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Breast Augmentation and PEBAM™The Future of Breast Implant Surgery01

In a move that revolutionizes breast implant surgery, Dr. Sayeg has merged endoscopy and minimally invasive surgery to redefine the entire procedure, leaving the patient with virtually minimal scars. The procedure involves making a mini-incision and creating and molding a pocket, into which he inserts a deflated saline breast implant. The desired amount of saline is inflated into the implant through tiny tubes.

After the filling is complete and the tubes removed, Dr. Sayeg closes the incision of which is done with an absorbable suture. The resultant scar is normally less than one centimeter in length which heals very well, and with the additional therapy of a silicone-based covering, is virtually unnoticeable.

Of particular note with this surgery are (1) the incisions are one-third of an inch, not the usual three centimeters (more than one inch); (2) the smaller the incision, the quicker the healing and the less the tension; (3) placement of the incision under the breast or in the axilla instead of through the belly button allows a smaller scar in less visible positions on the body; and (4) placement of the saline implant under the muscle, allowing the most optimal cosmetic effect.


Trans-Umbilical PEBAM™

This procedure utilizes the same technique as PEBAM™ via the umbilicus.
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Breast Reduction [Reduction Mammoplasty] and SPAIR

Breast reduction surgery answers the concern experienced by some women with very large, sagging breasts that can cause medical problems, such as back and neck pain, breathing difficulties, and – in extreme cases – skeletal deformities, not to mention feeling self-conscious.

To give the woman breasts that are in proportion to her body, the surgeon removes fatty, glandular tissue and skin, reposition the nipple, and reshape the breasts, leaving them smaller, lighter and firmer. Reducing the breast size also reduces the areola or darker skin around the nipples. Breast reduction is performed to alleviate a physical problem and not solely for cosmetic reasons, but the results are the same. Well-proportioned breasts eliminate the discomfort of larger breasts, build self-esteem, and give the woman more clothing options.

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Breastlift [Mastopexy]

Pregnancy, nursing, aging, and gravity eventually cause a woman’s breasts to sag, as the skin loses its elasticity and the breasts lose their fullness and firmness. Breastlift surgery raises and reshapes the breasts and reduces the size of the areola. Breasts of any size can benefit from this surgery, but results vary. If a woman plans to continue having children, she may want to wait, as stretching of the breasts during pregnancy could offset the positive effects of a breastlift. As with any plastic surgery, it is important to approach it with realistic expectations about the outcome.

For women who have small breasts or diminished volume following pregnancy, breast implants can be inserted at the same time as the breastlift to enhance size and firmness. Candidates for mastopexy must be healthy, emotionally stable, and realistic about the results of a breastlift. Women with small, sagging breasts notice the best results, but surgeons can lift breasts of any size, although the larger breasts usually will not experience longer lasting results.

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Post-Bariatric Reconstruction

Last year, more than 140,000 people underwent gastric bypass surgery to help them lose weight. For truly obese people, this surgical alternative to dieting may save their lives, but often when they approach this surgery, they do not consider what happens after they have it. They lose the fat, but what happens to the skin that supported it? It is unlikely to have sufficient elasticity to return to the body’s new shape. After losing 100 pounds or more, as much as 40 pounds of excessive skin can sag. This poses both health and cosmetic consequences. Heavy skin folds can trigger infections, cause cellulitis and abscess, and the extra weight can produce strain on the back and shoulders, causing chronic pain.

More surgery is in order for the post-bariatric patient. Thanks to plastic surgery, procedures can remove excess skin. In some cases, namely those that are not still massively obese and are relatively healthy otherwise, a total body lift may be in order, requiring many hours of surgery. The surgeon removes excess skin in several areas of the body, including buttocks, arms, back, and lower waist. In addition to people who underwent gastric bypass surgery, the body lift can be used on women who develop excess skin due to aging and some people who are 30 to 40 pounds overweight and cannot lose those pounds and cannot benefit from a tummy tuck.

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Breast Reconstruction

More than 200,000 women confront the reality of breast cancer each year. New approaches to breast cancer surgery and reconstructive surgery give women more choices than they would have had even a few years ago.

Most women with breast cancer opt for breast conservation surgery that minimizes the amount of breast tissue removed than in a mastectomy, in which the entire breast is removed). Those women who choose mastectomy, however, require reconstructive surgery to restore the appearance of their breast(s). The procedure rebuilds the contour of the breast and, if the patient wishes, the nipple and areola.

Breast reconstruction makes your breast(s) look balanced when wearing a bra, permanently regain your breast contour, and to give you a normal appearance without the need for prosthetic breasts.

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Thigh Lift [Thighplasty]

Thigh lift surgery is appropriate for individuals who have lost skin elasticity in the thigh, hip and/or buttock areas, due to extreme weight gains and losses or aging, or those who have saggy, dimpled skin or are simply self-conscious about the appearance of their lower body. The plastic surgeon removes excess skin and fat from either the inner or outer thighs in those patients for whom liposuction alone does not sufficiently correct the problem. The surgeon carefully places scars in locations that can fit within the bikini line.

