San Jose plastic surgeon Dr. Creasman

Q. What type of anesthesia will I have for Breast Augmentation?
A. General anesthesia provided by a board certified anesthesiologist.

Q. How what is the length of the procedure?
A. The procedure takes about one hour.

Q. How long does it take to recover from Breast Augmentation surgery?
A. Patients generally return to work after 4-5 days.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 24 hours. You will need a ride to your first follow-up appointment.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 2-3 days after surgery. Then he sees you after a week and then usually at 6 weeks and finally at 3-4 months.

Q. When can I drive?
A. You can drive once you have discontinued taking the pain medication, which is typically at 4-5 days.

Q. Do I need to stop taking any medications prior to surgery?
A. Two weeks prior to surgery do not take any medications without approval from Dr. Creasman. Medications including but not limited to Aspirin, Motrin, Ibuprofen or Aleve should be discontinued. Vitamin E, herbal medications and diet medications containing Mahuang or Ephedra should also be discontinued. Avoid Garlic in your diet. Tylenol is okay to take for pain.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic the morning of surgery.

Q. What medications do I have to take prior to surgery? When do I start taking them?
A. One day prior to surgery, you will start 2 tablets of Vioxx 25mg. Take this medication with food.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for pain medication to take when you get home. Please follow labeled instructions.

Q. Do I wear a bra after surgery?
A. If the implants are placed behind the pectoral muscle, usually you will go braless after the first follow-up for 2-4 weeks. If the implants are placed just behind the breast but in front of the muscle, you will wear a bra. If you have an inframammary incision, do not wear an underwire bra for 2 weeks or until it is comfortable to do so.

Q. After surgery, will I have drainage tubes?
A. No. Drains are rarely used with breast augmentation surgery.

Q. What are signs of an infection?
A. Uneven swelling, increased pain, fever, chills, redness and drainage from the breast and incisions.

Q. What position should I sleep in after surgery?
A. For the first 8 hours you should sleep on your back with your head and shoulders propped up. You can then sleep flat on your back. You can rotate from side to side after 48 hours.

Q. When can I shave my armpits with an axillary incision?
A. About 7-10 days, when incisions are sealed and healed.

Q. When can I take a shower after surgery?
A. After the first follow-up, usually after 2-3 days. Avoid baths, swimming pools, and hot tubs for two weeks.

Q. Sometimes I have sharp pain and/or burning sensation in my breasts. Is this normal?
A. This will go away with time. If this sensation is accompanied by uneven swelling, please call the office. Massaging the breasts can help.

Q. My nipples are numb. Is this normal?
A. Numbness may last 6 months to a year.

Q. My breasts feel hard. Is this normal?
A. The hardness should go away in time and usually is a result of swelling or tightness of the skin and muscle. The hardness can also be scar tissue that might need to be surgically removed, but this would occur later.

Q. Is it normal for my implants to make sloshing noises?
A. Yes. Sloshing and squeaking noises are normal and will subside. Air can be trapped around the implants, but the “sloshing” is not coming from inside the implants.

Q. When do the tapes come off the incisions?
A. The doctor will generally remove the tapes 8-9 days after surgery.

Q. When can I start exercising?
A. No lifting anything heavier than a coffee pot for one week. No running or weight lifting for 6 weeks. You may return to walking briskly in a week, situps/treadmill/stairmaster in 4-6 weeks.

Q. Can I sunbathe?
A. You can tan after 4 weeks. If scars are exposed to the sun, they may darken. Tanning prior to surgery is okay.

Q. When can I travel?
A. Two weeks after surgery. Get up and walk every hour when traveling by air.

Q. How often do I do the breast implant exercises?
A. You do 10 repetitions (one set) on each breast, every two hours for the first two weeks. After two weeks, do one to two sets daily for life.

Q. When do I start doing my breast implant exercises?
A. Usually 2-3 days after surgery. The doctor or his nurse will tell you when to begin them.

Q. What is the weight of my implants?
A. As a guide a 240cc implant weighs about a half a pound. A 480cc implants weighs about a pound.

Q. When do I start using the silicone sheeting to reduce the appearance of the scar? How long do I wear it?
A. After your suture removal and there are no crusts/scabs or open spots on your incision, you will wear the sheeting for 12 hours a day for 3 or more months.

Q. Do I need to take an antibiotic before a dental appointment?
A. Yes, if you are having invasive dental work, such as a crown prep or certainly a root canal. No, if you are only getting your teeth cleaned.

FAQs on Eye (Blepharoplasty):

Q. What type of anesthesia will I have for Blepharoplasty?
A. Local anesthesia with sedation. An intravenous line is placed and sedative medication is administered gradually, under continuous monitoring of your vital signs. Local anesthetic is injected while you are sedated. You will be unaware of the injections.

Q. How what is the length of the procedure?
A. The procedure takes about one to two hours.

Q. How long does it take to recover from Blepharoplasty surgery?
A. There is bruising and swelling for 7-14 days. Patients generally return to work 5-7 days. No computer, television or reading for 5 days. Full recovery is usually about six weeks to look and feel normal again.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 24 hours. You will need a ride to your first follow-up appointment.

Q. What can I eat after surgery?
A. Start out with a soft diet and drink plenty of fluids.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 4-5 days after surgery.

