CASE #1

This 26 year old woman had breast implants inserted several years earlier and over time, noticed that they were progressively “dropping.” This caused her to have a very unusual appearance to her breasts. She underwent corrective surgery which consisted of a capsuloplasty to correct the level of the breast crease and insertion of a new pair of 400 cc Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is shown six months after the corrective surgery.

CASE #3

This 31 year old woman complained that her right implant was “too low” and there was too much space between her breasts. She wanted to have better symmetry and improve cleavage. Her surgical correction consisted of removal of her saline implants and insertion of a new pair of 350 cc Moderate Profile Plus round silicone gel filled breast implants in the subglandular position. At the same time, the pocket was modified to improve her cleavage and also to raise the fold on the right side to match the left breast. Her postoperative result is shown one year after corrective surgery.

CASE #5

This patient presented with implants that were “too high.” This gave her breasts an abnormal configuration with the nipple appearing to “hang down.” The patient underwent corrective surgery consisting of removal of her implants, conversion from the subpectoral to the subglandular plane and modification of the periprosthetic space with insertion of a new pair of 450 cc Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is seen eight months after the corrective surgery.

CASE #7

This 27 year old woman had breast implants inserted two years previously. Over time, she noted descent of the implants so that the inframammary fold was too low (bottoming out). Also, the scars, which were supposed to be hidden in the crease, were obvious on the anterior surface of her breasts. The corrective surgery consisted of a capsuloplasty to modify the pocket and raise the inframammary crease. A new pair of 275 cc Moderate Profile Plus silicone gel filled breast implants was inserted. The patient’s postoperative result is shown one year after the corrective surgery.

CASE #9

This patient had breast asymmetry due to upward migration of her left breast implant. This caused an unsightly bulge of the upper half of her left breast. The patient underwent removal of both breast implants, modification of the pockets to create better symmetry and insertion of 350 cc High Profile silicone gel filled breast implants on both sides. The patient’s postoperative result is shown nine months after the corrective surgery.

Brow Lift – Many patients, particularly as they enter their 30s, 40s and beyond, notice that the eyebrow begins to “droop.” A youthful appearing eye is associated with an aesthetically desirable upper and outer “sweep” to the brow. This is sometimes lost as a result of aging and/or gravity. Patients who have brow drooping (Plastic surgeons often refer to this as eyebrow “ptosis”) tend to have a flat eyebrow, it may hang down too far laterally and can contribute to a baggy, sagging appearance of the upper eyelid. Patients with brow ptosis often look “tired” and sometimes appear to be “angry.”

There are a number of excellent surgical approaches available to correct brow ptosis. These can range from very minor, noninvasive treatments, such as injection of tiny amounts of Botox just beneath the lateral eyebrow, to major surgical procedures, including the coronal brow lift, which consists of an incision across the top of the scalp. The coronal brow lift not only enables us to elevate the eyebrows a significant amount on both sides, but also gives access to the underlying facial muscles. We can resect portions of the corrugator muscle, which causes the vertical “scowl” lines at the root of the nose, and we can also permanently erase the horizontal or transverse creases of the forehead by removal or portions of the frontalis muscle.

Between the “two extremes” — Botox on the one hand and a full coronal brow lift on the other — there are multiple other approaches to correcting the ptotic brow. These types of “limited” brow lift procedures are often extremely effective in correcting the downward drooping of the lateral brow and the excessive fullness of the upper eyelid. Typically, these procedures are performed through a very well hidden incision made within the hairline above and lateral to the eyebrow (in the temple area). Through a relatively short incision, the tissues of the forehead are elevated off the underlying bony structures. The ligaments that hold the eyebrow in the abnormal position are freed up to allow the eyebrow to become elevated and to be placed in a more aesthetically attractive position. The elevated eyebrow is held in place with nonabsorbable stitches attached to the forehead bone and then the skin is pulled upward, excess skin is trimmed away and the incision is closed. The result is a more youthful but natural looking eyebrow with a completely hidden scar in the hairline!