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Plastic Surgery FAQ Provided by Dr. Brian Heil

Frequently Asked Questions

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If You're Considering Abdominoplasty...

Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

If you're considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

The Best Candidates For Abdominoplasty

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

All Surgery Carries Some Uncertainty and Risk

Thousands of abdominoplasties are performed successfully each year. When done by a qualified plastic surgeon who is trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.

You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

Planning Your Surgery

In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs.

Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each.

If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result.

In any case, your surgeon should work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour.

During the consultation, your surgeon should also explain the anesthesia he or she will use, the type of facility where the surgery will be performed, and the costs involved. In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure.

Preparing For Your Surgery

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.

If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.

Where Your Surgery Will Be Performed

Many surgeons perform both partial and complete abdominoplasties in an outpatient surgical center or an office-based facility. Others prefer the hospital, where their patients can stay for several days.

Types of Anesthesia

Your doctor may select general anesthesia, so you'll sleep through the operation.

Other surgeons use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your abdominal region will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)

The Surgery

Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

Most commonly, the surgeon will make a long incision from hipbone to hipbone, ,just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.

Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.

In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.

After Your Surgery

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours or you may have to remain hospitalized for two to three days.

Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.

Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.

Getting Back to Normal

It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

Your New Look

Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.


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What is Breast Augmentation?

Breast Augmentation at Premier Plastic Surgery creates larger breasts through the placement of breast implants behind your existing breast tissue or chest muscles. There are many reasons for having breast augmentation. Pittsburgh residents know they can trust the natural results our surgeons achieve. Perhaps you feel that your breasts are too small; your breasts may have lost volume or their youthful shape after pregnancy; or your breasts may be different sizes and you'd like them to be more symmetrical.


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What is Breast Reconstruction?

Premier Plastic Surgery breast reconstruction surgery allows women who have lost a breast to cancer or disease to restore their previous appearance with breast augmentation. Pittsburgh surgeons support their practice of performing breast reconstruction surgery at the same time as a mastectomy with multiple studies that have shown the procedure is safe. Large studies indicate there is no increased recurrence if a patient has undergone breast reconstruction, and complication rates for a breast reconstruction performed at the same time as the mastectomy compared to the procedures separately are no higher.


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What is Breast Reduction?

Premier Plastic Surgery breast reduction is another option for natural looking breast enhancement. Pittsburgh surgeons perform breast reductions, which have been, and continue to be, a very effective way to reduce breast size that can often cause major discomfort and pain. Unlike other cosmetic procedures, some breast reductions are performed for medical reasons, not just cosmetic but can provide breast enhancement. Pittsburgh surgeons can reduce the size of oversized breasts, which can cause back and neck pain, skin irritation, skeletal deformities and breathing problems. A breast reduction surgery has the ability to eliminate these problems.


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What is a Breast Lift?

Pittsburgh surgeons help women who have experienced a change in their breasts due to pregnancy, breastfeeding, losing weight and gravity. Breasts once perky and firm can soon start to droop. Breast lift is a cosmetic procedure that allows women to regain more youthful appearing breasts by making them higher and firmer; a complete breast enhancement. Pittsburgh surgeons achieve beautiful results by moving the nipple position that can turn downward over time and tighten the skin.

In some cases, women with large sized breasts will experience the effects of gravity even more than smaller chested women because of the additional weight. Surgeons who specialize in breast augmentation will help each woman choose if a breast reduction and breast lift in combination is right for them. In other cases, women desire a breast lift because their breasts are not symmetrical. When the breasts are not the same size, women can choose to get breast implants, in order to even out the sides along with the breast lift, for a full breast augmentation.


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What is Gynecomastia?

Gynecomastia surgery in Pittsburgh is offer at Premier Plastic Surgery. An estimated 40 to 60 percent of men are affected by gynecomastia, which is the medical term for male breast overdevelopment. Our surgeons treat gynecomastia with a cosmetic surgery procedure often termed, male breast reduction. Pittsburgh surgeons acknowledge that there have been certain drugs and medical problems linked to gynecomastia, but there is no known cause in most cases. Among teenage boys, 90 percent of the time gynecomastia will usually go away in less than three years. For the other 10 percent left with the male breast overdevelopment we offer gynecomastia surgery in Pittsburgh, PA.


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Who is a good candidate for Liposuction?

Any area of the body with excess pockets of fat can have Liposuction. Pittsburgh plastic surgeons recommends that the best candidates for liposuction will have good skin elasticity that is able to reach the smoothest contours after the fat has been removed. Liposuction in Pittsburgh by Dr Heil is not intended to treat obesity and will be the most effective when performed on patients that exercise and follow a healthy diet but have problematic areas of fat that do not respond to traditional weight loss methods.


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What is Abdominoplasty?

