Lloyd B. Gayle, M.D.

Products And Services

• Facelift

  In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces and necks. Deep creases appear beside the mouth, the jaw line slackens and becomes jowly, and the neck develops loose folds and fat deposits. Facelifts counteract these signs of aging by tightening muscle, removing fat, and trimming excess skin, giving your face a fresher, youthful look. After surgery, some patients look 10-15 years younger. Facelifts, technically known as rhytidectomies (literally, “removal of wrinkles”), rejuvenate the mid- to lower face and neck. Facelifts are most effective for patients who want to correct: Midface sagging Deep creases under the eyes Deep creases between the nose and mouth (nasolabial folds) Jowls due to loss of muscle tone Sagging areas of fat Loose skin and fat under the chin and jaw Facelifts can produce a dramatic improvement in appearance for patients with the problems mentioned above. However, facelifts do not stop the aging process; in time, signs of aging will gradually appear once again. Further, facelifts will not rejuvenate the brow, eyelids, nose, and some of the midface. Patients who want to improve these areas may consider combining a facelift with a brow lift or eyelid surgery (blepharoplasty). Injectable soft-tissue fillers, facial implants and skin resurfacing can also enhance the effects of a facelift. CandidatesforFacelift The best candidates for rhytidectomy: Wish to improve one or more of the signs of aging indicated above Are men or women whose faces have begun to sag, but whose skin still has some elasticity Are generally healthy Do not smoke Have realistic expectations Are considering a facelift for personal reasons, not because someone else is pressuring them to do so During your consultation, Dr. Gayle will discuss whether a facelift is right for you. FaceliftProcedureTechniques Facelifts are typically outpatient procedures and may be performed in an office-based facility, surgery center or hospital. Patients may have a choice of IV sedation or general anesthesia. The procedure takes about two hours. The way a facelift is performed varies depending on the surgeon, the patient’s facial structure, and the extent of correction desired. The three most common incision techniques are: Traditional facelift: The “full” facelift for rejuvenating the face, jowls and neck, including fat sculpting, lifting and repositioning of muscle and deeper tissues, and skin trimming and redraping. The incision begins at the temples and travels down to the front of the ear, around the earlobe, and behind the ear to the lower scalp at the hairline. Sometimes, another incision is made under the chin. Limited-incision facelift: For limited rejuvenation around the eyes and mouth, including nasolabial folds and other deep creases. Short incisions are made at the temples and around the ear, and possibly in the lower eyelids and/or under the upper lip as well. Neck lift: A neck lift concentrates on jowls, loose skin on the neck, and fat under the chin. The incision is made around the ear lobe and behind the ear to the lower scalp. In all three methods, incisions are closed with stitches or tissue glue. Scars are hidden in the hairline and natural contours of the face. RecoveryfromFacelift After your rhytidectomy, Dr. Gayle will wrap the incisions in bandages and may place drainage tubes in the area. The tubes will be taken out the next day, when your hair will be carefully washed. If surgical clips are used to hold the incisions closed, they will be removed one week after the facelift along with your stitches. Many patients return to work by the third week. ResultsofFacelift Results of a facelift do not last forever. You may want to have another procedure in five or ten years. But in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had a facelift.

  Link: Facelift

• Browlift

  Browlifts can revitalize drooping or lined foreheads, helping you look less angry, sad or tired. Using either traditional or minimally invasive (endoscopic) methods, browlifts involve the removal or alteration of the muscles above the eyes to smooth lines and raise the eyebrows for a more youthful appearance. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.

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• Blepharoplasty

  Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty can be combined with BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes.

  Link: Blepharoplasty

• Otoplasty

  Otoplasty, or ear surgery, is a surgical procedure performed to correct large, protruding or otherwise deformed ears for a more proportionate appearance. Unlike most other plastic surgery procedures, otoplasty is most commonly performed on children, as the ears are typically finished growing by the age of four. Early treatment helps reduce teasing and any affect on self-esteem that large or misshapen ears may cause. Otoplasty may often be performed to correct ears damaged by an accident or injury. The results of the otoplasty procedure are permanent and scars will fade with time to become less noticeable.