Q. When can I drive?
A. You may drive one week after surgery, as long as you are off all pain medication.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic at the start of surgery.

Q. What medications do I have to take prior to surgery? When do I start taking them?
A. Vitamedica, a pre-operative pack of vitamins to help with post-surgical swelling and bruising is available for purchase at our office. Vitamedica should be started 2 weeks prior to surgery.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for a pain medication to take after surgery. Please follow labeled instructions.

Q. How long will the swelling last?
A. Swelling peaks at 48 hours. To reduce bruising and swelling, place a gauze pad over your eyes, then place a Ziplock bag filled with a handful of frozen peas over the gauze. Do this during waking hours. Do NOT put ice directly on eyes.

Q. How long to I apply the iced peas?
A. The first 72 hours or until swelling subsides. After this time, you may feel relief with the application of the frozen peas and it is certainly acceptable to continue using them, but not imperative. It is for your comfort.

Q. In what position should I sleep after surgery?
A. For the first 3-5 days, you should sleep with your head higher than your heart.

Q. When can I take a shower after surgery?
A. You can shower from the neck down after 48 hours. After your first follow-up, you may shower normally. Do not allow the shower stream to hit you in the face for about four weeks.

Q. When can I wear facial lotion or make-up?
A. After 7-10 days. Do not put on incisions until they are fully healed.

Q. My eyes are dry and itchy. Is there anything I can use for relief?
A. You can purchase Refresh PM (lubrication drops) from a drugstore.

Q. When can I start exercising?
A. Light walking is okay after your first follow-up. No lifting or bending for 6 weeks. You can start running/treadmill/situps/golf at 4 -6 weeks. Weight lifting at six weeks.

Q. When can I go swimming?
A. You can swim at 2 weeks. Apply suncreen to your face, including incisions.

Q. Can I sunbathe?
A. You can tan after 4 weeks when bruising subsides. If scars are exposed to the sun, they may darken. Avoid exposing incisions to the sun. Use a hat, sunscreen and sunglasses.

Q. When can I travel?
A. 2 weeks after surgery. When flying, get up and walk every hour.

FAQs on Face Lift:

Q. What type of anesthesia will I have for my facelift?
A. Local anesthesia with sedation. An intravenous line is placed and sedative medication is administered gradually, under continuous monitoring of your vital signs. Local anesthetic is injected while you are sedated. Occasionally, Dr. Creasman does facelifts under general anesthesia, such as when multiple procedures are being done, or if this is the patient’s preference.

Q. How long does it take to recover from facelift surgery?
A. There is bruising and swelling for 10-14 days. Patients generally return to work 10-14 days.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 48 hours. You will need a ride to your first two follow-up appointments.

Q. What can I eat after surgery?
A. Start out with a soft diet and drink plenty of fluids. Avoid very hot foods or beverages.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 2-3 days after surgery. The second visit is for the first suture removal at 4-5 days. The third follow-up is after 7-10 days for removal of a few more sutures. You will need a ride to the first two visits.

Q. After surgery, will I have drainage tubes?
A. This varies depending on the extent of your surgery. If a drain is used, it usually is removed at the first follow up visit.

Q. When can I drive?
A. You may drive one week after surgery, when you should be off all pain medication.

Q. Will I have pain with my facelift?
A. Pain is minimal with most facelifts. Severe pain can be a sign of a complication, so this should be reported to us at once.

Q. Any other restrictions?
A. Dr. Creasman recommends a minimum of talking and chewing. Moving the jawbone causes more swelling and bruising. Try to rest as much as possible, but get up and walk every couple of hours to avoid getting clots in your legs or pelvis.

Q. Do I need to stop taking any medications prior to surgery?
A. Yes, for two weeks prior and after surgery, you need to discontinue taking medications that contain Aspirin, Motrin, Ibuprofen or Aleve. Discontinue Vitamin E, herbal medications and diet medications containing Mahuang or Ephedra. Avoid Garlic in your diet. Tylenol is okay to take for pain. There is no need to discontinue birth control pills.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic at the time of surgery.

Q. What medications do I have to take prior to surgery?
A. When do I start taking them?Vitamedica, a pre-operative pack of vitamins to help with post-surgical swelling and bruising is available for purchase at our office. Vitamedica should be started 2 weeks prior to surgery.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for a pain medication to take after surgery. Please follow labeled instructions.

Q. What position should I sleep in after surgery?
A. For the first 4-5 days, you should sleep upright about 15 –20 degrees above horizontal, on your back with your head and shoulders higher than your heart.

Q. When can I take a shower after surgery?
A. You can shower after your first follow-up at 2-3 days.

Q. When can I use shampoo and conditioner?
A. You may use shampoo and conditioner after your first follow-up. Do not use styling products or a curling iron for 7-10 days.

Q. When can I get my hair colored or bleached?
A. For hair bleaching, apply two weeks prior or wait 4 weeks after surgery. For hair color, apply 2 weeks prior or wait 2 weeks after surgery.

Q. When can I wear facial lotion or make-up?
A. After 7-10 days. Do not put on incisions until they are fully healed.

Q. When can I wear my contact lenses?
A. One day after surgery. If you also had a blepharoplasty, wait a week.

Q. Is it okay to wear eye and/or sunglasses after surgery?
A. You can wear glasses 5-7 days after surgery. Prop glasses above your ear so the arm of the glasses rests in your hair and not on your ear.

