Cosmetic Surgery and You

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COSMETIC SURGERY

¾Arm Lift ¾Body Contouring ¾Tummy Tuck ¾Breast Augmentation ¾Breast Lift FEATURED SURGEON Dr. Joseph A. Mele, MD, FACS

YOU


Inside this issue you will find important information on the following subjects:

Body Lifts ¾ Arm Lift ¾ Body Contouring After Major Weight Loss ¾ Tummy Tuck

Breast ¾ Breast Augmentation ¾ Breast Lift Surgery

Featured Surgeon ¾ Dr. Joseph A. Mele, MD, FACS

The views and opinions or otherwise in this brochure do not represent that of any specific medical doctor, publisher or writers of this brochure. It is recommended that you research all options including talking with your medical provider before making any decision about any treatments listed here within. This is an advertisement.


Brachioplasty What is an arm lift?

An arm lift, also known as brachioplasty, reduces excess skin and fat between the underarm and the elbow, reshapes your arm to result in smoother skin and contours, and results in a more toned and proportionate appearance

Inside ¾ Beauty for life ¾ What to expect during your consultation ¾ Preparing for arm lift surgery ¾ Arm lift risks and safety information ¾ What happens during arm lift surgery? ¾ Arm lift recover ¾ The results will be long‐lasting ¾ How much will arm lift surgery cost? ¾ Brachioplasty words to know ¾ Questions to ask my plastic surgeon

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Brachioplasty

Beauty for life Enhancing your appearance with an arm lift Fluctuations in weight, growing older and even heredity can cause your upper arms to have a drooping, sagging appearance. Exercise may strengthen and improve the underlying muscle tone of the upper arm, but it cannot address excess skin that has lost elasticity or underlying weakened tissues and localized fat deposits. If the underside of your upper arms are sagging or appear loose and full due to excess skin and fat, an arm lift may be right for you. An arm lift: Reduces excess skin and fat between the underarm and the elbow Reshapes your arm to result in smoother skin and contours Results in a more toned and proportionate appearance. A special note: In order to achieve your improved image, there will be a scar on the inside of your upper arm.

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ARM TOPICS

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Brachioplasty

What to expect during your consultation The success and safety of your arm lift procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss: Why you want the surgery, your expectations and desired outcome Medical conditions, drug allergies and medical treatments. Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs, and previous surgeries. Your surgeon may also: ¾Evaluate your general health status and any pre‐existing health conditions or risk factors ¾Take photographs for your medical record ¾Discuss your options and recommend a course of treatment ¾Discuss likely outcomes of arm lift surgery and any risks or potential complications

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ARM TOPICS

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Brachioplasty

Preparing for arm lift surgery Prior to surgery, you may be asked to: ¾Get lab testing or a medical evaluation ¾Take certain medications or adjust your current medications ¾Stop smoking well in advance of surgery ¾Avoid taking aspirin, anti‐inflammatory drugs and herbal supplements as they can increase bleeding Special instructions you receive will cover: ¾What to do on the day of surgery ¾The use of anesthesia during your arm lift ¾Post‐operative care and follow‐up ¾Your plastic surgeon will also discuss where your procedure will be performed. Arm lift surgery may be performed in an accredited office‐based surgical center, outpatient or ambulatory surgical center, or a hospital. You’ll need help If your arm lift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

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ARM TOPICS

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Brachioplasty

Arm lift risks and safety information The decision to have arm lift surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications. The risks include: ¾Unfavorable scarring ¾Bleeding (hematoma) ¾Infection ¾Fluid accumulation ¾Anesthesia risks ¾Poor wound healing ¾Skin loss ¾Blood clots ¾Numbness or other changes in skin sensation ¾Skin discoloration and/or prolonged swelling ¾Asymmetry ¾Major wound separation ¾Fatty tissue found deep in the skin might die (fat necrosis) ¾Damage to deeper structures such as nerves, blood vessels, CONTINUED

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ARM TOPICS

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Brachioplasty

Arm lift risks and safety information ¾muscles, and lungs ¾Pain, which may persist ¾Deep vein thrombosis, cardiac and pulmonary complications ¾Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal ¾Possibility of revisional surgery These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, whether excitement for the anticipated outcomes or preoperative stress. Discuss these feelings with your plastic surgeon. When you go home If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. CONTINUED

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ARM TOPICS

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Brachioplasty

Arm lift risks and safety information Be careful Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your arm lift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon. END

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ARM TOPICS

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Brachioplasty

What happens during arm lift surgery? Step 1 ‐ Anesthesia Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. Step 2 ‐ The incision Incision length and pattern depend on the amount and location of excess skin to be removed, as well as the best judgment of your plastic surgeon. Incisions are generally placed on the inside of the arm or on the back of the arm, depending on the surgeon’s preference, and may extend from the underarm (axilla) to just above the elbow. If fat is to be reduced during your arm lift, it will be excised or treated with liposuction. Inner arm incision Depending on your specific conditions, incisions may be more limited. Then, underlying supportive tissue is tightened and reshaped with internal sutures. Finally, the skin is smoothed over the new contour of your arm. back of arm incision minimal incision CONTINUED

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ARM TOPICS

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Brachioplasty

What happens during arm lift surgery? Step 3 ‐ Closing the incisions Your incisions will be closed with absorbable sutures, or stitches that will be removed within 1‐2 weeks following your arm lift. Step 4 ‐ See the results The smoother, tighter contours that result from brachioplasty are apparent almost immediately following your procedure, although initial results will be somewhat obscured by swelling and bruising. Your new, shapely and toned upper arm is dramatically improved both in appearance and feel. END

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ARM TOPICS

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Brachioplasty

Arm lift recovery Following your surgery, dressings or bandages may be applied to your incisions, and your arms may be wrapped in an elastic bandage or a compression garment to minimize swelling. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You will be given specific instructions that may include: ¾How to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon. ¾Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period. ¾Where will I be taken after my surgery is complete? ¾What medication will I be given or prescribed after surgery? ¾Will I have dressings/bandages after surgery? When will they be removed? ¾Are stitches removed? When? ¾When can I resume normal activity and exercise? ¾When do I return for follow‐up care?

