Breasts:
Face:
Body:
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Breast Augmentation (Enlargement)
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:
- To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
- To correct a reduction in breast volume and sagging after pregnancy.
- To balance a difference in breast size.
- As a reconstructive technique following breast surgery
Correction of these problems can greatly improve self esteem for many women.
There are many options that a patient should consider prior to having breast implant surgery, such as type of implant, placement of the implant (above or below the muscle) and incisions used to place the implant. These options will be discussed with you during your consultation with Dr. Becker, at which time the optimal choices that best suit your body and desires will be determined.
Dr. Hilton Becker is best known for having developed the adjustable breast implant.
He is now pleased to offer his patients the New Cohesive Gel (Gummy Bear – MemoryGel) implants.
“Results with these new implants are now better than ever. The results look and feel more natural. Our patients that have received these implants are simply delighted”.
Dr. Hilton Becker has extensive experience using silicone gel breast implants. He has been part of the FDA Adjunct Study of Silicone Breast Implants and has been using silicone gel implants since the study was started in 1992.
In view of the fact that there is much confusion about the type of implants available and their appropriate use, Dr. Becker has written an article in order to facilitate you to make an educated choice for your breast augmentation.
What You Should Know About FDA Approval of Silicone Breast Implants By Hilton Becker, M.D., F.A.C.S
The FDA has approved Silicone Breast Implants after years of intense studies. Silicone breast implants have been approved, but with certain restrictions. They are only available to patients over 22 years of age. Furthermore, only the cohesive gel (memory gel – gummy bear) implants are available. If you have had or are considering Breast Augmentation, here are some facts you need to know.
INCISION AND PLACEMENT
Due to the firmer nature of the cohesive gel, a larger than normal incision is necessary; therefore, the inframammary (under the breast) incision is preferable for the insertion of these implants. The gel implant may also be inserted through a breast lift incision or an abdominoplasty (tummy tuck) incision.
Saline-filled implants, on the other hand, are placed through a smaller incision, as they are not filled until they are placed in the pocket.
PLACEMENT OF IMPLANT
Sub glandular (above the muscle – under the breast tissue)
Advantages:
- More natural position, appearance and feel
- Less painful, quicker recovery
Disadvantages:
- Less tapered upper pole (less noticable with sub fascial placement)
- Possible increase in capsular contraction
Sub muscular (behind the muscle):
Advantages:
- Gives more coverage and support to the implant, particularly in thin patients with small breasts
- More natural upper pole fullness
- Possible less interference with mammography
- Slightly less risk of capsular contracture
Disadvantages:
- More painful
- Longer recovery
- More movement with muscle contracture
- Possibility of visible step-off at muscle edge
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Types of Implants
Cohesive silicone gel (MemoryGel – Gummy bear) implants:
Advantages:
- Very low leakage rate (cohesive)
- Lighter than saline therefore less tendency to cause sagging if placed above the muscle
- More natural feel
- Less chance of rippling
Disadvantages
- Larger incision necessary
Saline implants:
Advantages:
- Smaller incision
- Lower cost
- Slightly less incidence of capsular contracture
Disadvantages:
- Higher leakage rate
- Higher incidence of rippling
- Heavier than gel, therefore preferable placement is behind the muscle to avoid sagging
Adjustable implants:
Advantages:
- Volume can be changed after surgery
- Patient has input into final size
- Better able to correct asymmetry
- Better able to treat complications following previous breast surgery i.e., irregularities in shape, capsular contracture, symmastia (disruption of midline)
Disadvantages:
- Injection dome has to be removed (can be buried or externalized)
- If the injection dome is buried, a second minor procedure, performed under local anesthetic, is necessary to remove the infection dome.
Textured verses smooth implants:
Smooth implants:
- More natural feel
- Less incidence of seroma (fluid) formation after surgery
Textured:
- May decrease capsular contracture (This has not been proven with the new cohesive gel implants)
OUR CURRENT RECOMMENDATIONS:
For patients over 22 years of age:
- Smooth, round, moderate profile- plus cohesive gel implants, preferably placed above the muscle, under the fascia (sub-fascial).
For patients under 22 years of age:
- Adjustable saline implants with external injection ports
- If the patient wishes to ultimately have silicone gel implants, adjustable saline implants are used to expand and adjust the pocket above the muscle. These can subsequently be replaced with silicone gel implants, usually with local anesthetics.