Q. When can I start exercising?
A. Light walking is okay after your first follow-up. No bending or lifting for 6 weeks. You can start running/treadmill/situps at 4 -6 weeks.

Q. When can I go swimming?
A. You can swim at 4 weeks. Apply suncreen to your face, including incisions.

Q. Can I sunbathe?
A. Avoid sun exposure after surgery for one month. You can tan after 4 weeks when bruising subsides. If scars are exposed to the sun, they may darken. Avoid exposing incisions to the sun. Use a hat and sunscreen.

Q. When can I travel?
A. 2 weeks after surgery. Get up and walk every hour when traveling by air.

FAQs on Liposuction:

Q. What type of anesthesia will I have for Liposuction?
A. Usually general anesthesia provided by a board certified anesthesiologist.

Q. How long does it take to recover from Liposuction surgery?
A. Patients generally return to work after 4-5 days. Bruising can last up to 10-14 days, and sometimes longer. Swelling can last up to 3 months.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 24 hours. You will need a ride to your first follow-up appointment.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 2-3 days after surgery.

Q. When can I drive?
A. You may drive 4-5 days after surgery. You cannot drive if you are taking pain medication.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic at the time of surgery.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for a pain medication to take after surgery. Please follow labeled instructions.

Q. Do I wear a garment after surgery?
A. You will wear a post-surgical garment 1 week for every decade of age. Example: Age 30 = 3 weeks.

Q. I had liposuction of my neck. How often do I wear the chin strap?
A. Wear the chin strap for the first 48 hours. Then wear the strap only at night for 2 weeks.

Q. What position should I sleep in after surgery?
A. For the first 8 hours, you should sleep upright with pillows positioned under your knees for support. Rotate occasionally from side to side. Do not stay in one position for long periods of time. You may sleep flat after the first 8 hours. Get up every hour and walk around.

Q. When can I take a shower after surgery?
A. You can shower 2 days after your surgery.

Q. When can I start exercising?
A. Light walking on the night of surgery. Brisk walking in one week. You can start running/treadmill/situps at 4- 6 weeks.

Q. When can I get a massage?
A. You may get a Lymphatic massage one week after surgery.

Q. Can I sunbathe?
A. You can tan one month after surgery. If scars/bruises are exposed to the sun, they may darken. Tanning prior to surgery is okay.

Q. When can I travel?
A. 2 weeks after surgery. When flying, get up and walk every hour.

FAQs on Nose:

Q. What type of anesthesia will I have for Rhinoplasty?
A. Local anesthesia with sedation. An intravenous line is placed and sedative medication is administered gradually, under continuous monitoring of your vital signs. Local anesthetic is injected while you are sedated. You feel no pain with this regimen.

Q. What is the length of the procedure?
A. The procedure usually takes about 2 hours, but depends on the scope of the work being done.

Q. How long does it take to recover from Rhinoplasty surgery?
A. Most bruising and swelling is gone after 7-10 days. Patients generally return to work in 6-10 days.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 24 hours. You will need a ride to your first follow-up appointment.

Q. What can I eat after surgery?
A. Start out with a soft diet and drink plenty of fluids. Avoid very hot foods or beverages because your upper lip may be numb.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 4-5 days after surgery. You will need a ride to the first follow-up.

Q. When will the bandages be removed?
A. They are generally removed at 4-5 days after surgery at your first follow-up appointment.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic at the time of surgery.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for a pain medicine that you will take after surgery. Please follow labeled instructions.

Q. My nose is bleeding (immediately after surgery). Should I be concerned?
A. Some bleeding is expected after nasal surgery. You should change the dressing on your upper lip as needed, and anticipate this will be necessary for 24 – 36 hours after surgery.

Q. How long will the swelling last?
A. Initial swelling lasts 5-7 days. There may be residual swelling for months.

Q. What can I do to minimize the swelling?
A. Soak compresses in ice water, wring them out and place them over the eyes. You can also put a handful of frozen green peas in a plastic bag and place over the cold washcloth. Minimize chewing and talking for the first couple of days to reduce bruising and swelling.

Q. My upper teeth are numb and tingling. Is this normal?
A. Yes. This will go away in 1-2 days.

Q. When can I blow my nose?
A. You should avoid blowing your nose for the first week after the dressings are removed.

Q. What position should I sleep in after surgery?
A. For the first 24 hours, you should sleep upright on your back. After 24 hours you may sleep on your sides and back.

Q. When can I take a shower after surgery?
A. Shower only below the shoulders 2-3 days after surgery. It is okay to take full shower when splint/tapes are removed.

Q. When can I wear facial lotion or make-up?
A. After 4-5 days. Do not put on incisions until they are fully healed.

Q. When can I wear my contact lenses?
A. You may wear contact lenses as soon as you feel comfortable doing so.

Q. Is it okay to wear eye and/or sunglasses after surgery?
A. You can wear glasses 2 weeks after surgery. Tape glasses up/off of your nose in the interim.

Q. When can I start exercising?
A. Light walking is okay after your first follow-up. You can start running/treadmill/situps at 4 -6 weeks. Avoid putting your head down (below the level of your heart) for the first several weeks as that will make your nose throb and even swell more.