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ARM TOPICS

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Brachioplasty

The results will be long‐lasting The results of arm lift surgery will be long‐lasting, provided that you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness, but most of your improvement should be relatively permanent

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ARM TOPICS

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Brachioplasty

How much will arm lift surgery cost? Cost is always a consideration in elective surgery. Surgeon’s cost for an arm lift may vary based on his or her experience, the type of procedure used, as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask. Cost may include: ¾Surgeon’s fee ¾Hospital or surgical facility costs ¾Anesthesia fees ¾Prescriptions for medication ¾Post‐surgery garments ¾Medical tests Your satisfaction involves more than a fee When choosing a plastic surgeon for an arm lift, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery. Most health insurance does not cover cosmetic surgery or its complications.

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ARM TOPICS

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Brachioplasty

Brachioplasty words to know Arm lift: A surgical procedure, also known as brachioplasty, to correct sagging of the upper arms. Axilla: The underarm area. Brachioplasty: A surgical procedure, also known as arm lift, to correct sagging of upper arms. General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. Hematoma: Blood pooling beneath the skin. Intravenous sedation: Sedatives administered by injection into a vein to help you relax. Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness. Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Skin laxity: Degree of loose skin. Sutures: Stitches used by surgeons to hold skin and tissue together

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ARM TOPICS

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Brachioplasty

Questions to ask my plastic surgeon Use this checklist as a guide during your consultation 1. Are you certified by the American Board of Plastic Surgery? 2. Were you specifically trained in the field of plastic surgery? 3. How many years of plastic surgery training have you had? 4. Do you have hospital privileges to perform this procedure? If so, at which hospitals? 5. Is the office‐based surgical facility accredited by a nationally‐ or state‐ recognized accrediting agency, or is it state‐licensed or Medicare‐certified? 6. Am I a good candidate for this procedure? 7. What will be expected of me to get the best results? 8. Where and how will you perform my procedure? 9. What surgical technique is recommended for me? 10. How long of a recovery period can I expect, and what kind of help will I need during my recovery? 11. What are the risks and complications associated with my procedure? 12. How are complications handled? 13. How can I expect my arms to look over time? 14. What are my options if I am dissatisfied with the cosmetic outcome of my arm lift? 15. Do you have before‐and‐after photos I can look at for this procedure and what results are reasonable for me?

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ARM TOPICS

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After Major Weight Loss for Men and Women What is body contouring after major weight loss?

Body contouring after major weight loss improves the shape and tone of your underlying tissue that supports fat and skin and removes excess sagging fat and skin.

Inside ¾ Beauty for life ¾ What to expect during your body contouring consultation ¾ Preparing for body contouring surgery ¾ Body contouring risks and safety information ¾ Body contouring procedure steps ¾ Body contouring recovery ¾ The results will be long‐lasting ¾ How much will body contouring surgery cost? ¾ Body contouring words to know ¾ Questions to ask my plastic surgeon

CONTENTS


After Major Weight Loss for Men and Women

Beauty for life Enhancing your appearance with body contouring surgery Following weight reduction surgery, or any substantial amount of weight loss, the skin and tissues often lack elasticity and cannot conform to the reduced body size. As a result, skin that has been severely stretched now is unsupported: Upper arms may sag and appear loose and full Breasts may flatten and hang with nipples pointed downward Abdominal area may extend around the sides and into the lower back area, resulting in an apron‐like overhang Buttocks, groin and thighs can sag and cause hanging pockets of skin Surgical body contouring following major weight loss improves the shape and tone of your underlying tissue that supports fat and skin, and removes excess sagging fat and skin. The result is a more normal appearance to the body, with smoother contours. This is, in essence, the final phase of your total weight loss experience. CONTINUED

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Is it right for me? Before you decide to undergo body contouring following major weight loss, your weight loss must be stabilized. If you continue to lose weight, sagging pockets will redevelop. If you rapidly regain the weight, you will traumatically stress your already weakened and thinned skin, causing further stress to the skin, visible stretch marks and wide scars. If you had weight reduction surgery, your plastic surgeon will work closely with your physician to determine when it is appropriate for you to begin body contouring. Good candidates for body contouring are: Adults of any age whose weight loss has stabilized Healthy individuals who do not have medical conditions that can impair healing or increase risk of surgery Non‐smokers Individuals with a positive outlook and realistic goals for what body contouring can accomplish Individuals committed to leading a healthy lifestyle including proper nutrition and fitness END OF TOPIC