In most cases, thigh lift surgery yields tighter, more attractive thigh and buttock skin, more appealing contours, and fewer irregularities in the surface of the skin.

In some cases, the patient may opt for additional procedures performed at the same time to enhance the results of thigh lift surgery. Liposuction, breast augmentation, and tummy tuck are often performed in conjunction with thigh lifts.

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Chin Implant Surgery [Mentoplasty]

For the patient with an imbalance to their facial features, facial surgery can strengthen the jawline and bring more harmonious balance and proportion to the face. In chin implant surgery, the plastic surgeon reshapes the chin either by implant enhancement or reduction of the bone. The surgeon inserts the appropriate size implant into a pocket over the front of the jawbone. This is done through a very small incision made inside the mouth or in the skin just under the chin.

In some cases of chin implant surgery, the surgeon will recommend nose surgery to bring both elements into improved proportion. In the final analysis, the new look that results from chin implant surgery will heighten your self-esteem.

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Cheek Implant Surgery

As in all types of facial implant surgery, plastic surgeons use implants to enhance the contours of the face and create a more harmonious appearance. Cheek implant surgery can be performed alone or in conjunction with a total facelift or other facial surgery, such as a forehead lift or eyelid surgery. In cases where the surgeon performs multiple facial implants or lifts, incisions to accommodate the cheek implants are made either inside the upper lip or lower eyelid. The implant is inserted in to the pocket formed by the incisions.

The duration and severity of post-operative side effects from cheek implant surgery depend largely on whether or not other cosmetic procedures were performed at the same time. Your ability to move our mouth and lips will be diminished temporarily, and it is important that you closely follow your surgeon’s instructions to optimize recovery and rehabilitation.

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Upper Arm Lift [Brachioplasty]

Whether it is due to extreme weight loss, aging, or a combination of both, men and women develop flabby upper arm skin and excess fat deposits. The upper arm lift removes the loose skin and fat deposits, leaving a tightened, younger looking upper arm. If there is excess fat in the upper arms, the surgeon may recommend liposuction in conjunction with the upper arm lift or as a stand-alone procedure.
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Hair Replacement

Dispelling the myths of hair loss, the concern of the plastic surgeon lies in enhancing the patient’s appearance and building his self-confidence. The ideal hair replacement candidate must have healthy hair in the back or sides of the head because hair replacement uses the patient’s own hair, not donor hair. Optimum results depend on the color of the hair, its texture, and curliness or waviness.

Several different techniques are used in hair replacement, and sometimes more than one is used to achieve the best results. Techniques vary depending on the degree of grafting the patient desires.

Hair replacement surgery is most often associated with men, but one in five women experience sufficient hair loss, from aging, illness or hormonal problems during menopause, to warrant hair replacement surgery.

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Liposuction [Lipoplasty or Suction Lipectomy]

Normal weight people with firm, elastic skin who have pockets of excess fat in certain areas of their bodies are considered the best candidates for liposuction. Older patients with loss of skin elasticity may undergo liposuction, but they will not achieve the results of a patient with younger, tighter skin. Liposuction should not be considered an alternative to dieting and exercise, but rather an option to remove fatty areas that do not respond to traditional methods of weight loss.

The plastic surgeon performs liposuction by using a narrow tube that draws fat out of the body, leaving the treated area free of fat forever, as the body does not regenerate new fat cells. The surgeon takes care to place incisions as inconspicuously as possible.

New refinements in the liposuction procedure help plastic surgeons give ideal candidates more precise results and faster recovery. Occasionally, a combination of liposuction and tummy tuck is warranted to yield the most appealing results.

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Male Breast Reduction [Gynecomastia]

Men with larger breasts than normal feel self-conscious, not unlike their female counterparts, but generally do not suffer the same side effects. The condition is quite common, however, affecting about 50 percent of men, and just one breast or both. The reduction procedure best serves those men whose skin is elastic and firm enough to enable the surgeon to reshape the new contours of the breasts.

The best candidates for breast reduction surgery are those who are healthy and emotionally stable. It is likely to be discouraged for those who are obese, or who drink heavily or smoke marijuana regularly, as it – along with anabolic steroids – may cause over-development of male breasts.

The plastic surgeon removes fat and/or glandular tissue and excess skin, if necessary, to produce a firmer, flatter chest with better contours. With the physical improvement comes renewed self-esteem.

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Scar Revision

The development of scars depends on the healing of one’s body, the original injury, or the skills of the surgeon. When they are severe and unsightly, perhaps from a serious injury, and do not respond to such treatments as injections or topical steroids, cosmetic surgery can make the appearance of scars less obvious through a revision procedure and remove attendant problems such as itching and tenderness.

The severity of a scar depends on its size and depth, the blood supply to the area, the thickness and color of the person’s skin, and the direction of the scar. In most cases, the scar cannot be completely removed. Minimizing its appearance, however, will put the patient at ease and, in some cases, improve his ability to function.

