The focus of Dr. Choi’s New York City practice is face, breast and body plastic surgery. Dr. Choi performs many of the latest breast surgeries including breast reduction with lollipop short scar technique, breast lift with minimal incision technique, and breast augmentation with cohesive silicone implants. As an experienced microsurgeon, Dr. Choi offers various breast reconstruction techniques after mastectomy using implants or autologous tissue such as DIEP flaps. Dr. Choi also performs body contouring surgeries including abdominoplasties, liposuctions, body and thigh lifts. She approaches each patient individually and customizes her surgery to the patient’s need, physique, and desire. She also has a Certificate in Hand Surgery and performs various hand surgeries.
Keywords Body Plastic Surgery, Breast Plastic Surgery, Face Plastic Surgery.
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Dr. Mihye Choi graduated from University of Rochester School of Medicine in 1987 and received general surgery training at Harvard Beth Israel Hospital. She completed plastic surgery residency at Mount Sinai Hospital, a research fellowship at Massachusetts General Hospital in Boston and a hand surgery fellowship at NYU Medical Center. She joined the Faculty at the Institute of Reconstructive and Plastic Surgery at New York University School of Medicine in 1998. Dr. Choi is certified by the American Board of Plastic Surgery since 1998. The focus of Dr. Choi’s New York City practice is face, breast and body plastic surgery. Dr. Choi performs many of the latest breast surgeries including breast reduction with lollipop short scar technique, breast lift with minimal incision technique, and breast augmentation with cohesive silicone implants. As an experienced microsurgeon, Dr. Choi offers various breast reconstruction techniques after mastectomy using implants or autologous tissue such as DIEP flaps. Dr. Choi also performs body contouring surgeries including abdominoplasties, liposuctions, body and thigh lifts. She approaches each patient individually and customizes her surgery to the patient’s need, physique, and desire. She also has a Certificate in Hand Surgery and performs various hand surgeries. Dr. Choi’s current research interests include using three dimensional imaging to accurately calculate breast volumes for reconstruction and other types of breast surgery. She is investigating a vertical incision design for breast reconstruction to shorten the length of scars. Dr. Choi is involved in studies to improve breast reconstruction with fat injections. She is also studying anesthetic techniques to reduce pain and shorten the recovery period associated with breast and body surgery.
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Brachioplasty, commonly known as an arm lift, attempts to procure a more natural and youthful look by removing the fat and excess skin hanging down from the underarms. This is most commonly requested by aging women, but some men opt to have this procedure as well. An arm lift is often performed on post-bariatric surgery patients who have lost huge amounts of weight in a short amount of time. The procedure helps to relieve patients’ self consciousness in wearing short sleeves or otherwise showing their arms. The Arm Lift (Brachioplasty) Procedure During the arm lift procedure, the incision is made beneath the arm and can extend from the elbow to the armpit, varying upon how much skin must be removed. The skin is then cut away from the rest of the arm and pulled taut around the extremity. This procedure is very likely to leave a scar that could be noticeable. Most doctors can adjust where they make their incision so that the cut runs either underneath the arm or on the inside surface. These are less visible in normal poses and can improve over time as the scar fades. However, most patients need to be firmly aware that they are essentially trading “skin for scars” with this procedure. Recovery From an Arm Lift The initial recovery time for this procedure is short, as the patient may return to light work within a week or less. However, exercise must remain off limits for two weeks. The results will be immediately obvious, but will show apparent improvement over the next two weeks as swelling subsides. The scars will heal and mature over the next six months, possibly fading from sight entirely.
Also called belt lipectomy, torsoplasty and panniculectomy, the circumferential body lift is performed to remove excess skin from the torso and upper legs. Candidates for Body Lifts Candidates for body lifts typically suffer from loose (inelastic) skin on many or most areas of the body as a result of age, childbearing or significant weight loss due to diet, exercise or bariatric surgery. Because of this, the procedure is often combined with others such as breast lifts, arm lifts and liposuction to retain a proper body proportion. Body lifts tighten and tone the abdomen, back, buttocks, hips and thighs. The Body Lift Procedure During the procedure, skin is lifted from underlying tissue, muscles are tightened and stitched, fat is removed where necessary, and the skin is sutured closed. The navel is often removed and replaced in its new position. Surgical tubes may be needed for a few days to drain any fluid, and patients may need to wear compression garments for a few weeks to facilitate faster healing. After the Body Lift Procedure After surgery, patients are encouraged to walk as soon as they are able to, although strenuous activities must be limited for about a month. Results are visible immediately.
