Click topic for more information:Email Dr. Tornambe
FAQ
Click for more information regarding:
Contact Dr. Tornambe
Abdominoplasty
Abdominoplasty, or "tummy tuck", is a procedure in which excess fat and skin is removed from the lower portion of the abdomen. An incision is made just above the pubic region below the "bikini line" and the excess fat of the abdominal region may be removed. The surrounding tissue may be liposculptured at the same time. There are two types of tummy tucks, a full tummy tuck and a mini- tummy tuck. A full tummy tuck involves an incision on the very lower portion of the abdomen above the pubic region which is well-hidden by bathing suits and clothing. The skin and fat layer is dissected away from the abdominal musculature layer and an incision is made around the umbilicus, or belly button. The dissection continues further up to allow maximum removal of excess skin and fat. Sometimes a small amount of liposuction is also included in the procedure when necessary. Following this, the abdominal wall and musculature is tightened with multiple sutures to give the patient a younger, fitter look to the abdomen. Once this is done, the excess skin and fat is pulled taut, trimmed, and a small opening is made for placement of the belly button. The wounds are then closed. This procedure is extremely useful in patients who have had one or more pregnancies which caused the abdominal wall musculature to become significantly weaker, even when a great amount of exercise is done. Once the musculature is tightened surgically, a firm taut tummy can then be obtained. A significant change in body contour can be successfully achieved with a full tummy tuck.
A mini-tummy tuck is a procedure in which a smaller incision, (approximately 8 inches long) is made in the lower abdomen. It is located in the same portion where a C-section is performed, and many times is actually performed at the same time as a C-section in conjunction with a Obstetric Gynecologist. In this case, the dissection only continues up to the belly button and no incision is made around the belly button. Usually liposuction is performed in conjunction with this and the lower portion of the abdominal wall is tightened as previously described. While less is removed in these patients, often that is all that is necessary for many people. The advantage of the mini-tummy tuck is that the scar is smaller, the procedure is not as drastic, and the down time is less. Not all patients are candidates for this operation and discussion with a plastic surgeon should be made in deciding which of these two operations should be performed.
The recovery time for a full tummy tuck is approximately two weeks and the recovery time for the mini-tummy tuck is approximately one week. Normal exercise can be resumed in approximately four weeks.
Contact Dr. Tornambe
Back to top
Blepharoplasty
Eyelid surgery, or blepharoplasty, is a common cosmetic procedure. In this operation, excess skin is trimmed and excess fat removed in an effort to return the eyelids and eye region to a more youthful appearance. The combination of gravity, aging, sun exposure and heredity contribute to the aging process of the eyelids. Baggy eyelids are a common trait passed on from generation to generation and for this reason, it is sometimes necessary to perform this operation in patients as early as their thirties. The advantage of this operation is that after surgery most people don't realize that surgery has been performed but they notice that the patient looks much more rested, relaxed and rejuvenated. Bedroom or sleepy eyes that make the patient look tired and inattentive at important meetings are no longer present.
Surgical Details
The operation is done usually under local anesthesia with mild sedation. Excess skin of the upper eyelids is trimmed and excess fat is removed. It should be noted that everyone has fat in their eyelids whether they are thin or heavy. The fat is part of the normal anatomy of the eyelid and once it is removed, is gone forever and does not return if the patient gains weight. In the lower eyelids, fat is removed through an incision either below the eyelid or through an incision just within the lower eyelid called the conjunctiva. This is a safe technique that is applied to younger patients who don't need excess skin removed from the lower eyelids and replaces the incision from the outer eyelids. In older patients, a skin incision is usually required not only to remove excess skin but to tighten the lower eyelid to prevent the scar from pulling the eyelid down post-operatively. Immediately after surgery, the patient will experience some blurry vision which is from antibiotic ointment which is placed within the eyes. Recovery time is usually one week and sutures are removed in 3 to 5 days. Swelling and bruising lasts 7 to 10 days. Many of our patients return to work one week after surgery.>
Possible Complications
Complications from this operation include infection, hematoma or blood formation under the skin and in extreme and rare cases, vision impairment. Generally speaking, this is a safe, tried and true procedure which carries a high level of satisfaction in our patients.
