FAQs

Yes, I have an active skin cancer reconstruction practice treating all types of cutaneous malignancies. I also treat non-cancerous skin conditions such as seborrheic keratosis, actinic keratosis, solar elastosis, age spots, hyperpigmentation, and scars to name a few.

Lesions under the skin such as lipomas and sebaceous cysts are also routinely removed. Traumatic wounds from burns and motor vehicle accidents may also require reconstructive surgery.

Cosmetic surgery is performed on healthy patients who are looking to correct, improve or enhance a body part that is either abnormal or that they are unhappy with.

There is absolutely no reason to feel guilty or ashamed for wanting to improve your physical appearance and the way you feel about yourself. It is purely your desire that is the motivation for cosmetic surgery.

Reconstructive surgery is performed to correct a physical abnormality causing a problem in terms of function and form. The cause for the abnormality may be from a birth defect, cancer, trauma or infection and surgery may be required to restore normal function.

Yes, we have worked with Care Credit for a number of years and patients have been extremely satisfied with the service they provide. We have provided a link to their website to facilitate the process for you. Any other questions you may have about financing are readily answered by our staff at the time of your consultation.

For purely cosmetic surgery, insurance will not cover you. When the surgery is required for reconstructive purposes your insurance will almost always cover at least part of the cost.

Some examples of procedures that are usually covered are breast reduction (if causing significant symptoms such as neck or back pain, shoulder notching or skin infections), rhinoplasty (aka nose job, for breathing problems) and eyelid surgery (to correct vision problems).

There is no "right age" for plastic surgery since everyone has problems or concerns that are specific to them. Many women elect to have breast augmentation in their late teens or early twenties while others have breast surgery after childbirth.

Weight loss surgery has become so popular and effective that patients of all ages are having body contouring of multiple body parts after massive weight loss.

In years past there were fewer options to treat facial aging but now women (and men) are electing to begin botox, fillers and skin care at a younger age to delay any need to consider surgery.

Prominent ears can be optimally corrected at age 5. So as you can see there is no such thing as a "right age".

The majority of my cosmetic procedures are performed at an ambulatory surgery center where you are discharged several hours after surgery. For lengthy procedures and patients with other medical problems I perform procedures at the main hospital with either discharge on the same day of surgery or a short inpatient stay. Certain procedures not requiring any type of sedation or anesthesia are done right in my office.

Here are several questions which I am happy to answer for you at any time:

Are you board certified?  Yes, I am double-board certified by both The American Board of Plastic Surgery and The American Board of Surgery.

What associations are you a member of?  I am a Fellow of The American College of Surgeons, the American Society of Plastic Surgeons, the New Hampshire Medical Society, the New England Society of Plastic and Reconstructive Surgeons, the Northeastern Society of Plastic Surgeons, and the American Society of Bariatric and Metabolic Surgeons.

What is your safety record?  I have an outstanding safety record since my primary concern for all of my patients undergoing elective surgery is their safety.

Feel free to ask any other questions at the time of your consultation.

The two types of implants used today are saline and silicone. There are also different shapes, including tear-drop (called anatomic) and round; and both smooth and textured. The vast majority of implants used for cosmetic purposes are smooth, round implants either silicone or saline. There are very specific indications for using the other types and that may be determined at your consult.

Saline implants are filled with sterile salt water that is injected into the implant after it has been placed in the pocket at the time of surgery. It is very important to properly fill the implant to ensure a natural look and feel to the breast. In the case of leakage or rupture, the body absorbs the saline harmlessly and the deflation is easily noticeable.

Silicone implants are filled with a polymeric gel of the element silicon which we all naturally have small amounts of in our bodies. The FDA has approved these implants for use in women 22 years of age and older, after many years of exhaustive studies proved that they cause absolutely no harm to women. Silicone implants may be used in younger women if the surgeon determines that a significant asymmetry or abnormality exists. Implant rupture may be harder to detect and could require an ultrasound or MRI to make the determination. Even so, the gel remains in the pocket that your body creates around the implant and is not dangerous. To read more about saline vs silicone, visit our saline vs silicone page.

All breast augmentation is done under general anesthesia which is exceedingly safe. The public perception of anesthesia being dangerous was from a previous era when the current drugs and practices weren’t available. For healthy individuals, general anesthesia carries virtually the same risk as sedation. All of my patients are administered anesthesia by experienced MDs at a brand new facility with the latest and safest equipment.