A thigh lift is performed to tighten the skin around the inner thigh to form a more aesthetically pleasing frame. The outer thigh is generally not targeted in a thigh lift as liposuction and a butt lift tend to produce better results in that area of the leg. The Thigh Lift Procedure This procedure requires a surgical incision of varying size based on how much skin must be removed. The location of the incision is usually on the medial side of the thigh and can be adjusted based on clothing preference or overall reduction of visibility. After the Thigh Lift Procedure After surgery, the patient is dressed in a compression garment to limit swelling. Discomfort is generally minimal in smaller lifts, but when large amounts of skin are removed, an overnight stay in the hospital may be required. In either case, pain medication and anti-inflammatory methods will be utilized. Light labor is normally possible after less than two weeks, while most physical activity is permissible at four to six weeks. All symptoms should be gone and scars maximally faded within six months.
Abdominoplasty, often called a “tummy tuck,” is a popular procedure used to flatten and shape the abdomen by removing excess fat and skin and tightening muscles. Dr. Choi has been performing tummy tucks in Manhattan with excellent cosmetic results for many years. Patients love the look of their new flat stomachs after surgery under our doctors’ exceptional care. Who is a good candidate for a tummy tuck in Manhattan? The best candidates for a tummy tuck are in good physical condition with pockets of fat or loose skin that haven’t responded well to traditional diet and exercise. This procedure can also benefit older, slightly obese people whose skin has lost some of its elasticity. Tummy tucks can also be useful for women with stretched skin and muscles from pregnancy. Results from the tummy tuck procedure will likely diminish if women continue to bear children, so we advise patients who plan to become pregnant to consider postponing this procedure until they are done having children. We also encourage patients who intend to lose a lot of weight to wait before undergoing the procedure, since skin in the abdominal area typically loosens after substantial weight loss. Customized Treatment for Optimal Cosmetic Results We take the time during every pre-operative consultation to learn what patients want to achieve from a tummy tuck both for their bodies and for their self-confidence. By listening to what patients have to say and closely examining them rather than performing a one-size-fits-all procedure on every person, we provide patients with a completely customized treatment that takes into account their specific goals. Our New York City Tummy Tuck Procedure Tummy tucks take approximately two to three hours and are performed under general anesthesia. This procedure may be performed on an in-patient or outpatient basis, depending on the complexity of your surgery and your doctor’s recommendation. Your New York City plastic surgeon will make two incisions: one from hipbone to hipbone close to the pubic area, and another around the navel. He or she will separate the skin from the abdominal muscles, which are then pulled together and stitched into place for a firmer abdomen and narrower waist. The skin flap is then stretched down and over the newly tightened muscles, excess skin is removed, and the navel is reattached in a natural position. Finally, your surgeon will close the incisions and apply sterile surgical dressings over the sutured areas. Recovery after Tummy Tuck After surgery, compression garments are worn and a temporary tube may be inserted under the skin to drain excess fluid from the surgical site. Recovery time ranges from two weeks to a few months. You should limit strenuous activities for at least six weeks, and may need to take off from work for up to two weeks. Your doctor will give you specific instructions for your individual recovery. Following these instructions can help speed up your recovery and reduce the risk of any post-surgery complications. Tummy Tuck Results A tummy tuck leaves patients with a flatter, more toned abdominal area that fits the natural contours of your body. It can improve a patient’s appearance and confidence by helping them look and feel younger and slimmer. The results of this procedure are visible right away and will continue to improve. With a balanced diet and regular exercise, results are long-lasting. Scars will fade with time, leaving your stomach sleeker and more defined than ever before. p 583036a A tummy tuck will leave a scar spanning the lower abdomen from hip to hip. We are very careful to make the incision low enough for even a bikini to conceal the scar. Risks of a Tummy Tuck Though rare, post-operative complications from any surgical procedure are possible. They may include infection, blood clots, and poor healing, which may require further surgery. Patients who have had previous abdominal surgery should know that their old scars could be raised, stretched or generally more noticeable after the tummy tuck procedure. A scar revision procedure after a tummy tuck can help minimize the appearance of unsightly scars. Partial Abdominoplasty (Mini Tummy Tuck) Partial abdominoplasty, or “mini tummy tuck”, is similar to the regular tummy tuck procedure, except it involves a shorter incision and the skin is only lifted to the navel, which does not have to be moved. This procedure is ideal for patients who need just a little improvement in order to reach their desired results. You can discuss the differences between these procedures, as well as weigh their benefits and risks with your doctor in order to decide which procedure is best for you. Contact Us for more information about a Tummy Tuck in New York City
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Liposuction is a minimally invasive cosmetic procedure used to remove localized areas of fat from the body through a small thin tube called a cannula. The fat from the targeted area is suctioned from the body through this tube to help patients achieve a slim and balanced appearance. While the conventional liposuction procedure was effective in removing excessive fat deposits, it was a painful procedure that involved suctioning out large areas of solid fat. New technology has allowed for different techniques that improve the accuracy and reduce the pain associated with this procedure. Today, liposuction is usually performed via the tumescent technique. This new technology has transformed liposuction into a much safer and less invasive procedure. Click here to view our Liposuction photo gallery Candidates for Liposuction The ideal candidate for liposuction is someone who is in good overall health and maintains a healthy life, but has one or more problem areas with unresponsive fat deposits. It is also important for patients to have realistic expectations, and remember that liposuction cannot be used as a means for major weight loss. It is instead used to remove localized areas of stubborn