Dr. Hahns Y. Kim, MD

During a blepharoplasty, tiny incisions are made under local anesthesia, and any excess skin or underlying tissue is removed from the eyelids. The procedure takes between one and three hours, and patients may have bruising and swelling around their eyes for a few days afterwards. Icing the area may help.

The surgery is sometimes done along with other facial surgery as part of a facelift. Typically, a blepharoplasty is considered cosmetic. In severe cases, however, upper eyelids may droop so significantly that they make it hard to see. In these cases, blepharoplasty may be considered a necessary treatment.

The patient and surgeon will discuss the patient's needs, preferences, and limitations to determine the type of implant and incision to use.

Using one's own fat for breast enlargement starts with a procedure called liposuction, which is the removal of excess fat from other parts of the body. After the fat is collected, it is rid of impurities and then injected into the breast. This option suits those who do not wish to have foreign materials placed inside their bodies.

Deformities such as tubular breasts may also be corrected using breast augmentation. Tubular breasts are characterized by small, droopy breasts and a narrow base. Aside from placement of an implant, the surgeon cuts the breast tissue to release the tightness and make the base wider.

Breast implants are not lifelong devices. They may rupture or may develop capsular contracture, which is the hardening of scar tissue around the implant. If these complications occur, another surgery may be required to replace or remove the implants.

While a breast augmentation enlarges the breast, a breast lift, also called mastopexy, raises the breast by repositioning the nipple and removing excess skin. Breast lifts can be done using three techniques. If there is only a small amount of sagging, removal of excess skin around the outline of the areola may accomplish the desired result. This technique is called a doughnut lift. If the nipples are just at or slightly below the level of the breast fold, a surgeon may recommend a lollipop lift. This type of lift involves a doughnut lift and a vertical incision from the bottom edge of the areola to the crease. If there is a lot of excess skin, a surgeon may recommend an anchor lift. This technique is similar to the lollipop lift, but it also involves a crescent-shaped incision along the breast fold to be able to remove more excess skin. Sometimes loss of breast volume accompanies sagging. If this is the case, an augmentation can be performed in combination with the lift procedure.

Because nerves around the nipple are cut during surgery and need time to heal, temporary loss of sensation in this area is common after having a breast lift. Sensation is usually regained after several weeks to a few months. Although uncommon, loss of sensation may also be permanent, especially if a significant amount of tissue around the nipple was removed.

Both breast augmentation and breast lift are typically done in an outpatient facility and do not require a hospital stay. Following surgery, patients should apply a cold compress over their breasts for the first 24 hours and keep their upper body elevated -- even during sleep -- for the first few days. Patients are also given a special type of bra to wear while recovering. Using cold compresses, staying elevated, and wearing the special bra help to minimize swelling and pain. Strenuous activities like running and working out should be avoided for four to six weeks, but light exercise may be started about one week after a breast augmentation procedure.

Mild sores may heal on their own when pressure on the affected area is reduced. This can be accomplished by simply repositioning the body every hour. If the sores are painful or infected, medications such as pain relievers and antibiotics may be prescribed. Cleaning the wound and changing dressings regularly also help the healing process. Severe pressure ulcers, on the other hand, may require surgery, which involves removal of any damaged, infected, or dead tissue and closing the wound. Wound closure can be achieved either by stitching the skin edges together or by using a flap of the patient's own tissue.

If a patient needs to have pressure ulcer surgery, they will likely be on bedrest for a few weeks to allow the wound to heal completely. The patient and their family members will be given instructions on positioning and transfer techniques to help keep pressure off the wound. When the doctor thinks the patient is ready, he or she will give the patient special exercises to help them regain their range of motion. To prevent the recurrence of ulcers, patients or their caregivers should be diligent about changing positions regularly, observing for early signs of new pressure sores, and replacing any worn-out mattresses or cushions.