Plastic surgery

Staten Island University Hospital offers exceptional expertise in cosmetic procedures including the following:

Also known as a "tummy tuck," abdominoplasty is a surgical procedure to remove excess skin and fat from the middle and lower abdominal area and tighten the abdominal muscles.

The most common causes of a protruding abdomen include:

• Pregnancy
• Aging
• Significant fluctuations in weight
• Heredity
• Prior surgery 

When exercise and weight control alone are not enough to attain a taut and toned abdomen, abdominoplasty may help. It can dramatically reduce the appearance of a protruding abdomen and result in a smoother, flatter tummy. 

Frequently asked questions

Who are the best candidates for abdominoplasty?
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 and exercise. We suggest that patients who are considerably overweight postpone the surgery and try to lose weight first. Women who are planning future pregnancies should also wait until after childbearing, as muscles in the abdomen that are tightened during surgery can separate during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

What are the risks?
There are risks associated with any surgical procedure and you should discuss them with your surgeon. Specific complications associated with abdominoplasty are rare but may include postoperative infection and blood clots. Poor healing, which results in conspicuous scars, may necessitate a second operation. If you are a smoker, your surgeon will require that you quit before surgery as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon's instructions before and after surgery, especially regarding when and how you should resume physical activity.

How do I prepare for surgery?
During your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. There are different procedures that your surgeon might recommend based on the extent of your fat deposits. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also known as a mini-tummy tuck. This procedure can often be performed on an outpatient basis. On the other hand, you may benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips for a better body contour. Or maybe liposuction alone would create the best result. Be sure to tell the surgeon if you smoke and if you're taking any medications, vitamins or other drugs. You should arrange for someone to drive you home after surgery and to help you out for a day or two after you leave the hospital.

What happens during surgery?
Abdominoplasty is usually performed under general anesthesia. Some surgeons use local anesthesia combined with a sedative to make you drowsy. In that case, you'll be awake but relaxed, and your abdominal region will be insensitive to pain, although you may feel some tugging or occasional discomfort. An incision is made just above the pubic area. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. Those muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

What happens after surgery?
For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort, which can be controlled by medication. You may be released within a few hours or you may have to remain hospitalized for two to three days. Your doctor will give you instructions for showering and changing your dressings. You may not be able to stand straight at first, but you should start walking as soon as possible. Surface stitches will be removed in five to seven days, and deeper stitches, with ends that protrude through the skin, will be removed in two to three weeks.

It may take weeks or months to feel like your old self again. Some people return to work after two weeks, while others take three to four weeks to rest and recuperate. Exercise will help you heal better. People who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise should be avoided until you can do it comfortably. Scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color.

Will the surgery be covered by my insurance?
In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should always check your policy to be sure.

Eyelid surgery can correct drooping upper lids and puffy bags below your eyes that make you look older and more tired than you feel and may even interfere with your vision. Technically called blepharoplasty, the procedure removes the skin—and sometimes fat and muscle—from the upper and lower eyelids. Eyelid surgery can be performed by itself, or in conjunction with other facial surgery procedures like a facelift or brow lift.

Frequently asked questions

Who are the best candidates for eyelid surgery?
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, 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.

What are the risks?
As with all surgical procedures, there are risks. Your doctor will discuss these risks with you. Medical conditions including thyroid problems, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes may create more risks for this kind of surgery. A detached retina or glaucoma is also a reason for caution; check with your ophthalmologist before you have surgery.

The minor complications that occasionally follow eyelid surgery include double or blurred vision for days, temporary swelling at the corners of the eyelids, and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out—your surgeon can remove them easily with a very fine needle.

Some patients may experience dryness or itchiness of the eyes, which may be caused by failure of the eyelids to completely close during the healing process. This can be treated with eye drops and ointment. People who have dry eyes before surgery are at greater risk of this happening.

Following surgery, some patients may have difficulty closing their eyes when they sleep. In rare cases, this condition may be permanent. Another very rare complication is ectropion, a condition where the lower lid pulls away from the eyeball. In this case, further surgery may be required.

Where is the surgery performed and what kind of anesthesia is used?
Eyelid surgery is performed in an operating room with local anesthesia and intravenous sedation. You'll be awake during the surgery, but relaxed and insensitive to pain. You may feel some tugging or occasional discomfort.