fat after the patient has attempted other natural weight loss methods. Liposuction can be used to treat localized fat deposits within the: Abdomen Ankles Arms Back Buttocks Calves Chest Face Hips Thighs This procedure may be performed alone, or can be combined with other cosmetic procedures, such as a facelift, breast reduction or tummy tuck, to achieve maximum results. Our New York City Liposuction Procedure There are several different techniques currently available for patients seeking liposuction treatment. New technologies have improved the accuracy of this procedure for both patient and doctor, and allow patients to achieve their desired results through a much less invasive procedure. Liposuction is performed through a tumescent technique. Liposuction is performed on an outpatient basis under local anesthesia with sedation. Dr. Choi will make several tiny incisions and inject a local anesthetic into the area to help expand and firm the fat, making it easier to remove. The cannula is then inserted through the incisions to suction out the fat. No stitches are needed after liposuction since the incisions are small enough to heal on their own. Liposuction Recovery and Results After the liposuction procedure, patients may experience mild swelling, bruising and discomfort in the treated area. Compression garments or elastic bandages may be used to help reduce these symptoms while the area heals. Patients can return to work and other regular activities as soon as they feel comfortable, which is usually after a few days. Exercise and other strenuous activities should be avoided for a few weeks. Dr Choi will give you special instructions on how to care for your treated area and reduce any complications after the procedure. The results of the liposuction procedure may not be visible until after swelling and bruising subside. This may take several months, and results will appear gradually throughout this time. The results of liposuction can be permanent, as long as patients maintain a healthy and active life. If substantial weight is gained after this procedure, the results may be altered. Liposuction Risks Although liposuction is considered safe, there are certain risks associated with any type of procedure. Some of these risks may include infection, scarring, allergic reactions, hematoma or unsatisfactory results. Liposuction is one of the most commonly performed cosmetic procedures and is almost always performed with no serious complications. You can minimize potential risks by choosing an experienced doctor and by following his/her instructions before and after your procedure. To learn more about the liposuction procedure, we encourage you to call us today and schedule a consultation. Contact Us for more information about Liposuction in New York City.
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What Is A Breast Lift? Breast lift, also known as mastopexy, is a surgical procedure performed to raise and reshape breasts that have sagged as a result of aging, pregnancy, weight loss, gravity or other factors. By trimming excess skin and tightening supporting tissue, patients can achieve an uplifted, youthful breast contour. After surgery, the breasts are higher on the chest and firmer to the touch. The nipple and areola can also be repositioned or resized during this procedure to further enhance the appearance of the breast. Since a breast lift does not change the shape or fullness of the breasts, many patients choose to combine this procedure with a breast augmentation or reduction in order to achieve their desired results. Am I A Candidate For A Breast Lift? A breast lift is a safe and effective procedure for many women seeking to enhance the appearance of their drooping breasts, although there are certain restrictions on eligibility. The ideal candidates for a breast lift are women with: Sagging breasts Breasts that have lost shape or volume Breasts that are flat or elongated Nipples or areolas pointing downward One breast lower than the other In addition to sagging breasts, it is also important for women considering this procedure to be in good overall health, maintain a stable weight and have realistic expectations for surgery. It is recommended that women still planning to have children postpone this procedure, as pregnancy and nursing can counteract the effects of a breast lift. Breast Lift Procedure This procedure is performed on an outpatient basis under general anesthesia and usually takes one to three hours. Depending on the size and shape of the breasts, as well as the degree of sagging and amount of excess skin, your surgeon will determine an appropriate incision approach for the procedure, which may include: Two rings around the areola in a doughnut shape, which is ideal for women with small breasts and minimal scarring Around the areola and down to the breast crease in a lollipop shape A lollipop shape with an additional incision along the breast crease for an anchor shape, ideal for breasts with significant sagging After the incisions are made, breast tissue is removed and reshaped to achieve the desired breast contour. The nipple and areola may be moved higher on the breast or resized as well. Finally, any excess skin is trimmed to create a tighter, more defined appearance. When the breast lift is complete, the incisions are closed with stitches and tend to heal well. What Is Recovery Like? After a breast lift, patients will likely experience bruising, soreness and swelling for a few days. Most likely, patients may feel pain or soreness around the incision area. Numbness in your breasts and nipples is also normal and may last for several weeks. Dr. Karp or Dr. Choi will walk you through and concerns you may have to create a quick and painless recovery. The breasts will likely be wrapped in an elastic bandage or a surgical bra for about a week, followed by a support bra worn continuously for a month. Any stitches will be removed after one or two weeks. Most patients will be able to return to work within a week, although exercise and other strenuous activity should be avoided for about a month. Your surgeon will provide you with specific instructions for your individual recovery. How Long Does A Breast Lift Last? The results of a breast lift are visible immediately after surgery and will continue to improve as swelling subsides and scars fade. Most patients who maintain realistic expectations and thoroughly discussed their goals prior to surgery are satisfied with the look of their lifted breasts. While results are not permanent, they will allow patients to enjoy a younger-looking appearance for many years to come. Are There Any Risks Involved? Although a breast lift is considered a safe procedure for ideal candidates, there are certain risks associated with any type of surgical procedure, which may include bleeding, infection, reaction to anesthesia or permanent scarring. These risks can be reduced by choosing an experienced surgeon to perform your procedure and by following the surgeon’s instructions before and after treatment.