For patients with previous saline implants who wish to replace with gel implants:
- Submuscular saline implants are removed, the muscle is returned to its original position and new silicone gel implants are placed above the muscle (it is usually not necessary to remove the capsule unless it is calcified)
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Breast Augmentation & Lift
The most common breast problem seen after a woman has had one or more children is sagging of the breasts, combined with a loss of volume. This condition is best treated by combining a breast lift procedure with a breast implant. However, by combing the two procedures, the risk of complications are increased since the breast lift procedure results in tightening of the breast skin, while the implant enlarges the breast, resulting in increased tension on the scar. It is for this reason that the sub-areola technique and the adjustable implant is beneficial when combining mastopexy with augmentation. Dr. Hilton Becker uses the adjustable implant, known as the Mentor-Becker implant, which he developed and pioneered in 1984. Use of this implant, either saline or a combination of gel-saline, reduces the risk of scarring and complications associated with the mastopexy augmentation procedure.
If the adjustable saline implant is used it is placed under the muscle, the silicone gel implant is placed above the muscle.
A minimal amount of saline is placed in the implant at the time of the surgery. Saline is added slowly over a period of 5-10 days to allow for healing of the incision. When swelling has subsided and the implants are filled to the desired volume, the fill tubes and domes are then removed. The implant seals itself with a self-sealing valve.
If a vertical scar is warranted, due to excessive ptosis (sagging), use of the adjustable implants greatly improves the shape and symmetry of the breast, while reducing the amount of scarring.
The new Silicone Cohesive Gel (MemoryGel –Gummy Bear) implants have been used with excellent results in combination with a sub areola mastopexy procedure.
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Replacement of Saline Implants with Silicone Gel Implants
Now that silicone gel implants have been approved for use by the FDA, women have the option of having the most natural form of breast enlargement available.
When Silicone gel implants were not available in the United States, woman had only two options available to them:
- Use saline implants placed above the muscle - Due to the weight of the saline implant they would tend to sag excessively, resulting in an abnormal shape, commonly known as Rock-In-The-Sock. Rippling was also problematic.
- Place the saline implant under the muscle. Although this technique reduced sagging, muscle contracture resulted in abnormal distortion of the implant.
It is of my opinion that the most beautiful and natural results in breast augmentation are seen with Silicone Gel implants, placed above the muscle. Our patients who have received these implants are happier than ever.
Patients, who have previously had saline implants and are dissatisfied with their results, can now have their saline implants replaced with the New Cohesive Gel (MemoryGel – Gummy bear) implants.
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Correction of Breast Implant Complications
Dr. Hilton Becker is a recognized expert on Breast Implants. He has developed several adjustable breast implants and published numerous articles and book chapters on breast implant complications and how to treat them.
Unfortunately due to the FDA moratorium on silicon breast implants, women seeking breast enlargements were only able to have saline implants. Although results with saline implants are generally good, the complications seen with saline implants may include:
- Rippling and thinning of the tissues
- Excessive sagging – if saline implants where placed above the muscle
- Distortion and excessive muscle movement if they were placed beneath the muscle
- Stretching of the areola
Fortunately, now that Silicone Gel Implants have been approved by the FDA, they offer a viable solution to many of the problems that were caused by saline implants.
“Our patients who have had problems with saline implants are delighted by the feel and shape of the new gel implants. By replacing gel implants above the muscle, abnormal movement is eliminated and a more natural shape and feel is restored.”
Treatment of Breast Implant Complications
Complications following saline breast implant surgery are often related to the physical characteristics of saline verses that of breast tissue. Saline is heavier than breast tissue, and when confined to a flexible silicone bag it has more of a tendency to ripple, compared to a silicone gel implant. Saline implants therefore have a greater tendency to become ptotic (sag), especially when placed above the muscle.
Capsular contraction is a result of the body’s reaction to the implant, this results in tightening of the tissues around the implant.
Dissatisfaction with size, symmetry and shape may only manifest several months after surgery.
The treatment of these complications is often difficult and complex.
The availability of the New Cohesive Gel (MemoryGel – Gummy bear) implants and the adjustable breast implants provide new options that are highly successful in treating these complications.