What happens during surgery?
The surgery usually takes one to three hours, depending on the extent of the work involved. If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids—in the creases of your upper lids and just below the lashes in the lower lids. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine stitches.

If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure, the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

What happens after surgery?
After surgery, your surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with pain medication prescribed by your surgeon. If you feel any severe pain, call your surgeon immediately.

You should keep your head elevated for several days and use cold compresses to reduce swelling and bruising. Bruising varies from person to person; it reaches its peak during the first week and generally lasts anywhere from two weeks to a month. You'll be shown how to clean your eyes, which may be gummy for a week or so. Many doctors recommend eye drops since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks, you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

Your surgeon will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once the stitches are removed, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better.

How long is the recovery?
You should be able to read or watch television after two or three days. However, you won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.

Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the remaining bruising. You may be sensitive to sunlight, wind and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.

Keep your activities to a minimum for three to five days; avoid more strenuous activities for three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol since it causes fluid retention.

Will there be scars?
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, they'll fade to a thin, nearly invisible white line.

Breast augmentation—also known as augmentation mammaplasty, breast enlargement or breast implants—is an effective way to increase or restore the size and shape of a woman’s breasts through the use of implants.

You may want to consider breast augmentation to:

• Correct a reduction in breast volume after pregnancy
• Balance breasts that are different sizes
• Provide reconstruction following breast surgery
• Enhance breast size

Frequently asked questions

Who are the best candidates for breast augmentation?
The best candidates for breast augmentation are women looking for improvement, not perfection. If you are physically healthy and realistic in your expectations, you may be a good candidate. In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift.

How large can my breasts be made? 
Usually, your bust line can be increased by one bra cup size or more. Your surgeon will talk with you about your options.

What are the risks? 
Although this is a relatively straightforward procedure, any time we do surgery there are some risks involved with proper healing. For discussions on any specific complications that may be involved, you should talk with your surgeon during your initial consultation. All risks can be reduced by choosing a board-certified plastic surgeon to perform your procedure.

Where will my surgery take place? 
The surgery is performed in an operating room and, in most cases, is done under general anesthesia. It takes about one to two hours to complete.

What happens during surgery? 
There are several different methods for inserting the implant, all of which depend upon your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple) or in the armpit. Regardless of the incision location, every effort will be made to minimize scars.

After the incision is made, the implant is carefully inserted either under the breast tissue or beneath the chest muscle. The implants are then adjusted to ideal size and symmetry before the incision is stitched closed.

What determines whether the implant will be placed under the muscle or the skin?
Often a woman wants a lift along with the augmentation. If so, the implant is often put under the skin, or a skin tuck is done. You and your doctor will make the final decision as to the location of the implant. Your doctor will go over the risks and complications for each option, helping you make an informed decision.

What types of implants do you use? 
At Staten Island University Hospital, we use either saline or silicone implants. The type of implant used depends on a number of factors, which should be discussed by you and your surgeon.

What is the recovery time? 
Following surgery, you're likely to feel tired and sore for a few days. Most of your discomfort can be controlled by medication prescribed by your doctor. You will be advised to take it easy the night after surgery, as bleeding around the implant can sometimes occur. It will take about three weeks for the swelling and discoloration to subside.

Within several days, your doctor will remove any gauze dressings and give you a surgical bra. You should wear it as directed. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

Where your implant is placed—under the breast tissue or under both breast and muscle—will, to a great extent, determine when you can return to work. Usually, if it is placed under the skin, you will be able to return to work in one week. If it's under the muscle, you can expect to be out of work for two weeks. In either case, it will be close to six weeks before you can participate in fitness activities other than walking or treadmill activity.

Does a breast augmentation leave visible scars?
Your scars will be firm and pink for at least six weeks. The scars may remain this way for several months or even appear to widen. After several months, however, your scars will begin to fade, although they will never completely disappear.

When a woman must have a breast removed (a procedure called a mastectomy) or a portion of a breast removed (called a lumpectomy), helping her return to a sense of normalcy is important. The doctors at Staten Island University Hospital’s Division of Plastic and Reconstructive Surgery understand this and provide compassionate and highly skilled breast reconstruction services. Our patient-focused surgeons use different techniques to create a breast that closely matches the shape, size, and feel of your own breast.