What is Breast Reconstruction? Breast reconstruction is a surgical procedure commonly performed after a mastectomy to offer patients psychological and aesthetic benefits when recovering from breast cancer. This procedure allows many women to fully return to the life they enjoyed before being diagnosed with breast cancer, with barely any signs of the disease remaining. Although the treatment of cancer is the main focus for both patient and doctor, restoring your appearance after breast cancer can often help ensure a complete recovery of body and mind. For many women, breasts are an important symbol of femininity that helps define their self-confidence and body image. The emotional affects of an altered appearance can be as psychologically damaging as the initial cancer diagnosis. Breast reconstruction serves to restore a woman’s body to its original condition after the treatment of breast cancer. Most of the aesthetic changes caused by breast cancer treatments such as a partial or simple mastectomy can be significantly helped by breast reconstruction. Types Of Breast Reconstruction There are two basic types of breast reconstruction: those that use a breast implant to replace the removed breast tissue, and those that use skin and fat from another area of the body (known as autologous tissue). With both procedures, there are several different modifications that can be made to best suit the individual patient’s needs. Breast Reconstruction Procedure Implant-based breast reconstruction is performed similar to a breast augmentation, with the use of a silicone or saline-filled implant to replace breast tissue. A breast implant requires coverage with the patient’s breast skin, some of which may have been removed during the mastectomy. If additional skin coverage is needed, it can be provided by using a tissue expander to stretch the remaining breast skin and muscle over a period of several weeks. When the expander is fully inflated, a second outpatient operation is performed to remove the tissue expander and place a permanent implant. The permanent implant most commonly is filled with silicone gel, but saline filled implants are also available. In some cases the implant reconstruction can be done in one stage, without needing to place the tissue expander. Drs. Karp and Choi will decide which technique is best for each individual patient during the initial consultation. Skin taken from the patient’s back can also be transferred to the breast area to cover the implant. Autologous tissue-based breast reconstruction uses a flap of the patient’s own skin and fat from another part of the body, with or without the underlying muscle, which is transported to the chest to create the reconstructed breast. This flap may remain attached to its original blood supply or can be reattached to another part of the body. There are several different types of flaps that can be used during breast reconstruction depending upon the condition of the breast area after the mastectomy. The most common technique for using the patient’s own tissue in breast reconstruction is called the DIEP (or tummy tuck) Flap. In this operation excess skin and fat from the lower abdomen is transferred to the mastectomy site and used to sculpt a new breast. No muscle is taken. Drs Karp and Choi specialize in this procedure. They have incorporated all of the latest technology in the preoperative planning of this surgery. This includes 3D imaging of the breast to very accurately define the anatomy of the breast and CT angiography to define the blood vessel anatomy. These techniques have resulted in better surgical outcomes in less operative time. Almost all mastectomies are performed with a skin-sparing techniques. In some cases, nipple and/or areola sparing mastectomies are performed. The type of incision that is used is made by the breast oncologic surgeon in consultation with the plastic surgeon. Can The Opposite Breast Be Treated During The Same Procedure? If a mastectomy has only been performed on one breast, the ideal reconstruction procedure would only require shaping and sculpting of the affected breast. However, many women need both breasts to be modified in order to achieve symmetric breasts. Dropping (ptotic) breasts are often hard to match in appearance during breast reconstruction, so both breasts can be treated during one procedure to reduce costs and recovery time for patients. During breast reconstruction, the opposite breast is often shaped with a breast lift to achieve symmetry. This procedure lifts the breast to reduce drooping and match the newly reconstructed breast. Scars from a breast lift are usually around and below the areola and can be easily concealed. Breast reduction may be needed for women with larger and ptotic natural breasts.