Q. When can I go swimming?
A. You can swim at 4-6 weeks, but do not dive into the water for three months. Apply suncreen to your face/nose. Your nose will be more sensitive to the sun for up to a year after surgery.

Q. Can I sunbathe?
A. You can tan after 8 weeks. It is recommended to wear a hat and use sunscreen.

Q. When can I travel?
A. 2 weeks after surgery. When flying, get up and walk every hour.

FAQs on Tummy (Abdominoplasty):

Q. What type of anesthesia will I have for Abdominoplasty?
A. General anesthesia provided by a board certified anesthesiologist. Dr. Creasman also does nerve blocks with local anesthetic for pain control after surgery.

Q. How what is the length of the procedure?
A. The procedure takes about two and a half to three hours.

Q. How long does it take to recover from Abdominoplasty surgery?
A. Patients generally return to work after 2 weeks. Full recovery is about 8-12 weeks.

Q. Do I need someone to stay with me after surgery?
A. It is recommended that someone stay with you for the first 48 hours. You will need a ride to your first couple of follow-up appointments.

Q. When do I see the doctor for follow-up?
A. The first follow-up is 2-3 days after surgery. The second follow-up is after 7-10 days.

Q. Do I need to take an antibiotic prior to surgery?
A. No. The doctor administers an IV antibiotic at the time of surgery.

Q. What medications do I have to take prior to surgery? When do I start taking them?
A. There are no medications you need to take prior to surgery.

Q. What medications do I have to take after surgery?
A. You will be given a prescription for a pain medication that you will take after surgery. Read the label and follow as directed.

Q. Do I wear a garment after surgery?
A. You will wear a post-surgical garment for one month.

Q. After surgery, will I have drainage tubes?
A. Yes. Usually they are removed after 5-7 days.

Q. What are signs of an infection?
A. Fever, chills, redness, unusual drainage and unusual pain.

Q. What position should I sleep in after surgery?
A. For the first 3-5 days, you should sleep upright with pillows positioned under your knees for support.

Q. When can I take a shower after surgery?
A. You can shower after the drains are removed, usually after 5-7 days. In the interim, you should take “bed baths” by using a washcloth and soapy water to clean yourself. Avoid baths, swimming pools, or hot tubs for two weeks.

Q. When can I start exercising?
A. You should get up and walk the evening of surgery and several times a day thereafter. Lengthy walking is okay after 7-10 days. Stretching is the most important issue after this operation, and you can begin to stretch your abdomen after the first week. You can start running/treadmill/situps at 6-8 weeks.

Q. When can I go swimming?
A. 6 weeks, when wounds have completely healed and after you have stretched adequately.

Q. Can I sunbathe?
A. You can tan after 4 weeks when bruising subsides. If scars are exposed to the sun, they may darken. Tanning prior to surgery is okay, but lowers your systemic immunity.

Q. When can I travel?
A. 3-4 weeks after surgery. Get up and walk every hour when in flight. No lifting luggage for 4-6 weeks.

Q. When do I start scar treatment using the silicone sheeting? How long do I wear it?
A. One week after your suture removal and there are no crusts/scabs or open spots on your incision, you will wear the sheeting for 12 hours a day for 3-6 months.

Glossary - Frequently Used Terminology

Abdominoplasty - Also known as “Tummy Tuck”, the procedure designed to recontour the abdomen which involves removal of fat and skin, and usually tightening of the muscle wall, particularly in patients after pregnancy. Results in a scar across the lower abdomen beneath the bikini line, but from hip to hip, and around the navel. In some patients who have insufficient laxity of their abdominal skin, a modified version is carried out, with removal of only the lower skin but without the incision around the navel.

Accreditation - refers to the formal approval of an operating facility by an independent, state-approved accrediting body. Dr. Creasman's facility is accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF), one of only three such bodies approved by the State of California. Since 1996, all facilities in California are required by state law to be accredited to perform outpatient surgery (AB 595).

Anesthesia - medication given to maintain a pain-free state during surgical procedures. Administered as either a local (injected) anesthetic, regional (nerve block with local injection, such as a spinal or epidural block), or general anesthetic (complete loss of consciousness). Regional and general anesthetics are administered by an Anesthesiologist (Physician trained in Anesthesia), while local anesthetic is administered by Dr. Creasman. Major local anesthetics are given under conscious sedation (intravenous administration of sedative medication). All anesthetics given under complete monitoring of vital signs and oxygen levels. All anesthetics except simple local anesthesia require a monitoring period after the procedure, known as recovery, prior to discharge from the facility. Dr. Creasman is assisted by anesthesiologists from Group Anesthesia Services (http://www.groupanesthesia.com/patientGuide.html) when general anesthesia is employed, and is certain circumstances when conscious sedation is used. All anesthesia services are provided by anesthesiologists certified by the American Board of Anesthesiology. All are members of the American Society of Anesthesiologists. Click on the link above for more information about the individual anesthesiologists.

Antioxidants - A group of compounds that help to protect the body from the formation and elimination of free-radicals. Free-radicals are formed from exposure to sunlight and pollution and also as a byproduct of cell metabolism. Alcohol, cigarette smoke, stress and even diet also affect the level of free-radical development in the body. Excellent antioxidants include Vitamin A, Vitamin E, Vitamin C, zinc, selenium, ginkgo biloba, grape seed extract, and green tea extract

Axillary - of or referring to the "armpit", or underarm. Indicates the location of one of the possible incisions for breast enlargement, namely, in the armpit.