The two most commonly performed incisions are through the fold under the breast (called the inframammary fold) and around the nipple (periareolar). Other approaches are in the armpit (axillary) and belly button (umbilical). Approximately 95% of my augmentations are done via the fold incision as it provides the best visualization and a highly acceptable scar that is hidden by a bikini top. If you have very small breasts, a periareolar incision may be preferable and gives the exact same results. I do not perform the armpit and belly button approaches because I feel that they don’t provide the same consistently excellent and reliable results that I achieve with the others.

Placing the implants behind the muscle provides multiple advantages including protection from capsular contracture, more accurate mammography, better coverage and camouflage of the implant, and protection from bottoming out. If adequate breast tissue is present, the implant will be well-disguised regardless of being placed above or below the muscle.  Also, since silicone implants are used almost exclusively again, subglandular implants provide much more consistent and excellent results.  Implants placed above the muscle is also called subglandular or suprapectoral augmentation.  It is an excellent choice that can provide superior results when properly indicated.  Indications for subglandular augmentation include minimal ptosis, bodybuilding or fitness models that pose while flexing, desire to avoid a breast lift or personal preference.  The most common indication for implants above the muscle is bodybuilders that are posing and are bothered by movement of the implant while flexing.  There is a slightly higher risk of capsular contracture but the risk is still approximately only 10%.

Below you will see listed the risks/complications that are possible. The thing to keep in mind, however, is that the chance of having any of these problems is exceedingly low in my practice.

• Bleeding
• Infection
• Hypertrophic scarring
• Capsular contracture (see separate article describing)
• Altered nipple sensation (usually increased early)
• Implant rupture or leakage
• Rippling (usually due to improperly filled implants)
• Implant malposition
• Deep vein thrombosis (blood clots in the legs)
• Need for revisional surgery
• Cardiac or pulmonary complications

Implants are not permanent and will need to be replaced at some point. Most implants will last a minimum of 20 years however. The rupture rate is roughly 10% at twenty years which is very acceptable. Excellent warranties are provided by the two implant manufacturers which cover almost the entire cost of replacement surgery and also provide for free implants. You can rely on the fact that your results will be long-lasting and it should be many years before you need to consider any revisional surgery.

The amount of pain you experience is somewhat subjective, but the majority of women have mild to modest discomfort. Long-lasting local anesthetic is injected into the breast pocket at the time of surgery which provides extended relief during the period of most pain, which is the first evening. You are provided with prescriptions for narcotics to provide relief during the first several days after your operation. Beginning ibuprofen (Advil, Aleve, Motrin) the evening of surgery usually allows discontinuation of the narcotics by the second day. I have performed hundreds of breast augmentations both with and without pain catheters left in at the time of surgery, and it is my opinion that the difference in pain levels is minimal. If you prefer the use of pain catheters it can be arranged. We also provide mild sedatives which I encourage you to take the night before surgery to ease any anxiety that you might be experiencing. The key to excellent control of pain and anxiety is never allowing it to become significant in the first place!

Mondor's Cords are firm cord-like bands that sometimes form just under the skin near the breast. One or more cords may appear. They are completely harmless and affect a small percentage of women. They can be painful and usually begin 1 to 4 weeks following surgery. Warm compresses and anti-inflammatories such as ibuprofen help to alleviate the discomfort. They will eventually go away in a month or two.

As I mentioned above, I have performed hundreds of breast augmentations and breast procedures are a large part of my practice. I had the opportunity to operate with many surgeons during my training and in doing so developed my own style which incorporates the best of all approaches. In addition to breast augmentation I perform breast reduction, mastopexy (breast lift), nipple-areolar reduction, and inverted nipple correction, as well as many other breast-related procedures.

I prefer that my patients stay active and in fact require that you are up and walking around the evening of surgery. Light exercise can begin after several days, not including chest-specific weight training though. All restrictions are removed after six weeks, and sometimes even earlier depending on your personal progress. It is important to follow all instructions during the early postoperative period to ensure excellent results. I always remind my patients that they went through the effort to have the surgery and to give themselves the proper time to recover.

