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Nipple Reductions

Nipple Reductions

It’s not a very common request but occasionally I see a woman with very long nipples. As long as an inch. Their complaints are usually that they are always visible through their shirt and that they get irritated by the bra, particularly while exercising.

There is a corrective surgery and it is quite simple. For comfort, I usually do this in the operating room. A lot of times I will do it when women are already having some other breast surgery, like an augmentation, lift or reduction. The surgery only takes about 15-20 minutes. There really is no recovery and the sutures I use do not have to be removed. It is very user friendly and well tolerated.

Lee Corbett, MD

The posts on this blog are presented by Louisville, KY Breast Augmenation specialist, Dr. Lee Corbett

Areolar Downsizing

The areola is the pigmented skin on the breast that surronds the nipple. It is not uncommon for the areola to enlarge with weight gain and/or pregnancy and some women just have large areola.

The “normal” areola is about 42mm in diameter or about 2 inches wide. There are a lot of women with areolae larger than this who do not like this appearance.

This problem can be easily addressed as part of a Breast Augmentation, Breast Lift, Breast Reduction or as a stand alone procedure. What we do is place what is called a cookie cutter over the nipple. This is a metal circle that is 38 to 45 mm in diameter. We center it over the nipple and press down (you are asleep) and then mark the circle. We then make an incision along our mark and a second one along the natural areolar border. The excess areola is then removed and the outer circle is sewn closed to the inner circle. You now have a smaller areola.

If done alone, this can be performed in the office under local anesthesia. When part of one of the other procedures, it will be done in the O.R.

Lee Corbett, MD

All posts on this blog are presented by Louisville Breast Enlargement Surgeon, Dr. Lee Corbett.

Facelift Incisions

Understandably, when patients are considering a facelift, they are concerned about the extent and placement of the scars.

A traditional facelift includes an incision that starts just above and in front of the ear. The incision comes down in front of the ear and loops around the earlobe to the back. Once there, we keep the incision in the crease behind the ear up to the level of the hairline, and then extend it outward along the hairline. This is your typical, classic incision and most facelifts follow some variation on this pattern.

In the last few years newer “mini” facelifts have become en vogue. There are a bunch of trade names for these like a “Quick Lift” or Lunch time Lift. These procedures use less incisions. Typically there is a transverse incision that runs just under the sideburn to the front of the ear and once there, it follows the crease in front of the ear down to the earlobe. There is no incision behind the ear with these operations.

From a scar perspective, these usually heal very well and are inconspicuous. They end up as a thin white line that is very easy to camouflauge with make-up or even your hair.

Lee Corbett, MD

All posts on the blog are presented by Louisville Facelift surgeon Dr. Lee Corbett

What all do Plastic Surgeons do?

Plastic Surgery is a very diverse field.

Most are familiar with the Cosmetic Surgery component. In Louisville Cosmetic Surgery is very popular. There are reality shows all over cable and articles about the topic in almost every woman’s magazine. But Plastic Surgeons do a lot of other things too.

Children: Plastic Surgeons deal with a number of issues involving kids. We are the ones who repair cleft lips and palates and skull malformations. We also treat birthmarks.

Burns: Plastic Surgeons typically man most Burn Units in conjunction with General Surgeons and Critical Care experts.

Hand: About half of all hand surgeons are Plastic Surgeons, the other half are Orthopedic Surgeons. We treat traumatic and congenital hand problems.

Head and Neck: Plastic Surgeons treat trauma and cancer affecting the head and neck.

Soft Tissue Loss: We are also experts at treating significant soft tissue deficits. Usually this is breast reconstruction following cancer, but we also reconstruct defects that occur all over the body that result from Trauma or Cancer.

Plastic Surgery is a huge field. Most Plastic Surgeons will narrow the scope of their practice simply because it is impossible to do it all.

Lee Corbett, MD

Recovery after breast augmentation.

Breast Augmentation is the most common cosmetic surgery performed in the U.S. In Louisville Breast Augmentation is equally as popular. So, I thought it worthwhile to blog on the recovery following the procedure.

Silicone Implants: Because these are most commonly placed above the muscle, recovery is easier. I advise patients to expect moderate discomfort for the first 48 hours. From day 3 to 7 you should be able to increase your activity level to near normal, exercise excluded. If you have an office position getting back to work after 4 or 5 days is reasonable. Exercise is allowed starting 2 weeks after surgery. Full activity should be reasonable by 1 month.

Saline Implants: Recovery with saline is a little longer and more difficult because the muscle is involved. Moderate or more pain can be an issue for the first 3 to 5 days and can be accompanied by significant breast swelling. Return to activities of daily living is possible within 24 hours and to a desk job, 7 days is reasonable. Again, I recommend against exercise for 14 days. Full unrestricted activity can resume in the 3 to 6 week zone.