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• Rhinoplasty

  One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done. Surgeons use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an “open” procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed. For a short time after surgery you may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.

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• Facial Implants

  Whether we notice it or not, full cheeks are often a part of how we judge a person’s face. Cheek implants can have a major impact on the appearance and self-confidence of a person whose cheeks have thinned or sunken due to age, illness or other causes. Likewise, the chin helps provide harmony to the facial features. Patients often seek a smaller nose when, in fact, a chin augmentation provides a balance to the facial features. Implant sizes and shapes to augment the cheek and chin areas are tailored to each patient’s desired appearance. The implants are placed during an outpatient procedure under local or general anesthesia, which usually takes less than an hour to perform. Dr. Gayle will make the necessary incisions in inconspicuous locations to allow for minimal scarring.

  Link: Facial Implants

• Scar Revision

  Scar revision is performed to reduce the appearance of scars caused by injury or previous surgery. Scars are by definition permanent, but surgery can narrow, fade and otherwise reduce the appearance of severe or unattractive scarring, which is especially helpful in areas of cosmetic importance such as the face and hands. There are many surgical methods of scar revision, only some of which may be appropriate for a particular type of scar or its location. These include surgical excision, skin grafts, flap surgery and Z-plasty (repositioning a scar so that it aligns with the face and is less noticeable). The effectiveness of scar reduction depends on a number of factors, including the nature of the injury, your body’s healing mechanism, the size and depth of the wound, how much blood supplies the area and the thickness and color of your skin.

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• Breast Augmentation

  Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. and one of our most popular services. Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast. Our patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under Dr. Gayle’s expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation. FullyCustomizedBreastEnhancement We know that every woman is unique in both her desires and her body shape. With that in mind, we take the time during the pre-operative consultations to learn what each patient hopes to gain from breast augmentation surgery and to decide which implant type and implant placement is best. In this way, every one of our patients enjoys completely customized treatment designed with her specific goals in mind. ComplementaryProcedures Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. SalineandSiliconeGelBreastImplants Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. Dr. Gayle will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle. After many years, the U.S. Food and Drug Administration (FDA) has approved silicone breast implants for breast augmentation surgery. We are proud to offer patients the option of silicone gel-filled breast implants, since they are much softer and feel more natural than saline-filled breast implants. BreastAugmentationSurgery–IncisionTechniques The breast augmentation procedure lasts one to two hours and is typically performed with general anesthesia. Incisions are made in inconspicuous places on the breast to minimize scar visibility. These may be located: In the armpit (transaxillary), In the crease on the underside of the breast (inframammary), or Around the areola, the dark skin around the nipple (periareolar). The breast is then lifted, creating a pocket into which the implant is inserted. Saline implants may also be placed endoscopically through an incision in the navel. This minimally invasive breast enhancement technique is known as a transumbilical breast augmentation or TUBA approach. BreastAugmentationSurgery–PlacementOptions Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery. Dr. Gayle will discuss which option may be best for you. In the TUBA procedure, implants cannot be placed beneath the chest wall. After the implants have been inserted and positioned beneath the nipples, the incisions are stitched closed, then taped and bandaged. In a few days, these bandages may be replaced with a surgical bra. Recovery Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. Stitches are removed in a week to 10 days after breast augmentation. Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars from breast augmentation incisions will begin to fade in a few months and will continue to fade for months or years. Complications Complications following breast augmentation surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant (implant rupture) as a result of injury or the normal compression and movement of your breast. If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water. If a silicone implant leaks, you will need to see a doctor immediately. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health.

  Link: Breast Augmentation

• Breast Lift

  A woman’s breasts may droop as a result of the natural effects of aging, heredity, gravity, pregnancy, breastfeeding, or weight loss. A breast lift, also called a mastopexy, is performed to return youthful shape and lift to breasts that have sagged or lost volume and firmness. Breast lifts rejuvenate the breasts by trimming excess skin and tightening supporting tissues to achieve an uplifted, youthful contour. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts can also reposition and reduce the size of the areola-the dark skin surrounding the nipple – which may have stretched or drooped. Mastopexy is usually performed on an outpatient basis under general anesthesia and lasts from 1 to 3 hours. Most patients are immediately satisfied with their new breasts and can typically return to work one to two weeks following the procedure.