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

What to expect during your body contouring consultation The success and safety of your body contouring procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss: Why you want the surgery, your expectations and desired outcome The options available in body contouring surgery Medical conditions, drug allergies and medical treatments Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs Previous surgeries Your surgeon may also: Evaluate your general health status and any pre‐existing health conditions or risk factors Examine and measure your body, including detailed measurements Take photographs for your medical record Discuss your options and recommend a course of treatment Discuss likely outcomes of your surgery and any risks or potential complications

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Preparing for body contouring surgery Prior to surgery, you may be asked to: Get lab testing or a medical evaluation Take certain medications or adjust your current medications Stop smoking well in advance of surgery Avoid taking aspirin, anti‐inflammatory drugs and herbal supplements as they can increase bleeding Special instructions you receive will cover: What to do on the day of surgery The use of anesthesia during your body contouring surgery Post‐operative care and follow‐up Your plastic surgeon will also discuss where your procedure will be performed. Body contouring surgery may be performed in an accredited office‐based surgical center, outpatient or ambulatory surgical center, or a hospital. You’ll need help If a component of your body contouring surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Body contouring risks and safety information The decision to have body contouring surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications. CONTINUED

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Possible risks of body contouring following major weight loss include: ¾Unfavorable scarring ¾Bleeding (hematoma) ¾Infection ¾Fluid accumulation ¾Poor wound healing ¾Skin loss ¾Blood clots ¾Numbness or other changes in skin sensation ¾Anesthesia risks ¾Skin discoloration and/or prolonged swelling ¾Fatty tissue found deep in the skin might die (fat necrosis) ¾Major wound separation ¾Asymmetry ¾Recurrent looseness of skin ¾Pain, which may persist ¾Deep vein thrombosis, cardiac and pulmonary complications ¾Persistent swelling in the legs ¾Possibility of revisional surgery Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your body contouring procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon. END OF TOPIC

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Body contouring procedure steps What happens during body contouring surgery? The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures. Plastic surgery procedures that may be recommended by your physician include: Lower body lift: to correct sagging of the abdomen, buttocks, groin and outer thighs Breast lift: to correct sagging, flattened breasts Arm lift: to correct sagging of the upper arms Thigh lift: to correct sagging of the inner, outer and mid thigh Step 1 ‐ Anesthesia Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. CONTINUED

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Step 2 ‐ The incision All body contouring procedures require incisions to remove excess skin. In many cases, these incisions may be extensive. Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and your doctor’s surgical judgment. Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case. Body contouring is often performed in stages. Your particular condition and goals, as well as your plastic surgeon’s best judgment, will all influence how your doctor defines a surgical plan. While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete. Body Lift A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure or in staged procedures. Incision patterns vary, and may include a circumferential incision around the body to remove the "belt" of excess skin and fat. END OF TOPIC

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Body contouring recovery After your body contouring procedure is completed, dressings or bandages will be applied to the incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow‐up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period. Where will I be taken after my surgery is complete? What medication will I be given or prescribed after surgery? Will I have dressings/bandages after surgery? When will they be removed? Are stitches removed? When? When can I resume normal activity and exercise? When do I return for follow‐up care? CONTINUED

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

When you go home If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. Be careful Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. END OF TOPIC

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

The results will be long‐lasting The results of a body contouring following aggressive weight loss are visible almost immediately. However, it may take as many as one to two years or more for the final results of all the recommended body contouring procedures to fully develop. Visible scars will remain, but the overall results are long lasting, provided that you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent.

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

How much will body contouring surgery cost? Cost is always a consideration in elective surgery. Prices for body contouring procedures can vary widely. A surgeon’s cost for body contouring procedures may vary based on his or her experience, the type of procedure used, as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask. Costs may include: Surgeon’s fee Hospital or surgical facility costs Anesthesia fees Prescriptions for medication Post‐surgery garments, and Medical tests Your satisfaction involves more than a fee When choosing a plastic surgeon for body contouring surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery. Most health insurance does not cover cosmetic surgery or its complications

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Body contouring words to know Areola: Pigmented skin surrounding the nipple. Arm lift: A surgical procedure, also known as brachioplasty, to correct sagging of the upper arms. Breast implants: Medical device placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel). Breast lift: Also known as mastopexy, surgery to lift the breasts. Breast contouring: A surgical procedure following massive weight loss to improve shape and tone and remove excess fat and skin. Circumferential incision: A surgical incision around the body to remove the "belt" of excess skin and fat and additional incisions that may resemble a bikini bottom pattern. General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. CONTINUED

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Hematoma: Blood pooling beneath the skin. Intravenous sedation: Sedatives administered by injection into a vein to help you relax. Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Lower body lift: Surgical procedure to correct sagging of the abdomen, buttocks, groin and outer thighs. Macerated skin: Excess skin that hangs and becomes wet or infected underneath. Medial thigh lift: A surgical procedure to correct sagging of the inner thigh. Outer thigh lift: A surgical procedure to correct sagging of the outer and mid‐ thigh. Sutures: Stitches used by surgeons to hold skin and tissue together. END OF TOPIC

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BODY CONTOURING TOPICS CONTENTS


After Major Weight Loss for Men and Women

Questions to ask my plastic surgeon Use this checklist as a guide during your consultation 1. 2. 3. 4.

