Reshaping Body Contours
Our Goal
The clinical presentation for body contouring surgery is as varied as the histories of individual patients. If all patients had pursued an idealized diet and exercise plan, maintained perfect health, and never been pregnant then many of our body contouring procedures would be less common. Nonetheless, at the Hamilton Clinic, we strive to encourage patients to pursue a healthy lifestyle along with balanced nutrition prior to these surgeries that require a healthy body to heal.
Our appearance plays a powerful role in our personal and social interactions, and certain body changes can progress to the point that it can impact confidence and social interaction. Dr. Hamilton evaluates and customizes each body contouring patient's plan to address requested anatomical changes in a personalized manner. Whatever the plan, the individual areas improved must harmonize with the overall physique to create a proportionate, balanced result.
Many patients require only well-defined liposuction to return to a proportional, more athletic physique, others require a surgical plan that involves removal of excess skin or large areas to tighten, firm and create a more harmonious proportion. The key to successful body contouring surgery is Dr. Hamilton's ability to individualize each patient's surgical needs and develop a customized plan to safely achieve the chosen goals.
Abdominoplasty
Abdominoplasty, also referred to as a tummy tuck, is designed to give you a smoother, flatter abdomen. The procedure removes excess abdominal skin, reduces fat, and tightens the muscles of your abdominal wall. It frequently is performed to correct muscle weakness and loose skin that can occur following multiple pregnancies or significant weight loss.
Abdominoplasty may be done on an outpatient basis or during a brief hospital stay. Generally, a horizontal incision is made just within or above your pubic area. The contour of this incision may vary. The resulting scar is permanent, but placed within the lines of the type of bathing suit or undergarments that you typically wear.
If you have loose skin above your navel (belly button), a second incision may be placed around your navel so that the skin can be pulled down and the excess removed. The position of your navel will not change. If there are stretch marks on your lower abdomen, these may also be removed. Any remaining stretch marks may be somewhat flattened, but don’t expect a dramatic improvement.
Abdominoplasty sometimes may be combined with liposuction to achieve the best results. If your skin laxity and muscle weakness are limited to the area below the navel, you may be a good candidate for a modified abdominoplasty that leaves a shorter scar and requires no incision around the navel. JP drains are placed for this procedure, and you will be instructed on how to monitor the output. Drains are typically removed within 7-14 days following surgery.
The day after surgery, you will be encouraged to get out of bed and walk for short periods to promote blood circulation. You will be instructed to wear a support garment for several weeks. You will also be required to avoid strenuous activity for a while but should be able to return to work within 2 weeks.
Lower Body Lift (Belt Lipectomy)
A lower body lift is designed to tighten loose skin or flesh around the body, particularly the lower back, buttocks, and outer thighs. The incision is placed within the contour of the lower back and buttocks. A lower body lift might be right for you if:
You have lost a significant amount of weight
You have excess fat and skin in one or more areas
You would like to improve the overall contours of your body
Diet and exercise have not been able to get you the results you desire
To ensure you are a qualified candidate, a consultation along with a medical history is important to determine if you are in good health with no medical conditions that could impair healing or increase risk.
What Should I Expect After My Lower Body Lift?
Lower body lift surgery is invasive, and its recovery is not always comfortable. There will be times when you are sore, tender, and tight. Your bruising and swelling will last for weeks. Although the recovery process is manageable, you should expect to take a minimum of two weeks off work and spend that time resting at home. With the proper amount of rest, you will be well on your way to realizing your dream physique. Drains may be placed following this procedure and are typically removed within 7-14 days during which time monitoring will take place to ensure accurate removal. Removing drains too soon can create post-surgical issues such as a build up of fluid which would require draining in the office.
Upper Body Lift (Torsoplasty)
An upper body lift, also referred to as a Torsoplasty or back lift, is a plastic surgery procedure whose primary goal is to remove excess back skin and fat. This can occur after massive weight loss or genetic factors. Sometimes this skin and fat collection is isolated or localized to the lateral chest above the bra strapline. Sometimes, the excess skin and fat is more severe, and can extend as an apron across the entire upper back. If you have minimal skin deformity and excellent skin contractility, you may just need back liposuction. If you have more extensive excess back skin, you may require an excisional approach. Whether the procedure is performed using the liposuction approach or excisional approach, it will be performed under general anesthesia on an out-patient basis. A garment is provided post-operatively to help reduce swelling and should be worn for a minimum of 6 weeks. After your procedure, you can return to light physical activity at approximately three weeks and heavy gym activity at approximately six to eight weeks. Different patients have different pain levels; however, most patients will require pain medications for the first five to seven days. Usually, drains are involved and may stay in for approximately one to two weeks.
