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Plastic Surgery FAQ Provided by Dr. Mark Chin

Frequently Asked Questions

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Breast Augmentation

Breast Augmentation is a surgical procedure used to increase the size and/or alter the shape of a woman's breasts through the use of an artificial implant. Women may choose to have this operation either as a reconstructive technique following breast surgery, to balance different sized breasts, or to enhance the contours of the body. Whatever the specific purpose, women who undergo breast augmentation can expect larger, firmer, and more visually satisfying breasts.

The Surgery
The surgery begins with an incision, made either in the crease of the breast, the armpit, or the perimeter of the areola (the dark skin surrounding the nipple). The placement of the incision will vary according to body type and the specifics of each procedure. The surgeon enters through the incision and creates a pocket, either underneath the breast tissue or under the chest wall muscle. The implant is placed in either location, centered directly behind the nipple. Finally, the original incision is sutured.

After Surgery
Once the incisions have been closed and taped, the breasts are wrapped and supported by a gauze bandage. Patients are fitted with a surgical bra that provides support for up to several weeks. Postoperative fatigue, soreness, and discomfort may be greatly reduced through medication. Swelling gradually subsides and becomes undetectable in a month's time. Stitches are removed within seven to ten days.

Health Concerns
As with any surgical procedure, complications, although rare, do exist. The biggest fear is a leak in the surgical implant. The FDA currently prohibits the use of silicone filled implants except for women involved in specific medical studies. Therefore, in a normal procedure, a leak would involve only a saline water solution. Capsular contraction (a tightening of the scar or capsule surrounding the implant) can occur following a breast augmentation procedure. If this happens, the surgeon either "scores" the scar tissue or removes the implant and re-inserts another. Other complications include excessive bleeding and infection in the area surrounding the implant. Scars may be evident for several months but gradually fade. In some cases, the nipples may become hypersensitive or under sensitive for a period of time after the surgery. In rare instances, the breasts may produce milk for several days afterwards. To maximize the success of surgery and minimize the risk of complication, always follow your doctor's instructions for surgical preparation and postoperative care.

 

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Breast Lift

A breast lift is a cosmetic procedure designed to give sagging breasts a more appealing look and feel. The procedure removes skin from the bottom of the breast and tightens the skin on the sides around the breast tissue, renewing firmness in the chest. Breast lifts are often sought by women whose breasts have been stretched from nursing after pregnancies. It may be performed in conjunction with breast augmentation.

The Procedure
A breast lift takes approximately one to three hours. The most frequent technique begins with an incision down the front and along the bottom of the breast. A circular cut is made around the areola -- the dark skin surrounding the nipple -- and continues straight downward to the crease underneath the breast. Then a horizontal cut is made along the crease. The surgeon moves the nipple up to a more attractive position. The skin from the sides of the breast is pulled down to wrap around the nipple's new placement, and the excess skin is removed. The surgeon then sews up the incisions.

Post-Op
After surgery, the breasts remain wrapped in a bandage; later, this will be replaced by a surgical bra. The patient may have mild pain, numbness, swelling, and/or bruising in the breasts. Most of these symptoms subside within a few weeks, though a slight amount of swelling and numbness may persist for longer.

Health Concerns
Like any surgical procedure, there are some risks associated with breast lift. In rare cases, patients may experience a reaction to the anesthesia or may suffer from infection. Small breasts usually produce the best results, as larger breasts tend to sag faster after a lift. And though a breast lift does not usually interfere with pregnancies or nursing in the future, the breasts can stretch out again during breast-feeding, negating the results of surgery.

 

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Breast Reduction

Breast reduction surgery in a procedure in which fat and glandular tissue are removed from the chest and the skin is pulled tight around the remaining tissue to form smaller, more manageable, and more aesthetically pleasing breasts. Women often seek breast reduction surgery because their breast size causes them embarrassment, inconvenience, or medical problems (examples include skin irritation, back pain, and inhibition of breathing).

The Procedure
Breast reduction has many variations, but the most common begins with an incision that begins at the areola (patch of skin surrounding the nipple) and runs down the center of the breast. Through this opening, Dr. Chin removes fat and glandular tissue. Often, the nipple is moved higher up on the breast, and the skin on the sides of the breast is pulled down and around it. Excess skin is taken off, and the incision is closed.

Post-Op
Dry skin, bruising, swelling, and general discomfort in the chest are all normal effects of breast reduction. Pain medication may be prescribed and a moisturizer recommended. After a few weeks, the patient should be feeling better again. Stitches are usually removed within a week to ten days. There may also be more extended effects of which the surgeon can warn the patient.