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Male breast reduction effectively decreases the size of enlarged male breasts, helping patients feel more comfortable and confident both physically and emotionally. What Is Gynecomastia? Gynecomastia is an overdevelopment of male breasts that, while not a serious medical condition, may be painful and can significantly affect a man’s self-esteem. Men with large or sagging breasts may feel uncomfortable with their body, especially in social situations, often restricting themselves from certain activities because they feel self-conscious about their breast size. Although not often discussed, gynecomastia is a common condition that affects 40 to 60 percent of men, frequently with no known cause. In some cases, gynecomastia may be associated with certain medications, medical conditions or as a result of a hormonal imbalance. Fortunately, regardless of the cause, any man who feels uncomfortable with his large breast size can find relief in Drs. Karp and Choi’s advanced male breast reduction procedures, which remove fat and/or glandular tissue from the breasts to create a contoured chest that is flatter and firmer. Optimal results are achieved when this procedure is performed on healthy men with firm, elastic skin that will reshape well to their body’s new contours. Like any other cosmetic procedure, it is important for patients to have realistic expectations in order to be satisfied with their results. Drs Karp and Choi will discuss the expected results and techniques to be used with you during your pre-surgical consultation. Male Breast Reduction Male breast reduction surgery is usually performed under anesthesia on an outpatient basis. The surgery typically takes one to three hours. Several techniques can be utilized in male breast reduction, depending on the extent of the procedure. If the enlarged breasts are primarily caused by excessive fatty tissue, liposuction can be performed through tiny incisions to remove the excess fat. The incisions may be made around the edge of the areola (the area around the nipple) and/or in the underarm. If excess glandular tissue is the primary cause of the enlarged breast, the tissue will be excised, or cut out, in addition to liposuction. In more extreme instances, when large amounts of fat or glandular tissue have been removed, excess skin may remain that has not been reshaped well. In these cases, the excess skin may have to be removed as well. The incisions are then closed using sutures and are usually covered with a dressing. A drain is often used in these cases. Drs. Karp and Choi determine the best technique for each individual patient after a thorough evaluation. Recovery from Male Breast Reduction Following male breast reduction surgery, patients will experience some bruising, swelling, and discomfort. This discomfort usually dissipates after a few days and can be reduced with prescribed medication. To help reduce swelling, an elastic pressure garment should be worn for about a month. Swelling and any skin discoloration will partially subside after a week or two, at which time stitches will be removed. You will be encouraged to walk around on the day of your breast reduction surgery and can expect to return to work in approximately one week. You may also begin light aerobic exercise after a week, but you should avoid strenuous activities for about three to four weeks following the surgery. Drs Karp and Choi take special precautions to help patients experience a shorter and more comfortable recovery. The results of the breast reduction procedure are visible immediately after surgery and will continue to improve as swelling subsides. Most of our patients experience a renewed sense of self-confidence in their smooth, flat chest. Any man who feels insecure about his enlarged breasts does not need to suffer any longer. Call us today to find out about male breast reduction.
Breast augmentation is one of the most frequently performed cosmetic surgery procedures in New York City, 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 Manhattan 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. Choi’s expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation. Fully Customized Breast Enhancement in NYC 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 preoperative 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. We use the latest 3D technology to simulate the surgery and show you what the result is most likely going to look like. Dr. Choi is a pioneer in 3D imaging technology and is one of the first to have this technology available to patients. Complementary Breast Procedures Breast augmentation can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining breast augmentation with other procedures such as a breast lift for more satisfying results. Saline and Silicone Gel Breast Implants Breast implants are silicone shells filled with either saline (salt water) or silicone gel. Both implant types are very safe, and each offers its own advantages. We will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue(rarely) or the chest wall muscle most commonly. 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. Breast Augmentation Incision Techniques The breast augmentation performed by our New York City plastic surgeons 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. Breast Augmentation Placement Options Implant placement beneath the muscle of the chest offers a few advantages over placement beneath the breast tissue. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantage includes elevated pain in the first few days following surgery. We will discuss which option may be best for you. After the implants have been inserted and positioned, the incisions are closed, then taped, and small bandages placed. A surgical bra is sometimes used for support. Click here to view our breast augmentation photo gallery Recovery from Breast Augmentation Procedure 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. Sutures are usually absorbable. 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. Breast Augmentation 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 and your body will absorb the salt water. If a silicone implant leaks, you will need to see your doctor. Regular monitoring of breast implants after breast augmentation is recommended to ensure continuing breast and implant health. Contact Us for more information about Breast Augmentation in Manhattan.