Contact Dr. Tornambe
Back to top
Body Contouring
Body contouring encompasses a vast array of procedures which are used to improve the contours of many areas of the body including the arms, chest, abdomen, hips, flanks, thighs and legs. No area of the body is immune to the aging process and long term effects of gravity. Skin elasticity decreases with time. Fatty tissue deposits itself in the flanks, abdomen, thighs and upper arms. All of these factors contribute to the unsightly changes associated with advancing age. These same changes are also seen, to a much greater degree, in patients young or old who have experienced significant weight loss through diet and exercise or bariatric surgery. Body contouring procedures are focused on reversing the effects of the aging process and or extreme weight loss with respect to all areas of the body. Body contouring frequently incorporates Liposuction as an adjunctive procedure.
Brachioplasty, or upper armlift, addresses the sagging and fatty deposition in the posterior upper arms, which presents usually at about age 50 or after extreme weight loss. Excess skin and fat is removed through incisions placed on the inner aspect of the upper arm. These incisions are relatively hidden, however, they may be visible when the arms are extended out from the body or overhead. Virtually anyone may be a candidate for upper arm lifting if they have excess skin, fat or a combination of both in the upper arms. Younger patients (less than 50 years) may benefit from liposuction alone in this area. This may be determined by a full consultation with our doctors. Since brachioplasty involves only skin and fat components of the arm, it is a well tolerated operation. Consequently, the recovery period is relatively brief and you may return to work within several days. A post operative compressive garment is utilized for anywhere from a few days to several weeks. Results of this procedure are dramatic and return your upper arms to their once youthful appearance.
Abdominoplasty, or the classic "tummy tuck" operation addresses the deposition of fat associated with the aging process in men and women. Additionally, the ravages of pregnancy on stretching the skin and abdominal musculature can be reversed through the removal of excess skin and the approximation of the abdominal muscles. It is a highly effective and necessary procedure in those patients who have experienced significant weight loss and are left with rolls of redundant abdominal skin.
In some cases these patients also demonstrate significant excess skin of the posterior lower back region, requiring a Circumferential Abdominoplasty or Total Body Lift. This may be done in one or two stages and may be covered by private insurance. A letter of medical necessity and preoperative photographs are usually required by most insurance companies before authorization will be given.
Abdominoplasty is not a weight reduction procedure, although generally, a few pounds are shed with the procedure. The primary goal is to improve the abdominal contour and enhance body lines. Morbidly obese individuals should first demonstrate stable weight reduction before undergoing abdominoplasty. This will improve your final results and significantly decrease your risks of surgery.
We have performed abdominoplasty successfully on an ambulatory basis in our AAAASF accredited surgical suite. Surgery involves elevating the abdominal apron from the abdominal wall and tightening the abdominal musculature. Since the procedure requires work on the muscles, recovery for abdominoplasty is rather significant. Surgical drains will be in place requiring daily maintenance. You will be required to wear a tight abdominal binder for two to six weeks and return to full activity will be allowed after six weeks. Your new, flatter abdomen will motivate you to further lose weight and exercise through improved body image and self esteem.
Other body lifting procedures, such as Thigh Lift and Buttock Lift, may also be employed to improve body lines and overall general appearance. These procedures are generally employed in our older patient population with inelastic skin or the extreme weight loss population who would not respond well to liposuction techniques alone. Significant redundant skin can collect in the thigh and buttock regions, and our technique greatly improves the shape, contour and integrity of those regions. We sometimes employ traditional or ultrasonic liposuction techniques in conjunction with these procedures to obtain a more natural looking result. In each of these procedures the length and texture of the scarring is significant, and must be fully understood by the patient.
Our doctors spend a great deal of time counseling and educating prospective patients with regard to all aspects of the postoperative result. Most patients understand this trade-off, but are greatly pleased to shed the excess skin and improve the contour of their body. Please consult your Madison Plastic Surgery physician for the best modality to suit your needs.
Contact Dr. Tornambe
Back to top
Breast Augmentation
Breast augmentation or enlargement is an operation to increase the size and shape of a woman's breast. Many of our patients undergo this surgery in an effort to enhance their body contour, to correct a reduction in breast volume after pregnancy or to balance different sized breasts. Placement of an implant behind the breast allows us to increase a woman's bustline by one or more bra cup sizes. Many of our patients note an increased sense of self confidence and improvement of their appearance after surgery. We always stress to our patients, however, that this surgery should be done for her only and not for her husband or boyfriend. It is your body and the decision for surgery should be yours as well. Expectations for this operation should be healthy and realistic and if so, you may be a good candidate.