You arrive at the facility approximately an hour prior to your scheduled time of surgery. The skilled nursing staff greets you and takes you to a private room in the preoperative area where you change and complete the admission process. You then meet your anesthesiologist who reviews your history with you and explains the procedure of going to sleep and waking up in the most comfortable and safe way possible. I arrive shortly thereafter to mark you for your surgery and answer any last minute questions that you might have. You receive a single dose of intravenous antibiotics as prophylaxis against infection and are then taken into the operating room where you comfortably drift off to sleep and wake up 45 minutes later with your new implants in place. After a short time in the recovery room you are taken back to the private room where you began before surgery. Your nurse then reviews the postoperative instructions that we provided you with and gets you ready for discharge usually within two hours of leaving the operating room. You can expect a call from me that evening to make sure that you are doing well. Remember, my phone number is provided to you and is on 24/7 for my patients.

You are seen in the office the day after your surgery so that one of our medical staff can review your exercises with you to help initiate implant mobility and soften the pocket. I see you multiple times out to at least one year following your surgery, and anytime after that if you desire. My goal is to provide excellent and long-lasting results in a practice that is always there for you.

Silicone implants are filled with a polymeric gel of the element silicon which we all naturally have small amounts of in our bodies. The FDA has approved these implants for use in women 22 years of age and older, after many years of exhaustive studies proved that they cause absolutely no harm to women. Silicone implants may be used in younger women if the surgeon determines that a significant asymmetry or abnormality exists. Implant rupture may be harder to detect and could require an ultrasound or MRI to make the determination. Even so, the gel remains in the pocket that your body creates around the implant and is not dangerous.

A tummy tuck usually takes about two hours to complete. You then spend several hours in the recovery room until you are drinking fluids, walking around, and are able to go to the bathroom. A drain will be in place and you will be instructed prior to discharge how to care for it. It is very easy to do and will require emptying usually twice a day until it is removed in one to two weeks. An abdominal binder will also be covering your abdomen to help maintain gentle pressure and provide comfort during the early portion of your recovery. Unless you have a pre-existing medical issue, you will not be required to stay overnight in the hospital, although it can be arranged if you desire to do so. Virtually none of my tummy tuck patients over the last 8 years have needed a hospital stay and our safety record has been outstanding. Patients that live more than an hour away stay in a local hotel and are seen in the office the following morning prior to your departure for home.

Abdominoplasty is performed under general anesthesia. This is the safest method and allows you to receive medications to minimize your pain and any anxiety you may have surrounding the time of surgery. Multiple agents are administered to prevent nausea and vomiting so you should not be concerned about that being an issue postoperatively. You will wake up gradually and sleep in the recovery room for several hours and before you know it you will be up and able to walk to the bathroom.

You will have a moderate amount of discomfort the first few days, but it improves quickly as you begin to become more active. A combination of medications will be provided and I encourage you to take whatever you need during those first two or three days to be comfortable. The most important thing to remember is to take what you need prior to the onset of pain. Most patients are able to manage their pain with Tylenol or Advil within a day or two after surgery.

I require you to walk several times the evening of surgery. The most important thing you can do to minimize pain and decrease the risk of complications is early ambulation and keeping yourself well-hydrated. I tell my patients to act as if they had a bad cold, meaning you still remain active but get as much rest as you can. I encourage you to resume light exercise within a few days and even allow you to walk around outside or on a treadmill if you desire. After six weeks I remove all restrictions and you can do as many sit-ups or run a marathon if you wish. Once your drain is removed you can begin swimming.

The incidence of major complications from abdominoplasty in my practice is exceedingly low and certainly below 1%. The most common complication is a collection of fluid that needs to be drained in the office; perhaps 5% of my tummy tucks require this. It is painless to drain and usually resolves after being drained once. Other complications include infection and bleeding but are, as I mentioned above, exceedingly infrequent. As with all of my procedures, we make sure you are cleared by your regular physician and check all pertinent lab work that may be indicated.

The majority of my procedures are performed at the Bedford Ambulatory Surgery Center (BASC) located just off Rte. 293 on South River Rd. in Bedford. The BASC is known for being a very comfortable and convenient setting, and has an outstanding reputation for patient safety.

Certain procedures are done at The River’s Edge facility located adjacent with the Queen City Bridge in Manchester, NH.

The staff at both locations is highly trained to care for my cosmetic surgery patients and almost all comment on how well they were treated.

We see you in the office the morning after surgery to exam you and answer any questions you may have. Then you are seen weekly until your drain is removed and at 3, 6 and 12 months, all included in the cost of surgery.