Are you certified by the American Board of Plastic Surgery? Were you trained specifically in the field of plastic surgery? How many years of plastic surgery training have you had? Do you have hospital privileges to perform this procedure? If so, at which hospitals? 5. Is the office‐based surgical facility accredited by a nationally‐ or state‐ recognized accrediting agency, or is it state‐licensed or Medicare‐certified? 6. Am I a good candidate for this procedure? 7. What will be expected of me to get the best results? 8. Where and how will you perform my procedure? 9. What surgical technique is recommended for me? 10. How long of a recovery period can I expect, and what kind of help will I need during my recovery? 11. What are the risks and complications associated with my procedure? 12. How are complications handled? 13. How can I expect to look over time? After pregnancy? 14. What are my options if I am dissatisfied with the cosmetic outcome of my procedure? 15. Do you have before‐and‐after photos I can look at for this procedure and what results are reasonable for me?

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BODY CONTOURING TOPICS CONTENTS


Abdominoplasty What is a tummy tuck?

Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in most cases restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. A flat and well‐toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals. Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging.

Inside ¾ What to expect during your tummy tuck consultation ¾ Preparing for tummy tuck surgery ¾ Tummy tuck surgery risks and safety information ¾ Tummy tuck procedure steps ¾ Tummy tuck recovery ¾ How much will a tummy tuck surgery cost? ¾ Tummy tuck words to know ¾ Questions to ask my plastic surgeon

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Abdominoplasty

What to expect during your tummy tuck consultation The success and safety of your tummy tuck procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss: ¾Why you want the surgery, your expectations and desired outcome ¾Medical conditions, drug allergies and medical treatments. ¾Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs. ¾Previous surgeries. Your surgeon may also: Evaluate your general health status and any pre‐existing health conditions or risk factors Take photographs for your medical record Discuss your options and recommend a course of treatment Discuss likely outcomes of the tummy tuck and any risks or potential complications

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TUMMY TUCK TOPICS

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Abdominoplasty

Preparing for tummy tuck surgery Prior to surgery, you may be asked to: ¾Get lab testing or a medical evaluation ¾Take certain medications or adjust your current medications ¾Stop smoking well in advance of surgery ¾Avoid taking aspirin, anti‐inflammatory drugs and herbal supplements as they can increase bleeding Special instructions you receive will cover: ¾What to do on the day of surgery ¾The use of anesthesia during your tummy tuck ¾Post‐operative care and follow‐up

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TUMMY TUCK TOPICS

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Abdominoplasty

Tummy tuck risks and safety information The decision to have tummy tuck surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential abdominoplasty complications are acceptable. Your plastic surgeon and/or staff will explain in detail potential tummy tuck complications. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications. Possible abdominoplasty risks include: ¾Unfavorable scarring ¾Bleeding (hematoma) ¾Infection ¾Fluid accumulation ¾Poor wound healing ¾Skin loss ¾Blood clots ¾Numbness or other changes in skin sensation ¾Anesthesia risks CONITNUED

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TUMMY TUCK TOPICS

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Abdominoplasty

¾Skin discoloration and/or prolonged swelling ¾Fatty tissue found deep in the skin might die (fat necrosis) ¾Major wound separation ¾Asymmetry ¾Recurrent looseness of skin ¾Pain, which may persist ¾Deep vein thrombosis, cardiac and pulmonary complications ¾Persistent swelling in the legs ¾Nerve damage ¾Possibility of revisional surgery ¾Suboptimal aesthetic result You’ll need help If your abdominoplasty is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

END OF TOPIC

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TUMMY TUCK TOPICS

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Abdominoplasty

Tummy tuck procedure steps What happens during tummy tuck surgery? Step 1 – Anesthesia Medications are administered for your comfort during abdominoplasty surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. Step 2 – The incision A full tummy tuck procedure requires a horizontally‐oriented incision in the area between the pubic hairline and navel. The shape and length of the incision will be determined by the degree of correction necessary. Through this incision, weakened abdominal muscles are repaired and sutured while excess fat, tissue and skin is removed. A second incision around the navel may be necessary to remove excess skin in the upper abdomen. CONTINUED

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Abdominoplasty

Step 3 – Closing the incisions Sutures, skin adhesives, tapes or clips close the skin incisions. Step 4 – See the results Your abdominoplasty procedure will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Within a week or two, you should be standing tall and confident about your new slimmer profile. END OF TOPIC

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TUMMY TUCK TOPICS

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Abdominoplasty

Tummy tuck recovery Following your surgery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect to minimize swelling after tummy tuck surgery. You will be given specific instructions to aid your recovery from tummy tuck surgery: ¾How to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow‐up with your plastic surgeon. ¾Be sure to ask your plastic surgeon specific questions about what you can expect during your individual abdominoplasty recovery period. ¾Where will I be taken after my surgery is complete? ¾What medication will I be given or prescribed after surgery? ¾Will I have dressings/bandages after surgery? When will they be removed? ¾Are stitches removed? When? ¾When can I resume normal activity and exercise? ¾When do I return for follow‐up care? ¾Previous abdominal surgery may limit the potential results of a tummy tuck. In women who have undergone cesarean section, the existing scars may often be incorporated into the new scar.