Since there has been such a great deal of controversy regarding breast implants, we like to educate our patients in every possible fashion regarding the pros and cons of this type of surgery so they fully understand all possible risks, expectations and complications first hand.
Types of Implants
The FDA (Food and Drug Administration) has recently approved silicone breast implants for use in cosmetic surgery. This significant turn of events now allows us to offer our patients the option of saline or silicone breast implants for cosmetic or reconstructive breast surgery. Exhaustive research and long-term follow-up of patients with silicone breast implants has demonstrated their safety, which has prompted the FDA approval. So there are now two approved options for breast implant fillers: saline and silicone. Although each filler has been approved by the FDA for breast implants, they have distinct features and benefits.
The saline implants have a silicone outer shell that is filled with saline, which is essentially a saltwater solution similar to your body's own makeup.
The newer approved silicone implants are different and better than their predecessors. The outer silicone shell is more durable and yet softer. The silicone gel filler is a thicker, softer compound. The unique qualities of today's silicone gel filled breast implants make it the filler of choice for patients in countries where both saline filled and silicone gel filled implants are widely available, because patients and physicians alike favor the natural look and feel.
Our doctors utilize all of the breast implants available, as shapes of the implants do differ, and offer advantages in some ways and differ from others. We select the breast implant possessing the most appropriate size, shape and texture which best fits the patient anatomy, providing the best possible result and satisfying the desires of our patient.
Surgical Details
This surgery is usually performed under local anesthesia with sedation but can be performed under general anesthesia as well. It is usually done in our fully certified operative suite with a board-certified anesthesiologist in attendance.
The incisions are made either directly below the nipple, in the crease below the breast, or in the axillary region, depending on the patient's preference and the patient's anatomy. We usually place our saline implants underneath the pectoralis or chest muscle for several reasons. Saline implants in this location give the breast a much more natural appearance, capsular contracture is usually lessened and if it does occur, far less obvious. Nearly all breast tissue may be visualized in mammograms with the implants under the muscle; less so when over the muscle.
Silicone implants may be inserted over the muscle or under the muscle, depending on the particular anatomy of the patient. There are times when placement of a silicone implant over the muscle can give a more desirable result and modestly lift the breast tissue, if it is sagging.
Dr. Tornambe evaluates each patient and her anatomy on an individual basis and ask the patient's preferences and desires and prefers that the patient participates in the process of determining the surgical plan.
After surgery, the patient can expect to be sore for one to two days but this is well controlled by pain medication that we prescribe for you. The dressing is usually removed 2 to 3 days after surgery and the sutures are removed 5 to 7 days after surgery. Most people return to work as early as 3 days after the operation. Normal activities are usually resumed 2 to 3 weeks after surgery as well.
Possible Complications
Breast augmentation is relatively straightforward, but some complications do occur. The most common problem that occurs is scarring around the implant, also known as capsular contracture. This can be treated in several ways if it does occur. The treatment is usually minor. As with other operations, excessive bleeding and hematoma can occur and this would require removal of the accumulated blood. Sometimes an infection can develop around the implant and this may require removal of the implant for a short amount of time to be replaced at a later date. Some women report either an increase or decrease of sensation in the nipples but this is a very rare complication and usually temporary.
There is no evidence that breast implants will affect fertility, pregnancy or the ability to nurse. Rarely, breast implants may leak or break and this would require removal of the implant and placement of a new implant. The advantage of saline implants is that the salt water present in the implant is harmless and will be absorbed by the body if a leak does occur. If a gel filled implant break occurs however, surgical removal of the implant and material is required to be replaced by another implant. It is usually more difficult to tell if a gel filled implant breaks as compared to a saline implant. MRI (magnetic resonance imaging) studies now diagnose leaks effectively.
It should be noted that contrary to the accusations of breast implants causing diseases of the immune system such as scleroderma and other arthritis-like conditions, recent research at major medical institutions around the country, such as Harvard and the Mayo Clinic, have found no clear link between silicone breast implants and the symptoms of what doctors refer to as "connective tissue disorders," There is no evidence that breast implants cause breast cancer, however, having breast implants may change the mammography technique necessary to detect cancer. When you undergo a mammogram be certain to inform the technician that you have breast implants so that the newer mammography techniques may be used. Sometimes additional views are required.