Brachioplasty
Brachioplasty, also known as an arm lift, can remove the excess skin and fat deposits, leaving the upper arms with a more pleasing and youthful contour. As a person ages, upper arm skin can become loose and flabby. Dr. Hamilton will consult with patients about undergoing surgery for an arm lift if they wish to tighten this skin to look and feel more youthful. The incision extends from the elbow to the underarm, and sometimes on to the side of the chest. In some instances, liposuction may be recommended to be used alone or in conjunction with the arm lift procedure to remove excess fat in the upper arm areas.
Breast Augmentation
Breast augmentation is designed to increase the size of small or underdeveloped breasts. Surgery can also restore and enhance your breast volume if it has decreased as a result of having children.
Breast implants come in various types and styles, which are discussed during your consultation, to ensure the right implant is selected to match your body style and goals.
The incision for placement of your implants can be made underneath your breast, just above the crease, around the lower edge of your areola, or in your armpit. A pocket is created for the implant either behind your breast tissue or behind the muscle between your breast and your chest wall.
Following surgery, you may wear a gauze dressing or surgical bra. There will be some swelling and discoloration that will gradually disappear. You should not engage in vigorous activities, especially raising your arms, for up to 3 weeks. You should be able to return to work within 1-2 weeks.
There is a great deal of scientific evidence supporting the long-term safety of breast implants. During your consultation, the known risks associated with breast implants will be discussed.
It is appropriate to mammogram the breast before breast augmentation. Younger patients will sometimes opt for breast ultrasound or alternative screening exams. Nevertheless, an effort should be made to rule out pre-existing breast malignancy before disturbing the breast tissue.
Dr. Hamilton offers the option of saline vs. cohesive gel implants (silicone) based on individualized considerations with each patient. Tear drop classic profile, moderate profile and high-profile designs exist to better tailor the selection of implant to the expectation and anatomy of each patient. Careful pre-operative review of photographs, measurements, and a precise scientific and artistic approach is essential to achieving balanced, natural-appearing and satisfying results.
Breast Reduction
Breast reduction, also referred to as reduction mammaplasty, enhances your overall appearance by making your breasts more proportional to the rest of your body.
Large, sagging breasts often interfere with normal physical activities. They can cause back pain, postural problems, deformities of the back and shoulders, skin rashes and breast pain. For these reasons, breast reduction generally is considered a reconstructive plastic surgery procedure. In addition to alleviating physical problems, however, it improves the shape of your breasts and nipple areas.
The procedure is performed under general anesthesia and may be done on an outpatient basis, or a brief hospital stay. During the procedure, excess breast tissue and skin is removed, your nipples and areolas are repositioned, and your remaining breast tissue is reshaped.
A commonly performed breast reduction technique uses incisions that encircle the areola and then extend vertically down the breast and horizontally along the crease underneath the breast. The exact technique used will depend on the individual patient factors and Dr. Hamilton’s recommendation. JP drains may or may not be placed. If placed, you will be instructed on how to monitor the drain output. Drains are typically removed within 7-14 days.
Following surgery your breasts will be wrapped in a gauze dressing or placed in a surgical bra. You may be instructed to wear a supportive bra for several weeks. Loss of breast or nipple sensation is possible, but usually is not permanent. You should avoid strenuous exercise and overhead lifting for at least a few weeks. You should be able to return to work within 2 weeks.
Male Breast Reduction
Gynecomastia is a medical term that originates from the Greek words for “women-like breasts.” This condition is far more common than many realize. It may affect only one breast or both. Although certain drugs such as anabolic steroids, medications containing estrogen, alcohol, marijuana, etc., and medical conditions including cancer, impaired liver function to name a few, may cause or contribute to enlarged male breasts, it is widely accepted that a large percentage of cases derive from unknown sources.
Men of any age who are healthy and emotionally stable are considered good candidates for this procedure. The best candidates are those who have firm, elastic skin that will reshape to the body’s new contours. In some instances, surgery may be discouraged for overweight men who have not first tried an exercise and diet regimen.
Male breast reduction surgery is performed with ultrasonic liposuction and/or direct glandular excision through a peri areolar incision. Typically, the chest can be restored to a normal, more aesthetic, and masculine appearance. The restored appearance of a masculine chest may give men a boost in self-confidence. There is little downtime with this procedure, and you may return to work within a few weeks.
Breast Lift
A breast lift, also called mastopexy, raises and recontours loose, sagging breasts. You may decide you would like a breast lift because you have lost volume and tone in your breasts after having children. Another frequent reason for having this procedure is the loss of a significant amount of weight.
A breast lift improves the appearance of your breasts in several ways. It elevates your breast tissue, removes excess skin from the lower portion of your breast and then reshapes your remaining breast skin. At the same time, it relocates your nipple and areola to a higher position. If the areola has stretched over time, they can also be reduced in size. Women who have their breasts lifted often may decide to also have them enlarged. If this is the case, an implant is placed behind the breast tissue or chest muscle (refer to Breast Augmentation).
