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Liposuction

Body contouring with liposuction was popularized in the late 1980′s for diet and exercise resistant fat deposits. Improvements in technique have increased safety, reducing blood loss and the risk of contour irregularity. The Tumescent Technique refers to injecting the fat with a dilute vasoconstrictive fluid prior to its removal to make blood loss minimal. Liposuction is performed as an outpatient under local anesthesia, IV sedation or general anesthesia. Results depend on the elasticity of the skin, the location of the fat deposits and the underlying anatomy. Wearing a compression garment (girdle) for about 6 weeks is important in optimizing the result. The contour change is generally permanent. Common areas treated are the neck, abdomen, flanks, buttocks, hips, thighs, knees, calves and ankles.

Liposuction is one of the most popular cosmetic procedures performed today.

Key Benefits

• • Permanent removal of fat and change of contour
• • Removes diet and exercise resistant fat deposits
• • Safe and effective procedure with minimum recovery time for most

Breast Augmentation (Augmentation Mammoplasty)

Breast enlargement is performed as an outpatient under general anesthesia. The scars are inconspicuously placed around the areola or under the breast. the implants used may be saline or silicone. The implants are most often placed under the chest muscle to decrease scar tissue, improve the quality of mammograms and produce a typically more natural appearance. Exercise may be resumed in 3-6 weeks following surgery and most patients will return to work in 5-7days.

Breast Augmentation can be a very satisfying procedure, enhancing your appearance and self-confidence.

Breast Reduction

This procedure is one of the highest in patient satisfaction. Large heavy breasts can cause back ache and neck pain, shoulder grooves and rashes. Difficulty with physical activities and problems in clothing fit are also noted. Breast reduction is performed under general anesthesia in 2 – 3 hours. An overnight stay in the hospital is common. A more proportionally appropriate breast size is created (usually a C cup). Scars fade over six months to a year. Most people return to work in 10 days to several weeks depending on their job activity. Insurance will usually cover this procedure if criteria for medical necessity are met.

Key Benefits

• • May relieve stress on the neck and back
• • Appear slimmer and less matronly
• • Improved fit in clothing and greater options in lingerie and swimwear

Breast Lift (Mastopexy)

The shape, position and firmness of a woman’s breasts can be unsatisfactory to her due to hereditary factors, aging, changes in weight, or as a result of pregnancy or breast feeding. Mastopexy can help lift and tighten the breasts. This is usually performed by removing excess skin and reshaping the breast. Sometimes implants are inserted as well.

Face & Neck Lift

A face & neck lift is a very effective procedure performed to improve sagging facial skin, jowls and loose neck skin. Facelifts are usually performed between the ages of 35 and 80 to remove fatty deposits & excess skin as well as gently tightening the skin and muscles to produce a very natural result lasting 5-10 years. The procedure is done in the office operating room under sedation or general anesthesia and takes 2-3 hours. Recovery usually takes 7-14 days but makeup may be worn after 5-7 days.

A face lift won’t stop the aging process but can “set back the clock” reversing signs of aging contributed to by stress, gravity, sundamage and hereditary factors.

Key Benefits

• • Removes fatty tissue from the neck area and the jowls
• • Tightens the skin and muscle to rejuvenate the face and neck
• • Refines the jawline and helps restore the patient’s original face shape

Mini Facelift

A “mini” face lift is a procedure to rejuvenate the face showing the first signs of skin sagging. It is a minimally invasive procedure that targets early jowls, loosening cheek skin, and sagging of the skin beneath the chin and of the upper neck. Typically women who are candidates for a minilift are mid-thirties to early fifties, or wish to tighten a face lift they underwent many years prior. It is a similar procedure to a face/neck lift however risks, operative time, and recovery time are less. Having a mini facelift early may retard the subsequent appearance of aging in the face and minimize the need for a more extensive procedure in the future.

Abdominoplasty (tummy-tuck)

This procedure usually produces a wonderful change in a protuberant abdomen with excess skin and fat, especially following child bearing changes. The muscles are tightened and the excess skin and fat are removed. The procedure takes 2 – 3 hours under general anesthesia and may require 1 – 2 days of hospitalization. The scar is fairly long but usually fades over time. You may return to work in 10 – 14 days, but it may take six weeks to resume strenuous activity. Results are generally permanent. Depending on the amount of fat and excess skin, sometimes a “mini” abdominoplasty need only be performed to achieve a flatter, trimmer abdomen.