Health Concerns
It is important that a prospective patient for breast reduction have fully developed breasts. It is also inadvisable to have breast reduction surgery if the patient anticipates future pregnancy, since breast reduction can sometimes inhibit milk production.

 

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Liposuction

Inherited traits often prevent people from achieving their desired body shape. Even years of exercise may not yield significant or noticeable results in certain people. For many, the answer is liposuction, a surgical procedure which extracts fat from specific areas of the body. Following the procedure, patients can expect a slimmer, more shapely figure.

The Surgery
The surgeon begins by inserting a cannula (a slim, hollow tube) into small incisions near the area to be recontoured. The cannula is moved through the layers of tissue and extracts the necessary fat. Once the fat and tissue have been removed, the surgeon stitches the incision and trims away excess skin. Several techniques exist. The super-wet technique involves an injection of fluid into the patient's body, roughly the same amount as the fat to be extracted. The tumescent technique involves an injection of double or even triple the amount of fluid. In UAL (Ultrasound-Assisted Lipoplasty), a specially designed cannula uses ultrasound to liquefy the fat and suction it away. Except in the most extreme cases, procedures are performed on an outpatient basis. Your surgeon will suggest the most appropriate form of anesthesia (epidural block, intravenous sedation, local, or general anesthesia).

After the Surgery
Following surgery, an elastic bandage is applied in order to reduce swelling and keep the skin in place. In complex procedures, patients should be monitored closely to make sure no complications occur. Patients return to work after several days and stitches are typically removed in one week.

Health Concerns
As with any cosmetic surgical procedure, complications are rare, but include infection, a reaction to the anesthesia, blood clotting, and fluid loss. Less severe risks include numbing of the skin and moderate changes in skin pigmentation. It is extremely important to choose a physician who has proper and extensive training, with state-of-the-art facilities and a good standing in their field. If you smoke, your surgeon will advise that you stop both two weeks prior to and following surgery. To maximize the success of surgery and minimize the risk of complication, always follow your doctor's instructions for surgical preparation and postoperative care.

 

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Tummy Tuck

The tummy tuck reforms weak muscles, removes fat, and trims away skin to produce a flatter, firmer abdomen. For patients who are in reasonable shape, but require a simple fix for a troublesome tummy, this procedure is perfect.

The Procedure
Depending on the patient's needs, a tummy tuck may be limited to the lower abdomen or may be used to eliminate overall protrusion throughout the abdominal region. A partial tummy tuck starts with an incision where the abdominal muscles end and the pubic region begins. The skin is pulled away from the underlying muscle and fat as far up as the navel. Fat is removed, and the lower abdominal muscles may be pulled into a more natural position. Then the skin is pulled downward, with some being trimmed off at the bottom, and the incision is sewn up.

During complete abdominoplasty, a second incision is made in a circle around the navel. The skin is pulled away from the muscle structure almost all the way to the ribcage. Fat is again removed and muscles repositioned closer to the center of the body. The skin is pulled down so that the excess can be trimmed, and a new hole is created for the navel. The incisions are then sewn up.

Post-Op
Some pain and swelling are to be expected after surgery. Pain medications can help to provide relief. Patients will need to refrain from driving and other activities for a couple of weeks following a thigh lift. Most patients can return to work in approximately two weeks. More strenuous activities may be resumed in about a month.

Health Concerns
Like any surgical procedure, there are some risks that accompany thigh lifts. Patients may experience significant scarring that may spread and form a thick band. Loss of sensation in the area is also possible but usually temporary. Bleeding, infection, and adverse anesthesia reaction are possible complications of most surgical procedures. Following Dr. Chin's instructions can help you reduce your risks.

 

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Brachioplasty

As a person ages, skin loses elasticity and firmness. In the upper arms, this often leads to loose skin that sags unattractively. Brachioplasty, or arm lift, is a surgical procedure that tightens loose upper arm skin to produce a more youthful appearance. During the procedure excess fat is often removed as well, making the arms look more toned.

The Procedure
Brachioplasty is most often performed under general anesthesia. Dr. Chin typically makes the necessary incisions on the inside part of the upper arm, beginning near the armpit. He then removes the excess sagging skin and tissue. Liposuction may be used to remove fat from the arms at the same time. The remaining skin is then pulled tightly and stitched back in place. In some cases, a tube may be used to facilitate the drainage of fluids from the treatment area.

Post-Op
Some pain and swelling is to be expected after surgery. Medication can help to minimize pain. Although patients can usually go home the day of their surgery, rest is needed for several days. Lifting and bending should be avoided for at least the first week. Most people can return to their jobs and to moderate exercise with two weeks, but vigorous workouts should be postponed for at least a month.