Dr. Becker specializes in Plastic and Reconstructive Surgery of the Breasts, Facial Rejuvenation, and Liposuction. Dr. Becker is both nationally and internationally recognized for his expertise in plastic surgery, having published more than 60 articles in medical literature. He has developed several medical patents, including: The Becker Adjustable Saline Breast Implant, which can be adjusted to make the breast smaller or larger after it has been placed in the body. He has also developed a similar device used in facelift surgery to help elevate and stretch the deeper layer of the face. This procedure assists in elevating the jowls. Dr. Becker has also been innovative in the field of liposuction. He has developed several liposuction cannulas. Both products are used by plastic surgeons in the United States and throughout the world.
Use of Adjustable Implants to Treat Breast Implant Complications
Complications following saline breast implant surgery are often related to the physical characteristics of saline verses that of breast tissue. Saline is heavier than tissue, and when confined to a flexible silicone bag it has more of a tendency to ripple compared to a silicone gel. Saline implants therefore have a greater tendency to become ptotic (sag) especially when placed above the muscle.
Dissatisfaction with size, asymmetry and shape usually manifests several months after surgery.
Capsular contraction is a result of the body’s reaction to the implant. The treatment of these complications is often difficult and not always successful.
A new implant has recently been FDA approved for use under an adjunct study. Offering many advantages over standard implants, the Smooth Becker 50/50 implant is an adjustable implant that contains 50% silicone gel and 50% saline.
The implant is adjustable after surgery by means of a small injection dome that allows the inner saline compartment to be increased or decreased.
The advantages of the Smooth Becker 50/50 implant include:
- Post-operative adjustability
- Ability to stretch scar tissue
- Ability to modify the shape after surgery
- Ability to change the size of the implant after surgery to the size desired by the patient and to match more accurately the size of the opposite breast in cases of asymmetry.
Smooth Shell
- More natural feel
- More elasticity of shell
- Less rippling
50% Silicone
- More natural feel
- Lighter in weight, less tendency towards sagging
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Auto-Augmentation (Breast Enlargement using patient's own tissue)
In certain patients the breasts can be enlarged using the patients own tissue by repositioning the sagging tissue and bringing in more tissue in from the side of the breast. A moderate degree of enlargement can be obtained without the use of an implant.
Patients seeking to have implants removed are often concerned about the shape and size of the breast following removal. Not only is the size reduced by removing the implant, but sagging and depression of the tissues can be problematic. In this procedure the remaining breast tissue is lifted and the tissue at the side of the breasts, are moved into the center of the breast to give move fullness. Patients have been extremely gratified finding out that they can have normal looking breasts after their implants have been removed.
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Mastopexy
Traditional Mastopexy
One of the major concerns of a patient undergoing breast lift surgery is the resultant scars. Traditionally, breast lift surgery was performed using an anchor incision, which included a scar around the areola, a vertical scar and a horizontal scar at the bottom of the breast.
Vertical Mastopexy
Recently, the vertical mastopexy has come into vogue. With this procedure, the horizontal scar under the breast is eliminated, leaving only a vertical scar.
The Doughnut Mastopexy
The doughnut mastopexy eliminates both the vertical and horizontal scars; leaving the circular scar around the areola. Unfortunately with this technique, the scar around the areola can become stretched and visible. Puckering of the skin around the scar can also be problematic.
Sub-areola Mastopexy (“Invisible scar” breast lift)
Dr. Becker has developed a new technique called the sub-areola mastopexy. This technique enables a breast lift to be performed with virtually no scarring. The sub-areola mastopexy also results in less tension at the suture site. The scars are often barely noticeable.
The most common breast problem seen after a woman has had one or more children is sagging of the breasts, combined with a loss of volume. This condition is best treated by combining a breast lift procedure with a breast implant. However, by combing the two procedures, the risk of complications are increased since the breast lift procedure results in tightening of the breast skin, while the implant enlarges the breast, resulting in increased tension on the scar. It is for this reason that the sub-areola technique and the adjustable implant is beneficial when combining mastopexy with augmentation.
Dr. Hilton Becker uses the adjustable implant, known as the Mentor-Becker implant, which he developed and pioneered in 1984. Use of this implant, either saline or a combination of gel-saline, reduces the risk of scarring and complications associated with the mastopexy augmentation procedure.
If the adjustable saline implant is used it is placed under the muscle, the silicone gel implant is placed above the muscle.