Key Benefits

• • Can flatten a protuberant abdomen
• • Excess skin and fat are removed
• • Removes stretch marks from the lower abdomen

Eyelid Surgery (Blepharoplasty)

Tired looking or drooping eyes can be improved by removing excess skin and fat. This results in a younger, more well-rested appearance. Local anesthesia, sedation, or general anesthesia is used in the office surgery suite. Bruising and swelling, resolve in several weeks,and usual activities may be resumed in a week. Reading may be resumed in 2 – 3 days and you may return to work in 7 – 10 days. Results may last years and are sometimes permanent.

Eyelid Surgery can enhance your appearance by giving you a more alert and youthful look

Key Benefits

• • Results in a more youthful, alert, well-rested appearance
• • Reverses early signs of facial aging
• • May improve field of vision

BOTOX® Cosmetic

BOTOX® Cosmetic is a simple and effective therapy for the correction of forehead frown lines and “crow’s feet.”

BOTOX® (Botulinum A Toxin) is injected into the small muscles between the eyebrows (which cause frowning or an angry appearance) or in the temple area (where “crow’s feet” or squint creases can occur) to weaken or inactivate the action of those muscles. Long standing skin creases will soften and may eventually disappear. The result is a softer, more relaxed and pleasant appearance. BOTOX® Cosmetic has been used safely over 15 years.

The effect takes several days to develop, with results lasting 3-8 months. Repeat injections may be needed less frequently as the muscles weaken from disuse and the habit of frowning is broken.

The procedure takes about 10 minutes and you may return to work and activities immediately, although exercise and reclining should be avoided for about 4 hours to keep the toxin concentrated at the injection site. Possible rare side effects include temporary mild swelling at the injection site, headache, bruising or rare allergic reaction or temporary drooping lid or eyebrow.

BOTOX® Cosmetic is an exciting cosmetic procedure that can simply, safely and effectively improve frown lines, “crow’s feet,” and forehead wrinkles.

ArteFill®

ArteFill® is the First FDA-Approved Permanent Aesthetic Injectable ImplantTM for the Correction of Nasolabial Folds (smile lines)

What is ArteFill®?

ArteFill® is a combination of purified bovine collagen gel and highly purified, carefully filtered homogeneous micro spheres made of polymethylmethacrylate (PMMA). PMMA is a very inert non-reactive substance which has been used in surgery (for instance, to help stabilize total joint replacements, or to fashion a synthetic bone plate) for over 50 years. It also contains 0.3% Lidocaine to help decrease any discomfort of the injection.

How Does ArteFill® Work?

Once the ArteFill® is injected in the deeper portion of the skin under a wrinkle, the material provides structural support to lift and plump the wrinkle. The nasolabial fold (or smile line) is decreased, smoothed and further wrinkling is potentially prevented. As the collagen gel is absorbed, the micro spheres stay in place and one’s own collagen becomes deposited around the spheres, enhancing and stabilizing the results. Excellent results have been seen , even at 5 years after injection. Most currently available fillers only last 2-6 months.

How Can I Get ArteFill®?

Doctors who may administer this product must complete a training module and demonstrate competency in proper injection technique. Dr. Marialyn Sardo in La Jolla, California is trained and experienced in ArteFill® injections.

The process involves an initial consultation to discuss the procedure and to obtain a skin test to assure that you won’t have an allergy to the bovine collagen component of the solution (very rare). Then, 28 days later you may be treated. The procedure takes about 15 minutes and is performed after the application of a topical anesthetic cream. After the injection, there may be mild swelling and redness which subsides quickly. Results can be seen immediately. You will be evaluated again in 1-3 months to check the correction and to determine if more fill is needed for optimal results. Most people will need 2-3 treatments to achieve maximum results.

PermaLip Implants™

FDA cleared permanent soft tissue enhancement for lips featured on The Doctors.
Now Available!

PermaLip implant and Perma Facial Implant by SurgiSil are safe, definitive solutions for permanent tissue augmentation. Perma Facial Implant is a patented, FDA approved implant made of a soft solid silicone elastomer using a process to produce a naturally contoured implant with a smooth, non- porous surface. The implant cannot rupture or deflate and may be removed at any time. The lip implants come in 3 sizes (3,4, and 5 mm) in 3 lengths for creating the beautiful permanent enhanced lip fullness.