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Nose Surgery [Rhinoplasty]

Reshaping the nose has become one of the most commonplace plastic surgery procedures. [In 2004, it was the second only to liposuction, with 305,000 performed.] The surgery can reduce or increase the size of the nose, change its shape at the tip or bridge, narrow the span between nostrils, or alter the angle between the nose and upper lip. In addition, rhinoplasty corrects birth defects and injuries, and helps relieve breathing problems.

The best candidates for nose surgery, other than those who suffer from any of the problems previously listed, are those who desire improvement, but not perfection, in their looks. They must be physically healthy and psychologically stable. Age is a factor; however, as most plastic surgeons will not perform nose surgery on teenagers until after they complete their growth spurt.

Whatever the reason one seeks to undergo nose surgery, the result will bring enhanced appearance and a boost in self-confidence. As with all procedures that are performed for cosmetic reasons, the patient must approach surgery with realistic expectations.

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Tummy Tuck [Abdominoplasty]

No matter how much some people diet and exercise, there always remains a bulge or sagging skin. The problem can result from pregnancy or from a yo-yo dieting habit. Whatever the cause, the tummy tuck can decrease the excess fat and skin and tighten the abdominal muscles.

The best candidate for a tummy tuck is one who is in relatively good shape but wants to get rid of that unsightly bulge that diet and exercise will not remove. If the patient is a woman, whose abdominal skin and muscles have stretched due to multiple pregnancies, the tummy tuck should yield particularly good results. A tummy tuck may not be possible if the patient has scarring from previous abdominal surgery.

A tummy tuck is major surgery. While it can dramatically change a person’s appearance and give her the desired flat stomach, it leaves a permanent scar that can extend from hip to hip.

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Eyelid Surgery [Blepharoplasty]

Eyelid surgery, the fourth most popular surgical cosmetic procedure in 2004, with 233,000 performed in the United States, addresses the problem of baggy, drooping or puffy upper and lower eyelids. It is often performed alone, but can be performed in conjunction with a facelift or forehead lift. Although it is generally performed for cosmetic reasons, at times it is used to improve a person’s vision. It does not remove crow’s feet or wrinkles, eliminate dark circles under the eyes or lift sagging eyebrows.

Droopy eyelids can be hereditary, and if that is the case, the person may opt to have eyelid surgery earlier than the normal 35-plus age range more typical of this elective surgery. Some health conditions heighten the risks of eyelid surgery, including hypothyroidism, Graves’ disease, dry eye or insufficient tears, high blood pressure, cardiovascular disease, and diabetes. If the person has a detached retina or glaucoma, he should consult his ophthalmologist before undergoing eyelid surgery.

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Ear Surgery [Otoplasty]

Most ear surgery is performed on children, aged 4 to 14, who have protruding or large ears, although no greater risk occurs when the surgery is performed on adults. Ears are fully developed usually by the age of four, so parents might want to consider surgery for their child early to minimize the risk of ridicule as the child approaches school age. They should pay attention to their child’s concerns about his ears and consider surgery only after the child decides he wants it.

During the procedure, the surgeon sets back prominent ears closer to the head or reduces their size. When children are involved in the decision for ear surgery, they are more cooperative and pleased with the result.

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Forehead Lift (Browlift)

Generally, forehead lifts are performed after the age of 40 to offset obvious signs of aging, such as droopiness and pronounced horizontal lines and furrows. This procedure also helps anyone, who have deep frown lines and furrows due to stress or heavy physical exertion, or even in some cases where heredity plays a role. A forehead lift can be performed as a stand-alone procedure or in conjunction with eyelid surgery or a facelift. Sometimes a person chooses eyelid surgery only to learn a forehead lift would produce better overall results.

Patients who are bald or have a receding hairline or had previous upper eyelid surgery can still have a forehead lift. In every case, the goal of the plastic surgeon is to refresh the patient’s appearance and improve his self-confidence.

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Facelift [Rhytidectomy]

Facelifts were the fifth most popular plastic surgery procedure in the United States in 2004. For a variety of reasons, including aging, gravity, overexposure to the sun, and stress, people opt for this complex procedure that involves removing excess fat, tightening facial muscles and redraping facial and neck skin. A facelift can be a stand-alone procedure or accompany a forehead lift, eyelid surgery or nose surgery.

The best candidate is one whose face and neck skin, which has started to sag, still retains some elasticity, and who has a strong bone structure. A facelift cannot put the aging process in check, but it can minimize the obvious signs of aging. Most facelifts are performed in patients from their forties to sixties, although excellent results can be achieved in much older patients.

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Fat Injection

To enhance facial contours, fat recycled from the patient’s hip or stomach area serves well for injections. Essentially the procedure involves a form of liposuction, known as Syringe Tumescent Liposuction, to harvest fat from other areas of the patient’s body. The fat is purified before being transferred to the face, where it can highlight lips, cheekbones and the jawline.

Although collagen has been used for facial contouring, it is more expensive than recyclable body fat. Plastic surgeons have found that re-injection of body fat restores a youthful appearance to the face.