A minimal amount of saline is placed in the implant at the time of the surgery. Saline is added slowly over a period of 5-10 days to allow for healing of the incision. When swelling has subsided and the implants are filled to the desired volume, the fill tubes and domes are then removed. The implant seals itself with a self-sealing valve.
If a vertical scar is warranted, due to excessive ptosis (sagging), use of the adjustable implants greatly improves the shape and symmetry of the breast, while reducing the amount of scarring.
The new Silicone Cohesive Gel (MemoryGel –Gummy Bear) implants have been used with excellent results in combination with a sub areola mastopexy procedure.
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Breast Reduction
Breast reduction is most often performed to alleviate the physical symptoms associated with large breasts. Most women with large, sagging breasts experience a restriction in their physical activities, as well as physical discomfort such as neck and back pain. Bra straps may leave indentations in the shoulders. Very large breasts can also make a woman feel very self-conscious.
Breast reduction is usually performed after a woman's breasts have fully developed; however, it is sometimes performed earlier under extenuating circumstances. Breast reduction results in a smaller, uplifted breast by removing excess tissue and skin. The incisions vary, depending on the degree of 'sag' that needs correction. Most often, the reduction can be performed using an incision that circles the areola and extends downward to the breast crease. In some cases a circular scar (circum-areolar) may be used. Occasionally, breast reduction can be performed using liposuction only. In patients with extremely large breasts, the nipple areola complex is removed and sutured back in position as a skin graft. In this procedure, a single incision is made in the breast crease.
Recent studies have shown that breast reduction may reduce the risk of breast cancer.
Breast Reduction Using Liposuction
Dr. Becker was one of the first plastic surgeons to describe the technique of liposuction breast reduction with no visible scars. He has been performing this technique since 1990 and published his article in Annals of Plastic Surgery in May of 1992.
Many women who are concerned about the scarring and magnitude of traditional breast reduction surgery now have the liposuction option available to them. The procedure is performed in our certified surgical center with twilight sleep anesthesia and local anesthetic.
Several tiny incisions are made in the breast fold where the cannula for liposuction is introduced. There is minimal pain after surgery and no loss of sensation as there is no cutting of the breast tissue.
Thanks to new instrumentation and technique, it is possible to get the skin to shrink following the liposuction reduction. This allows the areola to be lifted several centimeters. The procedure also works extremely well in patients who have already had traditional breast reduction surgery and desire further reduction in size without having to undergo another large surgical procedure.
Another indication for liposuction breast reduction is the patient with asymmetric breasts (i.e., where the two breasts are of different sizes). This is often seen in the young patient where a scarless reduction is a gratifying option for both the patient and the surgeon.
A limiting factor of this operation is that we cannot obtain a high degree of breast lift using liposuction alone. However, a second procedure (if necessary) can be done at a later stage under local anesthesia to elevate the nipples. This involves excision of the skin around the edge of the areola leaving a circular scar, which is usually not very noticeable.
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Male Breast Reduction (Gynecomastia)
Gynecomastia, or enlarged male breasts, is often a temporary condition of puberty. At times, however, the condition can persist beyond the teen years, sometimes affecting males during adulthood. No amount of dieting or exercise can reduce the size of the breasts. Many factors such as medications, hormonal excess, steroids, and marijuana use can also contribute to gynecomastia; these factors should be addressed prior to surgery.
How is gynecomastia treated?
The treatment of gynecomastia involves removal of excess breast tissue. Traditionally, the breast is reduced using a combination of liposuction and removal of the tissue through an incision around the areola. In the past, those with enlarged breasts had to undergo a surgical procedure leaving visible and often unsightly scars and depressions.
A new scarless technique, pioneered by Dr. Becker, allows the breast tissue to be removed through two or three tiny incisions, using a special dissecting cannula. The cannula breaks down the tissue, which is then "sucked" out in a manner similar to liposuction. These incisions are often so small that no sutures are required. In the majority of cases, the procedure is done under local anesthesia with twilight sedation. Surgery time is less than one hour; and patients often resume normal activity in 24 hours.
Recovery
After surgery, a special garment is worn around the chest for the first two weeks. Routine activities are usually resumed within one week of surgery.
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Breast Reconstruction
Dr. Becker is recognized both nationally and internationally as an expert in breast reconstructive surgery. He has lectured and published extensively on the subject.