After careful consultation with your healthcare team, your surgeon will help you decide your best course of action. Should you decide to proceed with breast reconstruction surgery, considerations will include whether to do it at the same time as the mastectomy or lumpectomy or at a later time. The state of your health and any other treatments you might be undergoing will factor into this decision.

Immediate breast reconstruction
Immediate breast reconstruction can have both emotional and visual advantages. Some women find that waking up from a mastectomy with two breasts helps to ease the grief caused by losing a breast. Another advantage is that your surgeon can use a technique that results in less scarring.

Delayed breast reconstruction
You may need to wait for reconstruction until after you have completed other treatments. For example, you should not have reconstruction until at least six months after completing radiation therapy and at least two to four weeks after chemotherapy. Delayed breast reconstruction allows you more time to explore your options. It can be performed weeks or even years after having a mastectomy.

Our approach
We use cutting-edge methods to reconstruct the most natural breast possible, including:

• Autologous tissue flap (using your own skin, muscle and fat to create a new breast)
• Breast implants filled with saline or silicone
• Fat grafting to correct minor deformities
• Skin-sparing mastectomy to preserve most of the breast skin and potentially preserve the nipple
• A combination of these methods

For more information, call (718) 226-6780.

A brow lift minimizes some of the visible signs of aging by smoothing wrinkles and furrows in the forehead and raising sagging eyebrows. Our surgeons use the latest in minimally invasive techniques to reduce your recovery time and lessen scarring.

Frequently asked questions

Who are the best candidates for a brow lift?
Although this procedure is best for people in their 40s to 60s, it can also help people with inherited conditions like a droopy brow or furrowed lines above the nose. It can be done alone or in conjunction with a facelift, eyelid surgery or reshaping of the nose.

What are the risks?
As with all surgical procedures, there are some risks. Your surgeon can discuss specific risks with you during your consultation. A few of the rare complications associated with brow lifts include injury of nerves that control eyebrow movement, hair loss along edges of the scar, bleeding, and infection. You can minimize post-surgery complications by following the directions provided by your surgeon.

Where will the surgery take place?
Most often brow lifts are done on an outpatient basis in ambulatory surgery under local anesthesia (meaning that you are awake during the procedure). Some physicians and patients prefer to do the procedure under general anesthesia so you are asleep for the entire procedure.

What happens during the procedure?
There are two different methods of performing a brow lift. During the classic brow lift, the surgeon makes an incision behind the hairline of the scalp from above the ear on one side to the same position on the other side. The entire forehead is lifted and some of the forehead muscles are interrupted to reduce wrinkling. The skin is then tightened, the excess skin is removed and the incision is closed.

At Staten Island University Hospital, we often use a newer approach to this surgery called endoscopic brow lift. Rather than making one long incision, your surgeon will make three, four or five short scalp incisions, each less than an inch in length. A thin, fiber-optic telescope (an endoscope) connected to a television monitor is inserted through one of the incisions, providing the surgeon with a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance. The eyebrows may also be lifted and secured into their higher position by stitches beneath the skin's surface or by temporary fixation screws placed behind the hairline. When the lift is complete, the scalp incisions will be closed with stitches or clips.

How will I feel after surgery?
After surgery, you might have some local numbness and itching of the forehead and scalp and weakness of the forehead muscles, but these symptoms are rarely permanent. Hair will not grow in the scar area.

What is the recovery time?
You should be up and about in one to two days. However, you should plan to take it easy for a least a week following your surgery. As soon as your bandages are removed you should be able to shower and shampoo your hair; this usually takes place within one to two days. Most patients return to work within seven to 10 days. Vigorous activities like jogging, heavy housework, bending or any activity that increases your blood pressure should be limited for several weeks. Prolonged exposure to heat or the sun should be limited for several months. Most visible signs of the surgery should fade within two to three weeks. Minor bruising can be almost immediately covered with special camouflage makeup. As with any surgery, it is normal to feel a bit tired after the procedure. This will fade when you begin to look and feel better.

Does a brow lift leave any visible scars?
When receiving the classic brow lift, the incision will start at the level of your ears and run across the top of your forehead. By wearing your hair down on your forehead, most scars become relatively inconspicuous. If you are bald or balding, your surgeon may recommend a mid-scalp incision so the scar follows the natural junction of two bones in your skull. Endoscopic brow lift produces very small scars, which are usually hidden in the eyebrows and hairline.

