Dr. Sevinor's Blog

Arm Sculpting (Dermolipectomy)

 Dermolipectomy of the arms is a surgical procedure designed to remove excess, sagging skin and fat from the upper-inner arms. It is most effective in those patients who are overweight and have recently lost weight from successful dieting and exercise, leaving an excess of skin and underlying fat which will not shrink to conform to the new body shape.

If a patient has no loose skin of the upper-inner arms but only has localized areas of fat, then they may be a candidate for liposuction alone without removal of skin.

Hospital stay is usually 1 or 2 nights but this depends upon the individual’s response to surgery. Approximate surgical time is 3 to 4 hours.

There are a variety of incisions which may be used, and Dr. Sevinor will select the one he feels is best for your particular problem. The incision is generally placed within the upper-arm from the armpit to the elbow.

The patient is usually asked not to exercise for two weeks. The stitches are usually removed in 7 to 10 days. Of course, like any operation, there are potential complications. The risks and possible complications associated with dermolipectomy of the arms will be discussed in detail by Dr. Sevinor.

Breast Augmentation

Cosmetic enlargement of the breasts is done by surgical implantation of breast prostheses (medical grade silicone shell filled with saline(salt water) solution) placed beneath the breast. The three common techniques for inserting the implant are (1) inframammary, (through a small incision underneath the breast); (2) transaxillary (a small incision in the armpit); and (3) periareolar (small incision around the brown part of the skin which surrounds the nipple).

We prefer to do the surgery under general anesthesia. The patient is sedated and the surgery lasts approximately two hours. The patient may return home that afternoon or stay in the hospital overnight.

A small incision, approximately 1 1/2 to 2 inches in length, is made under the breast or around the areolar, depending upon the technique utilized. This usually heals to a fine lined scar by six months.

The patient is restricted to rest at home with minimal arm movement, especially during the first 48 hours. There is usually some mild discomfort, possible swelling and/or discoloration which is common with this surgery for a short period of time. A sleeping bra is worn night and day after the dressings are removed.

It is sometimes (but very rarely) necessary to remove an implant due to an unforseen complication. Complications such as bleeding is uncommon (1-2%) but always possible. Infection, changes in sensation and firmness or leakage or rupture of implant can occur as well. There are risks associated with all surgical procedures and these will be discussed in detail with you prior to surgery.

Take your medications as prescribed by Doctor. DO NOT TAKE ASPIRIN OR ANY ASPIRIN COMPOUND CONTAINING SALICYLATES FOR AT LEAST TWO WEEKS BEFORE OR AFTER SURGERY. You may take Tylenol or any Acetaminophen-containing compound in it’s place.

Someone should stay with you day and night for 24 hours after surgery. Social activity should be limited for approximately 10 days following surgery. Excessive arm movements and exercise should be restricted for the first two weeks.

You may expect some discomfort the first several days postoperatively. This will be similar to a muscle pain after strenuous activity. As soon as you begin to feel discomfort after you get home begin taking your pain pills as prescribed- do not wait until the pain is severe.

Do not disturb the dressings we put on in surgery until you are seen in the office for your first post-operative visit.

Breast Lift (Mastopexy)

A mastopexy procedure elevates and reshapes loose, sagging breasts. Gravity, breast feeding, pregnancy and weight gain or loss can all have an effect on the appearance of the breast. As a result, the breasts may sag, droop, and flatten to various degrees. As a result, there can be a decrease in firmness and elasticity. The mastopxy procedure can reshape, firm, and lift sagging and shrinking breasts. The procedure can also reduce the size of an enlarged, streated areola (the dark pigment skin around the nipple). During the procedure, excess skin on the lower portion on the breast is removed and the nipple and areola is located to a higher position thereby reshaping the remaining breast tissue. ocassionally breast are augmented with a saline implant which is placed under the breast itself or under the chest muscle during the mastopexy procedure.

The operative procedure is about 2 hours in length. A surgical gauze dressing is placed and the next day the patient is placed in a bra.

All surgeries carry some chance for risk and complications. These will be thoroughly discussed with you by Dr. Sevinor. Complications such as infection, delayed healing, bleeding, wide scars, asymmetry, or decreased sensation can occur but are rare.

We usually require a mammogram before surgery. Further specific instructions on how to prepare for surgery including guidelines will be given to you in detail.

A mastopexy procedure is usually performed under general anesthesia but in some cases when small incisions are made, local anesthesia combined with a sedative may be used.