Dr. Becker is best known as the inventor of the adjustable breast implant, otherwise known as the Becker Expander Mammary prosthesis. The Becker Expander implant functions as a tissue expander, and then converts to a breast implant once the tissues have been expanded sufficiently.
Traditionally, a tissue expander is placed at the first surgery and used to expand the overlying skin. It is then removed at a second surgery and replaced with a breast implant. Thanks to the invention of the Becker expander implant, a second operation is no longer necessary to replace the expander with an implant- it can all be done in one surgery.
The Becker expander implant has become one of the most widely used implants for breast reconstruction. It is used throughout the U.S., at institutions such as the Mayo Clinic and the Cleveland Clinic. It is also used in other countries throughout the world.
The results of reconstruction following mastectomy are directly related to the mastectomy technique that is performed. The techniques used for mastectomy are dependent on the nature of the condition being treated and the philosophy of the treating surgery.
Techniques available are:
- Simple mastectomy - An elliptical incision is made across the breast, removing the nipple areolar complex with the surrounding skin. The incision is closed with a straight scar running across the breast.
- Skin sparing mastectomy - A circular incision is made around the areola. The breast tissue is removed through this incision. The circular incision is closed as a purse string, usually leaving a small puckered scar.
- Areolar preserving incision - The nipple is excised together with the breast tissue through a horizontal incision through the areola. The areolar skin is later used to reconstruct the nipple.
- Subcutaneous mastectomy - An incision is made at the inferior edge of the areola or in the breast fold. The breast tissue is excised, leaving the nipple areolar complex intact. Tissue is usually removed from the base of the nipple and checked with frozen section prior to closure.
One Stage Immediate Breast Reconstruction (performed at the time of the mastectomy)
For women who are contemplating breast reconstruction, a revolutionary procedure has emerged; this procedure is known as skin-sparing single-stage breast reconstruction. This procedure is gaining popularity among progressive surgeons throughout the country and the world.
One nationally known plastic surgeon who has embraced this technology is Dr. Hilton Becker, based in Boca Raton, Florida. Dr. Becker is the developer of the Becker Expander Implant and is one of the first surgeons to perfect single-stage breast reconstruction. Single-stage breast reconstruction has been made possible by combining skin sparing mastectomy with the expander implant, which allows physicians to restore their patients’ natural breast appearance, while only having to undergo one major surgical procedure.
These new breast implants differ from standard implants in that they have a fill tube attached to them. This fill tube enables a surgeon to inject small amounts of saline into them for several months during routine office visits, following a woman's single reconstruction procedure. Over time, the woman's body slowly adjusts to the growth of the implant in the same manner that her body adjusts to a gradual growth of the abdomen during pregnancy. When the implant has been expanded to a size and shape that mirrors the patient's natural breast, the fill tube is removed. The expander implant then seals itself; and reconstruction is complete.
Dr. Becker believes that single-stage breast reconstruction affords his patients several important benefits. “The advent of single-stage reconstruction enhances the physical and emotional well-being of my patients because it allows them to awake after their mastectomy with some breast fullness that will be expanded to their satisfaction.”
Many patients look as good, if not better, after their bilateral mastectomy and reconstruction then they did before the surgery.
It is important to note that every woman's body and medical condition is different; so not all women are eligible for single-stage reconstruction. Your doctor is the best person to discuss with you whether or not single-stage breast reconstruction is a suitable option.
Delayed Breast Reconstruction
Dr. Becker is recognized both nationally and internationally as an expert in breast reconstructive surgery. He has lectured and published extensively on the subject.
Dr. Becker is best known as the inventor of the adjustable breast implant, otherwise known as the Becker Expander Mammary prosthesis. The Becker Expander implant functions as a tissue expander, and then converts to a breast implant once the tissues have been expanded sufficiently.
Traditionally, a tissue expander is placed at the first surgery and used to expand the overlying skin. It is then removed at a second surgery and replaced with a breast implant. Thanks to the invention of the Becker expander implant, a second operation is no longer necessary to replace the expander with an implant- it can all be done in one surgery.
The Becker expander implant has become one of the most widely used implants for breast reconstruction. It is used throughout the U.S., at institutions such as the Mayo Clinic and the Cleveland Clinic. It is also used in other countries throughout the world.