A commonly performed breast lift technique uses incisions that follow your breast’s natural contour. The resulting scar, which is permanent but will fade to some extent over time, encircles the areola and then extends vertically down the breast and horizontally along the crease underneath the breast. There are other breast lift techniques that may eliminate the horizontal incision, the vertical incision, or both. The use of any particular pattern of incisions depends on the individual patient factors and Dr. Hamilton’s recommendations.
Following surgery, your breasts will be wrapped in a gauze dressing or placed in a surgical bra. You may be instructed to wear a supportive bra for several weeks. Swelling and discoloration are to be expected but will gradually subside. You may experience decreased breast or nipple sensation, which is usually temporary. You should be able to return to work within 1-2 weeks.
Breast Reconstruction
Nearly 300,00 women are diagnosed each year with in-situ or invasive breast cancer in the United States, joining the nearly 4 million survivors affected by this disease. Roughly 50 percent of those diagnosed will undergo breast reconstruction. As a plastic surgeon, I have the privileged opportunity to help rebuild the lives of those affected by guiding them through the reconstruction process. The surgical process of rebuilding the shape and look of a breast involves using autologous tissue, prosthetic implants, or a combination of both. The goal is to reconstruct a natural-looking breast. Surgical options are discussed per each individual case and typically several procedures are required to complete the final aesthetic outcome.
Nipple/Areola Reconstruction
The nipple and areola are usually the final phase of breast reconstruction. This is a separate surgery done to make the reconstructed breast look more like the original breast. It can be done as an outpatient surgery or sometimes as an office procedure. It’s usually done about 3 to 4 months after surgery after the new breast has had time to heal.
Ideally, nipple and areola reconstruction tries to match the position, size, shape, texture, color, and projection of the new nipple to the natural one (or to each other, if both nipples are being reconstructed). Tissue used to rebuild the nipple and areola comes from the newly created breast or, less often, from skin from another part of your body (such as the inner thigh). If a woman wants to match the color of the nipple and areola of the other breast, tattooing may be done a few months after the surgery.
Some women opt to have just the tattoo, without nipple and areola tissue reconstruction. A skilled plastic surgeon or other professional may be able to use pigment in shades that make the flat tattoo look 3-dimensional.
Labiaplasty
Over recent years women have become more self-conscious about the appearance of their labia due to cultural norms shifting as it relates to grooming. They may notice that the labia appear larger than normal, which can also create friction while wearing certain garments such as workout gear, swimwear, tight jeans or even shorts. One labium may also appear larger than the other, creating embarrassment in intimate settings. A labiaplasty has both medical and aesthetic benefits. Excess labia tissue can lead to pain and discomfort during exercise and intercourse. It can also interfere with other routine activities. A labiaplasty is a simple procedure to remove the extra tissue using a customized incision. The natural appearance of the labia is preserved while the extra “bulk” is removed. This procedure is done under general anesthesia or IV sedation. Normal activities can typically resume within 4-6 weeks.
Liposuction
Liposuction, also known as lipoplasty, removes localized collections of fatty tissue to give you a smoother and slimmer body contour. For the best results, you should be of relatively normal weight with extra fat localized in specific areas such as the hips, buttocks, and abdomen. Liposuction is also effective in removing fat deposits from the back, legs, arms, face, and neck.
Liposuction is neither a substitute for proper diet and exercise nor a method for overall weight loss. It cannot eliminate cellulite or correct loose, hanging skin. In fact, the best results from liposuction are achieved when you have healthy, elastic skin with the capacity to shrink evenly after surgery. If your skin has lost much of its elasticity, you may need a skin tightening procedure such as a tummy tuck, thigh lift, buttock lift, or arm lift.
Local anesthesia (usually with sedation), regional or general anesthesia may be used, depending on what Dr. Hamilton judges as the safest and most comfortable choice for your particular surgery. Liposuction is usually performed using a suction pump device to vacuum away excess fatty deposits. In some cases, a hand-held syringe may be used instead of a pump. There are a number of variations to conventional liposuction. Ultrasound-assisted liposuction, for example, uses energy from sound waves to liquefy the fat before it is removed. The technique chosen for your specific case depends on individual factors that Dr. Hamilton will discuss with you.
Following surgery, you may wear a snug dressing or garment, perhaps for several weeks, to promote skin shrinkage and to minimize swelling and bruising as you gradually resume normal activities. Depending on the degree of your procedure, JP Drains may or may not be placed. If drains are placed, you will be instructed on how to monitor the output and they are typically removed within 7-14 days. You can expect to return to work within 1-2 weeks. In Dr. Hamilton's opinion, the use of ultrasonic-assisted liposuction (or VASER) helps achieve higher definition results and often helps the skin to tighten during healing.
Thigh Lift
The medial thigh lift will lift and tighten the sagging skin of the inner thigh. The incisions are usually placed in the groin area, but this is dependent on the patient and Dr. Hamilton’s recommendation on technique used.