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TUMMY TUCK TOPICS

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Abdominoplasty

How much does a tummy tuck cost? Cost is always a consideration in elective surgery. Tummy tuck costs can vary widely. A surgeon’s cost for a tummy tuck may vary based on his or her experience, the type of procedure used, as well as geographic office location. Many plastic surgeons offer financing plans to help patients cover the cost of abdominoplasty surgery, so be sure to ask. The price of tummy tuck surgery may include: ¾Surgeon’s fee ¾Hospital or surgical facility costs ¾Anesthesia fees ¾Prescriptions for medication ¾Post‐surgery garments, and ¾Medical tests Your satisfaction involves more than a fee When choosing a plastic surgeon for a tummy tuck, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

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TUMMY TUCK TOPICS

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Abdominoplasty

Tummy tuck words to know Abdominoplasty: A surgical procedure to correct the apron of excess skin hanging over your abdomen. Diastasis: Condition in which abdominal muscles have separated. General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. Hematoma: Blood pooling beneath the skin. Intravenous sedation: Sedatives administered by injection into a vein to help you relax. Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness. Local anesthesia: A drug is injected directly to the site of an incision during an operation to relieve pain. Sutures: Stitches used by surgeons to hold skin and tissue together. Tummy tuck: A surgical procedure to correct the apron of excess skin hanging over your abdomen.

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TUMMY TUCK TOPICS

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Abdominoplasty

Questions to ask your plastic surgeon Use this checklist of tummy tuck questions during your consultation. 1. Are you certified by the American Board of Plastic Surgery? 2. Were you specifically trained in the field of plastic surgery? 3. How many years of plastic surgery training have you had? 4. Do you have hospital privileges to perform this procedure? If so, at which hospitals? 5. Is the office‐based surgical facility accredited by a nationally‐ or state‐ recognized accrediting agency, or is it state‐licensed or Medicare‐ certified? 6. Am I a good candidate for this procedure? 7. What will be expected of me to get the best results? 8. Where and how will you perform my procedure? 9. What surgical technique is recommended for me? 10. How long of a recovery period can I expect, and what kind of help will I need during my recovery? 11. What are the risks and complications associated with my procedure? 12. How are complications handled? 13. How can I expect my stomach to look over time? After pregnancy? 14. What are my options if I am dissatisfied with the cosmetic outcome of my tummy tuck? 15. Do you have before‐and‐after photos I can look at for this procedure and what results are reasonable for me?

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TUMMY TUCK TOPICS

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Augmentation Mammaplasty What is breast augmentation surgery?

Also known as augmentation mammaplasty, breast augmentation surgery involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.

Inside ¾ Breast augmentation before and after ¾ Preparing for breast augmentation surgery ¾ Breast implant risks and safety information ¾ Important facts about breast augmentation risks and complications ¾ Breast augmentation procedure steps ¾ Breast augmentation recovery ¾ Breast augmentation results ¾ Breast augmentation costs ¾ Augmentation mammaplasty words to know ¾ Questions to ask your breast augmentation surgeon

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Augmentation Mammaplasty

Breast augmentation before and after If you are dissatisfied with your breast size, breast augmentation surgery (either breast enhancement or breast enlargement) is a choice to consider. Breast augmentation can: ¾Increase fullness and projection of your breasts ¾Improve the balance of your figure ¾Enhance your self‐image and self‐confidence ¾Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. ¾Implants also may be used to reconstruct a breast after mastectomy or injury. What it won't do Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. Your plastic surgeon will assist you in making this decision. CONTINUED

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Augmentation Mammaplasty

Is it right for me? Breast augmentation is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. Pictures of breast augmentation procedures performed by ASPS Member Surgeons may help you in the decision‐making process. Breast augmentation may be a good option for you if: ¾You are physically healthy ¾You have realistic expectations ¾Your breasts are fully developed ¾You are bothered by the feeling that your breasts are too small ¾You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss, or with aging ¾Your breasts vary in size or shape ¾One or both breasts failed to develop normally END OF TOPIC

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Augmentation Mammaplasty

Preparing for breast augmentation surgery After researching the basics about breast enhancement or breast enlargement, many patients want to know what to expect before breast augmentation surgery. Prior to breast surgery, your ASPS Member Surgeon may ask you to: Get lab testing or a medical evaluation. Take certain medications or adjust your current medications. Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue Stop smoking well in advance of your breast augmentation surgery. Avoid taking aspirin, anti‐inflammatory drugs and herbal supplements as they can increase bleeding. Special instructions you receive will cover: ¾What to do on the day of surgery ¾Post‐operative care and follow‐up ¾Breast implant registry documents (when necessary) ¾Your plastic surgeon will also discuss where your procedure will be performed. Breast augmentation surgery may be performed in an accredited office‐based surgical center, outpatient ambulatory surgical center or a hospital. You'll need help If your breast augmentation is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

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Augmentation Mammaplasty

Breast implant risks and safety information The success and safety of your breast augmentation procedure depends very much on your being completely candid during your consultation. By being actively involved your consultation about breast augmentation, problems, concerns and questions you may have can be addressed by your ASPS Member Surgeon. You'll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss: ¾Why you want breast augmentation surgery, your expectations and desired outcome ¾Medical conditions, drug allergies and medical treatments ¾Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs ¾Previous surgeries ¾Family history of breast cancer and results of any mammograms or previous biopsies Your surgeon may also: ¾Evaluate your general health status and any pre‐existing health conditions or risk factors ¾Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples ¾Take photographs for your medical record ¾Discuss your options and recommend a course of treatment ¾Discuss likely outcomes of breast augmentation surgery and any risks or potential complications ¾Discuss the use of anesthesia during your breast augmentation procedure

