Endoscopic Procedures

Endoscopic Breast Augmentation is a newer procedure that involves making a 1 inch incision in the armpit.  An endoscope is then inserted in this incision to gain visualization of the breast pocket which is clearly seen on a monitor.  This allows for more precision and control when creating the breast pocket for the future implant.  This dissection is performed with specially designed endoscopic equipment.  The saline implant is then inserted through the inch incision and inflated to a certain amount.  The incision in the armpit is then stitched, thus avoiding any scar on the breast.

Endoscopic Forehead Lift is a newer procedure that involves making small incisions in the hairline.  This is in contrast to the older way of making an incision from ear to ear in the hairline.  The endoscope and other endoscopic equipment is inserted through these incisions and dissection is accomplished through visualizing it on a monitor at all times.  The forehead is then resuspended in usual manner.  Since the incision is smaller, the post-op pain is usually less and recovery time is usually less.

The first picture is the retractor that is used in an endoscopic breast augmentation and the second picture is the endoscope that is used simultaneously.

 

Back to top   Breast Procedures Breast augmentation is a surgical procedure to enhance the size of a woman's breast.  Any one of the following conditions may indicate that you are a good candidate for breast augmentation: * Self-conscious that your breasts are too small or self-conscious when wearing a swimsuit or form-fitting top * Weight loss or having children have changed the shape of your breast and caused your breasts to become less firm and full * One of your breasts is noticeably smaller than the other       The technique used for your surgery depends on your preference and the characteristics of your breasts.  The incisions used are small and are usually made in one of three locations: underneath the breast just above the crease, around the lower edge of the nipple-areolar complex, or within the armpit.  Endoscopic surgery can keep the incisions small in the armpit and thoroughly guide the precision of the implants placed.  The saline implants are usually placed submuscular, but there are some indications for subglandular placement. Breast lift (mastopexy) is a surgical procedure to raise a breast, reposition the nipple-areolar complex, and reduce the nipple-areolar complex diameter. If you lost breast volume and want an increase in size simultaneously, implants may be inserted during a breast lift.  Any one of the following conditions may indicate that you are a good candidate for breast lifting: * Breasts are pendulous, but at a satisfactory size * Breasts lack fullness and firmness * Nipples point downward or are located at a very inferior position on the breast         The technique used varies with degree of ptosis (sagging).  Grade I ptosis usually requires only an incision around the nipple-areolar complex.  Grade II ptosis usually requires an incision around the nipple-areolar complex and have a vertical component.  Grade III ptosis usually requires and incision around the nipple-areolar complex, vertical component, and a component in the breast fold/crease.   Breast reduction surgery is a surgical procedure to reduce a patient's breast size but simultaneously maintaining breast shape.  Any one of the following conditions may indicate that you are a good candidate for breast reduction surgery: * Breast are very large and sag onto the upper abdomen * Breast size restricts certain activities * Breast size cause physical discomfort like back or neck pain * Breasts size causes persistent rashes in the breast folds * Breast size continually causes bra strap grooves on the shoulders           The technique involves removing skin, fat, and glandular tissue from the breasts making them smaller and firmer.  It also reduces the size of the nipple-areolar complex.  The technique requires making incisions that will result in scars around the nipple-areolar complex, in a vertical plane, and in a horizontal plane in the breast fold. Reconstructing breasts that have been removed due to diseases like cancer is a very rewarding experience for a plastic surgeon.  Reconstruction can be done immediately at the time of mastectomy or delayed to a later date.           The technique used for reconstruction varies.  In simple cases, the remaining skin is stretched by a tissue expander over several months.  This expander is then removed in a second operation and a permanent implant is then inserted.  The nipple-areolar complex is reconstructed later.  In more complex cases, a tissue flap taken from other parts of the body, such as the back or abdomen, is used.  Sometimes enough tissue is transferred so no implant is required.  The nipple-areolar complex is reconstructed later.   Gynecomastia is a condition where men can have large breasts.  Gynecomastia may affect one side or both.  There is no know cause in the majority of cases but certain drugs and medical conditions seem to be associated with the condition.  Any one of the following conditions may indicate that you are a good candidate for gynecomastia surgery:  * Breast size and shape is similar to a woman's breast * Breast size provokes anxiety when without a shirt in public * Self-conscious that your breasts or nipples are too large and prominent             The technique involves removing the excess fatty tissue in the breast.  This can be performed with liposuction alone.  In more severe cases, an incision is required around the nipple-areola complex and allows direct excision of fatty tissue in the breast.  Liposuction is often used in conjunction with these cases.  In the most severe cases, skin will also be excised with the fatty tissue but this is more common in older men.   Back to top   Body Procedures  Liposuction is a surgical technique developed to remove persistent fat deposits from parts of the body that don't respond to dieting and exercise.  The fat that is removed is gone forever resulting in a new contour and shape of your body.  This procedure is recommended for men and women who want to improve their body contour and still have good skin and muscle tone.  Any one of the following conditions may indicate that you are a good candidate for liposuction: * Self-conscious about certain parts of your body when naked * Persistent fat deposits that are unresponsive to dieting and exercise * You want to improve your body contour and have good skin and muscle tone          The technique involves making tiny incisions near the fatty areas to insert a cannula.  