No, men can experience enlarged areolas typically after massive weight loss. Men sometimes have enlarged nipples that protrude through clothing making them self-conscious and feel like they can’t go shirtless. This can be corrected in a very quick procedure in the office with excellent results.

Since the entire scar is along the border between the pink areola and regular skin, it is well-disguised and very difficult to notice. After six to twelve months it fades to a thin, pale white line. Your results should last a lifetime unless you experience massive weight loss or breast enlargement again, and even then it is unlikely to recur.

Yes, this procedure does not involve the nerves to the nipple which enter from deep in the breast. Nipple sensation can be affected during certain types of breast reduction or mastopexy but it is very unlikely in areola reduction.

Areola reduction takes approximately thirty minutes; nipple reduction slightly less time. All of your sutures will be dissolvable and you will have thin adhesive strips for a week after the procedure. You are seen back in the office one to two weeks afterward and then approximately three months later. All of your post-operative visits are included in the fee for your areola reduction.

The technique which I have used for a number of years is called the L-brachioplasty. It has provided excellent results with very few complications, and consistently satisfied patients. The scar runs on the inner part of the arm from just above the elbow crease to the armpit and then down the chest wall for a short distance. Most of the armpit hair-bearing skin is removed which means that most women no longer need to shave in that area after surgery. Unless your arms are raised the scar is not visible from the front or back. We instruct you as to how to care for your scar to further diminish the appearance once it has matured. The interventions that we always recommend are moisturizer, massage, sun block and silicone or paper tape. All of these contribute to more rapid flattening and fading of the scar.

There is minimal pain post-operatively because only skin and fat are involved. All of the sutures are dissolving and the tape over the incisions falls off after about one week. Mildly compressive ACE wraps are worn the first night followed by a compressive garment that is worn for several weeks afterward. A drain will be placed in each arm in most cases that is removed the morning after surgery. Most women are able to control the mild discomfort with Tylenol or Advil but you are given a prescription for pain killers in the event that you require more relief.

Your results will be long-lasting and any loosening of the skin is usually easily addressed in the office in a minor procedure. Slight fluctuations in weight does not have a great effect on the upper arms, particularly if liposuction was performed as part of the procedure.

Since so many patients have undergone bariatric surgery in the last decade I have become very experienced in body contouring after massive weight loss. I routinely speak at the Dartmouth-Hitchcock Clinic bariatric support group meetings so that patients have a good understanding of the options that are available to them as they continue on their journey of self-improvement following their weight-loss surgery.

I prefer that my patients stay active and in fact require that you are up and walking around the evening of surgery. Light exercise can begin after several days, not including chest/arm-specific weight training. All restrictions are removed after six weeks, and sometimes even earlier depending on your personal progress. It is important to follow all instructions during the early postoperative period to ensure excellent results. I always remind my patients that they went through the effort to have the surgery and to give themselves the proper time to recover.

You arrive at the facility approximately an hour prior to your scheduled time of surgery. The skilled nursing staff greets you and takes you to a private room in the preoperative area where you change and complete the admission process. You then meet your anesthesiologist who reviews your history with you and explains the procedure of going to sleep and waking up in the most comfortable and safe way possible. I arrive shortly thereafter to mark you for your surgery and answer any last minute questions that you might have. You receive a single dose of intravenous antibiotics as prophylaxis against infection and are then taken into the operating room where you comfortably drift off to sleep and wake up two hours later with your newly contoured breasts. After a short time in the recovery room you are taken back to the private room where you began before surgery. Your nurse then reviews the postoperative instructions that we provided you with and gets you ready for discharge usually within two hours of leaving the operating room. You can expect a call from me that evening to make sure that you are doing well. Remember, my phone number is provided to you and is on 24/7 for my patients.

You are seen in the office the day after your surgery so that Sarah can answer any questions you may have about the early postoperative period. Your drains will be removed and you can shower as soon as you get home. You will also begin wearing a more convenient and comfortable compression garment from this point on. I see you multiple times out to at least one year following your surgery, and anytime after that if you desire. My goal is to provide excellent and long-lasting results in a practice that is always there for you.