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Augmentation Mammaplasty

Important facts about breast augmentation risks and complications The decision to have breast augmentation surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks of breast implant safety and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications. The risks of breast implants and complications after breast augmentation include: ¾Unfavorable scarring ¾Bleeding (hematoma) ¾Infection ¾Poor healing of incisions ¾Changes in nipple or breast sensation, may be temporary or permanent ¾Capsular contracture, which is the formation of firm scar tissue around the implant CONTINUED

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Augmentation Mammaplasty

¾Implant leakage or rupture ¾Wrinkling of the skin over the implant ¾Anesthesia risks ¾Fluid accumulation ¾Blood clots ¾Pain, which may persist ¾Deep vein thrombosis, cardiac and pulmonary complications ¾Possibility of revisional surgery Although there potentially may be complications with breast implants, they do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases. Other important considerations: Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime. END OF TOPIC

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Augmentation Mammaplasty

Breast augmentation procedure steps What happens during breast augmentation surgery? Step 1 ‐ Anesthesia Medications are administered for your comfort during breast augmentation surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. Step 2 ‐ The incision Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include: Inframammary incision Transaxillary incision Periareolar incision Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient‐surgeon preference. Step 3 ‐ Implant choice: Silicone breast implants or saline breast implants? Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon. Implant type and size will be determined not just on your desired increase in size but more importantly on your breast anatomy, skin elasticity and body type.

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Augmentation Mammaplasty

Saline breast implants are filled with sterile salt water. They can be filled with varying amounts of saline which can affect the shape, firmness and feel of the breast. Should the implant shell leak, a saline breast implant will collapse and the saline will be absorbed and naturally expelled by the body. Silicone breast implants are filled with an elastic gel. The gel feels and moves much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell, or may escape into the breast implant pocket. A leaking implant filled with silicone gel may not collapse. If you choose these implants, you may need to visit your plastic surgeon regularly to make sure the implants are functioning properly. An ultrasound or MRI screening can assess the condition of breast implants. Implant manufacturers occasionally introduce new styles and types of implants, so there may be additional options available. Currently Saline breast implants are FDA‐approved for augmentation in women 18 years of age and older. Currently Silicone breast implants are FDA‐approved for augmentation in women 22 years of age and older. Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes. CONTINUED

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Augmentation Mammaplasty

Step 4 ‐ Inserting and placing the breast implant After the incision is made, a breast implant is inserted into a pocket either: Under the pectoral muscle (a submuscular placement), or Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement) The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and your surgeon’s recommendations. Step 5 ‐ Closing the incisions 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. Step 6 ‐ See the results The results of breast augmentation surgery are immediately visible. Over time, post‐surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for fuller breasts. END OF TOPIC

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Augmentation Mammaplasty

Breast augmentation recovery Many patients have questions about breast augmentation and recovery. Although many factors are involved with determining your actual recovery time for breast augmentation, you will likely experience a post‐surgical recovery period of 24 to 48 hours and an additional reduced‐activity period of a few days, you will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at the direction of your plastic surgeon. Over time, post‐surgical swelling will decrease and incision lines will fade. You will be given specific instructions that may include: How to care for your breasts following breast augmentation surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow‐up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period. ¾Where will I be taken after my surgery is complete? ¾What medication will I be given or prescribed after surgery? ¾Will I have dressings/bandages after surgery? When will they be removed? ¾Are stitches removed? When? ¾When can I resume normal activity and exercise? ¾When do I return for follow‐up care? CONINUED

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Augmentation Mammaplasty

When you go home If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur after breast augmentation, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. Be careful Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. END OF TOPIC

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Augmentation Mammaplasty

Breast augmentation results The results of your breast augmentation surgery will be long‐lasting. You will find it easier to wear certain styles of clothing and swim wear. Like many women who have had breast augmentation, you may also have a boost in self confidence. Implants may need to be replaced or revised It's important to know that after receiving breast implants, results are not permanent and they may require replacement during your lifetime. You should expect to have future visits with your plastic surgeon to discuss changes in your breasts. Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour. Continue to follow your plastic surgeon's instructions to ensure the best results for breast enlargement or breast enhancement, and attend follow‐up visits as scheduled.

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Augmentation Mammaplasty

Breast augmentation costs As an elective surgery, the cost of breast augmentation is a consideration for many patients. A surgeon's cost for breast augmentation may vary based on his or her experience, the type and cost of breast implants used, as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask. Cost may include: ¾Surgeon’s fee ¾Hospital or surgical facility costs ¾Anesthesia fees ¾Breast implant cost ¾Prescriptions for medication ¾Post‐surgery garments ¾Medical tests Most health insurance plans will not cover cosmetic breast augmentation costs, related complications or another surgery to revise the appearance of your breasts. Some carriers even exclude breast diseases in patients who have breast implants. You must carefully review your health insurance policy. Your satisfaction involves more than a fee When choosing a plastic surgeon for breast enlargement or breast enhancement, remember that the surgeon’s experience with breast implants and your comfort with him or her are just as important as the final cost of the surgery.