For many women, breast enlargement is a satisfying positive experience. We like to examine our patients on a yearly basis after surgery to be certain that the implants are in appropriate position and this yearly examination is included in the overall surgical fee. We do recommend mammography as per recommendations of the American Cancer Society (ACS) and the mammographer should be made aware of your breast implants.
Breast augmentation is a highly personal operation that is not understood by many people. One should never forget that it is your feelings and justifications that are most important in this regard. If the surgical goals have been met, then your surgery was a success.
Contact Dr. Tornambe
Back to top
Breast Reconstruction
Breast reconstruction after mastectomy is an important facet in the treatment of breast cancer. It is extremely important, not only to remove the cancerous tissue, but reconstruct that tissue in a way to permit the patient to go on with her life and remove any "type" of deformities.
Breast reconstruction has advanced greatly over the years and it is now possible to start the reconstructive process at the time of the mastectomy. There are several manners in which to reconstuct a woman's breast. At the time of the mastectomy, or at a later date, a device called a tissue expander, which is basically an empty filler bag, can be surgically placed underneath the pectoralis major muscle in the chest. Over time, the tissue expander is inflated in the doctor's office. It then begins to resemble the patient's opposite breast. At a second operation the tissue expander, which is filled with saline, is removed and replaced with either a saline or a silicone gel implant to complete the reconstruction. At that time, the nipple can also be reconstructed and thereby the reconstructive process for the breast is completed. Sometimes it is necessary to either lift or even increase the size of the opposite breast to obtain symmetry.
A second option is what is known as the Tram flap or tummy tuck procedure. In this operation, excess skin and subcutaneous fat is moved from the tummy up to the chest region, attached to one or both of the abdominal wall muscles, and then molded into breast tissue. This can be done at the time of the mastectomy or at a later date. This allows the surgeon to reconstruct the woman's breast with her own tissue and no implants are required. At a second stage down the road, the reconstructed breast may need to be revised to match the opposite breast or the opposite breast reduced, lifted, or enlarged to obtain symmetry. At that time, again, the nipple is reconstructed. This procedure has the advantage of not only reconstructing the woman's breast with her own tissue, but she also obtains a tummy tuck at the same time. The overall contour of the upper body is nicely improved.
The tissue expander and implant operation adds approximately one hour to the mastectomy operation and increases the hospital stay one to two days. The Tram flap is a bigger procedure and does add three to five hours to the mastectomy operation. The total hospital stay requires five to seven days. Each of the above procedures has advantages and disadvantages, but both provide excellent results in breast reconstruction.
Contact Dr. Tornambe
Back to top
Breast Reduction
Breast reduction surgery, in contrast to breast lift surgery, is usually performed for relief of medical/physical problems which are caused by the excessively heavy breast. Neck and back pain, skin rashes and breathing problems are medical conditions frequently associated with large breasts. Many women also feel an extreme sense of self consciousness secondary to the unusually large size of their breasts. Breast reduction surgery, also known as reduction mammaplasty, is designed to alleviate these problems. The surgical procedure involves the removal of skin, fat and breast tissue from the breasts creating a smaller, lighter and firmer structure. If the size of the areola is also excessive, this may be corrected during breast reduction surgery.
Surgical Details
Depending on the size of your breasts, the desired post-operative size and the technique utilized, the procedure may take anywhere from two to five hours. The surgery is performed in a hospital setting or in office-based ambulatory facilities. However, many insurance companies continue to recognize the medical necessity for breast reduction surgery and will finance a hospital procedure. Some insurance companies require a minimum volume of tissue to be removed to cover the procedure. This should be pre-determined by your plastic surgeon and a letter of pre-determination sent to your insurance carrier along with photographs of your condition to demonstrate the necessity for surgery. Various techniques are available to alleviate your condition which should be discussed at length with your plastic surgeon. The most commonly used technique involves an inverted-T-shaped incision similar to the most common breast lift incision. Newer techniques with shorter scars are available and are used by our doctors, but these techniques do not apply to many patients.