Healing is a gradual process. Most patients return to work within one week. Patients should avoid lifting heavy objects and delay strenuous exercises for 3 to 4 weeks. Detailed instructions will be given to you postoperatively.

Breast Reduction

The operation for reduction of excessively large breasts is a major operation performed in the hospital under general anesthesia. It is usually performed to reduce weight-bearing pain, pain in the upper portions of the neck as well as shoulders from brassiere strap marks due to excessive weight of the enlarged breasts. In addition, breast reduction allows a patient a wider range of clothing styles and improved over-all general appearance.

There are many types of specific operative procedures for breast reduction, however, most fall into two basic categories. One of these requires the complete removal of the nipple, followed by large amounts of breast tissue, fat and skin, with reshaping of the breasts and then re-applying the nipple as a free graft in a new position on the reformed breast. In this type of operation, the sensation of the nipple is lost. This procedure may be necessary if the patient has extremely large breasts. The second type of operation is done when the nipple area is transported without being completely removed from the breast; therefore these nipples frequently retain sensation, however, this sensation may be reduced to varying degrees. Future breast feeding with both types of operation is not possible.

Extensive measurements are made before the actual surgery in an attempt to give a normal position to the nipple complex as well as equal size and shape. No breasts are ever exactly the same size nor will they be after this surgical procedure. All possible attempts are made to produce symmetry.

Hospital stay is approximately two days, depending on the individual and her healing process. Surgical time is approximately four hours and is performed under general anesthesia.

Discoloration and swelling may be present about the incisional area, which is normal with a procedure of this magnitude.

The patient is placed in a brassiere-type bandage, which is changed at the discretion of the surgeon. The stitches are removed in approximately seven to fourteen days. Drains (plastic catheters) may be utilized and would exit from underneath the dressings and be attached to a small pump or other suction apparatus.

There are risks involved with every surgical procedure – they will be discussed with you in detail. All medical questions should be directed to your surgeon. Take all medications EXACTLY as ordered.You may be requested to take some medicines before your surgery. DO NOT TAKE ASPIRIN OR ANY ASPIRIN-COMPOUNDS FOR TWO WEEKS AFTER YOUR SURGERY. Acetaminophen (Tylenol, Valadol, Tempra) may be used in place of Aspirin. AT THE FIRST SIGN OF HIVES OR A RASH, DISCONTINUE ALL MEDICATION AND CALL YOUR DOCTOR IMMEDIATELY.

The surgical scars are permanent and reasonably extensive. There is generally a vertical scar beneath the nipple and a horizontal scar under the entire breast where it meets the chest. Also, a scar surrounds the areola (the pigmented soft skin immediately surrounding the nipple). These scars are quite noticeable for a period of time, up to a year or more. Up to that time, however, the cosmetic disability is usually mild (Occasionally it is necessary to revise these scars.)

Liposuction (Body Contouring)

Liposuction results in the permanent removal of localized fatty tissues. It is the most useful for the removal of localized fatty deposits from the ’saddle bag area, abdomen, hips, buttocks, chin, neck, arms calves, ankles and knees. It is not useful for general obesity.

The Surgery consists of (1) small incision, less than 1/2 inch in length, (2) with or without the injection of a hypotonic solution into the fatty tissues, and (3) the subsequent removal of fat by surgical suction with a blunt cannula.

The end result is dependent upon a great number of factors which are different in each individual patient, including – among others – age, physical condition, elasticity of the skin, genetic makeup (heredity), diet, exercise, smoking, alcoholic intake, exercise and physical condition, etc. No two persons are exactly alike and no two persons, despite similar appearance, will have exactly the same result.

In general, the localization of fatty deposits is determined by heredity and hormonal factors. Think about the body build of your parents, grandparents, aunts and uncles.

The end result will be dependent upon the condition and elasticity of the skin, amount and the location of the fat, the underlying bone structure and the inherent proprtions of the remainder of the body, whether harmonious or disharmonious.

Male Breast Reduction (Gynecomastia)

Gynecomastia is the term used to describe the enlargement of the male breast. It is not an uncommon condition, affecting as many as 40 percent of men. It may affect only one breast or both. The majority of the cases have no known cause while the others might be related to the use of certain drugs and/or medical conditions, for example advanced liver disease. The enlargement of the male breast can be caused by either excess glandular tissue, excess fat or both.

Breast reduction for this condition can be performed by the removal of the excess fat and or the glandular tissue. Men who have excess skin will also have the skin removed at the same time to give them the best possible appearance.