A lower body lift takes approximately four to five hours to complete. You then spend several hours in the recovery room until you are fully awake and are then transported to your room. I only perform these cases as the first case of the day given the length of surgery. Later that afternoon you will be allowed to eat and drink and will be required to take several short walks in your hospital room or hallway. By requiring you to be out of bed we greatly reduce the risk of deep vein thrombosis (blood clots) and also decrease your pain by preventing muscle spasm. You will have several drains in place, as well as mildly compressive garments to make you more comfortable and help decrease swelling during the early portion of your recovery. By the next morning you will be feeling much better, ambulating more readily and tolerating more food and liquids. Over the last 8 years, ninety percent of my body lift patients are discharged on the day after surgery. Patients that have pre-existing medical conditions or are uncomfortable may stay an extra day or two if necessary. Prior to discharge you will be instructed as to how to care for your drains and thorough discharge instruction sheets will be provided.

Body lifts are performed under general anesthesia. This is the safest method and allows you to receive medications to minimize your pain and any anxiety you may have surrounding the time of surgery. Multiple agents are administered to prevent nausea and vomiting so you should not be concerned about that being an issue postoperatively. You will wake up gradually and sleep in the recovery room for several hours and before you know it you will be up and able to begin eating and drinking.

You will have a moderate amount of discomfort the first few days, but it improves quickly as you begin to become more active. Until you are able to take medication orally, intravenous pain medications will be administered by your nurses. By the next morning you will be taking a combination of medications by mouth to maximize your comfort. I encourage you to take whatever you need during those first two or three days to be comfortable so that you can mobilize and gradually increase your activity. The most important thing to remember is to take what you need prior to the onset of pain. Most patients are able to manage their pain with Tylenol or Advil within a day or two after surgery but you will also have narcotic analgesics prescribed until you no longer need them.

I require you to walk several times the evening of surgery. The most important thing you can do to minimize pain and decrease the risk of complications is early ambulation and keeping yourself well-hydrated. Within 2-3 days you will no longer be hunched over and can walk completely upright. I tell my patients to act as if they had a bad cold, meaning you still remain active but get as much rest as you can. I encourage you to resume light exercise within a few days and even allow you to walk around outside or on a treadmill if you desire. After six weeks I remove all restrictions and you can do as many sit-ups or run a marathon if you wish. Once your drains are removed you can begin swimming or using a hot tub.

The incidence of major complications from lower body lifts in my practice is exceedingly low and certainly below 1%. The most common complication is a collection of fluid that needs to be drained in the office; perhaps 5% of my body lifts require this. It is painless to drain and usually resolves after being drained once. Other complications include infection and bleeding but are, as I mentioned above, exceedingly infrequent. As with all of my procedures, we make sure you are cleared by your regular physician and check all pertinent lab work that may be indicated. The national data reported by plastic surgeons demonstrates a blood transfusion rate in this type of surgery approximately 20-25% of the time. Over 8 years of performing these procedures less than 5% of my massive weight loss patients have required a transfusion.

All body lifts require an overnight stay and are performed at the main campus of The Elliot Hospital. The operating room staff is very experienced in these complex procedures and every effort is made to make your procedure flow as smoothly as possible. Your markings will be completed in the comfortable office setting the afternoon prior to surgery since it takes approximately 30 minutes to do. This is done so that you can relax the morning of surgery and not have to worry about standing for an extended period of time.

Your first visit is one week after discharge from the hospital. Then you are seen weekly until your drain is removed and at 3, 6 and 12 months, all included in the cost of surgery.

A breast reduction usually takes about two hours to complete. You then spend several hours in the recovery room until you are drinking fluids, walking around, and are able to go to the bathroom. A bra will be in place to help maintain gentle pressure and provide comfort during the early portion of your recovery. Unless you have a pre-existing medical issue, you will not be required to stay overnight in the hospital, although it can be arranged if you desire to do so. Virtually none of my breast reduction patients over the last 8 years have needed a hospital stay and our safety record has been outstanding. Patients that live more than an hour away stay in a local hotel and are seen in the office the following morning prior to your departure for home.

Breast reduction is performed under general anesthesia. This is the safest method and allows you to receive medications to minimize your pain and any anxiety you may have surrounding the time of surgery. Multiple agents are administered to prevent nausea and vomiting so you should not be concerned about that being an issue postoperatively. You will wake up gradually and sleep in the recovery room for several hours and before you know it you will be up and able to walk to the bathroom.