Arnica Montana - also known as Leopard’s Bane or Wolf’s Bane - A plant that has been used for hundreds of years in homeopathic medicine to treat bruises, injuries and soreness.

Asymmetry – difference in size or other appearance between the two sides of a part of the body, e.g. eyelids that look different, or breasts that are two different sizes. Symmetry, which means sameness, is very uncommon in the human form.

Blepharoplasty - eyelid surgery to remove excess skin, muscle, and fat. Can be performed on the upper and/or the lower eyelids. Can be performed on the lower eyelids either using a skin incision or from the inside lining of the lower eyelid in younger patients (known as a transconjunctival lower lid blepharoplasty) to remove fat only.

Board-certified - With regard to plastic surgery, this refers to the successful completion of rigorous examinations by the American Board of Plastic Surgery (ABPS). There are no other boards certifying physicans in the practice of Plastic Surgery. The ABPS is the only board approved by the American Board of Medical Specialists, which is the body within the United States which grants such approval. Beware of "bogus boards", which sound impressive, but lack this approval.

Body Mass Index (BMI) - The body mass index is one measure of the appropriateness of your weight with respect to your height. It is used by the Centers for Disease Control (CDC) and the World Health Organization (WHO) as a tool to research nutrition and the effect of weight on health

Research has shown that being overweight causes health risks, and uses a body mass index (BMI) of 25 kg/m2 as the definition of overweight. This is a common method used in data analysis. Numerous studies have confirmed that having a body mass index over 25 kg/m2 is associated with increased risk of disease (like diabetes, high blood pressure, heart attacks, etc), and risk of a shortened lifespan.

The definition of "underweight" at a BMI below 19 kg/m2 is also arbitrary. It may be somewhat suitable for women, but is quite unsuitable for men.

A better definition of weight categories2 is shown in the table below. It suggests that an "overweight" BMI is actually 27.3 for women, and 27.8 for men.

Adults	Women	Men
anorexia	< 17.5
underweight	<19.1	<20.7
in normal range ideal weight	19.1-25.8	20.7-26.4
marginally overweight	25.8-27.3	26.4-27.8
overweight	27.3-32.3	27.8-31.1
very overweight or obese	>32.3	>31.1
severely obese	35 - 40
morbidly obese	40 - 50
super obese	50 - 60 kg/m2

Botox – the registered trademark name for Botulinum Toxin Type A, a purified nerve toxin used as an injectable treatment to temporarily paralyze small muscles in the face, thus reducing their undesirable effect of creating wrinkles. The toxin is not expected to be present in the peripheral circulation when injected directly into muscles, and acts at the junction of the nerve ending within the muscle. The typical length of effect is approximately three months, but can vary. An alternate form (botulinum toxin B), known as Myobloc has an ostensibly greater longevity.

Bra - here is a list of bras that we have found to work well after Breast Augmentation surgery:

These bras are just suggestions for you. If you cannot find any of these bras in stock-DON'T WORRY! Just follow these simple rules while finding your post-operative bra:

Breast Augmentation - enlargement of the breast by placement of an implanted prosthesis behind the breast and often deep to the pectoralis major muscle. The prosthesis or implant used is comprised of a silicone rubber shell or bag, filled with either saline (saltwater IV fluid), or silicone gel.

Bromelain - A proteolytic enzyme (digests protein) that is extracted from the root of the pineapple stem. Bromelain’s most common application is in the treatment of inflammation and soft tissue injuries.

Brow Lift - elevation of the forehead to raise the eyebrows to a more cosmetically pleasing position, to smooth wrinkles in the forehead and frown lines between the eyebrows. Can be performed as an "open" procedure, using an incision from ear to ear in the hair-bearing scalp, or alternatively as an "endoscopic" procedure, using multiple smaller incisions and a lighted tube with a camera attached to visualize the tissues beneath the scalp. See Endoforehead Lift below.

Buccal Fat Pad Excision - procedure to remove a small discrete fat pad in the cheek to streamline the appearance of the cheeks. Incision is inside the mouth, leaving no visible scars.

Capsular Contracture - this refers to the shrinkage of otherwise normal scar tissue surrounding breast implants, leading to a hard-feeling breast. An appropriate metaphor is “shrink wrap”. The exact cause of this problem is unknown. What is known is that it occurs with greater frequency when implants are placed above the pectoralis muscle vs below the pectoralis muscle, and with greater frequency when silicone gel implants are used vs. saline filled implants.

Cheek Augmentation - procedure to surgically enhance the size of the cheekbones, usually by placement of appropriate-sized silicone rubber prostheses through incisions either in the mouth or through lower eyelid incisions. They can also be implanted at the time of a facelift through the facelift incision.

Chin Augmentation - procedure to surgically enhance the size and improve the shape of the chin. Usually involves placement of a small silicone rubber or other type prosthesis through an incision inside the mouth or beneath the chin.

Collagen - A protein that comprises about 72% of the skin. Collagen is responsible for giving skin its strength. Collagen is a fibrous protein that is the main component of cartilage and provides the supportive structure.