Surgery of the abdomen or "tummy tuck", is called Abdominoplasty. Pittsburgh Premier Plastic Surgery offers this cosmetic procedure, designed to firm and smooth the skin. Although diet and exercise will have a lot to do with how much fat is stored in the abdominal region, sometimes the desired result can still be extremely difficult to achieve. For women, after having children, the pregnancies can leave the abdominal region loose and unresponsive to diet and exercise. Women and men already in relatively good shape but who desire a smoother, flatter stomach should consider Abdominoplasty. Pittsburgh surgeons can discuss if you are a candidate at your consultation.


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What is a Body Lift?

For patients who have succeeded in losing a significant amount of weight there is little that is more disappointing than having unflattering excess of skin. Pittsburgh cosmetic surgery surgeons recognize that loose, sagging skin detracts from the appearance of a trimmer, healthier body and hides your new body shape. Fortunately, we are able to remove extra skin and improve your contour by performing a procedure known as a body lift performed from our Pittsburgh plastic surgeon, Dr Heil. The goal of the surgery is to smooth and tighten the skin and surgically remove the excess skin, revealing the slimmer physique beneath. The best candidates for this procedure have healthy skin with good elasticity.


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What is an Arm Lift?

The Arm Lift, or Brachioplasty, is a surgical procedure offered by our Board Certified Pittsburgh plastic surgeon. It lifts, tightens and re-contours the arm by removing excess skin and fat deposits. As we age, or if major weight loss occurs, the upper arm begins to sag due to the great affect of gravity, skin laxity, thinning skin, muscle and fat tissues. An Arm Lift does not affect muscle tone, and normal physical activity is not only possible but highly recommended once recovery is completed.


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Why a Facelift?

The availability of lasers and injectable fillers allows patients that do not show advanced aging to take a more preventative approach to cosmetic surgery, but as lines and folds became deeper and loose skin and excess fatty tissue develops, some patients want a more permanent result that cannot be achieved with injections alone.

A facelift in Pittsburgh with Dr. Heil can leave a patient looking refreshed and rejuvenated, but a healing time must be expected first. The patient will begin to see the swelling and puffiness subside, numbness diminish and a smoother, more youthful appearance result after several weeks following the facelift.


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Why get Rhinoplasty?

One of the top three most frequently performed plastic surgery procedures in the country is nose reshaping or Rhinoplasty. Pittsburgh plastic surgeon Dr Heil notes that because the nose is situated in the middle of the face, it draws significant attention to itself. A displeasing nose can detract attention from an otherwise attractive face. In addition to concerns regarding nasal appearance, many people have a deviated septum, in which the internal nose is out of position and can cause breathing problems. Both the outside and inside of the nose can be improved with nose plastic surgery-Rhinoplasty. Pittsburgh Premier Plastic Surgery offers this surgery and many more cosmetic surgery options.


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What is a Blepharoplasty?

Cosmetic Eyelid Surgery in Pittsburgh can help the appearance of aging and gravity, as well as heredity, can create visible changes in the area around the eyes. Fat beneath the lower eyelid can disappear, resulting in a more sunken appearance, and the wall holding in the fat can weaken, resulting in a bag under the eye. Offered in Pittsburgh, cosmetic surgery for the eyelid, or blepharoplasty, is performed to remove baggy lower eyelids and droopy upper lids.

Puffiness, drooping and winkles around the eyelids can make people appear tired, sad or older than they really are or feel. Cosmetic eyelid surgery, Pittsburgh, is able to smooth out the appearance of the eye area, making a person appear more rejuvenated and youthful. After a couple weeks of recovery, the cosmetic eyelid surgery patient can enjoy long-lasting results of having a firmer eye area.


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What is an Otoplasty?

Otoplasty, also known as ear surgery, is usually performed to pin back ears that stick out away from the head or to reduce the size of large ears. The Pittsburgh cosmetic surgery procedure is often performed on children because unlike other parts of the body, patients usually will have already experienced full ear growth by the age of four. Since many children may endure taunting and teasing for having prominent sized ears, otoplasty at a younger age can eliminate the ridicule, as well as produce a more pleasing appearance.


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What is BOTOX?

BOTOX® FDA approved for cosmetic use, temporarily stops unwanted muscle movement around the eyes to remove frown lines, crows feet, and more. Now widely used in combination with dermal fillers and skin tightening, BOTOX/Dysport is an important component of non-surgical "facelift" facial restoration.


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Brian V. Heil, M.D. F.A.C.S.
Premier Plastic Surgery of Pennsylvania
Office Address:
144 Emeryville Dr, Ste 110
Cranberry Twp, PA 16066

Upper St. Clair
1614 Washington Rd.
Upper St. Clair, PA 15241

Roesch-Taylor Building
2110 Jane St, Ste 801N
Pittsburgh, PA 15203

Cypher Building
901 E Brady St, Ste 301
Butler, PA 16001

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