This cannula is then used in a forward-backward motion to suck fatty tissue through a negative pressure system.  No skin is removed and the elastic fibers in your skin is responsible for the improved contour after the fat is removed.   Abdominoplasty is a surgical technique to flatten the abdomen by removing excess skin and fat from the lower abdominal region and tightening the muscles of the abdominal wall.  Any one of the following conditions may indicate that you are a good candidate for an abdominoplasty: * Pregnancy has resulted in significant lower abdominal laxity or stria (stretch marks) * An abdomen that protrudes and is out of proportion to the rest of your body * Excess fat and skin in the lower abdomen that is refractory to dieting and exercise * Lax abdominal muscles that have been weakened by pregnancy or aging          The technique involves making a horizontal incision that is usually placed just above the pubic area.  The length of the incision depends on the amount of skin and fat removed but can extend out to the hip bones.  The extra skin and fat is excised and often a new umbilicus (belly button) is created.  Simultaneous muscle tightening procedures are often performed.  All attempts are made to keep the incision low and hidden in the bikini line.   Body Lift is a surgical technique that removes extra skin and fat from certain areas of the body.  This procedure is more common in patients that have lost massive amounts of weight and now have much redundant skin in the arms, back, abdomen, or thighs.  These areas are addressed with a brachioplasty (arm lift), truncal lift (back and abdomen lift), and medial thigh lift (inner thigh lift). Back to top   Nasal Reshaping Nose surgery, or rhinoplasty, can change the way your nose looks.  Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, reduce the hump on your nose, narrow the span of the nostrils, or change the angle between the nose and upper lip.  It may also correct a birth defect or injury, or help relieve some breathing problems.  Any one of the following conditions may indicate that you are a good candidate for a rhinoplasty:     * Your nose is too big or small relative to the rest of your face * Your nose has a hump on it that is prominent * Your nostril span is long * The width of your nose is too wide or has a deviation * Your nose points up or down relative to your upper lip * The tip of your nose is to round or prominent * Breathing problems secondary to congenital reasons or trauma        The technique requires making an incision in the columella (vertical strip of tissue separating the nostrils) or inside the nostril.  The cartilage and bone causing the deformities are altered and reshaped or removed if necessary. All incisions are closed with stitches and a nasal splint is worn for 7 days. Back to top   Facial Procedures A face lift is a facial rejuvenation procedure that is tailored to each patient's needs.  Facial skin stretches over time and is pulled down by gravity resulting in skin wrinkling and sagging.  Face lifts correct this problem by pulling the loose skin back up (and sometimes underlying tissue) and restoring the volume in the face through various techniques.  A face lift can be done alone, or in conjunction with other procedures such as forehead rejuvenation, eyelid surgery, or laser.  Any one of the following conditions may indicate that you are a good candidate for a face lift:  * You have significant folds below your cheeks or at your jaw line * You feel that you always look tired and old * You feel like your face has lost its youthful volume and shape * Your neck has become fuller and has extra skin         The technique involves making incisions in the hairline and in front of the ear. This allows access to the underlying tissues that are pulled up to restore the volume your face once had.  The skin is then re-draped and the extra skin is removed to create a more youthful look.  All attempts are made to hide the incisions in hairline and around the ear so they are barely noticeable.   Blepharoplasty is a rejuvenation procedure for the upper and/or lower eyelids.  Eyelids can appear tired and droopy due to excess skin and/or fat.  This can make you look tired constantly despite sleep and makeup.  Any one of the following conditions may indicate that you are a good candidate for a blepharoplasty: * Excess skin that hides the natural fold of the upper eyelids or hangs down over the upper eyelid * Puffiness in the upper eyelid that makes you look tired * Excess skin and wrinkles of the lower eyelid * Puffy "bags" and/or dark circles of the lower eyelid        The technique involves removing excess skin from the upper and lower lids with incisions that are usually well hidden in natural skin creases.  Newer procedures are available that keep the incision on the inside of the lower eyelid avoiding an external scar.  Fat may also be removed or repositioned to correct contour irregularities in upper lid or in the lower lid/cheek junction.  Repositioning the fat eliminates the bags of the lower lid and returns the smooth contour that you once had.   Forehead lift (or brow lift)  is a rejuvenation procedure that lifts the muscles and skin to smooth the forehead, raise the upper eyelids and minimize frown lines that can make a person appear angry, sad, or tired.  It is often performed in conjunction with other facial rejuvenation procedures.  Any one of the following conditions may indicate that you are a good candidate for a brow lift: * Your eyebrows are located in a more inferior position than they once were * You have "hooding" over the eyes * You have deep furrows and frown lines in your forehead      The technique involves making incisions in the hairline.  Extra skin is pulled superiorly and some of the forehead muscle can be removed.  The skin is then anchored at its new position.  Newer procedures such as endoscopic techniques are now used which minimize the incisions and allow for quicker recovery time and less pain. Back to top   Other Procedures Laser Resurfacing                              Laser Hair Removal Spider Vein Treatments   Chemical Peels Microdermasion                     Botox injections Collagen injections Hylaform injections Restylane injections Professional Skin Care Ear Pinning (Otoplasty) Skin Cancer Reconstruction Scar Revision Microvascular/Hand Surgery - trauma, reconstructive, elective Back to top   Please schedule an appointment with Dr. Tattini to learn more about the risks and benefits of each procedure and to determine which one best suits your needs.   Office:  309-664-1007

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