Computer Imaging - specialized software enabling manipulation of images gathered with a digital camera, for purposes of communication and education, not to be implied as a warranty of surgical results, only as an educated estimate by the doctor.

Crow's Feet - term applied to wrinkles at the outer corners of the eyes extending out in a radial pattern like the foot of bird. The treatment is periodic injection of Botox.

Deep Venous Thrombosis - with long procedures and/or with inactivity in the recovery phase, clots can form in the deep veins of the legs and pelvis which can break off and float to the lung vessels, which can impair oxygen delivery and are potentially lethal. (Pulmonary emboli)

Dental Soft Diet – a diet composed of foods that can be swallowed without having to do much chewing. Examples of typical foods would include yogurt, pudding, oatmeal, small bite-size pasta, sherbet, jello, and most liquids. This diet is recommended to avoid moving the jaw after operations on or around the jaw.

Dermis - The inner layer of the skin which serves many important functions including fluid and temperature regulation, skin cell replacement, protection and removal of toxins.

Drain - small rubber tube placed temporarily during certain procedures to drain away unwanted blood and serum from the operative site. Attached to a small suction bulb to maintain constant vacuum suction in a closed system, it requires periodic emptying and accounting of output. Technical details are covered during the preoperative visit. Removed once the tendency to produce drainage diminishes by sliding it out through its small insertion site.

Endoscope - an illuminated tube, attached to a camera, that enables surgery to be done with only tiny incisions, using special instrumentation.

Endoforehead Lift - a procedure to raise eyebrows, reduce frown lines, and smooth forehead, using only small incisions.

Epidermis - The outer layer of the skin which provides protection against the elements. The epidermis replaces itself about every 45-75 days and is comprised of four layers: stratum corneum, granular layer, spinous layer and basal layer. The stratum corneum is the outer most layer and is primarily made up of keratin proteins. The basal layer is where the cells grow and divide.

Facelift - a procedure to elevate the soft tissues of the face, including the cheeks and neck to a more youthful position. The procedure is done to rejuvenate the aging face, and is done by making incisions concealed in folds around the ears, and usually utilizing a small incision beneath the chin. Corrects sagging skin, jowls, neck bands, and smooths creases in the skin, including to some extent the creases from the nostrils to the corners of the mouth.

Flap - term used to describe transfer of tissue from one part of the body to another part, with an established blood supply, either by leaving it attached, or by reconnecting blood vessels to the flap at the recipient site using microsurgery.

Frown lines - creases in the facial skin which develop over time from the repetitive action of facial muscle movement. Found most noticeably between the eyebrows. Treatment can be with either Botox injections (which are temporary), or more permanently with a Browlift.

Graft - term used to denote transfer tissue from one site of the body to another site, after detaching it from its native blood supply. Can be done with skin (skin graft), cartilage (cartilage graft), bone, etc. Requires the re-establishment of blood supply, and thus oxygen, to nourish the graft. When this occurs, the graft is said to have "taken". When grafts fail to take, or are broken down by the body’s immune system, they are said to have undergone “resorption”.

Homeopathic – refers to remedies of often herbal substances given in minute doses to prevent or reduce symptoms of a disease, or as is the case in plastic surgery, reduce the effects of normal physiological responses to the injury of surgery. Specifically, the administration of arnica montana and bromelain seem to reduce swelling and bruising with surgery. This is particularly useful with facial surgery, wherein one is unable to hide the effects of surgery with clothing. Dr. Creasman uses a product called Vitamedica (www.vitamedica.com/html/surgeryprogram.html), and recommends patients use it when undergoing facial procedures.

Homeopathy - The literal interpretation of homeopathy is “like treating like”. The principle behind homeopathy is that our bodies have natural defense mechanisms to aid in healing. This is often reflected as symptoms. While prescription medications tend to suppress symptoms, homeopathic medications try to elicit them. This approach helps to heal the body faster and is intended to stimulate a person’s overall resistance to infection.

Ideal Body Weight - Approximately 100 lbs. for females at height of 5’0”, adding 5 lbs. for every inch over five feet of height. For example, female standing 5’6” should ideally weigh 130 lbs.

Implant – refers to an implanted prosthesis which is made of a biomaterial of some kind, often of silicone rubber, but other materials have been used. The most commonly used prosthesis in plastic surgery is the breast implant. Other implants used include chin, cheek, and nasal. See prosthesis, below.

Implant Massage Exercises - Begun at 2-3 days after breast augmentation, displacement of the implant is done in the upward and inward directions, using the opposite hand of the side being moved. Hold the position of the implant in the upper pocket for 10 seconds and then hold it toward the breastbone for 10 seconds. Do the opposite breast. Repeat nine more times. Do 10 displacements of each side every other hour, while awake for the first 3-4 weeks after initiating the exercises. After the first month, you will need to do them only twice a day, forever. See Demonstration.

Inframammary - underneath the breast. Indicates the location of one of the possible incisions for breast enlargement, namely, under the breast.

Liposuction - procedure to remove fat from the subcutaneous layer of the body by utilizing small tubes, or cannulas attached to a vacuum apparatus. The fat is first injected with a very dilute local anesthetic (superwet or tumescent technique), after which very small incisions are made and the fat is then sculpted. Newer form is known as Ultrasonic Liposuction.