The results of reconstruction following mastectomy are directly related to the mastectomy technique that is performed. The techniques used for mastectomy are dependent on the nature of the condition being treated and the philosophy of the treating surgery
Prophylactic Mastectomy with Immediate Reconstruction
Prophylactic preventative mastectomy is the surgical procedure performed to remove one or both breasts in an effort to prevent or reduce the risk of developing breast cancer.
Because all or most of the skin and muscle are retained following a prophylactic mastectomy, there is no need to bring in extra skin by means of a flap. The muscle is strengthened with an acellular dermal graft (Alloderm, Surgimend or Neoform). While a flap can be used to replace the volume of the breast, the implant developed by Dr. Becker (the Mentor Becker 50/50) is considered by many surgeons to be the ideal implant to reconstruct the breast following prophylactic mastectomy.
The Mentor Becker 50/50 implant is a double-chambered implant with cohesive gel in the outer chamber and saline in the inner chamber. Saline can be added or removed from the implant by means of an injection dome. The implant can be placed under the muscle in the same way that it is done for breast augmentation. Saline is added once the skin has sufficiently healed, and then over-expanded to improve the shape of the breast. The volume is then reduced, and the injection dome is removed through a tiny incision. In select cases where circulation to the skin is not comprised, a gel implant can be used to eliminate the need for delayed filling or expansion.
The scar at the areola becomes almost invisible; and there is no donor site scar that is seen with flap surgery.
The reconstruction surgery takes approximately one hour following the mastectomy
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Facelift (Rhytidectomy)
The Deep Layer Facelift
The deep layer facelift has revolutionized face lift surgery. This technique involves repositioning the jowls and cheeks back to their original positions. The fullness of the face is restored and very little skin is excised. This deep layered facelift enables the plastic surgeon to improve the patient’s appearance in a way that is not possible with the standard skin excision face lift.
With the standard skin excision technique the skin is pulled backward towards the ears, often resulting in an unnatural wind swept appearance. With the deep layered technique, the deep tissues are pulled in an upward direction. The skin falls into place naturally and is closed without any tension. A more natural youthful appearance results.
In order to correct the upper lids and brow an endoscopic lift is done. Dr. Becker has developed his own technique for this procedure which he has presented at plastic surgery meetings and is soon to be published in the Aesthetic Surgery Journal.
The facelift procedure may be performed in the doctor's office or in an outpatient surgical facility. Premedication is generally recommended to relax the patient. The procedure is usually performed under local anesthesia with sedation. The incision is placed in the natural crease of the facial skin and begins inside the hairline, in the temple area above and forward of the ear. It continues in front of the ear around the earlobe and behind the ear. The skin is lifted outward and the surgeon tightens and repositions the underlying muscles and tissues. Excess skin and fat may also be removed. A facelift can take between two to four hours depending on the extent of the procedure.
Mid Face Lift
The Mid Face Lift is ideally suited to the younger patient who wants to avoid visible scarring.
An incision is made in the temporal hair line. A device called the endotine is used to elevate the checks and jowls, resulting in a fuller more youthful appearance.
Neck Lift
For patients whose main problem is excessive skin or sagging of the neck, a neck lift can be performed. This procedure may consist of:
- Liposuction of the neck
- Liposuction and suspensions of the neck muscles
- Formal neck lift which is essentially a lower Face Lift
Lunch Hour Facelift
There are several procedures that are considered lunch hour face lifts. These include thread lift, mini face lift, neck lift, fat injections and laser treatments.
With the hectic lifestyles most people live today, it is difficult to take time out of our work and social schedules for surgery, especially if the recovery is going to be 2-3 weeks.
With this in mind, Dr. Becker has developed the hydrostatic face lift. This procedure takes less than one hour to perform. The patient wears a neck band and is able to return home shortly thereafter.
Tiny incisions are made behind the ear and under the chin being virtually invisible. For further elevation of the lower face, an incision is made in the hairline above the ear. Once again this incision is not seen.
The procedure is performed in our certified surgical center under local anesthesia. The skin of the neck and lower face is elevated off the underlying tissues using hydrostatic pressure i.e. injection of saline fluid to lift the tissues. The tissues are then further freed using special elevator, developed by Dr. Becker.