Health Concerns
Brachioplasty is considered to be relatively safe, but as with any surgical procedure, there are some risks. Patients may experience a reaction to the anesthesia, may bleed excessively, or may suffer from an infection. Nerve damage and extensive scarring are also possible. To limit the risk of complications, patients should carefully follow Dr. Chin's instructions.

 

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Thigh Lift

Losing weight is great for your health and self-esteem, but significant weight loss can sometimes leave behind sagging skin. Thigh lift is a procedure designed to remove excess skin from your legs, making them appear tighter and smoother. It is sometimes combined with liposuction but can be done alone.

The Procedure
During a thigh lift, an incision is made either in the crease of the groin area or hidden beneath the bikini lines. Dr. Chin then trims away excess skin and tissue. He repositions and tightens the skin before stitching it back into place. Thigh lift is performed under general anesthesia.

Post-Op
Some pain and swelling are to be expected after surgery. Pain medications can help to provide relief. Patients will need to refrain from driving and other activities for a couple of weeks following a thigh lift. Most patients can return to work in approximately two weeks. More strenuous activities may be resumed in about a month.

Health Concerns
Like any surgical procedure, there are some risks that accompany thigh lifts. Patients may experience significant scarring that may spread and form a thick band. Loss of sensation in the area is also possible but usually temporary. Bleeding, infection, and adverse anesthesia reaction are possible complications of most surgical procedures. Following Dr. Chin's instructions can help you reduce your risks.

 

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Rhinoplasty

Surgery to reshape the nose is a common cosmetic procedure that can have profound results on a person's appearance and self-confidence. Rhinoplasty can accomplish any number of changes, including size augmentation or reduction, a narrowing of the nostrils, changes in the bridge or tip of the nose, or an alteration to the angle of the nose and upper lip. Regardless of the specific purpose, surgery to reshape the nose creates a more contoured and shapely nose.

The Surgery
The surgeon begins by making an incision, either from within the nose or across the columella (the vertical strip separating the nostrils). The skin is then separated from the underlying framework of the nose and the bone and cartilage is sculpted to the desired shape and size. Finally, the surgeon reattaches the skin to the new contoured framework and stitches the incision. Surgery usually lasts one to two hours and is performed on an outpatient basis.

After the Surgery
Following surgery, a splint is applied to the nose to maintain the new shape. The surgeon may also decide to place nasal packs or soft plastic splints in the nostrils to stabilize the septum (the dividing wall between the air passages). Patients can experience some swelling and bruising around the eyes and nose, although medication greatly reduces any discomfort you may experience. Stitches are usually removed in five to seven days and patients can return to work in ten to fourteen days. Patients who wear eyeglasses must have them specially fitted to their heads for up to seven weeks.

Health Concerns
As with any cosmetic surgical procedure, complications are rare but may include infection, nosebleeds, or a reaction to the anesthesia. In certain cases, small burst blood vessels may appear as tiny red spots on the skin's surface (a minor but permanent condition). Some patients may experience mild depression - a common and temporary side effect. Minor scarring may occur if the surgeon makes the incision across the columella. To maximize the success of surgery and minimize the risk of complication, always follow your doctor's instructions for surgical preparation and postoperative care.

 

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Facelift

Facelift is a procedure performed in order to reverse the effects of age, gravity, exposure to the sun, and daily stress by removing excess fat, tightening facial muscles, and readjusting the facial skin. A facelift is also an excellent procedure for those with excess skin hanging from the neck or jowls. A facelift may be done in combination with other facial procedures such as a forehead lift (brow lift), eyelid surgery (blepharoplasty), or a nose job (rhinoplasty.)

Facelift is a highly individualized procedure that your surgeon will tailor to your unique bone structure, skin texture, and underlying muscle tone. Facelifts do not improve skin texture, although they can be done in conjunction with procedures that do improve texture, such as laser or chemical skin peels.

The Procedure
Facelift surgery usually takes several hours to complete. For extensive and/or multiple procedures, your doctor may schedule two separate sessions. Some surgeons complete one side of the face at a time, some do all at once, and others will determine the sequence of events based upon your facial structure and the surgeon's own technique.


Incisions usually begin above the hairline at the temple, continue behind the ear, and terminate behind the earlobe in the lower scalp area. The skin is then separated from the underlying fat. This fat is trimmed or suctioned away selectively in order to improve the contours of the face. The doctor then tightens the facial muscles and pulls the skin back. Some excess skin may also be removed. Stitches are used to close the incisions, and metal staples may be used to reattach the skin to the scalp.