Mammoplasty - plastic surgery of the breast, whether by enlargement (augmentation mammoplasty) reduction (reduction mammoplasty) or lift (mastopexy).

Mastopexy - Breast lift procedure involving incisions into the skin, either just around the nipple and areola, or also involving a scar running down the central lower pole of the breast to the inframammary fold. May or may not involve use of a breast implant.

Midface Lift – refers to elevation of the tissues beneath the lower eyelid down to the corners of the mouth. Can be done one of two ways, depending on the anatomy of the patient and the preference of the surgeon. One method is to carry it out entirely through an lower eyelid incision. Another method is to make incisions in the scalp and in the inside of the mouth. Ideally this procedure elevates what is called the “lid/cheek junction” , moves the cheek mass upwards, and diminishes the depth of the crease from the nostril to the corner of the mouth (nasolabial crease). Often combined with Endoforehead lift. Midface lifts have no impact on jowls, and do not correct neck laxity. The scars are invisible to inconspicuous.

Otoplasty - procedure done to improve the appearance of the ears, usually for prominence or over projection of the ears. The incision is placed in the crease behind the ear, where is meets the head, and is barely visible. During the procedure, stitches are placed to shape the ear to lie closer to the head.

Periareolar - around the areola, which is the dark area around the nipple on the breast. Indicates the location of one of the possible incisions for breast enlargement, namely, around the lower one-third to one-half of the areola.

Photoaging - Changes in the skin such as wrinkling, sagging and discoloration as the result of exposure to the sun. Also known as “actinic” damage, it is estimated that over 90% of qualitative aging is a result of sun exposure. Surgery does not really address photoaging. This is best addressed through regular skin care. Surgery addresses quantitative aging, which is primarily the effect of gravity and animation on the soft tissues of the face and body.

Prosthesis – an artificial device to simulate or otherwise enhance a body part. There are various prostheses, some of which are external devices that are worn (e.g. artificial limbs, external breast prostheses), and some of which are implanted devices placed inside the body (e.g. breast, nose, chin, cheek, heart valve, hip joint). Implanted prostheses are commonly known as “implants”, as in “breast implants”.

By definition, prostheses are made of synthetic materials, including silicone rubber (Silastic), stainless steel, Dacron, etc. Body organs transplanted from another individual (e.g. kidneys), or tissue taken from one part of the body and moved to another part (e.g. skin) are not considered prostheses, but are known as grafts.

Pulmonary Emboli - clots that block blood flow in the lungs, thereby imparing oxygenation. (See Deep Venous Thrombosis)

Reduction Mammoplasty - procedure done to reduce the size of overly large breasts. Incisions placed around the areola and down the midline of the breast, and sometimes in the inframammay fold. Raises the position of and decreases the diameter of the nipple and areola. Sometimes covered by insurance plans, as it is frequently not a cosmetic, but rather a functional, procedure.

Resorption – refers to the breakdown of tissue or suture material from the body’s defenses. Often used to describe a tissue graft that has lost its bulk, e.g. a free fat graft that dissolves away along with the effect enhancing a skin depression or filling in of a wrinkle.

Rhinoplasty - procedure done to reshape the appearance and to sometimes functionally improve the nose. Can be done through incisions completely within the nose, but sometimes requires use of a small incision across the small vertical strip of skin on the underside of the nose called the columella.

Saline - salt water, a natural liquid similar in consistency to water. Used as a standard intravenous fluid. It is used as a filler in breast implants.

Silicone - a plastic material. When formed into a gel, it provides an excellent match for breast tissue and is used as a filler in breast implants. When formed into a slightly denser version, it is used as a shell for both silicone gel and saline implants. A solid form is used for implants for other parts of the body, including chin and cheeks.

SMAS - refers to the subcutaneous musculoaponeurotic system, an extension of the platysma muscle in the neck. Used in the facelift operation as a flap to elevate the cheeks, correct sagging jowls, and tighten the neck. Gives strength and longevity to the facelift procedure.

Subglandular - under the breast tissue or gland. One of the locations for breast implant placement. Also known as above the muscle because placement is above the pectoralis muscle but below the breast tissue.

Submuscular - under the muscle. Another location for placement of the implant, i.e., under the pectoralis muscle. Also called "subpectoral."

Suture – surgical thread material used to close wounds. Commonly referred to as “stitches”. These come in a wide variety of materials, many of which are broken down by the body (absorbed). The absorbable sutures do create more inflammation, so often removable material is used to close cosmetic operations so that less reaction is created. Suture removal is not painful. The timing of suture removal varies according to what part of the body is involved.

Symmetry – a term describing sameness of appearance between two sides of a person or two structures, e.g. eyes or ears, or breasts. Only a relative term when it comes to the human form; perfect symmetry is actually never seen.

Textured - Type of breast implant in which the outer surface, or shell, is rough and/or irregular instead of smooth.

