest permanent absorption rate. Thus, the procedure usually involves hundreds of micro fat injections. Correct injection methods are essential to achieve a uniform, smooth, natural appearance to the buttocks.

What to Expect After the Surgery

Following your plastic surgeon's post-operative instructions is crucial for ensuring fat cell survival following your Brazilian butt lift. Recovery for this procedure involves these important protocols:

• Bed rest and drink lots of fluids for the first week
• No sitting directly on your buttocks for three weeks
• No driving for three weeks
• Minimum 2 weeks off from work , if you do not have to sit in the third week
• Follow up office appointment at post-operative day 6-8
• Wear compression garment for 24 hours/day for the first 2 weeks

Most importantly, you must not sit directly on your buttocks for up to three weeks. This allows the best take of the fat graft in your buttocks and ensures the most long lasting result.

What Are the Benefits

You will look better in clothes and swimwear. You will have a more youthful-looking figure. Satisfaction with your new image should continue to grow as you fully recover from surgery.

Lower body lift surgery tightens and sculpts the buttocks, back of the thighs, outer thighs, inner thighs, hips and abdomen. Loose skin that looks aesthetically displeasing or causes mobility restrictions is removed. A lower body lift is appropriate if you are near your ideal weight and may precede or follow an upper body lift procedure.

When to Consider a Lower Body Lift

• If you have had dramatic weight loss due to bariatric surgery or dieting.
• If you have relatively thin layers of fat below the skin in the hip, thigh, abdomen and buttock areas.
• If overhanging skin in your lower body restricts your mobility and/or causes painful chafing, rashes or infection.
• If you are distressed by sagging skin in your lower body.

Understanding the Surgery

A complete lower body lift has the advantage of treating the buttocks, abdomen, waist, hips and thighs in one procedure. Basically, the lower body lift extends the tummy tuck incision completely around the lower torso, which allows Dr. Stephan to lift or suspend the thighs and tighten the buttocks as well as to execute the traditional tummy tuck. The length and the pattern of incisions depend on how much extra skin is removed and where that skin is located. Dr. Stephan will do his best to take your incision preferences into consideration. 

Here is a typical scenario for performing this procedure:

• Dr. Stephan will create a circumferential incision extending around your torso, through which he will remove an apron of excess skin and fat below the incision and reposition and tighten your tissues.
• The remaining skin in your buttocks and thighs will be pulled upward and your skin and underlying tissues will be suspended and tightened. You will be positioned on your tummy or side during this part of the procedure.
• Once your back and sides have been addressed, you will be positioned on your back to treat your front side.
• At this point, two options are available, which will be discussed with you preoperatively. One option is to combine the lower body lift with abdominal contouring, otherwise known as a tummy tuck (abdominoplasty). The other option is to combine the lower body lift with an inner thigh lift, if your abdomen does not require contouring or if you have already had an abdominoplasty.
• Your incisions will be closed in multiple layers over drains to control stretching and swelling. Deep support sutures within the underlying tissues help to form the newly shaped contours. Sutures, skin adhesives or tapes are used to close the skin incisions.

What to Expect After the Surgery

Generally, you can expect to be bandaged and wearing compression garments, and you may have some surgical drains. You will likely spend at least two days in the hospital or another setting in which you are receiving skilled nursing care. During this time you will learn how to take care of your drains and feel comfortable walking and moving. Once you are comfortable with oral pain medications, you will be discharged.

What Are the Benefits

• Loose skin will be removed and your contour sculpted, so you can see the results of your weight loss.
• You will experience the improved self-esteem that comes from looking better.
• You will get rid of overhanging skin that may cause painful chafing, rashes and infections.

Surgical body contouring following major weight loss removes excess sagging fat and skin while improving the shape of the underlying support tissue. The result is a more normal appearance with smoother contours.

Combination of post-pregnancy plastic surgery, skin treatment, and cellulite removal. These procedures are primarily meant to address the unwanted physical effects of pregnancy that cannot be reversed through diet and exercise alone.

Mommy Makeovers are uniquely personalized treatment plans, and Dr. Stephan will help you select the procedures best suited to your case, based on your cosmetic goals, budget, health, and desired timeline. While none of the procedures are intended to be weight loss treatments, following your Mommy Makeover, you could enjoy a sleeker, younger looking figure that more closely resembles your pre-pregnancy body.