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What Is A Brow Lift? Brow lifts can revitalize drooping or lined foreheads, helping you look less angry, sad or tired. Using either traditional or minimally invasive (endoscopic) methods, brow lifts 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. While brow lifts are typically performed on patients aged 40-60 to counteract the effects of aging, anyone with lined or inelastic skin on the forehead – whether it’s caused by muscle activity or inherited conditions – are eligible. The procedure is usually performed in an office-based facility or surgery center under local anesthesia and sedation. If you aren’t sure that you want a brow lift, try standing in front of a mirror and placing the palms of your hands to the sides of your eyes above the eyebrows. Then pull the skin back from the eyes, raising the forehead. This is approximately how the procedure will make you look. The Brow Lift Procedure Brow Lifts may be performed in one of two ways: with conventional methods, in which the incision is hidden beneath the hairline (for patients with thinning hair, who are bald or who have had previous surgery in the area, the incision will likely be moved somewhere less conspicuous); or with an endoscope, in which a tiny camera and instruments are inserted through a few small incisions. Both techniques produce similar results. You and your surgeon will discuss which option is better for you. Note: Patients with very short hair may want to let it grow before surgery to better camouflage the healing scar. Traditional Brow Lift First, the patient’s hair is tied with rubber bands near the incision site. Then the surgeon makes a coronal (headphone-shaped) incision behind the hairline, stretching between the ears and across the top of the forehead. The incision may be placed further back or made along the skull bone joints to minimize visibility in patients with thinning hair or who are bald. Then the forehead skin is lifted, tissue is removed, muscles are adjusted and the eyebrows may be lifted. Excess skin is trimmed and the incision is closed with stitches or clips. The site is washed and the rubber bands are removed. Some surgeons will protect the stitches with gauze or bandages. Endoscopic Brow Lift After the hair is tied as with the traditional procedure, the surgeon makes three to five short incisions (less than an inch long) behind the hairline. The endoscope is placed in one so the surgeon can see beneath the skin without having to make a large incision, while he or she lifts the skin and adjusts muscles through the other incisions. If the eyebrows are lifted they will be stitched or screwed (temporarily) into place. The site is washed and the rubber bands are removed. Some surgeons will protect the stitches with gauze or bandages. What to Expect After the Brow Lift Procedure Traditional surgery patients may experience some numbness and discomfort at the incision. Numbness could be replaced by itching, which will subside within six months. Your head may need to be elevated for two to three days to reduce swelling. Bandages are removed in one to two days, and stitches or clips are taken out in two weeks. Hair near the incision may fall out or thin, but normal growth should return within weeks or a few months. Endoscopic surgery patients may experience some numbness, discomfort and swelling around the incisions, though there is less itching than with traditional surgery. Stitches or staples are removed in a week; temporary fixation screws are taken out within two. With both procedures, you will be on your feet and able to wash your hair in a day or two, and many patients return to work or school in 7-10 days or less. Swelling and bruising should fade by the third week. Complications are rare and usually minor but may include temporary numbness, nerve injury, hair loss along scar edges, formation of a broad scar requiring surgical correction, and infection and bleeding.
Ear surgery typically serves two functions: setting prominent ears back closer to the head, and reducing the size of large ears. Surgery may also be helpful for “lop ear,” “cupped ear” and “shell ear,” large or stretched earlobes, and lobes with large creases and wrinkles. Surgeons are also able to construct new ears for patients who are missing them from injury or other causes. Although surgery for adults is available, the operation is most often performed on children aged four to 14 — ears are almost fully grown by age four, and early surgery can prevent a child from being teased in school. Otoplasty lasts from two to three hours and may be performed in a hospital, office-based facility or an outpatient surgery center. General anesthesia is recommended for very young patients, while local anesthesia and a sedative are used for older children and adults. During surgery, a small incision is made behind the ear, revealing the cartilage which is then sculpted, bent into its new position and stitched into place. In some types of otoplasty skin is removed but the cartilage is left in one piece and merely bent back on itself for a smaller-looking ear. A bandage is wrapped around the head to ensure the new positioning. To achieve better balance, both ears may be operated on even if only one has a problem. Patients of all ages usually feel back to normal after a few hours, although the ears may ache or throb for a few days. Bandages are replaced with a surgical dressing after a few days, and stitches are removed within the week. Adults often return to work in five days and children may return to school in seven. Otoplasty leaves a faint scar on each ear that fades with time. You should not expect your new ears to match exactly; even normal, natural ears are not identical. Complications are rare and usually minor, but may include blood clots and cartilage infection (usually treatable with antibiotics but occasionally requiring surgery). Restylane® Restylane is a biodegradable gel used by dermatologists in injections targeted at smoothing out wrinkled skin. Restylane is primarily composed of hyaluronic acid, a natural substance occurring within the body. This compound is also the only FDA approved dermal filler on the market for use in treating wrinkles. In addition, not only does the injected volume of Restylane add fullness to skin, but it also attracts water molecules to the site of injection, further enhancing its effectiveness. While inside the body, Restylane provides longer lasting results that are apparent almost immediately after injection, although it may take a day or two before natural body processes and swelling subside. A follow-up appointment will be scheduled for a later date (4-8 months) for another set of injections to further prolong the effect. There are very few complications associated with Restylane. The compound itself is derived from bacterial origins, so most allergies should not be an issue (unless specific to bacterial proteins). The side effects are minimal and will not interrupt daily routine. These may include: Slight redness Minor swelling Mild discomfort These will all subside within three days or less as your body adjusts to the new hyaluronic acid. Consequently, the suggested recovery period of Restylane treatment is just under three days. It is advised to refrain from rubbing or massaging the treated area for approximately 48 hours.