If your breasts are excessively large and pendulous it may require removal of the nipple areola complex and replacement of these structures as free grafts. Your plastic surgeon will inform you if this is the best technique for your situation and should apprise you of the risks and benefits of this technique. In the majority of cases however, the nipple areola complex is left attached to the underlying skin and blood supply. Your plastic surgeon should also discuss the possible changes in sensation to the nipple areola complex which may occur with breast reduction surgery. Liposuction may be added to the procedure for removal of fat primarily at the outer portions of the breast.
After the operation, you may have surgical drains which usually remain in place for approximately 24 hours. The use of these drains is a matter of your plastic surgeon's preferences and findings during the operative procedure. Your breasts will be bandaged either in elastic Ace wrap type bandages or in a surgical bra. The dressings are usually changed a few days following the procedure and stitches are ready to begin being removed approximately one week later. The healing process may be affected by smoking and concurrent medical problems such as diabetes. Occasionally, small areas of open skin at the corners of the incisions may occur. These are typically treated with antibiotic ointments and heal without great concern.
If you have excessively large breasts which hamper your physical activity, cause physical symptoms, or create a sense of extreme self consciousness, you may be a candidate for Breast Reduction surgery.
Contact Dr. Tornambe
Back to top
Brow Lift
With advancing age, the loss of skin elasticity coupled with the effects of gravity cause the eyebrows to descend, as well as the facial skin. Frequently, excess upper eyelid skin is the result of a descended or sagging brow. If this condition goes unrecognized and an upper eyelid lift (blepharoplasty) is performed without addressing the descended brow, the results will suffer. It is therefore essential that you choose a qualified plastic surgeon who can recognize the true cause of your excess upper eyelid skin. The brow lift operation, by raising the eyebrows, returns excess upper eyelid skin to its normal position giving a youthful appearance to the orbit.
The brow lift procedure also addresses wrinkling in the forehead and inner eyebrow area. These wrinkles are caused by the action of the facial muscles during expressions such as frowning. Repeated expression over years and years leads to creasing of the skin and wrinkling. During a brow lift operation, these small muscles are removed effectively and permanently remove the wrinkles caused by them.
The operation itself may be performed using various techniques including the open brow lift through an incision over the top of the head, the endoscopic brow lift using a small telescope like instrument through small scalp incisions, and limited access open techniques using small temporal scalp incisions or upper eyelid incisions. A full consultation with our Plastic Surgeons at Madison Plastic Surgery will determine which technique is best for your situation.
Contact Dr. Tornambe
Back to top
Face Lift
Facelift, or rhytidectomy, is an operation designed to counteract the effects of aging and gravity. The skin starts losing its elasticity and begins to sag as early as the mid-thirties in many people, continuing to sag and lose elasticity as the aging process continues. The effects of gravity, sun exposure and stress all contribute to this problem. Creases form in the forehead and mid-face region, smile lines deepen and jowls become more prominent. The skin around the neck sags and fat may deposit in the neck and beneath the chin.
A facelift in essence, pushes back the clock, improving the most prominent signs of aging by removing excess skin, tightening muscles below the skin. Fat is removed if necessary. A facelift can be done alone or in conjunction with other procedures such as eyelid surgery, nasal surgery, forehead lift or even liposuction. A facelift can make you look younger and fresher.A facelift also enhances your self confidence. Patients should have reasonable expectations prior to undergoing a facelift and realize that while they will look younger, fresher and more rested, the clock can't be turned back indefinitely. A facelift does not stop the aging process.
A facelift takes 2 to 3 hours to be performed and can be done under local anesthesia or general anesthesia. This operation is usually done with a combination of local and twilight anesthesia. The patient is made sleepy and extremely comfortable, but remains awake. The surgery is usually performed in our fully accredited OR suite and a fully trained physician anesthesiologist is present during the operation to administer appropriate anesthetics. Incisions are made within the hairline, in front of the ear and behind the ear. They are placed in such a way that when healed they fall into the natural lines of the face. The incisions are normally not visible. Excess skin is trimmed and the underlying musculature is tightened. Excess fat may be removed during the operation. Sutures are removed anywhere from 3 to 10 days after surgery. Sometimes a small draining tube is placed under the skin to remove excess fluid. This tube is usually taken out on the day after surgery. Bandages are placed immediately after surgery, removed the following day and at that time the patient is allowed to bathe normally. The patient can expect bruising and swelling to last for 2 weeks, after which time any remaining bruising can easily be covered by make-up. Usually, there is not much discomfort or pain after this type of surgery, however, pain medication is usually prescribed and taken if needed.