When to Consider a Mommy Makeover

• If your pregnancy has negatively affected the size and shape of your breasts
• If you’re distressed about your sagging tummy and stretch marks
• If pockets of fat on your waist, abdomen, arms or thighs do not improve with diet and exercise

Understanding the Surgery

Mommy makeover is a descriptive term, not a procedure, so your first step is to consult with Dr. Stephan and decide on the procedures you will undergo. The following procedures described below are common to mommy makeovers. 

Tummy tuck – also known as abdominoplasty

A flabby abdomen results from fat, poor skin elasticity, excess skin, and stretching of the inner girdle of connective tissue (fascia) and abdominal muscles (rectus muscles), extending from the ribs to the pubic bone. This inner girdle, which holds the internal organs in place, gets stretched during pregnancy or weight gain and the stomach protrudes. Abdominoplasty removes loose, excess skin and fat and tightens slack fascia, removing stretch marks and excess skin in the lower abdomen below the belly button.

How it is done

• Dr. Stephan will remove most of the skin and fat between the belly button and pubic hair in a horizontal oval or elliptical shape.
• Then the fascia overlying the abdominal muscles is tightened with sutures.
• The skin around the belly button is repositioned and the belly button is brought out through a small incision and sutured in its normal position.
• The incision, which typically runs from hip to hip, is closed with sutures. This will leave a scar that falls along the natural crease within the bikini line. The length and visibility of the scar varies.

Liposuction – also known as lipoplasty

A tummy tuck may narrow your waist, but not your hips. Liposuction can improve the contour of flanks or hips, so the surgeon performing your mommy makeover will likely recommend liposuction of the hips and thighs at the same time as a tummy tuck. Liposuction is also effective in the chest, thighs, neck, upper arms, and knees.

How it is done

• During surgery, a sterile liquid will be injected along with a local anesthetic to control pain and epinephrine to minimize bleeding.
• After you receive anesthesia, your surgeon will make very small incisions near the area where fat will be removed.
• A thin, hollow rod (cannula) will be inserted through the incision to create tunnels through the fat. Then suction forces the fat into the cannula and out a high-vacuum hose.
• After fat removal, dressings and a compression garment will be applied.

Breast lift – also known as mastopexy

A breast lift or mastopexy treats sagging and uneven breasts, decreased breast volume, drooping nipples, and stretched areolas, returning a youthful shape and lift to your breasts. Women who desire larger, smaller, or more rounded breasts may want to consider a breast augmentation or breast reduction along with the breast lift.

How it is done

• You will receive either a general anesthetic or a combination of local anesthesia and intravenous sedation.
• Dr. Stephan will make incisions. Mastopexy incisions vary, depending on the amount of excess skin, the position of your nipples, your preference, and your surgeon’s suggestions.
• After making the incisions, the surgeon repositions and reshapes the breast tissue and surgically removes excess skin.
• Then the nipple and areola are repositioned to a more youthful height. (Note that nipples and areolas usually remain attached to underlying mounds of tissue, which usually allows for the preservation of sensation and the ability to breastfeed.) If needed, the size of the areola can be reduced by excising skin around the perimeter.
• Dr. Stephan will then tighten the remaining skin while closing the incisions. The sutures are layered deep within the breast tissue to support the newly-shaped breasts and may use skin adhesives and/or surgical tape to help close and support the skin.

Breast reduction

During pregnancy, your breasts usually swell to a fuller size and shape. In some women, the breasts remain larger. This can be a welcome change unless your breasts have become disproportionately large and cause pain, poor posture, rashes, breathing problems, skeletal deformities, or low self-esteem. Breast reduction solves these problems by removing fat and glandular tissue and tightening skin to produce smaller, lighter breasts.

How it is done

• Dr. Stephan will make incisions on your breasts and surgically remove excess fat, glandular tissue, and skin. (In some cases, excess fat may be removed through liposuction in conjunction with excision. If breast size is largely due to fatty tissue and not excess skin, liposuction alone may be used.)
• Depending on your surgeon’s recommendation, you may have intravenous sedation or general anesthesia.
• After deciding what is the best incision option for you, Dr. Stephan will make the incision, reposition the nipple (which remains tethered to its original blood and nerve supply), and reduce the areola by excising skin at the perimeter, if necessary.
• Then he or she will reduce, lift, and shape underlying breast tissue and then bring the incisions together to reshape the now smaller breast. The sutures are layered within the breast tissue to create and support the newly-shaped breasts, and then the skin is closed with sutures, skin adhesives, and/or surgical tape.
• Your breasts will be wrapped in special gauze. You may be required to wear a surgical bra.