Eyelid surgery, also called an eyelid lift or blepharoplasty, can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and/or lower eyelids. Eyelid surgery may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient’s field of vision. What can eyelid surgery do for me? Blepharoplasty is ideal for the correction of: Loose, sagging and/or folded upper eyelids that may limit vision Puffy fat deposits in the upper eyelids Under-eye bags Sagging lower eyelids that may show the white of the eyes below the iris Excess skin in the lower eyelids Fine wrinkles in the lower eyelids What won’t blepharoplasty correct? Blepharoplasty cannot raise the eyebrows or reduce the appearance of deep wrinkles, crow’s feet or dark circles under the eyes. However, eyelid lifts can be combined with other procedures such as brow lifts, BOTOX® Cosmetic treatments and laser procedures to achieve these results. Am I a good candidate for an eyelid lift? The best candidates for blepharoplasty: Are generally healthy Do not smoke Have realistic expectations Do not have any serious eye conditions Your doctor will talk to you about whether you are a good candidate for eyelid surgery. How is blepharoplasty performed? Eyelid surgery is usually performed in an office, usually with local anesthesia and IV sedation. The procedure can take less than 45 minutes. Incisions are made along the eyelids in inconspicuous places: in the natural creases of the upper lids for upper eyelid blepharoplasty and just below the lash line on the lower lids for lower eyelid blepharoplasty. If no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars. In all cases, the surgeon then removes excess skin from the eyelids using a scalpel, laser or radiofrequency (RF) tool. Fat may be removed as well. He or she then closes the incisions with fine sutures, tissue glue or surgical tape. What is recovery from eyelid surgery like? Bruising, swelling and a sense of tightness in the eyelids are common after eyelid surgery. These should subside within 2-4 weeks. Most patients resume activities in 3-5 days, when non-absorbable stitches are removed, and return to work in about 10 days. By one to two months after surgery, you should see the true results of your eyelid lift: a more awake and cheerful look around the eyes, and greater self-confidence. Contact lenses may not be worn for two weeks. Eyes can be sensitive to light and wind and may be slightly irritated for a short while; your surgeon may prescribe eye drops and cool compresses to ease any discomfort. What are the risks of eyelid surgery? Complications from blepharoplasty are uncommon, but can include infection, reaction to anesthesia, dry eyes, double or blurred vision for a few days, temporary swelling of the eyelids, tiny whiteheads, and difficulty closing eyes when going to sleep. Uneven healing and scarring, and ectropion (pulling down of the lower lids) are very rare and may require surgical correction. Patients with thyroid problems, dry eye, high blood pressure, diabetes, detached retina, glaucoma or other health problems should consult with an ophthalmologist about eligibility.
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. What can a facelift do for me? 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 What won’t a facelift correct? 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. Am I a good candidate for a facelift? 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 During your consultation, our Manhattan plastic surgeons will discuss whether a facelift is right for you. How is a rhytidectomy performed? 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. What is the recovery from a facelift like? After your rhytidectomy, your doctor 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. At first, you may experience swelling, numbness, bruising, and a feeling of tightness or tension in the face and neck. Your face may look uneven or distorted, and your facial muscles may feel stiff. Most of these usually resolve within 3-6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy or itchy in time. Many patients return to work by the third week. Camouflage cosmetics can be used to minimize the appearance of bruising. You should be gentle with your skin and hair as you recover. Men may need to shave behind the neck and ears where areas of beard-growing skin have moved. How long do the effects of a facelift last? 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.
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Rhinoplasty, or nose surgery, is one of the most common plastic surgery procedures performed today. It can reshape, reduce or augment a person’s nose to achieve facial harmony and boost self-confidence. It may be performed as a reconstructive procedure to correct a birth defect or an injury such as a broken nose. Rhinoplasty may be performed for functional rather than cosmetic reasons as well. Combining nose reshaping with septoplasty or endoscopic sinus surgery can effectively treat certain breathing problems, such as those caused by a deviated septum. Goals of Rhinoplasty Rhinoplasty is an excellent procedure for achieving the following: Balance the size of the nose with the other facial features Modify the width of the nose at the bridge Improve the nasal profile, including removing humps or depressions Contour a nasal tip that is too large, “boxy,” drooping or upturned Change the angle between the nose and the mouth Narrow and reshape the nostrils Correct asymmetry or deviation Candidates for Rhinoplasty The best candidates for rhinoplasty: Are at least 13 years old; Have finished facial growth; Are generally healthy; Do not smoke; Are seeking rhinoplasty for personal reasons, not pressure from others; and Have realistic goals for the procedure. Rhinoplasty Procedure Rhinoplasty is usually an outpatient procedure performed under IV sedation or general anesthesia. Our surgeons use one of two techniques when performing nose surgery. In a closed rhinoplasty, incisions are made within the nostrils. In an open rhinoplasty, the incision is made across the columella, the tissue between the nostrils. With both methods, the surgeon gently lifts the soft tissues covering the nose. He or she sculpts the bone and cartilage to the desired shape. Any additional cartilage needed to augment the nose can often be taken from the septum. If the patient has a deviated septum, the surgeon will adjust the septum and the inner structures of the nose to improve breathing. Then the tissues are re-draped and stitched closed. If the patient desires nostril reshaping, this is done as the final stage of rhinoplasty. The entire procedure generally lasts one to two hours. Recovery and Results after Rhinoplasty For a short time after surgery, patients 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. The results of rhinoplasty become gradually apparent as the days pass after surgery and swelling recedes. Swelling may reappear from time to time in the first year after the procedure. It is typically more noticeable in the morning and fades during the day. Contact lenses can be worn immediately, but glasses may need to be taped to your forehead or propped on your cheeks for up to seven weeks. Patients with realistic goals for rhinoplasty are generally very happy with the new shape of their nose. The exact results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age. Risks of Rhinoplasty Complications associated with rhinoplasty are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia.