How long do the results of this surgery last?
Recent advances in plastic surgery have made the brow lift a relatively simple procedure with results that last from five to 10 years or longer.

Liposuction is a process that removes excess fat deposits from targeted areas of the body. It works best after you have already reached a desirable weight through diet and exercise. Then, if there are still localized areas where unwanted fat remains, our surgeons can perform liposuction to help you attain a more desirable body contour.

Some common areas of the body where liposuction can be effective are stomach, chin, neck, cheeks, upper arms, above the breasts, buttocks, hips, thighs, knees, calves and ankles.

Frequently asked questions

Who are good candidates for liposuction?
The best candidates for liposuction are close to their normal weight but still have pockets of excess fat in certain areas of their body. Firm, elastic skin usually responds better to this kind of procedure. Liposuction poses a greater risk for men and women with medical problems such as diabetes, heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be worked on.

Does liposuction help with cellulite?
No, liposuction by itself will not improve the dimpled skin known as cellulite.

What are the risks?
As with any surgery, there are some risks. Some complications that may result from liposuction include uneven skin surface (especially with non-elastic skin), numbness, discoloration, and fluid/blood accumulation under the skin. While liposuction is generally a safe procedure, the risk of complications increases with the number of areas treated. We urge patients to be realistic about the limitations of the procedure and what they hope to achieve.

Where will the surgery take place?
Most often the procedure will be performed in our minor surgery suite. It will be done in the operating room if you have too much excess skin or if your muscles are very weak, therefore requiring other procedures to go along with the liposuction. When the operating room is used, patients may require a hospital stay of one to three days.

What kind of anesthesia is used?
If the procedure is not extensive, you may have local anesthesia, which will numb the area being worked on. You will also be given a sedative about 30 minutes prior to your surgery. Although you'll be awake for the procedure, you will be relaxed and should only feel minor discomfort. If the procedure involves a large area of your body or a number of areas, you'll be given general anesthesia so you'll sleep through the entire operation.

What happens during surgery?
A tiny incision is made in the skin. A narrow tube, called a cannula, is inserted and maneuvered through the fat tissue, breaking up fat cells. This tube is attached to a high-vacuum hose, which suctions out the unwanted fat. When the desired amount of fat has been removed, the incisions are closed and dressings are applied.

How long is the recovery period?
Recovery from liposuction is a slow and gradual process. Most patients are able (and encouraged) to move about after surgery to reduce swelling and help prevent blood clots from forming in the legs. Depending on the amount of fat removed, some patients may require a few extra days of bed rest. Most patients begin to feel better after one to two weeks and are able to return to work within one week.

Strenuous activity should be avoided for one month. Your surgeon might recommend a tight fitting girdle to reduce swelling. Most of the bruising and swelling will disappear within a few weeks, but some swelling may last up to six months.

Depending on the amount of swelling, you may be able to notice some of the results of the surgery immediately after the procedure. After four to six weeks, you'll notice a greater improvement as most of the swelling and bruising will have subsided. After about three months, you'll be able to notice the final results.

Does liposuction leave any visible scars?
Any scars that result from the surgery are small and usually well hidden from view.

A breast lift (called mastopexy) is a surgical procedure to reshape and raise breasts that are sagging due to pregnancy, nursing or aging. It can also make the size of your areola (the darker skin surrounding your nipple) smaller.

Frequently asked questions

Who are the best candidates for a breast lift?
The best results are usually seen in women who have smaller breasts, although breasts of any size can be lifted. With larger breasted women, the results may not last quite as long simply because the weight of the breast itself is conducive to sagging. If you are planning to have more children, it's best to postpone this kind of procedure.

What are the risks?
As with any surgery, there are some risks. Your surgeon will discuss specific risks based on your individual case. You can reduce your risk of complications by closely following your surgeon's instructions before and after surgery, especially regarding when and how you should resume physical activity. It is important that you do not smoke for a while before or after the procedure. Smoking often results in poor healing and wider, more visible scars.

Where will my surgery take place? 
Most often breast lifts are performed in an operating room under general anesthesia.