Complications are infrequent and usually minor, however, any type of surgery carries a risk. Hematoma, a collection of blood which may or may not have to be removed by the surgeon, infection, or injury to the nerves that control facial muscles, which is usually temporary, can occur. Poor healing and scarring can also occur. In general, most complications are minor and reversible.
In conclusion, a facelift is an operation that carries a very high rate of satisfaction in our patients. While the clock is not turned back permanently, the improvements made can be striking. A facelift may last anywhere from 5 to 10 years. However, years later you will continue to look better than if you had never had a facelift at all!
Contact Dr. Tornambe
Back to top
Gynecomastia
Gynecomastia is a condition encountered in men in which their breasts are larger than normal. Many times, this condition occurs in young boys reaching puberty, but once puberty is completed the condition reverses. In a certain percentage of individuals condition remains permanent when surgically corrected. Late middle aged men may also become affected. While the exact cause of this condition is not known, it may be linked to hormone levels and hypertrophy of tissues in the male breast region. When found in adolescents who have past puberty, it is sometimes necessary to check hormone levels that may be causing this condition. Most of the time surgery is the appropriate treatment.
The surgery consists of removing extraneous breast and fatty tissue from the chest region. In many cases, the gynecomastia can be treated with a combination of ultrasonic liposuction and traditional liposuction. This is done through small incisions in and around the arm pit and below the breasts. The scars are small and well hidden. In these cases, the skin shrinks back once the extraneous breast and fatty tissue is removed and no further treatment is necessary. Sometimes small revisions are required to remove excess skin and obtain an optimal result. In same cases, it is necessary to make a small incision below the nipple and actually remove the breast tissue surgically. This is usually combined with liposuction to smooth and refine the results. In either case, the operation can be done under local anesthesia with sedation or under general anesthesia on an ambulatory basis. An elastic garment is worn two to four weeks after, but return to normal daily activities in 3-5 days.
While this condition is more common in younger boys, it can be seen in men of middle and older age groups. The treatment is similar, although more often, with significant enlargement of the breasts it is necessary to remove some skin. The scars are placed around and below the nipples. The operation has a high rate of satisfaction and in some cases is covered by health insurance. A high satisfaction rate is achieved in young boys who, due to peer ridicule, are unable or unwilling to participate in gym classes because of this condition.
Contact Dr. Tornambe
Back to top
Liposuction
Suction assisted lipectomy or liposuction is a technique used to aspirate or remove fatty deposits from virtually any area of the body. The most frequently involved areas include the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs and knees. Again, just as with body contouring procedures, liposuction is not a panacea or primary procedure for weight reduction. It is aimed at removal of focal areas of fatty deposition which are unresponsive to dieting and exercise. The best candidates for liposuction are generally patients who are in good physical health and psychologically stable with realistic expectations. In consultation with your Madison Plastic Surgery Physician, the elasticity or firmness of your skin will be determined and may be the most important factor dictating the results of your liposuction surgery. Your appearance and self confidence can be greatly enhanced with the changes made available with liposuction.
Multiple variations in the technique of suction assisted lipectomy are now available. These include superficial suctioning techniques as well as the most recent technological advance in liposuction, ultrasonic liposuction. Be sure to choose a physician who is adequately trained in all of the available techniques and maintains an American Board of Plastic Surgery Certification or Eligibility. The procedure itself is usually performed in our fully accredited ambulatory operative suite by our Plastic Surgeons. Multiple small incisions are usually utilized. The scars resulting from these small incisions are relatively inconspicuous. Even though liposuction remains a very safe procedure, infrequent minor complications including fluid accumulation, skin injury, or irregularities in the surface contour of the skin may occur even if your surgeon is extremely skilled. We at Madison Plastic Surgery have incorporated ultrasound therapy as a post liposuction adjunct to alleviate the infrequent surface contour irregularity. As always, smoking may increase your risks of liposuction surgery. You will likely be asked to refrain from smoking for two weeks prior to and following surgery as well as avoiding any aspirin containing medications which may increase your risk of bleeding and bruising.