Laser Skin Resurfacing

Skin resurfacing by CO2 or Erbium:Yag Laser is used to treat wrinkles, sun damaged skin, pre-cancerous lesions, uneven pigmentation, shallow acne scars or superficial growths. The skin may take 1 – 3 weeks to heal depending on the depth of the peel. It is important to keep the face moist and out of the sun while healing. Laser resurfacing results in a permanent improvement of the skin, although, the aging process and further sun exposure can lessen the effect over time. Sometimes the skin may stay pink for a number of weeks after healing. However, it may be covered easily with make-up. These procedures may be repeated for additional effect.

Laser resurfacing is one of the most exciting and effective methods for reducing fine skin wrinkles.

Key Benefits

• • Most effective treatment in the reduction of fine wrinkles
• • Refines texture and evens skin pigmentation
• • Removes sun damaged skin removing potentially pre-cancerous growth

Juvéderm®

Juvéderm® is a cosmetic dermal filler made of non-animal-based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid in Juvéderm® is biodegradable and fully biocompatible with human hyaluronic acid.

Allergy testing is not required. After treatment, there may be some temporary redness or swelling. If this occurs avoid sunbathing or cold outdoor activities until these symptoms disappear, usually in less than 7 days.

Typical areas treated include the nasolabial smile lines, lines at the corners of the mouth, frown lines between the eyebrows and along the lip border which gives the lips a fuller appearance and helps minimize wrinkles around the mouth.

The effects of Juvéderm® may last up to a year.

Forehead Lift (Brow Lift)

A low or sagging brow may cause a person to look sad, tired or angry. Factors contributing to a furrowed forehead or drooping eyebrows are heredity, aging, or overactive facial muscles. A browlift can be performed to soften frown lines, creases in the forehead and raise the brow position. This procedure is either done endoscopically (using special instrumentation through multiple small incisions in the scalp) or via an “open” approach whereby an incision is made in the scalp to facilitate raising and smoothing the forehead and removing excess skin. A browlift is often combined with other facial rejuvenation procedures.

Skin Cancer Surgery and Reconstruction

Dr. Sardo and her staff are trained in screening your skin for potential skin cancer. This condition is particularly prevalent in Southern California, as most of us have had significant sun exposure in our lives. Other environmental factors, toxins and hereditary factors can influence the likelihood that you will develop skin cancer.

Preventive measures such as avoiding sun exposure, using sunscreens, and treating your skin for pre-cancerous conditions are important.

The most common forms of skin cancer are basal cell, squamous cell, and melanoma.

Basal Cell Skin Cancer

This is the most common type of skin cancer. There are many types, and they may be raised and nodular or flat, pink and indistinctly bordered. The rate of growth and aggressiveness can vary. Most are relatively slow growing and can be easily cured by excision. If the lesion is located on or near the nose, eyelids, or lips, it may need to be excised by the Moh’s technique. This is performed by removing concentric shavings of skin and examining the tissue microscopically until it is completely cleared of tumor cells. This makes reconstruction potentially easier as only the skin that needs to be removed is excised.

Squamous Cell Skin Cancer

Squamous cell skin cancer is more aggressive and usually grows faster than basal cell. It must be excised with wider margins. It tends to ulcerate and left untreated may metastasize to local lymph nodes. It is curable by adequate excision and is treated the same way as the basal cell cancer.

Actinic Keratoses – Pre-Skin Cancer

Actinic Keratoses are skin lesions resulting from cumulative sun damage. They appear as small red patches with a thin scaly crust. AKs may develop into skin cancers over time or indicate skin that is prone to the development of skin cancers. This superficial condition can be treated by removal of the top layers of the skin using liquid nitrogen (“freezing”) , TCA acid peel, laser resurfacing, or Efudex a prescription cream which specifically attacks AKs when used as directed over a 2-4 week period.

Melanoma

Melanoma is a serious and potentially lethal skin cancer. It is very important to remove this skin cancer in its early stages.
When screening for this type of lesion, or any types of skin cancer, a helpful method is the ABCD mnemonic.

A) – Asymmetry: Has the lesion changed appearance or become asymmetric.

B) – Borders: Are the borders of the lesion smooth or are they irregular or notched.

C) – Color: Is the color homogeneous, or is it variegated. Are there any areas of red, white, or blue.

D) – Diameter: Has the lesion been changing in size, or is it 6mm or larger (roughly the diameter of a pencil eraser)