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• Breast Reduction

  Large breasts can negatively impact a woman both physically and emotionally, causing symptoms such as chronic back pain, rashes, poor posture, low self-esteem and restricted activity. Many women seek treatment to reduce the painful effects of their large breasts, while also improving their self-confidence and overall quality of life. Also known as reduction mammaplasty, breast reduction surgery reduces the size of large, disproportionate breasts by removing excess fat, tissue and skin for a more desirable appearance and relief of physical and emotional symptoms. During the breast reduction procedure, the surgeon makes either two circular incisions around the nipple or an anchor incision that circles the nipple and extends down the breast and along the breast crease. Fat and glandular tissue is then removed, while excess skin is tightened to produce a smaller, natural-looking breast. In some cases, the nipple and areola may need to be removed and then repositioned higher on the breast. The results of a breast reduction are visible right away and will continue to improve as swelling and bruising subside. Scars will continue to fade over time, becoming less and less noticeable.

  Link: Breast Reduction

• Breast Reconstruction

  Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman’s natural breast as closely as possible in shape, size and position. Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives. The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia. There are several ways to reconstruct the breast, both with and without implants; Dr. Gayle will work together with you in deciding which is best for you.

  Link: Breast Reconstruction

• Gynecomastia

  Gynecomastia is a common condition that affects nearly half of all men, resulting in localized fat and/or glandular tissue in the breasts. For most cases of gynecomastia, the cause is unknown, but this condition may be linked to certain medications or diseases. Many men are embarrassed by this condition and seek treatment to achieve a smooth, contoured chest through male breast reduction. Male breast reduction may be performed using liposuction, surgery or a combination of the two, depending on the amount and type of tissue found in the breasts. If the breasts consist of mostly fatty tissue, liposuction may be used to suction out fat from an incision in the nipple or underarm areas. For breasts with an excessive amount of glandular tissue, excision surgery may be performed, which requires cutting away the excess fat, skin and tissue through a larger incision. Dr. Gayle will determine which technique is best for you based on your individual goals for surgery.

  Link: Gynecomastia

• Abdominoplasty

  An abdominoplasty (tummy tuck) tightens the abdominal walls and removes excess skin to create a flatter contour of the abdomen. This procedure is popular with mothers who have passed their childbearing years and is not recommended for women who may get pregnant in the future. Also, people who have undergone bariatric (weight loss) surgery are common subjects of tummy tuck surgery. Anyone who has difficulty reducing abdominal fat and increasing tone despite frequent exercise is a good candidate for this surgery. The abdominoplastyprocedure is performed under local or general anesthesia and begins with an incision along the bikini-line and the removal of the navel. Once the abdominal walls have been strengthened and repositioned, the skin flap is pulled down, stretched and cut for the new navel fixture. Supplemental liposuction can be used to smooth the transition between the new locations of the skin. The belly button is then reattached and all incisions sewn shut. The procedure is moderately invasive and requires several weeks of recovery before returning to work and even more time before exercise can be attempted. For the first week, patients should not lift any weight heavier than ten pounds. Patients are also advised to wear the compression garment fitted at the end of surgery as much as possible to reduce the swelling.

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• Liposuction

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

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• Body Contouring

  Body contouring after weight loss surgery can help reduce excess skin and fat, and also restore tightness and elasticity to the skin. After major weight loss, certain areas of your body may sag and appear misshapen, masking the changes your weight loss has provided. These areas, such as the face, neck, arms, breast, abdomen, buttocks and thighs, can be easily improved through multiple procedures that will lift and sculpt your new and improved body. Known as a body lift when combined together, you can pick and choose which procedures you would like to help achieve the look you desire.

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• Hand Surgery

  Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best. Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma.