During your initial consultation with one of our plastic surgeon you should be forthright in discussing your areas of concern and expectations from liposuction surgery. Your surgeon will be equally forthright in determining which areas should be addressed and which technique would be most efficacious for your particular situation. Your plastic surgeon will also describe the type of anesthesia to be used and the specific facilities available to perform the procedure.
Surgical Details
The surgery itself usually takes one to two hours, but time may vary depending on the number of areas and the amount of fat to be suctioned. During the operation, a hollow tube cannula is inserted through the small incisions. The cannula is manipulated within the layers of fat to break up and suction the fat from your body. The ultrasonic technique involves melting the fat cells away with ultrasound energy. The melted fat is then aspirated through the aspiration cannula. This technique generally affords better results in more fibrous areas such as the flanks, lower back and male breasts. Your certified Plastic Surgeon at Madison Plastic Surgery will determine if ultrasonic liposuction is best for you.
After the surgery you will be placed in a snug elastic garment or girdle which must be worn over the suctioned area to help control swelling and fluid accumulation. This garment may be worn anywhere from two to six weeks depending on your surgeon's instructions and preferences. The first 24 to 48 hours of recovery may find you sore and bruised. In addition, your weight may even slightly increase due to the fluids given during the surgery. The pain and soreness may be controlled with medications prescribed by your plastic surgeon. Sensation will most likely be decreased in the areas which were suctioned. This is usually a temporary phenomenon and subsides over the ensuing weeks to months. You will most likely be on your feet within one to two days of the surgery depending on how much work was performed. Any stitches which were placed are usually removed in 7 to 10 days. Your follow-up visits will be scheduled as indicated by your individual recovery pattern.
Liposuction is an extremely effective technique for creating a new body, neck or facial contour with minimal scarring. The results are permanent provided you maintain a routine exercise regimen and eat a sensible diet. Most patients have an improved self confidence and self esteem after liposuction and are very satisfied with their results. If you follow your plastic surgeon's recommendations and instructions you should be pleased with your new appearance.
Ultrasonic Liposuction (UAL)
Ultrasonic liposuction is the latest technique available in liposuction/body contour surgery. This technology uses sonic (sound) energy to emulsify or melt fat cells. After the fat cells are emulsified, they are evacuated with gentle vacuum suction. Vital structures such as blood vessels are selectively spared from injury by the ultrasound energy. This results in a less traumatic procedure with lower blood loss. It has also been reported that less swelling and bruising occur with this technique, although this remains to be proven in large series of patients. The safety of this technique has been proven in Europe where UAL has been in use for over a decade. In this country we are in the process of defining which situations and body regions would benefit most from this newly available technology.
An even newer technologic advance in liposuction surgery has recently received press, that of External Ultrasonic Liposuction (EUL). This technique applies the ultrasonic energy through the skin. Incisions and an evacuation phase are still required, however. Ultrasonic technology is available at our certified operating suite at Madison Plastic Surgery. Ask our Plastic Surgeons if you might benefit from this technique.
Contact Dr. Tornambe
Back to top
Mastopexy
Just as the facial structures are victims to the force of gravity, so too are a woman's breasts. Over the years with aging, the skin loses elasticity and the breasts often lose their firmness causing them to sag. Pregnancy and breast feeding may contribute to this process resulting in a less youthful appearance of the female breast. Mastopexy, or Breast Lift surgery, is designed to reshape the sagging breast. In addition to the loss in breast firmness, the nipple and areola (pigmented area around the nipple), are subject to stretching with loss of elasticity and descent of the breasts. The areola expansion is also addressed during the Breast Lift procedure.
If you have concerns about the changes occurring in your breasts as you age, you may be a candidate for Mastopexy surgery. This type of surgery can enhance your youthful appearance and improve your overall self confidence and self esteem. The best candidates for Mastopexy surgery are healthy women who are realistic about what the surgery can afford after a complete consultation. Breast Lift surgery can be performed for all breast sizes. The best results are usually achieved in patients with small to moderate sagging breasts. Results in larger breasts may not be as long lasting, due to the continued effects of gravity. Although planned future pregnancies are not a specific contraindication to having Breast Lift surgery, you may wish to consider postponing your surgery until childbearing is completed. Pregnancy, may stretch the breasts again after surgery offsetting the results of the procedure.