Remember though that everyone’s pain levels are different. Some women come back and say the operation was a breeze and other that it was as much as childbirth. In all cases, you will be given enough pain medicine and muscle relaxers to maximize your comfort.

All posts on this blog are presented by Louisville Breast Implant specialist Dr. Lee Corbett.

What is a hematoma?

A hematoma is collection of blood that can form after surgery. It usually results when a vessel starts to leak blood after your surgery has been completed.

Hematomas are not very common, less than 1% in most surgeries and a bit higher with facial surgery. But, they are always a risk whether you are having a Breast Aug, Facelift, or Tummy Tuck. In fact, a hematoma can occur after almost any surgery. If they occur, unfortunately, a second surgery will usually be required to drain the blood.

When the occur it is almost always within the first 24 hours after surgery. During this time period, at about the 6-8 hour point, your body actually starts to release proteins that break down blood clots to keep you from clotting too much. When this happens, the clot on the end of a tiny blood vessel that was not bleeding during surgery can dissolve and bleeding ensues. This can lead to a hematoma.

The good news is that in the vast majority of cases, the diagnosis is made quickly, treatment rendered, and in the end your surgical result and health are in good stead!

Lee Corbett, MD

All posts on this blog are presented by Louisville Plastic Surgeon Dr. Lee Corbett.

After surgery, will I have stitches or do they dissolve?

Surprisingly, I find that a lot of my patients are more scared about having their stitches removed than having surgery!

Be it a facelift, breast augmentation or tummy tuck, there are usually a few sutures that need to be removed. Sorry. Here’s why.

There are absorbable and non-absorbable sutures. Both can be used to re-approximate deep tissues under the skin or the skin itself. More often than not though, we use the non-absorbable kind to close the skin. The reason is that they tend to be a mono-filament, like fishing line. This type of suture elicits less of a scar reaction than a braided suture. Most absorbable ones are braided. So non-absorbable ones make for nicer scars, the goal of every Louisville plastic surgeon.

What I like to do is use a long lasting absorbable mono-filament suture for skin closure. I put one stitch outside the skin, tie a knot to anchor it, and then run it under the skin surface and when I get to the other end of the incision I tie another knot to secure the stitch. That way, all I have to do is clip the knot on either end the rest will dissolve. Plus, because the suture lasts several months, it continues to add strength to the stitch line to keep the scar from widening. So yes, most of the time I do have to remove sutures but I try to make it as user friendly as possible!

Lee Corbett, MD


All posts on this blog are presented by Louisville Cosmetic Surgery expert, Dr. Lee Corbett.

Acne Scarring Treatment

Acne scarring is one of the toughest skin problems out there.

Louisville facelifts will not help.

The skin has to be resurfaced and the best technique is a CO-2 laser. The CO-2 laser is the “grand daddy” of all resurfacing lasers. A number of newer less powerful non-ablative lasers have hit the market since the CO-2 was invented, but none are capable of fully treating acne scarring. In fact, some patients will require repeat treatments even after a CO-2 laser session.

This type of treatment is typically done in the OR. The procedure takes about 45 minutes and anesthesia is required. After surgery you will need about 7-10 days of fairly vigilant care for your skin while everything heals.

Lee Corbett, MD

Botox and the lower face

In Louisville Botox is an invaluable tool for contouring the upper third of the face. The forehead, the creases between your eyes, and your crow’s feet. Use in these areas is pretty universal, very safe & predictable, and very successful.

Once we get below the level of your eyes, Botox use becomes a lot more tricky. Now it’s not as useful as a Louisville Facelift, but Botox can be very helpful for a gummy smile or a downturn of the corners of your lips.

Use below the eyes is almost entirely directed towards the mouth. The problem is that unlike most of the muscles on the forehead and around your eyes, the muscles around the mouth serve more of a function. Namely, they allow us to speak and eat without food and drink leaking out of your mouth! Weakening these muscles can definitely interfere with these functions.

Now, that doesn’t mean you shouldn’t use botox to treat your lower face. What it does mean is that you need to seek out an injector with significant experience. Otherwise you may get more than you bargained for.

Lee Corbett, MD

What a Blepharoplasty won’t do.

A Louisville Blepharoplasty is a procedure that improves the appearance of the eyelids.

On the upper lid this usually means removing excess skin and maybe some fat. On the lower lids this usually entails smooting out the ‘bags’ we get under our eyes and smoothing out some of the laxity.

What a blepharoplasty will not do is change the quality of the skin that is  left behind when the excess is removed. In other words, if the skin of the lids is covered with fine wrinkles these will be there after. We cannot remove so much skin that we can pull it tight. If we did this you would be left with a big problem called an ectropion. We can do it on a tummy tuck but not on eyelids.

If your skin is like this, laser skin resurfacing is your answer. This is something your Plastic Surgeon will help you figure out.

Lee Corbett, MD