What happens during the procedure? 
There are several different methods used to perform a breast lift. Your surgeon will review these with you in detail and recommend which one is best for you based on several factors. A breast lift can take anywhere from one and a half to three and a half hours to complete. No breast tissue is removed, so you will remain the same size, although your breasts will seem larger because the skin is tightened.

What is the recovery time? 
After surgery, your breasts will be bruised, a bit swollen, and somewhat uncomfortable for a few days. The pain shouldn't be severe. Your surgeon will cover the treated area with bandages or a surgical bra (placed over gauze), which will be replaced by a soft support bra after a few days. You should wear this bra 24 hours a day for the next three to four weeks.

After surgery, your nipples and breast skin might be numb - a result of the swelling and surgery. As the swelling decreases, the numbness will also begin to fade. In some patients, the numbness may last up to a year or longer. About 10 days after surgery, your stitches will be removed. Although you'll probably be up and about within the first couple of days, you shouldn't plan on returning to work for at least one or two weeks. You must also avoid lifting anything over your head for three to four weeks.

What results can I expect?
You will see an immediate “lift” of sagging breasts. A breast lift is not permanent. The effects of gravity, aging and weight fluctuations will eventually cause sagging again. Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller, consider breast lift and augmentation surgery. If you want smaller breasts, consider combining breast lift and reduction surgery.

Does a breast lift leave any visible scars?
Breast lifts do leave some scars but they will not be visible if you are wearing a bathing suit or bra.

Rhinoplasty is the surgery of the nose. It is the most common of the plastic surgery procedures and can provide relief for people who have breathing problems due to a birth defect or injury. As a cosmetic procedure, it may also be the answer for people who feel that their nose doesn't fit their face. Our world-class surgeons work to create a natural looking nose by reshaping, decreasing, or enhancing the patient's original nose. The surgery can be tailored to your own individual needs and what you hope to achieve.

Frequently asked questions

Who are the best candidates for rhinoplasty?
The best candidates for rhinoplasty are people looking to improve their features, not achieve perfection. As with all cosmetic surgery procedures, it's important to discuss your expectations with your surgeon.

What are the risks?
As with any surgery, there are some risks involved with proper healing. When performed by a board-certified plastic surgeon, complications with rhinoplasty are infrequent and minimal. After surgery, small burst blood vessels may appear as tiny red spots on the skin's surface; these are usually minor but may be permanent. Your surgeon will discuss other risks and possible complications with you during the consultation.

Where will my surgery take place and what kind of anesthesia is used?
Most often rhinoplasty procedures are performed in an operating room using general anesthesia.

What happens during surgery?
Most rhinoplasties are performed on an outpatient basis and usually take an hour or two depending on the extent of the correction. First, the skin of the nose is separated from the bone and cartilage. Then, the surgeon sculpts the bone and cartilage to the desired shape. The skin is then re-draped over the reshaped nose.

Depending on the desired outcome and the patient, rhinoplasty can either be performed from inside the nose (all incisions are made inside the rim of the nostrils), or from the exterior base of the nostrils, also called an "open" procedure (this is usually reserved for more complicated procedures).

When the surgery is complete, a splint is applied to help the nose maintain its new shape. Nasal packs or soft plastic splints may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

What happens after surgery?
After surgery, particularly during the first 24 hours, your face will feel puffy, your nose may ache, there may be some bruising around your eyes, and you may have a dull headache. You can control any discomfort with pain medication prescribed by your surgeon. You should stay in bed with your head elevated for the first day.

The swelling and bruising around your eyes will reach its peak two or three days after surgery. Cold compresses will reduce the swelling and may help you feel better. Most of the swelling and bruising should disappear within two weeks.

A little bleeding from your nose is common during the first few days after surgery, and your nose might also feel stuffy for several weeks. You should refrain from blowing your nose for a week or so while the tissues heal.

If you have nasal packing it will be removed after a few days and you'll feel much more comfortable. Usually, by the end of the first week after surgery, all dressings, splints, and stitches will be removed.

How long is the recovery period?
For the first 24 hours, you should plan to stay in bed with your head elevated. Most patients are moving around within two days after surgery. You should be able to return to sedentary work within a week to 10 days after the procedure. It will take several weeks for you to return to your daily routine.

Does rhinoplasty leave any visible scars?
When rhinoplasty is performed from inside the nose, there is no visible scarring. When an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, there will be small scars on the base of the nose. These scars are usually not visible.