Patients who are alcoholic, on drugs (e.g. steroids) or overweight are not good candidates for the reduction procedure until they try to correct their medical problem first. If the condition persists after the correction of these medical problems, the patient may be considered for the procedure at that time.

Like any surgical procedure, there is some risk and possible complication with breast reduction procedure for men. Dr. Sevinor will explain these risks and complications.

Breast reduction surgery for men is usually performed in the hospital under general anesthesia.

If the breast enlargement is caused by excess glandular tissue, it will be surgically removed. If it is caused by excess fatty tissue, liposuction will likely be used to remove the excess fat. A combination of both excision and liposuction is often used to achieve the best results.

You will be instructed to stay out of work for one week and avoid any contact sports for four weeks. You should be able to resume most of your normal activities within a month.

Tummy Tuck (Abdominoplasty)

Abdominal lipectomy is a major surgical procedure performed in the hospital under general anesthesia. The operation is designed to remove excess sagging skin and fat from the lower abdominal region. It is most effected in those patients who have been overweight and have recently lost weight from successful dieting, leaving an excess of skin and underlying fat which will not shrink to conform to the new body shape.

In some patients it may be desirable to surgically tighten up the abdominal muscles at the same time the excess of skin and fat are removed. Your surgeon will decide if this is necessary in your situation.

There are a variety of incisions that may be used and your surgeon will select the one he feels is best for your particular problem. In many instances as incision is made just above the pubic area, from one hip to the other, while in other cases, a vertical incision may be added, especially if the patient already has a vertical abdominal scar. If the muscles that support the abdominal wall have separated, they will be tightened up as a part of the operation.

Hospital stay is two to three days depending on the individuals response to surgery. Surgical time is approximately 4 hours.

The patient is usually kept at bed-rest for the first few days. Drains (plastic tubes) may be used, exiting beneath the dressings and are attached to a suction device, for two to four days. Stitches are removed in seven to fourteen days. The patient is given proper medication at the time of hospital discharge if required.

All medical questions should be directed to your surgeon. There are risks and possible complications associated with all surgical procedures and they will be discussed in detail with you by your doctor. Take all medications EXACTLY as ordered. You may be requested to take some medicines before your surgery, DO NOT TAKE ASPIRIN OR ANY ASPIRIN CONTAINING COMPOUNDS FOR TWO WEEKS BEFORE OR AFTER YOUR SURGERY. Acetaminophen (Tylenol, Valadol, Tempra) may be used on place of Asprin. AT THE FIRST SIGN OF HIVES OR A RASH, DISCONTINUE ALL MEDICATION AND CALL IMMEDIATELY.

Surgical scars are permanent and fairly extensive depending upon the type of incision your surgeon performs. Often there is a single transverse scar which usually is covered by a bathing suit. Occasionally a vertical scar may also be present.

The patient is restricted to sponge baths for about one week. Your surgeon will notify you when bathing is permitted.

Social activity is limited for approximately three weeks following surgery and strenuous activity is limited four about five weeks after surgery.

Spider Veins

PhotoDerm® VL safely eliminates unattractive veins without injections or surgery. It is a non-invasive medical technology that uses light therapy to eliminate varicose veins, spider veins on the legs and face, as well as other vascular conditions. The device generates intense pulsed light which safely destroys unsightly visible veins so they fade and slowly disappear. Treatment is applied by placing a hand-held treatment unit on your skin. You will feel a sensation like a pinch or a snap of an elastic band, but local anesthesia or pain medication is not required. You can return to work the same day and resume all regular activities. You should limit exposure to the sun, which is always a good idea.

PhotoDerm® VL uses innovative patented technology that allows your doctor to customize the treatment specifically for your skin type and the size and depth of your leg veins. This flexible interactive approach to treatment cannot be achieved with any non-invasive method currently available.

Your doctor can determine if your condition is suitable for PhotoDerm® VL treatments. This may require a consultation visit. Usually 4-6 treatments are required, depending on the severity and density of veins. Each session generally lasts 15-20 minutes.

You may experience some side affects which generally last only a short time. This may include slight reddening of the skin or local swelling which goes away in a few days. In rare instances there may betransitory blistering or burning. Longer lasting side effects may include temporary changes in skin color, which last up to several months.

Insurance coverage varies according to carrier and the nature of the medical problem. Your doctor and insurance company can answer this question. Treatments of a cosmetic nature are often not covered.