Post - Op
Following surgery, a small tube is often placed underneath the skin in order to facilitate drainage of blood that often collects behind the ears. The tube is removed after a couple of days. Your head may also be wrapped and dressed to prevent bruising and swelling. Pain medication is available for those who desire it. Numbness of the face is a common complaint. This sensation will disappear within a few weeks.

Sex, running, and other vigorous activity should be avoided for at least two weeks. Alcohol, steam baths and saunas should be avoided for at least two months. Facial features can remain somewhat swollen for several months after surgery and will gradually return to normal.

 

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Brow Lift

Forehead wrinkles, drooping eyelids, and sagging eyebrows can make a person look older and more tired than they may feel. A brow lift is a cosmetic surgery procedure than can help to correct these problems, rejuvenating the patient's facial appearance. Skin will be smoother and tighter, and the eyes may seem bigger and more alert. Compared to other cosmetic surgery procedures, brow lifts are simpler and less painful.

The Procedure
Brow lift surgery can be done using either general or local anesthesia. It is typically an outpatient procedure. To perform a brow lift, Dr. Chin begins by making an incision at the near the ear. It extends around the forehead near the hairline so that visible scarring is minimized. He then removes excess tissue and pulls the skin taut. Excess is trimmed away and stitches or clips are used to suture the incision. A special bandage is then applied over the treated area.

Post-Op
Recovery time varies, but most patients can return to work within two to three weeks. Vigorous physical activity should be avoided for four to six weeks. Patients may experience some pain, tenderness, and swelling after surgery, which can usually be alleviated with pain medication. Scars typically fade over time.

Health Concerns
Brow lift surgery is generally considered safe. All surgical procedures do entail some risk, however. Infection, bleeding, and reaction to the anesthesia are rare but possible. Loss of sensation, nerve damage in the forehead muscles, and excessive scar formation have also been known to occasionally occur. Patients can reduce their risk of complications by adhering to Dr. Chin's instructions and by refraining from smoking prior to and following surgery.

 

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Blepharoplasty

Eyelid surgery - also known as blepharoplasty - is the process by which fat, skin, and possibly muscle are surgically altered to streamline the area around the eyes. Upper blepharoplasty can alleviate the common problem of skin that droops over the patient's eyes, while lower blepharoplasty is designed to eliminate the baggy or puffy look that can sometimes develop in the skin beneath the eyes.

The Procedure
The procedure is typically short. In the case of surgery on the upper eyelids, the surgeon makes an incision in one of the creases to keep it inconspicuous. For the lower eyelids, the incision may be made just below the lashes on the outside or on the inside, in the part of the lid that contacts the eye itself. The surgeon trims away fat and may reposition the muscles to create a more natural look. Skin may also be trimmed if it is too loose to reform around the new eyelid structure. Then the incisions are sewn back up.

Post-Op
After surgery, the patient will likely feel tightness, bruising, and swelling around the eyes. The patient may experience a temporary blurring of the vision or other bothersome effects on the eye. However, if the patient uses pain medication and takes steps to protect the eyes, most of the discomfort and aftereffects should be fairly mild and should subside within a few weeks.

Health Concerns
A patient should definitely discuss any of the following conditions with a blepharoplasty surgeon before undergoing the procedure: dry eyes, hormonal problems, circulatory disorders, diabetes, and cardiovascular diseases.

 

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Fat Injections

Fat injections can be used to fill in wrinkles and lines, to create contours in the face, and to fill in scars. Fat injections are a safe and versatile option; because they use fat from one area of a patient's body to fill in another, there is little chance of allergy or incompatibility. Although fat injections are impermanent, they can be repeated as necessary.

The Procedure
Fat injections are usually done on an outpatient basis with local anesthetic. The donor site (often the buttocks or abdomen) is first numbed and injected with fluid to make extracting the fat easier. The donor fat is collected through a needle and syringe. After the fluid is removed, another needle is used to reinsert the fat into the treatment area. Dr. Chin will at first slightly overfill the treatment area because some of the injected fat will be reabsorbed by the body.

Post-Op
Most patients can resume normal activities soon after undergoing fat injection. Some minor swelling and bruising can occur during the first few days following fat injection. Fat injections are not usually permanent. How long the results last varies among individuals.

Health Concerns
In more areas, fat injections are considered to be very safe. The breasts, however, are inappropriate for this procedure. Injected fat may reduce the efficacy of mammograms, making breast cancer diagnosis more difficult. To limit the risk of complications, patients should follow Dr. Chin's directions carefully.

 

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Mark A. Chin, M.D.
Valley Institute of Plastic Surgery
Office Address:
6175 N. Fresno Street
Suite 101
Fresno, CA 93710
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Dr. Chin has 5 patients available for view in the Before and After Photo Gallery. Click here to visit.
   

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