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• Microsurgery

  Microvascular surgery or microsurgery is a modern surgical technique that allows surgeons to operate on tiny blood vessels and organs. Using microscopes, highly precise instruments (some were adapted from jewelers’ tools) and surgical techniques developed in the last 50 years, microsurgeons can perform a variety of delicate procedures, including tissue transplantation (“free flaps”), replantation (re-attachment of amputated body parts), treatment of vascular disease, and nerve repair and grafting.

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• BOTOX® Cosmetic

  BOTOX® Cosmetic is a highly purified protein injected into the skin to relax the muscles that cause some kinds of wrinkles. While BOTOX® can treat certain medical conditions, such as excessive sweating, it is most commonly used for cosmetic purposes, primarily to reduce wrinkles on the face and neck. BOTOX® injections are relatively painless, as the needle used is significantly smaller than those used for other injectable fillers. The best candidates for BOTOX® are men and women seeking an enhanced appearance with fewer wrinkles. In addition, it is important that those seeking treatment are in good physical health, are not pregnant or nursing, and do not have a neuromuscular disorder. People seeking BOTOX® injections should have realistic expectations regarding this procedure’s abilities and should discuss their desired goals with Dr. Gayle beforehand.

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• Dermal Fillers

  When you smile, laugh, frown, or look puzzled, you contract the muscles of your face. Over time, these contractions produce permanent furrows and deep wrinkles in the skin, especially around the eyes and mouth, between the eyebrows, and on the forehead. These lines can make you look older, sad, angry or tired. Dermal fillers can not only prevent you from deepening these lines during natural facial movements, they can also erase these marks of aging, leaving you looking younger and refreshed. Dermal fillers are FDA-approved and safe for use by most patients. Many of the fillers are made from substances found naturally in the body, or synthetically made to mimic natural substances or stimulate collagen production. These fillers are injected directly into the skin of the targeted area to restore volume and reduce the appearance of fine lines and wrinkles. Dr. Gayle offers patients several different dermal filler options in order to provide the best possible results for their individual needs, including: Juvéderm® Injectable Gel Restylane® Radiesse® Sculptra® Aesthetic

  Link: Dermal Fillers

• Microdermabrasion

  Microdermabrasion improves mild to moderate sun damage, scarring, wrinkles and other superficial skin problems. A gentle stream of tiny particles exfoliates the outer layer of skin and provides a fresh, glowing, younger appearance. Only a small amount of skin is removed, so sensitive areas such as the face, chest, neck, arms and hands can be treated. Results are comparable to a light chemical peel and should be immediately visible. Microdermabrasion is often performed in conjunction with other skin renewal procedures, such as laser treatment and chemical peels. Multiple treatments are recommended for full effect.

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• Chemical Peel

  Chemical peels remove damaged outer layers of skin on the face to smooth texture, reduce scarring, and remove blemishes to produce healthy, glowing skin. There are three types of chemical peels, ranging from mild to strong – alphahydroxy acids (AHAs), trichloroacetic acid (TCA) and phenol – and formula strengths are tailored to each patient. Peels can be combined with other procedures such as facelifts for a younger look.

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• Laser Skin Rejuvenation

  Laser skin rejuvenation is a popular treatment option for restoring aging skin to a smoother and more youthful appearance. This term includes several different noninvasive techniques used to treat wrinkles, sagging skin, brown spots, enlarged pores and more. Different types of laser treatments are used to treat different skin conditions. Some of the most commonly used procedures include: Intense pulsed light (IPL) – Light therapy that penetrates deep in the skin and does not injure the surface, best used to improve skin texture and color Photodynamic therapy (PDT) – Two-part procedure that makes the skin more sensitive to light and then uses the light to reduce redness, age spots and freckles with minimal downtime Non-ablative laser rejuvenation – Used for early signs of aging and requires no downtime Ablative laser resurfacing – Heats the skin to reduce deep wrinkles and other signs of aging, but causes a visible wound that requires healing Results from laser treatments are usually not immediate and can take several months to appear. Several sessions may be needed in order to reach the patient’s desired results, but laser techniques are often effective in completely eliminating age spots and other concerns.

  Link: Laser Skin Rejuvenation