Topical Silicone Gel Sheeting - commercial product used to painlessly treat surgical scars. Adhesive coated sheets applied to scar generate static electric charge which is thought to inhibit thickness of scar. Sold in our office, please call for pricing. For scars not able to use sheeting, silicone gel in a tube may be useful. (e.g. facelift scars)

Tumescent Technique - describes a technique of injection of high volumes of dilute local anesthetic into subcutaneous fat for the purposes of: 1. Providing local anesthesia (numbing); 2. Distending up the fat cells in order to magnify the thickness of the area to be treated with liposuction, thereby reducing the margin of error for creating contour irregularities; 3. Mechanically displacing blood from the area, which aids in reducing blood loss during liposuction; 4. Delivering epinephrine, added to the local anesthetic, to the area. Epinephrine causes vasoconstriction (squeezing down of blood vessels) which reduces dramatically the amount of blood loss during liposuction.

Ultrasonic Liposuction (UAL) - variation of liposuction, in which energy in the form of sound waves is used to break up fat cells, making extraction of fat less traumatic and more efficient. Results are often of superior quality in terms of the smoothness of the skin following the procedure than with traditional liposuction, particularly with certain areas of the body. Recently introduced in the U.S. in 1996, it has been in wide use in Europe for over ten years with excellent results. The long-term effect of the ultrasonic energy on the human body has not yet been established, but no adverse short-term consequences aside from those commensurate with the procedure itself, have been described. This procedure is somewhat more risky than traditional liposuction, but is safe in the hands of an experienced, board-certified Plastic Surgeon.

Vitamin - An essential nutrient that is required by the body and that must be obtained through diet or supplementation. Vitamins and minerals are essential components in enzymes (speed up reactions) and coenzymes (help enzymes in their chemical reactions). Vitamins can be classified into two groups: water-soluble and fat-soluble. Water-soluble vitamins must be taken into the body daily as they can’t be stored and are excreted within one to four days. Fat-soluble vitamins can be stored for longer periods of time in the body’s fatty tissue and liver.

Vitamin A - A fat-soluble essential nutrient that must be obtained through diet or supplementation. Vitamin A is an antioxidant that protects against cancer and is necessary for new cell growth. Prevents skin disorders and helps treat superficial wrinkles. Needed for maintenance and repair of epithelial tissue. Helps remove age spots.

Vitamin C - An important water-soluble essential nutrient that is important for antioxidant protection. Vitamin C plays a primary role in the formation of collagen and is needed for tissue growth and repair. This important antioxidant promotes the healing of wounds, protects against blood clotting and bruising. It also protects against the harmful effects of pollution, helps to prevent cancer and enhances immunity.

Vitamin D - Necessary for growth and development of bones & teeth. Important in prevention and treatment of osteoporosis. Required for proper absorption & utilization of calcium and phosphorus.

Vitamin E - Important antioxidant that prevents oxidation of fats and Vitamin A. Promotes healing, healthy skin and hair. Retards aging, enhances UV blockers in sunscreen and is a natural moisturizer. Vitamin E is composed of a compound called tocopherols. Of the eight tocopherols, the most effective is d-alpha-tocopherol.

Vitamin K - An essential nutrient needed for bone formation and repair and for blood clotting. Vitamin K, along with Vitamin D and calcium, play an important role in the prevention of the bone thinning condition called osteoporosis.

Vitamin B1 - An essential nutrient that is part of the “B-complex” family. Also known as thiamine, vitamin B1 is known as the “morale vitamin” because of its beneficial effects on the nervous system and mental attitude. B1 also enhances circulation, aids digestion (especially carbohydrates), and promotes growth.

Vitamin B2 - An essential nutrient that is part of the “B-complex” family. More commonly referred to as riboflavin, vitamin B2 promotes healthy skin, nails and hair. B2 also aids in the metabolism of carbohydrates, fats and proteins. B2 is necessary for red blood cell formation, antibody production, cell respiration and growth.

Vitamin B3 - An essential nutrient that is part of the “B-complex” family. More commonly referred to as niacin, vitamin B3 is necessary for proper circulation and healthy skin. B3 aids in functioning of the nervous system, in promoting a healthy digestive system and reduces cholesterol and triglycerides.

Vitamin B5 - An essential nutrient that is part of the “B-complex” family. Also referred to as panthothenic acid and the “anti-stress” vitamin, B5 plays a role in the production of adrenal hormones. B5 is essential for the conversion of fat and sugar into energy and is necessary for the synthesis of antibodies.

Vitamin B6 - An essential nutrient that is part of the “B-complex” family. Also known as pyridoxine, vitamin B6 helps with the digestion of fats and protein and maintains the sodium and potassium balance in the body’s cells. B6 promotes red blood cell formation and aids in the prevention of arteriosclerosis.

Vitamin B12 - An essential nutrient that is part of the “B-complex” family. Also known as cobalamin, vitamin B12 helps in the development and maintenance of nerves. B12 is needed to prevent anemia and aids folic acid in regulating red blood cells and helps in the utilization of iron.

Zone Diet – a diet developed by Dr. Barry Sears, Ph.D., and based on a balance of carbohydrate, protein, and fat in a ratio of 40%, 30%, 30% respectively. Dr. Sears has written several books, including Enter the Zone, and Mastering the Zone. There are starter kits and informational materials available on the Zone website at www.zoneperfect.com.

Frequently Asked Questions & Glossary

FAQs on Breast Enlargement:

FAQs on Eye (Blepharoplasty):

FAQs on Face Lift:

FAQs on Liposuction:

FAQs on Nose:

FAQs on Tummy (Abdominoplasty):

Glossary - Frequently Used Terminology