Forehead Lift (Browlift)
While no one is immune to the effect of aging, a forehead lift, also known as a browlift, can minimize some of the most visible signs - drooping eyebrows, "hooding" over the eyes, forehead furrows and frown lines that appear between the eyebrows even in 
early thirties.

In a forehead lift, the muscles and skin that cause the problems are released or repositioned to smooth the forehead, raise the upper eyelids and minimize frown lines. The result can be a more alert, more animated, more youthful appearance. Recent advances in plastic surgery have made the forehead lift a relatively simple 
procedure with results that last from five to ten years or longer. It can be done along or in conjunction with other procedures, such as facelift, eyelid surgery, or nose reshaping. A tool called an Endoscope can be used to minimize incisions used to complete the procedure and speed recovery.

This procedure is most commonly performed for people to slow the visible effects of aging, it can also help people with inherited conditioned, such as a droopy brow or furrowed lines above the nose.

If you are bald or have a receding hairline, you may still be a good candidate for a forehead lift. I will simply alter the location of the incision to camouflage it as much as possible. If you have  already had plastic surgery on your upper eyelids, a more conservative forehead lift may be in order to assure that enough skin remains to allow you to close your eyes comfortably after surgery.

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Surgery of the Nose/Rhinoplasty
Rhinoplasty, or surgery to reshape the nose, is one of the most common of my surgical procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also be combined with surgery to correct breathing obstruction or snoring.

The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate.

I prefer not to operate on teenagers until after they've completed their growth spurt - around 14 or 15 for girls, a bit later for boys unless a broken nose is present.

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Surgery of the Ear/Otoplasty
Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. Typically, the operation is performed on children of ages 4-14. Ears are almost fully grown by age 4, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

I as well as most surgeons, recommend that parents stay alert to their child's feelings about protruding ears; don't insist on surgery until your child wants to change. Children who feel uncomfortable about their ears and want the surgery are generally more cooperative during the process and happier with the outcome.

In the initial meeting, I will evaluate your child's condition or yours if you are considering surgery for yourself, and recommend the most effective treatment.

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Liposuction/Suction-assisted Lipectomy
Suction-assisted lipectomy - also known as liposuction, fat suction, or suction lipectomy - is a technique to remove unwanted fat deposits from specific areas of the body, including the chin, neck, and cheeks; the upper arms and above the breasts; the abdomen, buttocks, hips, and thighs; and the knees, calves, and ankles. Liposuction is not a substitute for weight reduction, but a method of removing localized fat that doesn't respond to dieting and exercise.

The best candidates for liposuction are of relatively normal weight but have pockets of excess fat in particular areas.

Most important, having firm elastic skin will result in a better final contour. (Hanging skin won't reshape to your body's new contours, and may require an additional procedure to surgically remove the excess skin. This process will leave visible scars.)

The scars from liposuction are small and strategically placed to be hidden from view, even in a bikini. However, other cosmetic problems may occur, even if your surgeon is very skilled. The operation usually requires 2-5 days off work.

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Ultrasound-assisted Lipoplasty
Ultrasound-assisted lipoplasty, commonly known as "UAL," is a relatively new liposuction technique that uses sound waves to "liquefy" unwanted fat. Although, it is not a substitute for traditional liposuction, UAL can be an effective tool for removing fat from fibrous body areas, such as the male breasts or the back, or for removing larger volumes of fat in a single procedure. Often, traditional liposution is performed with UAL to help shape UAL-treated areas or to treat areas of the body not suited for UAL, such as the neck and inner thighs.

One potential complication specifically related to the UAL technique is thermal skin injury or burn caused by the heat from the ultrasound device. Also, temporary collections of fluid beneath the skin surface (seromas) are most common with UAL.

The longer incisions that are needed for UAL require that they be placed carefully in the hidden areas. For this reason, I may sometimes prefer to use the traditional liposuction technique in areas where an obvious scar may result.

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Surgery of the Abdomen/Abdominoplasty
Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. The operation can be combined with procedures to lift the buttocks and/or 
thighs for a tighter more youthful body.

The best candidates for abdominoplasty are men and women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdomen muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

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Facial Implants/Surgery of the Chin, Cheeks and Jaws
Facial implants can enhance your appearance and may bolster your self-esteem.

Plastic surgeons will frequently use such implants to bring better balance to the features of a patient with unbalanced facial relationships such a chin or flat cheekbones.

The maturer patient may choose to have an implant placed in conjunction with another cosmetic procedure.

Implants may also be selected to fill out a face that appears "sunken" or tired.

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Eyelid Surgery/Blepharoplasty
Eyelid surgery (technically called blepharoplasty) is a procedure to move or remove fat - usually along with excess skin and muscle - from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision.

Blepharoplasty can be done alone, or in conjunction with other facial procedures such as a facelift or browlift.

The best candidates for eyelid surgery are men and women who are physically healthy and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

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Laser in Plastic Surgery/Skin Resurfacing
Laser resurfacing is performed using a beam of laser energy, which vaporizes the upper layers of damaged skin at specific and controlled levels of penetration.

It's clear that laser resurfacing may offer a number of advantages over other resurfacing methods; precision, little (if any) bleeding and less post-operative discomfort. However, laser resurfacing treatment, such as dermabrasion or chemical peel, may still be a better choice.

All resurfacing treatments work essentially the same way. First, the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. 

However, a number of studies using microscopic examination have shown that the physical changes that occur to laser-treated skin are essentially identified to those that occur with either dermabrasion or chemical peel. 

It's also important to consider the length of recovery when choosing among the skin-resurfacing alternatives. In general, the more aggressive the resurfacing procedure is, the more prolonged the recovery is likely to be. "Light" resurfacing procedures, such as superficial chemical peels or superficial laser resurfacing, offer shorter recovery times.

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Facelift/Rhytidectomy
As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck. A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock" improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

The best candidates for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelift can be done successfully on people in their seventies or eighties as well. A facelift can make you look younger and fresher, and it may enhance your self-confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth.

Facelifts are very individualized procedures. In your initial 
consultation, I will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.

If you decide to have a facelift, Dr. Anigian will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.

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Breast Lift/Mastopexy
Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on women's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts - at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have loose volume - for example, after pregnancy - breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

A breast lift can enhance your appearance and self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently.

The best candidates for mastopexy are healthy women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

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Breast Augmentation/Augmentation Mammaplasty
Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons:

• To enhance the body contour of a woman who for personal reasons, feels her breast size is too small.
• To correct a reduction in breast volume after pregnancy.
• To balance a difference in breast size.
• As a reconstructive technique following breast surgery.

By inserting an implant behind each breast, surgeons are able to increase a woman's bustline by one or more bra cup sizes.

The best candidates for breast augmentation alone are women with small to medium size breasts with minimal sag. If breasts have loss fullness due to pregnancy or age, a "lift" can be beneficial to return a youth like shape. Even large breasts can be successfully lifted at the same time fullness is restored.

Saline-filled implants continue to be available to breast augmentation patients on an unrestricted basis pending further FDA review. I offer all currently available designs including the European "no valve" implant, which can give a softer more natural feel and appearance. 

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. Early results indicate that saline implants may produce fewer contractures that older silicone gel filled implants.

While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required.

While the majority of women do not experience these complications, you should make sure you understand the risks and consequences of breast augmentation.

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