You will have a very modest amount of discomfort the first few days, but it improves quickly as you begin to become more active. Since only skin, fat and breast tissue are resected the only pain you feel afterward is a low-level burning sensation along the incisions. A combination of medications will be provided and I encourage you to take whatever you need during those first two or three days to be comfortable. The most important thing to remember is to take what you need prior to the onset of pain. Most patients are able to manage their pain with Tylenol or Advil within a day or two after surgery.

I require you to walk several times the evening of surgery. The most important thing you can do to minimize pain and decrease the risk of complications is early ambulation and keeping yourself well-hydrated. I tell my patients to act as if they had a bad cold, meaning you still remain active but get as much rest as you can. I encourage you to resume light exercise within a few days and even allow you to walk around outside or on a treadmill if you desire. After six weeks I remove all restrictions and you can do as many sit-ups or run a marathon if you wish. You will be required to wear a bra with excellent support for the first 3-4 weeks for most of the time every day. You will be permitted to remove it for several hours a day while relaxing at home but are advised to wear it while sleeping and when out and about.

The incidence of major complications from breast reduction in my practice is exceedingly low and certainly below 1%. The risk of nipple-loss is present but has not happened in my hands to date. Minor complications include small areas of skin breakdown, infection and bleeding but are, as I mentioned above, exceedingly infrequent. As with all of my procedures, we make sure you are cleared by your regular physician and check all pertinent lab work that may be indicated.

The majority of my procedures are performed at the Bedford Ambulatory Surgery Center (BASC) located just off Rte. 293 on South River Rd. in Bedford. The BASC is known for being a very comfortable and convenient setting, and has an outstanding reputation for patient safety. Certain procedures are done at The River’s Edge facility located adjacent with the Queen City Bridge in Manchester, NH. The staff at both locations is highly trained to care for my cosmetic surgery patients and almost all comment on how well they were treated.

We see you in the office the morning after surgery to exam you and answer any questions you may have. Then you are seen at 1, 3, 6 and 12 months, all included in the cost of surgery.

Labia reduction, or labiaplasty, is a procedure which removes a portion of the labia minora or inner vaginal lips in a very precise surgical procedure. The result is a single, straight line incision that is closed with absorbable sutures which dissolve over the course of several weeks. What you can expect after surgery is that you will have minimal to no projection of the inner lips (labia minora) beyond the edge of the outer lips (labia majora). This eliminates a number of issues that having enlarged labia can cause such as abrasion or irritation during intercourse or exercise, as well as being visible in tight fitting clothing. Once you are fully healed, it is highly unlikely that a partner would be able to tell that you’ve even had surgery.

There is not a lot of preparation required. We ask that you shave the area two days prior to the procedure as this reduces the risk of infection compared to shaving performed at the time of surgery. You should have ice at home for the evening after your procedure, as well as some ibuprofen (Motrin, Advil, Aleve, etc.). We will provide you with prescriptions for anxiety and pain reduction which you fill prior to the day of surgery. If you are anxious about the procedure, I encourage you to take the anti-anxiety medication the evening before your surgery so that you feel more comfortable.

The risk/complication profile of labiaplasty is very low, meaning that it is the rare patient who experiences any problem. The most common complication is a collection of blood (hematoma) in the area of surgery that requires drainage the day after surgery. This occurs in less than 1% of my patients. You can expect some mild bleeding the night of surgery which tapers off by the next morning. You can also expect swelling and bruising of the labia which resolve over the course of several days and is completely normal. The genital area is highly resistant to infection and I have not had to treat a patient for that problem. The labia are extremely rich in nerve endings thus there is a very low risk of loss of sensation. As I mentioned above, most women find that they have enhanced sexuality following labia reduction.

There are multiple options available from local only (lidocaine and marcaine), to a combination of local anesthetic and oral sedation, or if you prefer to be asleep an anesthesiologist can administer sedation or general anesthesia. The vast majority of women opt for local only, which allows them to drive themselves to and from the procedure. There is minimal discomfort which lasts for approximately 3-4 seconds while the anesthetic is being injected. Once that takes effect you have absolutely no discomfort until 4-6 hours after the procedure at which time you will have started taking the prescribed analgesics (pain medication) to alleviate the pain.

For the procedure, you lay flat on the table with your legs in stirrups. The genital area is washed with a sterile cleanser and drapes are placed over the area. We talk you through every step, and once the local anesthetic has been administered you feel no discomfort at all. The surgery then takes approximately 45 minutes from start to finish and you are able to leave as soon as you feel comfortable. Full instructions are given weeks before surgery so that you have all of the information you need prior to your procedure date. We strive to make the procedure as comfortable physically and emotionally for you as we possibly can.