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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. BOTOX® Cosmetic treatments 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 more refreshed. What can BOTOX® treatments do for me? BOTOX® Cosmetic is the most popular cosmetic procedure in the country and one of our most requested services. Quick, safe and effective, BOTOX® reduces or eliminates facial lines and wrinkles for up to six months with no downtime and little to no discomfort. Through a series of tiny injections, BOTOX® gives you a rejuvenated look by smoothing crow’s feet beneath the eyes, frown lines between the eyebrows, horizontal lines across the forehead, worry lines around the mouth, and lines on the neck. In addition to smoothing out fine lines and wrinkles, BOTOX® may be useful for treating migraine headaches, excessive sweating, chronic back and jaw pain, and muscle spasms. How BOTOX® Cosmetic Works BOTOX® is the brand name for botulinum toxin A, a therapeutic muscle-relaxing agent derived from the bacteria Clostridium Botulinum. Originally approved by the FDA for the treatment of eye and muscle spasms, BOTOX® was quickly recognized for its cosmetic value. Physicians have been using BOTOX® Cosmetic for years as a treatment to correct visible signs of stress and aging. The medication relaxes the muscles in the face that cause wrinkles. When injected in small doses in specific areas, BOTOX® injections block nerve muscles responsible for the repetitive actions that cause fine lines and wrinkles. In this way, BOTOX® smoothes the lines in the skin that make you look tired or angry. Candidates for BOTOX® A good candidate for BOTOX® treatment may be anyone looking to enhance their appearance by getting rid of unwanted lines or wrinkles. It is also important that patients seeking treatment with BOTOX® Cosmetic are in good physical health, are not pregnant or nursing, and do not have a neuromuscular disorder. Men and women considering BOTOX® treatment should have realistic expectations of what the procedure can do. You should discuss the desired results with your doctor to ensure that your goals can be achieved. The BOTOX® Procedure Using a very fine needle, a qualified physician will inject BOTOX® Cosmetic into designated muscles in your face that are causing lines and wrinkles. You may experience brief, mild discomfort during the injection, but you can be assured that the treatment is very safe and effective. Taking only a few minutes, BOTOX® treatment requires no anesthetic and recovery is immediate, allowing you to return to work and resume your normal daily activities that same day. The Importance of Choosing a Qualified Physician Even though BOTOX® is not a surgical procedure, it is very important to choose a highly experienced and qualified physician when deciding to undergo BOTOX® treatments. Doctors who are less familiar with the technique could leave you looking “frozen” or perpetually surprised. Our doctors are intimately familiar with BOTOX® Cosmetic, having successfully treated hundreds of patients at our office. Not only that, we also take the time to talk with each candidate before beginning the injections to find out what he or she wants to achieve and to determine how best to correct their problem area(s), so patients can be happy again with their smoother, younger-looking faces. BOTOX® Cosmetic Results Immediately following the BOTOX® treatment, some patients may experience mild bruising, which will go away shortly. You will see your wrinkles begin to fade within 24 hours, with continued improvement over the next 5 days. The effects of BOTOX® Cosmetic typically last up to four months, although many have reported results lasting up to a full year. After several BOTOX® treatments, the results may be prolonged. BOTOX® Cosmetic treatment will relax the muscles in your face and soften the skin, giving you a more relaxed and youthful appearance. For optimum results, many patients choose to use BOTOX® in conjunction with a facelift, skin rejuvenation therapy, and/or laser skin resurfacing. Risks and Side Effects of BOTOX® Side effects of BOTOX® Cosmetic are rare and are usually mild and temporary. The most common side effects caused by BOTOX®are headaches and temporary redness or bruising of the skin at the site of injection. In rare cases, slight drooping of an eyelid or asymmetry of expression may occur. Any risk of complication can be reduced by choosing a qualified and experienced physician. Contact Us for more information about BOTOX®
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