Extreme Makeover Facelift
We have developed a rejuvenation process which is based on the concept of utilizing whatever is necessary to accomplish an optimal result. This may include:
- A brow lift
- Eyelid surgery
- Nasal refinement
- Cheek enhancement
- Deep layer face lift
- Smas face lift
- Neck lift
- Skin peeling and laser treatments
- Injectables- micro fat injection, botox, sculptra, restylane, radesse.
- Post operative skin care maintenance.
These procedures are performed over a six month period. The procedures are packaged in a comprehensive one time fee which will enable the surgeon and the patient to freely utilize any of these during this period to obtain the desired result.
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Brow Lift (Forehead Lift)
Wrinkles and frown lines in the brow and forehead area are often some of the earliest signs of aging. A brow lift (forehead lift) can smooth out the wrinkles and correct drooping brows and heavy lids to provide a younger, friendlier appearance. A brow lift can be performed alone or with other facial rejuvenation procedures such as a facelift, eyelid surgery, or laser skin resurfacing.
A brow lift is usually performed as an outpatient procedure under local anesthesia with sedation. The procedure may take 1 to 2 hours to perform.
Endoscopic Brow Lift
Endoscopic or minimal-scar brow lift is performed using a tiny fiberoptic lens inserted through half-inch incisions placed in the hairline. The lens is attached to a camera, which is connected to a television monitor, allowing for visualization of the surgery. Additional half-inch incisions are made for the insertion of tiny scalpels, scissors and retractors. Your surgeon performs the procedure while viewing the television monitor and manipulating the tiny instruments externally.
An endoscopic brow lift is particularly useful with younger patients where the removal of excess skin is not required. With an endoscopic brow lift, loss of sensation or hair at the incision site is minimized. Since an endoscopic brow lift can significantly reduce the frown lines between the eyes, it is often performed in conjunction with upper eyelid surgery to achieve optimal results.
What Are The Benefits Of Endoscopic Brow lift Surgery?
- Smaller incisions
- Minimal scarring
- Less bleeding
- Less hair loss
- Minimal numbness
- Quicker recovery
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Blepharoplasty – Eyelid Surgery
Upper lid blepharoplasty
The upper lid bleparoplasty procedure involves excising the excess skin, fat and muscle that causes fullness and heaviness of the upper lid. An incision is made in the lid crease and the excess tissue excised. The scar is concealed in the natural crease line and therefore barely noticeable.
I often combine a brow lift with an upper blepharoplasty. A brow lift will raise the brows into a more youthful position while at the same time opening the lid folds. Brow ptosis (sagging) is usually the first sign of aging and sometimes a brow lift is performed instead of a blepharoplasty. I will be happy to discuss your options during your consultation. An upper lid blepharoplasty can be performed under local anesthetic, whereas a brow lift will require sedation. (click here for more on brow lift)
Lower lid blepharoplasty
There are many techniques available to correct problems related to the lower lids. These include:
- Laser peeling to correct fine lines.
- Fat injections to correct tear trough deformities (hollowness of the lower lids).
- Fat pad excision either :
- Trans conjunctival (from the inside of the lid)
- Through an incision below the eye lashes where the scar is hidden in the natural crease
- Excision of excess skin through an incision at the lash line.
- Elevation of the cheeks - By elevating the tissues below the lid, less tension is placed on the lid resulting in a more youthful appearance. An incision is made in the temporal hair line. A special device known as the endotine is then tunneled through the skin and anchored to the cheek tissue.
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Rhinoplasty (Nose Surgery)
The nose is the most prominent feature on the face, second only to the eyes. The size and shape of the nose are considered the most defining characteristic of the face.
Rhinoplasty is the reshaping of the nose. It can be performed on an outpatient basis under local or general anesthesia. The procedure usually takes an hour or two, although a complicated procedure may take longer. Most incisions are made inside the nose, where they are not visible. The skin and tissues of the nose, along with the underlying bone and cartilage, are sculpted to a desired new shape. In certain circumstances, the contour of the nose can be improved by adding tissue.
Often, only nasal tip correction, which can be performed under local anesthesia, is necessary to elevate (or refine) the tip of the nose
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Abdominoplasty (Tummy Tuck) – Standard and Mini
Sometimes dieting and exercising are simply not enough to take care of problems around the waist line. In such cases, a patient may wish to consider a tummy tuck (otherwise known as abdominoplasty).