The evening of surgery you will have moderate discomfort that is easily controlled with a combination of ibuprofen, Vicodin or Percocet, and ice. You will have some oozing that night but it will stop by the following morning. Within 48 hours, most of the discomfort is gone and usually ibuprofen or Tylenol will suffice to ease any lingering pain. The sutures (stitches) will be visible for several weeks until they dissolve. There will also be some swelling and bruising which resolve within days of the procedure. Tampons and intercourse are to be strictly avoided during the first 3-4 weeks after surgery. After that time I remove all restrictions. You are seen in the office one week and three months after surgery for follow up and instructions. I also ask that you check in at one year either in person or by phone to insure your level of satisfaction with the procedure.

As mentioned above, you can expect to have a beautiful appearance afterward with virtually no evidence of surgery once you have fully healed. There will be minimal to no projection of the labia beyond the outside vaginal lips. Approximately 2% of my patients require a minor revision if residual excess tissue is present. Labia reduction is a very safe procedure with minimal risks and complications in my experience.

Yes, many photos are available for you to view in the office. I prefer not to display them on the internet due to the privacy of the procedure.

Are you board certified? How many of this procedure have you done? Are your patients satisfied with their results? Do many patients require revisions?

There are many different variations of breast lift surgery available depending on the degree of breast hang and laxity.  All of the procedures result in a scar around the areola but it is hardly noticeable due to the interface between the different skin colors.  In some cases that is the only scar but for more extensive lifts there will be a vertical and horizontal scar as well.  Again, a beautiful new shape is always more important than the scars which fade away until they are minimally visible.

There is minimal pain post-operatively because only skin and breast tissue is involved.  All of the sutures are dissolving and the tape over the incisions falls off after about one week.  A mildly compressive bra is worn for several weeks afterward, which provides support and comfort while the breast heals.  Most women are able to control the mild discomfort with Tylenol or Advil but you are given a prescription for pain killers in the event that you require more relief.

Your results will be long-lasting and your nipple should remain in good position essentially for the rest of your life.  You may find that there is further atrophy of breast tissue as you age resulting in smaller breasts.  If that happens, you may consider breast implants to return some of the fullness that you may have lost.  If you do need further tightening many years later it is easily done through the same incisions from your first procedure, but most women won’t need this.

I have performed hundreds of breast lifts and all breast procedures are a large part of my practice.  I had the opportunity to operate with many surgeons during my training and in doing so developed my own style which incorporates the best of all approaches.  In addition to breast lifts I perform breast reduction, breast augmentation, nipple-areolar reduction, and inverted nipple correction, as well as many other breast-related procedures.

I prefer that my patients stay active and in fact require that you are up and walking around the evening of surgery.  Light exercise can begin after several days, not including chest-specific weight training though.  All restrictions are removed after six weeks, and sometimes even earlier depending on your personal progress.  It is important to follow all instructions during the early postoperative period to ensure excellent results.  I always remind my patients that they went through the effort to have the surgery and to give themselves the proper time to recover.

You arrive at the facility approximately an hour prior to your scheduled time of surgery.  The skilled nursing staff greets you and takes you to a private room in the preoperative area where you change and complete the admission process.  You then meet your anesthesiologist who reviews your history with you and explains the procedure of going to sleep and waking up in the most comfortable and safe way possible.  I arrive shortly thereafter to mark you for your surgery and answer any last minute questions that you might have.  You receive a single dose of intravenous antibiotics as prophylaxis against infection and are then taken into the operating room where you comfortably drift off to sleep and wake up two hours later with your newly contoured breasts.  After a short time in the recovery room you are taken back to the private room where you began before surgery.  Your nurse then reviews the postoperative instructions that we provided you with and gets you ready for discharge usually within two hours of leaving the operating room.  You can expect a call from me that evening to make sure that you are doing well.  Remember, my phone number is provided to you and is on 24/7 for my patients.

You are seen in the office the day after your surgery so that Sarah can answer any questions you may have about the early postoperative period.  I see you multiple times out to at least one year following your surgery, and anytime after that if you desire.  My goal is to provide excellent and long-lasting results in a practice that is always there for you.