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Augmentation Mammaplasty

Augmentation mammaplasty words to know Areola: Pigmented skin surrounding the nipple. Augmentation mammaplasty: Breast enlargement or breast enhancement by surgery. Breast Augmentation: Also known as augmentation mammaplasty; breast enlargement or breast enhancement by surgery. Breast Implants: Medical devices placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants fall into two categories: saline breast implants and silicone breast implants. Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm. General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. Hematoma: Blood pooling beneath the skin. Inframammary incision: An incision made in the fold under the breast. Intravenous sedation: Sedatives administered by injection into a vein to help you relax. Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. CONTINUED

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Augmentation Mammaplasty

Mammogram: An x‐ray image of the breast. Mastectomy: The removal of breast tissue, typically to rid the body of cancer. MRI: Magnetic Resonance Imaging; a painless test to view tissue similar to an x‐ ray. Periareolar incision: An incision made at the edge of the areola. Saline implants: Breast implants filled with salt water. Silicone implants: Breast implants filled with an elastic gel. Submammary or subglandular placement: Breast implants placed directly behind the breast tissue, over the pectoral muscle. Submuscular or subpectoral placement: Breast implants placed under the pectoral muscle, which is located between the breast tissue and chest wall. Sutures: Stitches used by surgeons to hold skin and tissue together. Transaxillary incision: An incision made in the underarm area. Ultrasound: A diagnostic procedure that projects high frequency sound waves into the body and records the echoes as pictures. END OF TOPIC

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Augmentation Mammaplasty

Questions to ask your breast augmentation surgeon It is important to be an active participant in the process, so we've developed the following list of questions to ask about breast augmentation during your consultation: 1. 2. 3. 4.

Are you certified by the American Board of Plastic Surgery? Were you trained specifically in the field of plastic surgery? How many years of plastic surgery training have you had? Do you have hospital privileges to perform this procedure? If so, at which hospitals? 5. Is the office‐based surgical facility accredited by a nationally‐or state‐ recognized accrediting agency, or is it state‐licensed or Medicare‐certified? 6. Am I a good candidate for breast enhancement or breast enlargement? 7. What will be expected of me to get the best results? 8. Where and how will you perform my breast augmentation surgery? 9. What shape, size, surface texturing, incision site and placement site are recommended for me? 10. How long of a recovery period can I expect, and what kind of help will I need during my recovery? 11. What are the risks and complications associated with my procedure? 12. How are complications handled? CONTINUED

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Augmentation Mammaplasty

13. How many additional implant‐related operations can I expect over my lifetime? 14. How will my ability to breastfeed be affected? 15. How can I expect my implanted breasts to look over time? After pregnancy? After breastfeeding? 16. What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts? 17. How will my breasts look if I choose to have the implants removed in the future without replacement? 18. Do you have breast augmentation before‐and‐after photos I can look at for this procedure and what results are reasonable for me? END OF TOPIC

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Mastopexy What is breast lift surgery?

Commonly referred to as a breast lift or boob lift, mastopexy surgery raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Inside ¾ What to expect during your breast lift consultation ¾ Preparing for breast lift surgery ¾ Breast lift risks and safety information ¾ Breast lift procedure steps ¾ Breast lift recovery ¾ Breast lift results will be long‐lasting ¾ How much will breast lift cost? ¾ Mastopexy words to know ¾ Questions to ask your breast lift surgeon

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Mastopexy

What to expect during your breast lift consultation The success and safety of your breast lift procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be prepared to discuss: ¾Why you want the surgery, your expectations and desired outcome ¾Medical conditions, drug allergies and medical treatments ¾Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs ¾Previous surgeries ¾Family history of breast cancer and results of any mammograms or previous biopsies Your mastopexy surgeon may also: Evaluate your general health status and any pre‐existing health conditions or risk factors Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas Take photographs for your medical record Discuss your options and recommend a course of treatment Discuss likely outcomes of breast lift surgery and any risks or potential complications Discuss the use of anesthesia during your breast lift

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Mastopexy

Preparing for breast lift surgery Before mastopexy surgery, you may be asked to: ¾Get lab testing or a medical evaluation ¾Take certain medications or adjust your current medications ¾Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue ¾Stop smoking well in advance of surgery ¾Avoid taking aspirin, anti‐inflammatory drugs and herbal supplements as they can increase bleeding Special instructions you receive will cover: ¾What to do on the day of surgery ¾Post‐operative care and follow‐up ¾Your plastic surgeon will also discuss where your procedure will be performed. Breast lift surgery may be performed in an accredited office‐based surgical center, outpatient / ambulatory surgical center, or a hospital. You’ll need help If your breast lift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

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Mastopexy

Breast lift risks and safety information The decision to have surgery is extremely personal and you'll have to decide if the benefits will achieve your goals and if breast lift risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications. The risks include: ¾An unfavorable breast lift scar ¾Bleeding (hematoma) ¾Infection ¾Poor healing of incisions ¾Changes in nipple or breast sensation, which may be temporary or permanent ¾Anesthesia risks ¾Breast contour and shape irregularities ¾Skin discoloration, permanent pigmentation changes, swelling and bruising ¾Damage to deeper structures ‐ such as nerves, blood vessels, muscles, and lungs ‐ can occur and may be temporary or permanent ¾Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents CONTINUED

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Mastopexy

¾Breast asymmetry ¾Fatty tissue deep in the skin could die (fat necrosis) ¾Fluid accumulation ¾Excessive firmness of the breast ¾Potential partial or total loss of nipple and areola ¾Deep vein thrombosis, cardiac and pulmonary complications ¾Blood clots ¾Pain, which may persist ¾Possibility of revisional surgery You should know that: Breast lift surgery can interfere with diagnostic procedures Breast and nipple piercing can cause an infection Breast lift surgery does not normally interfere with pregnancy, but if you are planning to have a baby, your breast skin may stretch and offset the results of mastopexy and you may have more difficulty breastfeeding after this operation Where will my surgery be performed? A breast lift procedure may be performed in your plastic surgeon's accredited office‐based surgical facility, an ambulatory surgical facility or a hospital. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety. CONTINUED