Breast augmentation – also known as augmentation mammaplasty

Breast augmentation increases or restores breast size using silicone gel implants, saline implants, or fat grafting.

How it is done

• In breast augmentation using implants, Dr. Stephan makes an incision, lifts the breast tissue, creates a pocket in the chest/breast area, and places a saline or silicone gel implant.
• The implant is placed in a pocket underneath the pectoral muscle, which is located between the breast tissue and chest wall, or underneath the breast tissue and on top of the pectoral muscle.
• You will be wrapped in a gauze bandage or a surgical compression bra. Drainage tubes may be used for a short time to drain the surgical site.

Breast lift combined with breast augmentation

If you want your breasts to be larger in addition to being less droopy, or if you desire to maintain projection and roundness of the breast mound and your drooping is severe, Dr. Stephan may recommend a breast lift combined with a breast augmentation as part of your mommy makeover.

What to Expect After the Surgery

Because procedures are performed together, the benefit is that you only have to endure one recovery time. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. After that, you'll probably be feeling pretty well, but you will not be able to do any heavy lifting (such as picking up your children) for six weeks.

What Are the Benefits

• Restores a more youthful bust and flat tummy
• Your clothes and swimwear will fit better
• Helps you return to a more youthful-looking body appearance

Plastic surgery after dramatic weight loss reduces excess skin and fat left behind after major weight loss. Its goal is to restore attractive proportions by removing the sagging skin around the face, neck, upper arms, breasts, abdomen, buttocks and thighs that creates a misshapen contour.

Botulinum toxin (Type A) is a cosmetic injection that blocks the nerve signals that cause muscles to contract. This effect relaxes and smoothes the look of lines and wrinkles caused by repetitive movements on the face—most commonly, between the brows, crows-feet around the eyes, and horizontal forehead creases. Botulinum toxin is also used cosmetically to balance facial asymmetry and relax tight neck bands, as well as medically to reduce perspiration and to treat migraine headaches and muscle spasticity.

When to Consider Botulinum toxin injections

• Deep lines between your eyes make you look tired, angry, sad, or upset.
• Your facial expressions cause wrinkles in and around your eyes and forehead.
• There is asymmetry in your eyebrows or face that can be corrected by relaxing a muscle.
• You suffer from migraine headaches and botulinum toxin may provide relief from this condition.

How is a botulinum toxin procedure performed?

• Botulinum toxin injections can usually be completed on the same day as the initial evaluation. They do not require hours to perform or days to recover. Once you and Dr. Stephan have decided on an appropriate treatment, he will prepare you and the medication for the procedure. The injection site will be cleansed and will usually not require anesthesia prior to injection. The needles used are very short and thin, causing minimal pain. Depending on your specific concerns and condition, a number of injections will be needed to achieve the desired result. Slight pain, short-lasting swelling, and minimal redness and bleeding will likely occur as a result of your procedure.
• In the hands of an experienced injector, such as a Dr. Stephan board-certified plastic surgeon, your procedure will seem simple and you will experience minimal discomfort. The injector's understanding of the muscles in the face and body is essential for a safe and successful procedure

What to Expect After the Injections

After the injections, you can return to your regular activities immediately; however, strenuous activity is discouraged for the remainder of the day. Redness and swelling that occur at the time of injection usually resolve quickly. Any bruising that might occur will usually resolve over a week or two.

What Are the Benefits

• Can help you appear less angry and more approachable.
• Make subtle changes that give you a refreshed or well-rested look.

Over time, the natural aging process can cause your breasts to sag and lose their shape. Pregnancy can also have similar effects on your breast tissue. A breast lift, or mastopexy, is a surgical procedure that reshapes and cosmetically alters your breasts. After a breast lift procedure you can expect improved shape, contour and lift to your breasts that restores a more youthful appearance.

When to Consider Fillers

• If you have deep lines around the eyes, brow or mouth
• If you would like to change the contours of your jaw or lips
• If you are interested in a minimally invasive procedure

Understanding the Surgery

Fillers are administered with a syringe to various areas on the face and head, including around the eyes, along the jaw, around the lips and in the forehead. The number, location and depth of the injections depend largely on the type of dermal fillers used and the desired results.

