Dr. Andres Antonio Mascaro Pankova, MD

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.

Rhinoplasty may also be done to correct a deviated septum or other breathing impairment. In that case, the nasal structure is adjusted so that airflow is increased to a comfortable level.

Typically, rhinoplasty is only performed on adults because kids' and teens' faces are still growing and changing. After a rhinoplasty, healing will take 1-2 weeks, but subtle shifts in the face and occasional swelling can last up to a year.

In all cases, the skin graft may either be full-thickness or partial-thickness. While thicker grafts make recovery more difficult for the donor site, they heal more easily than thinner grafts.

Before skin graft surgery, patients are given anesthesia so they cannot feel any pain. If using an autograft, the surgeon carefully measures and removes the skin from the donor site. Sometimes the graft is cut in a mesh-like pattern, to allow a small piece of donated skin to stretch and cover a larger area. This also helps oxygen pass through the graft. The site where the skin graft will go is cleaned well to remove any dirt, bacteria, or dead skin cells. Then the skin graft is placed and attached with stitches or staples. It is often covered with antibacterial ointment and supportive bandages for the first few days.

As the skin graft heals into its new position, new blood vessels grow to reach and support the skin. Depending on the thickness of the graft, oil glands, sweat glands, and hair follicles may also regrow. Recovery time depends on the thickness of the graft and the overall health of the skin in the grafted area, but it generally takes from two to four weeks.