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Mastopexy

When you go home If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. Be careful Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing to minimize the chances of breast lift scarring. Your doctor will give you specific instructions on how to care for yourself. END OF TOPIC

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Mastopexy

Breast lift procedure steps What happens during breast lift surgery? Your mastopexy surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on: ¾Breast size and shape ¾The size and position of your areolas ¾The degree of breast sagging ¾Skin quality and elasticity as well as the amount of extra skin Step 1 ‐ Anesthesia Medications are administered for your comfort during breast lift surgery. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. Step 2 ‐ The incision There are three common incision patterns: ¾Around the areola ¾Around the areola and vertically down from the areola to the breast crease ¾Around the areola, vertically down from the breast crease and horizontally along the breast crease CONTINUED

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Mastopexy

Step 3 ‐ Reshaping your breasts After your doctor makes the incisions: The underlying breast tissue is lifted and reshaped to improve breast contour and firmness. The nipple and areola are repositioned to a natural, more youthful height. If necessary, enlarged areolas are reduced by excising skin at the perimeter. Excess breast skin is removed to compensate for a loss of elasticity. Step 4 ‐ Closing the incisions After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed. Some incision lines resulting from breast lifts are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin. Step 5 ‐ See the results The results of your breast lift surgery are immediately visible. Over time, post‐ surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for breasts which have been restored to a more youthful and uplifted position. END OF TOPIC BACK

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Mastopexy

Breast lift recovery After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect after breast lift surgery. You will be given specific instructions that may include: How to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow‐up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual mastopexy recovery period. ¾Where will I be taken after my surgery is complete? ¾What medication will I be given or prescribed after surgery? ¾Will I have dressings/bandages after surgery? When will they be removed? ¾Are stitches removed? When? ¾When can I resume normal activity and exercise? ¾When do I return for follow‐up care?

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Mastopexy

Breast lift recovery After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect after breast lift surgery. You will be given specific instructions that may include: How to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow‐up with your plastic surgeon. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual mastopexy recovery period. ¾Where will I be taken after my surgery is complete? ¾What medication will I be given or prescribed after surgery? ¾Will I have dressings/bandages after surgery? When will they be removed? ¾Are stitches removed? When? ¾When can I resume normal activity and exercise? ¾When do I return for follow‐up care?

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Mastopexy

Breast lift results will be long‐lasting The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time. Your mastopexy results will be long‐lasting. Over time, your breasts can continue to change due to aging and gravity. But, you’ll be able to retain your new look longer if you: ¾Maintain your weight ¾Keep a healthy lifestyle Special note: While a breast lift does not usually affect breast function, if you are planning to become pregnant, discuss this with your plastic surgeon. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast lift provides. Likewise, plans for significant weight loss should also be discussed.

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Mastopexy

How much will a breast lift cost? Cost is always a consideration in elective surgery. Breast lift prices can vary widely. A surgeon’s cost for breast lift may vary based on his or her experience as well as geographic location. Many plastic surgeons offer patient financing plans, so be sure to ask. ¾The cost of breast lift surgery may include: ¾Surgeon’s fee ¾Hospital or surgical facility costs ¾Anesthesia fees ¾Prescriptions for medication ¾Post‐surgery garments, and ¾Medical tests Most health insurance plans will not cover breast lift surgery, related complications or another surgery to revise the appearance of your breasts. You must carefully review your health insurance policy. Your satisfaction involves more than a fee When choosing a plastic surgeon for breast lift surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

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BREAST LIFT TOPICS

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Mastopexy

Mastopexy words to know Areola: Pigmented skin surrounding the nipple. Breast augmentation: Also known as augmentation mammaplasty, breast enlargement by surgery. Breast lift: Also known as mastopexy; surgery to lift the breasts. Breast reduction: Also known as reduction mammaplasty, reduction of breast size by surgery. Excision: To remove the skin. General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. Hematoma: Blood pooling beneath the skin. Intravenous sedation: Sedatives administered by injection into a vein to help you relax. Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Mammogram: An x‐ray image of the breast. Mastopexy: Surgery to lift the breasts. Sutures: Stitches used by surgeons to hold skin and tissue together.

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Mastopexy

Questions to ask your breast lift surgeon Use these breast lift questions as a guide during your consultation. 1. Are you certified by the American Board of Plastic Surgery? 2. Were you trained specifically in the field of plastic surgery? 3. How many years of plastic surgery training have you had? 4. Do you have hospital privileges to perform this procedure? If so, at which hospitals? 5. Is the office‐based surgical facility accredited by a nationally‐ or state‐ recognized accrediting agency, or is it state‐licensed or Medicare‐certified? 6. Am I a good candidate for this procedure? 7. Where and how will you perform my procedure? 8. What surgical technique is recommended for me? 9. How long of a recovery period can I expect, and what kind of help will I need during my recovery? 10. What are the risks and complications associated with my procedure? 11. How are complications handled? 12. How will my ability to breastfeed be affected? 13. How can I expect my lifted breasts to look over time? After pregnancy? After breastfeeding? 14. What are my options if I am dissatisfied with the cosmetic outcome of my lifted breasts? 15. Do you have before‐and‐after photos I can look at for this procedure and what results are reasonable for me?

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