A tummy tuck is the surgical removal of excess skin or fatty deposits from the abdomen, along with the repositioning of abdomen muscles into a tighter formation. This bodily enhancement procedure is designed for those who wish to have a flatter and tighter stomach. It is also helpful in remedying the vertical separation of abdomen muscles, known as diastases, which can occur following pregnancy.
Reasons for Considering an Abdominoplasty:
- Inability of dieting and exercise to improve the abdominal area
- Excessive accumulation of skin following weight loss
- Loss of skin elasticity or diastases (loose abdominal muscles) due to pregnancy
- The removal of unsightly skin and fat deposits, as well as the proper alignment of the abdominal muscles, to produce a more flattering look
About the Procedure
Abdominoplasty surgery lasts anywhere from one to five hours, depending on the desired look and the patient’s unique physiology. To begin the procedure, an incision is made just above the pubic bone area. This incision goes horizontally across the lower abdomen, and sometimes around to the back. The skin is then stretched away from the muscle tissue and excess skin is removed. The abdominal muscle tissue is then tightened to provide a firmly contoured stomach and well-defined waistline. Finally, the incision is closed and the skin is stitched back into place. In order to provide the best results during a full abdominoplasty, an additional incision is made around the navel.
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Liposuction / Lipoplasty
Traditional Liposuction
Liposuction is a body-sculpting procedure to remove fat that is unresponsive to dieting and exercise, thus helping to yield a slimmer and better proportioned figure. Liposuction can be applied to nearly any area of the body and is commonly used on multiple areas during surgery.
The New VASER - LipoSelection
Dr. Becker uses the New VASER LipoSelection System, a procedure that combines new patented technology with advanced surgical techniques to break up and remove fatty tissue. This procedure allows unwanted fat to be efficiently removed from the abdomen, breasts, arms, back, hips, knees, love handles, neck, chin, saddlebags, thighs and any other place that has developed “extra cushioning”.
The VASER LipoSelection System uses ultrasound energy, together with a Tumescent, which is a local anesthetic solution used to liquefy and dissolve fat cells, leaving surrounding tissue such as nerves, blood vessels and connective tissue relatively intact. The dissolved fat cells are then removed with gentle suction and massage. This procedure is not only safer than traditional liposuction, but there is less bruising, less down time, more skin tightening and smoother results.
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Arm Lift (Brachioplasty)
Fluctuations in weight, growing older and heredity can cause the upper arms to have a drooping, sagging appearance. While exercise may strengthen and improve the underlying muscle tone of the upper arm, it does not help with excess skin that has lost elasticity or underlying weakened tissues and localized fat deposits.
Excessive fullness of the upper arm can be reduced with liposuction; however, in patients where excess skin is a problem, or in patients who have lost significant amounts of weight, more is needed. Brachioplasty, otherwise known as an arm lift, can help reduce excess skin and fat between the underarm and the elbow in order to give a more toned and proportionate appearance. During an arm lift, the excess skin is excised, thus restoring a more pleasing contour to the arm.
Arm lifts are popular among women who are unable to wear sleeveless clothing. It restores their choices of dress and helps boost their self-confidence.
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Reduction of the Labia (Labioplasty)
Labioplasty is a procedure that many women are choosing to undergo as a way to enhance the appearance of their genitalia.
Labioplasty helps reduce the size of the inner lips of the vulva. For many women, elongated inner lips can cause women to feel self-conscious when wearing thongs, skimpy bikini bottoms or underwear. Prominent labia can even affect everyday activities; and in some cases, it can even interfere with sexual activity.
The labioplasty procedure is performed under twilight anesthesia, combined with local anesthesia, so that no discomfort is felt. The recovery period for labioplasty is relatively short. After the procedure, there may be 5-10 days of discomfort; full recovery usually takes 2-3 weeks.
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Buttock Augmentation (Enlargement) - *New* Fat Grafting Technique
Microfat grafting has been used successfully for many years in patients undergoing facial rejuvenation. Microfat grafting procedures on other parts of the body have recently gained popularity and we are seeing improved results.
Dr. Becker is now using this fat grafting technique to enlarge the size of the buttock, specifically to fill in depressed areas. The fat is injected in tiny amounts into the buttocks. The procedure is relatively non-invasive; patients usually return to normal activities within a few days