At your consultation, we realistically discuss and describe the procedure in great detail regarding the risks and the limitations as well as the expected scarring from the operation. There are many techniques available for lifting the female breast. The most common procedure involves an inverted ėT' shaped incision following the natural contour of the breast. Modifications of this technique have reduced incisions where possible. These newer techniques decrease the size of the scars, but do not apply to all patients. Our doctors are well-versed in all of the techniques, and will assist the patient with her decision as to which technique will afford the best possible result.
If your breasts have lost volume, the procedure is sometimes coupled with placement of an implant to restore breast volume. (See Breast Augmentation). This operation, called Augmentation Mastopexy, is more complicated than mastopexy alone and requires deft expertise and careful surgical planning. Our surgeons have a great deal of experience with all aspects of Breast Surgery, and comfortably possess the required expertise. In extreme cases, it is sometimes necessary to perform this operation in two separate stages to obtain the best result.
Surgical Details
The procedure may take anywhere from two to three hours depending on the extent of the work required to restore your breasts to their youthful appearance. The surgery is usually performed on an out patient basis in our fully accredited office surgical suite with a certified physician anesthesiologist. General or sedation anesthesia may be utilized. The post operative recovery is usually very smooth as this operation is primarily an operation of the skin. As with most breast surgical procedures, however, you may experience some nausea afterwards.
After a few hours in recovery, you will be able to go home. Your post operative care may require wearing a surgical bra for extra support during the healing time. Showering may be allowed 48 hours following the procedure. The incisions are usually healed well enough to begin removing stitches at about one week. Some sutures may remain in place for up to two weeks depending on the tightness of the lift.
Breast lift surgery undoubtedly returns your breasts to a more youthful appearance. However, just as with facelift surgery, the aging process and effects of gravity can never be permanently reversed. The aging clock is merely set back ten to fifteen years with breast lift surgery. Speak to us about the multitude of available options for enhancing your appearance and returning a more youthful look to your breasts.
Contact Dr. Tornambe
Back to top
Rhinoplasty
Nasal surgery is one of the most common cosmetic surgical procedures performed. Rhinoplasties are done for two reasons; cosmetic improvement of the nose and alteration and improvement of the breathing of the nose. Nasal surgery can reduce or increase the size of the nose. Bumps can be removed and the tip refined. The span of the nostrils may be reduced as well as the overall shape of the nose and tip.
Internally, the nasal septum, or wall between the two nostrils, can be altered to improve breathing. Also, it is sometimes necessary to change internal structures such as turbinates (the humidifier of the nose) or nasal polyps which are small growths within the nose. Alteration of these structures can improve nasal airway breathing.
Surgical Details
Nasal surgery is performed under general or local anesthesia with sedation. It is performed via a closed or open technique depending on the amount and type of changes required. In the closed technique, all incisions are made on the inside of the nose and no scars show externally. In the external approach a small incision is made on the columella (bridge of tissue between the two nostrils). This scar fades greatly after surgery and due to its location is barely visible. Cartilage grafts maybe taken from inside the nasal septum, or sometimes, cartilage from different sites such as the ear or rib, may be necessary for very extreme reconstructive cases. Sometimes the nasal bone must be surgically broken to realign the nose, but many times this is not necessary.
After surgery the patient will wake up with soft splints inside the nose which have a straw-like opening. Many times this opening allows the patient to breath somewhat through the nose, but often it clogs up and the patient must breath through their mouth. A plastic splint is also placed on the top of the nose to protect it as well. These splints are removed usually 6 to 7 days after surgery. Post-operatively, there is minor pain and medication is given to relieve this. Usually, only 24 hours of pain medication is necessary. We also recommend the use of anti-histamines to prevent the sinuses from becoming uncomfortably swollen after this nasal surgery. The majority of the swelling lasts 3 to 6 weeks but most people return to normal activities in 2 to 3 weeks. Most of our patients return to school or sedentary work a week after surgery. Strenuous activity is usually avoided for 2 to 3 weeks.
While the healing process for nasal surgery is slower than many other cosmetic procedures, the results are long lasting and positive. The final results of rhinoplasty may not be apparent for six months or more.
Contact Dr. Tornambe
Back to top
Email Dr. Tornambe
Back to top