There are three types of fillers commonly used: temporary, semi-permanent, and permanent. Hyaluronic acid-based fillers are temporary, while other types of fillers offer longer-lasting results.

What to Expect After the Surgery

You will likely see the results of your injections immediately following the procedure, though it’s not uncommon for patients to experience swelling or minimal bruising in the area of the injection site. Your physician may give you an ice pack or cold compress to help stem swelling. The period of swelling will depend largely on the type of soft tissue filler you received, though most swelling, bruising, and redness should dissipate within one week to ten days.

One of the most enticing features of soft tissue fillers is their minimal recovery time. In the approximate week it takes for swelling and bruising to disappear, your doctor may advise you to avoid wearing hats or other headgear and only use small amounts of makeup.
 

What Are the Benefits

• Filler injections are quick and only require a topical anesthetic at most
• Results are immediate and there is little to no downtime
• Fillers provide a subtle look that can be adjusted to meet your aesthetic needs

A fat grafting procedure transfers fat from areas in which you have excess fat, such as the outer thighs, and injects it into areas that may be lacking in volume, such as your face, hands, breasts or buttocks. This safe, long-lasting, well-tolerated procedure produces natural-looking results.

When to Consider a Lipofilling

• If you have facial areas that appear creased and sunken
• If you desire more permanent correction than is provided by temporary fillers
• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate your hands and face
• For use in breast reconstruction, to fill in contour irregularities or hide obvious signs of breast implants

How is a Lipofilling procedure performed?

Fat is harvested from one part of your body, washed and purified, and then carefully reinjected with specially designed needles into the areas that need augmentation. It may be necessary to repeat the fat grafting procedure several times to achieve the desired result. Fat grafting can be explained as a three-stage process: (1) harvesting (2) purification and transfer and (3) placement.

Harvesting: You and Dr. Stephan will select a site for fat removal and will inject it with a local anesthetic. Dr. Stephan will then create a small incision in the area for fat removal and, using a sterile technique, insert a cannula connected to a syringe to carefully extract fat (liposuction).

Purification and transfer: Once enough fat is obtained from the donor area, your surgeon will process it to prepare the fat cells for transfer to small syringes that will be used for fat injection. Purification may require the use of a centrifuge to spin the fat or a filtration process to remove impurities.

Placement: The area designated to receive the graft will then be prepared. Dr. Stephan will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. Some surgeons recommend massaging the grafted areas to create a satisfactory contour. Others prefer to rely on the placement technique to create the appropriate contour. Dr. Stephan may also place a dressing or bandage over the grafted area.

What to Expect After the Injections

There is great improvement in most cases between the seventh and tenth days, but you may still not be ready to go out in public.

Once the swelling recedes, you will be able to appreciate the changes, but subtle swelling may persist for weeks.

What Are the Benefits

• Fat injection results are natural, long lasting and safe.
• Fat injection is a noninvasive method for achieving facial rejuvenation.

Platelet-Rich Plasma (PRP) is a facial rejuvenation procedure that is so cutting edge, it is still offered by only a few practices. Dr. Stephan is pleased to provide his patients with this innovative anti-aging technique that uses their own blood to restore a more youthful look to the face by promoting local tissue growth and repairing damaged tissue.

When to Consider a PRP

• If your goal is to achieve a more youthful, vibrant look
• If you want an overall facial makeover
• To treat dark circles, puffiness, and crow’s feet around your eyes
• To treat fine lines and wrinkles around your mouth
• To treat acne scars

How is a PRP procedure performed?

During PRP therapy, Dr. Stephan draws a small amount of your blood and places it into a sterile tube. The tube is then placed into a unique centrifuge machine, which separates your plasma and platelets from red and white blood cells.

Following this process, the PRP is applied using microneedling, or injected into the areas you want treated using a fine needle.

What to Expect After the Injections

You start seeing noticeable results from PRP therapy within a few days of treatment, but the best results can be seen within two to three months.

Results from PRP therapy can last between one and two years, depending on the individual’s skin condition and lifestyle habits. For instance, those who wear sunscreen, practice a good skin care regimen, and eat healthy, whole foods can get more from PRP therapy.

What Are the Benefits

• You don’t have to worry about your body rejecting treatment or experiencing allergic reactions.
• Recovery time is little to none
• Gaining a more youthful appearance with your own healing and growth factors