Augmentation mammaplasty is typically performed to enhance the size of normal breasts in order to make them more aesthetically pleasing. The procedure may also be utilized to enlarge small, underdeveloped breasts, asymmetrical breasts, breasts that have decreased in size after childbearing, or breasts that have in undergone post-mastectomy reconstruction.

The procedure consists of making a small incision in the fold beneath the breast and developing a pocket behind the breast that will accommodate a suitable implant. Alternatives to this incision are the periareolar incision around the nipple or the transaxillary incision in the armpit. Depending upon the aesthetic goals of the patient, the shape of the breast, the type of implant to be utilized, and the degree of development of the pectoral muscle, the implant may be placed either on top or below the pectoral muscle overlying the ribs.

The most common implant employed is a saline implant, which consists of a soft silicone rubber shell containing a specified volume of harmless salt water. Since 1992, a FDA moratorium has prohibited the use of silicone gel implants in augmentation mammaplasty until issues of "safety and efficacy" are resolved. The state-of-the-art of saline implants today is one that closely rivals that of silicone gel implants.

The procedure is performed as an outpatient procedure under a superficial plane of general anesthesia. The patient is discharged from the facility in a comfortable dressing, which is removed the following morning. No drains are employed. The morning after surgery, the patient may shower and wear an ordinary bra. Postoperative pain is modest and return to normal non-athletic activities is usually within 2-3 days. Full athletic activities may be a resumed three or four weeks

Breast Lift

Over the years, factors such as pregnancy, nursing, and the force of gravity may alter the appearance of a woman's breast. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, or Mastopexy, is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If the breasts are small or have lost volume, for example after pregnancy, breast implants may be inserted in conjunction with Mastopexy and can thereby increase both firmness and size.

Mastopexy is generally performed as an outpatient procedure under a superficial plane of general anesthesia. Techniques vary, but the most common procedure involves an anchor- shaped incision following the natural contour of the breast. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to a higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downward from the nipple area, and along the lower crease of the breast. Modern techniques of Mastopexy relocate the nipple in such a way that sensation to both the nipple and the breast remains intact. On the first postoperative day, the dressing is removed. The patient is allowed to shower, and may then wear an ordinary bra. Pain is modest, and bruising and swelling are minimal. The patient may generally return to normal non-athletic activities in two to four days and to full activities in approximately one month.

Breast Reduction

Women with very large, pendulous breasts may experience a variety of medical problems referable to the excessive weight of the breasts. These might include back and neck pain, skin irritation, skeletal difficulties, and breathing problems. Bra straps may leave indentations in the shoulder areas. Unusually large breasts may make a woman or teenage girl feel extremely self-conscious, if not embarrassed by the disproportionate size of her breasts. Breast reduction, technically known as reduction mammaplasty, is designed for such women.

Breast reduction is usually performed for both physical relief and aesthetic improvement. Most women undergoing the surgery are troubled by large, sagging breasts that restrict their activities and cause physical discomfort. In addition, large pendulous breasts limit the choice of clothing and swimwear. In most cases, breast reduction is deferred until breasts are fully developed. It may however be undertaken earlier if large breasts are causing serious physical discomfort or embarrassment.

The procedure is performed in an outpatient surgical facility under a superficial plane of general anesthesia. Discussion between patient and surgeon prior to surgery will determine the amount of reduction thought to be aesthetically pleasing. The procedure utilizes an anchor-shaped incision that circles the areola, extends downward towards the fold beneath the breast, and follows the natural curve of the crease beneath the breast.

The excess glandular tissue, fat, and skin are removed, and the nipple and areola are moved into their new position.  The skin is then brought in from both sides of the breast down to and around the areola, shaping the new contour of the breast.  Liposuction may be used to remove excess fat from the armpit area.

The excess glandular tissue, fat, and skin are removed, and the nipple and areola are moved into their new position. The skin is then brought in from both sides of the breast down to and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area. The scars of reduction mammaplasty are noticeable, but with maturation and healing blend with the surrounding tissue. Because they are placed in the lower portion of the breast, they are easily concealed by a brief bra or bikini top. Modern techniques of reduction mammaplasty almost always preserve the sensation of the nipple and breast.

Reduction mammaplasty may be performed as outpatient surgery, or with an overnight stay. On the first postoperative day, the dressings are removed and the patient is allowed to shower and put on an ordinary bra. Normal, non-athletic activities may be resumed after three to four days. Athletic activities may be undertaken after three to four weeks. Discomfort may be experienced for a few days following surgery, and is managed by oral analgesics. Sutures are removed on the seventh postoperative day. The patient may usually return to work after one week following surgery.

Tummy Tuck (Surgery of the Abdomen)

Abdominoplasty, more commonly known as a 'tummy tuck' is a surgical procedure designed 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 and create a flat athletic appearance with greater waist definition.

The most suitable candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by deposits of abdominal fat and loose abdominal skin that will not respond adequately to diet or exercise. The surgery is particularly effective for 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 considerable amount of weight should do so before surgery. Women who plan future pregnancies should also defer surgery, as vertical muscles in the abdomen repaired during surgery can separate again during a subsequent pregnancy.

Abdominoplasty is performed in an outpatient surgery center under a superficial plane general anesthesia. An overnight stay following the surgery is recommended.

An incision is made in the bikini line just above the pubic area and extends laterally towards the waist to the region of the hipbone. This incision can be designed so that it is imperceptible beneath a brief, swimsuit, or other garment. A second circular incision is made around the navel to free it from surrounding tissue. The abdominal apron consisting of skin and fat is separated and lifted in an upper direction to the level of the ribs. In doing so, the vertical rectus abdominus muscles are visualized and sutured together in the midline. This produces a firm, flat abdominal wall, and narrows the waistline. The skin flap is then stretched down and the extra skin and fat are removed. A new hole is cut for the navel, which is then secured in place. The incision is then closed and dressings applied. Small drainage tubes are left in place for 24 to 48 hours following surgery.

Ambulation is begun on the first postoperative day. For first few days, the abdomen may feel tight and uncomfortable, and mild analgesics may be required. Showering is permitted upon the removal of the drains on the first or second postoperative day. All sutures are removed seven days following surgery and return to normal non-athletic activities is anticipated within one week. Full athletic activities, with the exception of sit-ups, may be undertaken 4-6 weeks following surgery. Sit-ups or abdominal crunches are permitted 8 weeks following surgery.