If you have been wanting to improve the look of your body so that you can be ready for the summer in time to wear a bikini, NOW is the time to do something about it!  Dont wait until the weather starts heating up, if you have your surgery now, you have the time to recover, heal, AND start exercising to be in you best shape when summer arrives.  Whether you will benefit from breast implants, a breast lift, liposuction or tummy tuck, now is the time to schedule your consultation with Dr. Amy T. Bandy, and find out what results you can achieve.  Call us today to schedule your consultation. Look your best for summer!

Board Certified Plastic Surgeon Dr. Amy T. Bandy Prides herself in being considered one of the Premier Plastic Surgeons in Newport Beach, California. Dr. Bandy enjoys educating her clients on what to expect with Plastic Surgery.

Because most people are not familiar with the normal course of healing after Plastic surgery or other medical situations, they tend to panic when anything seems “not normal” to them. This means anything that they don’t normally experience in their lives on a daily basis. For example, patients do not consider swelling, bruising, redness, and discomfort normal. Following surgery, surgeons and medical personnel DO consider swelling, bruising, redness, and discomfort normal since it is an expected part of healing.

Using good common sense will tell you that if an area has recently been operated upon, it is going to go through a healing process. Having surgery is not like going to the beauty salon for a haircut. Healing occurs in the human body by a process called inflammation. Inflammation consists of four components, which in Latin are: rubor, calor, and dolor.

1. Rubor means redness. For proper healing, blood vessels dilate and carry extra blood to the area that had surgery. This causes redness in the area.

2. Tumor means swelling. An area that has had surgery is expected to swell. This is a normal part of the inflammatory process by which we heal.

3. Calor refers to heat (like calories). This means that an area that has recently had surgery is expected to be warmer than it normally is until healed.

4. Dolor means pain. An area that recently had surgery is expected to cause discomfort. This is a normal warning system that makes an area tender to touch so that you will not disturb it while it is healing. This is a protective kind of pain.

Following surgery, most of the instructions that we give are designed to protect your blood vessels. This is to prevent postoperative bleeding. Excess straining, lifting, bending, working out at the health club, etc., will cause your blood vessels to dilate and may cause bleeding or excess swelling. At the time of the surgery, many blood vessels are divided and then sealed with an electrocautery. They do not heal together strongly, however, for approximately two weeks following surgery. If you do something strenuous you may “blow out” a healing blood vessel and cause bleeding underneath the skin which is referred to as a hematoma. If this occurs, it might require going back to surgery to repair the damage which would start the healing from the beginning. For this reason, it is sensible to limit your athletic activities for the full two-week period.

The right and left sides of the body do not heal the same. One side always swells more, hurts more, gets more numbness, or exhibits some difference over the healing period; this is normal and temporary. Example: if both eyelids have surgery, one eyelid always swells more, one side feels more numb, one side is stiffer, one side moves better than the other, etc. This may make them look quite different. These differences occur in the two sides of the face, two breasts, two hips, in the feet, or even the two sides of the same nose.

After the surgery, you have been instructed to telephone my office when you have questions that require explanation. Questions like “When can I take a shower?” Or, “Do I remove my bra to take a shower?” are certainly IMPORTANT, but they do not represent EMERGENCY questions. Important questions are to be directed to my office during standard office hours, 9:00 a.m. to 5:00 p.m., Monday through Friday. We are available to respond to EMERGENCY calls 24 hours a day. Emergency calls will include things like:

1. Excessive bleeding.

2. Sudden painful swelling of one operated area with associated bruising (this does not mean slight swelling and bruising, this means what it says, sudden excessive painful swelling).

3. Fainting or loss of consciousness.

4. Excessive vomiting which is not controlled by medication.

5. Skin rash which covers a large portion of the body (not an occasional red bump).

During the time of healing, when the normal inflammatory processes and swelling distort the tissues, it is virtually impossible for you to determine what you final result will be. Do not be impatient. When you see the swelling and distortion of the tissues, please understand that this is NORMAL during early healing (at least two weeks). It is also temporary. For instance, when cheek implants or chin implants are placed, there is a considerable swelling around them during the early weeks following surgery. This does not mean the implants are two large, or that they are
malpositioned. It means that your body is healing normally and has swelling around the implants. How long will the swelling last? It varies form one patient to another, but may persist in the cheekbone areas or chin areas for a month or two. Not two days – not five days – but a month or two.

BREAST IMPLANTS, which are placed behind the muscle, may require three months or more before the muscle stretches out and allows the breast to shape itself the way it finally will be. Actually, it requires three to twelve months before the final shape is achieved. It is impossible for you to tell the exact size and shape that your breast will be or the size of the breast implants, which are used during the first few weeks after surgery. This is due to tightness of the pectoral muscle, tightness of the skin and breast tissue over the implant (which makes them look smaller) and swelling (which makes them look larger) than the final result will be. The implant which was used is the one agreed upon at you preoperative consultation, and will give the result which you selected by looking at photographs. During early healing, however, your breast may appear larger than you think you selected, or smaller than you think you selected, depending on you own tissues. Please give them time to heal normally before panicking. All of these things will be discussed at your regular postoperative appointments, and do not require a phone call in the middle of the night or over the weekend. Actually, it requires three to twelve months before the final shape is achieved. Not three days, not ten days, anywhere from three months to a year.

NASAL SURGERY the lower one third of the nose requires approximately 12 months to lose all of the swelling which occurs following surgery. Patients find this very hard to understand, and while the nose will show marked improvement within two to three weeks following surgery, the nose will not refine itself or lose all of its swelling for at least one year. Mark the date on your calendar. Not two weeks, two months – one year.

EYELID swelling normally goes down pretty fast, and eyelids often look good within a week or two. They are not healed in a short time, however the eyelids normally feel stiff for at least six to twelve weeks following surgery, especially when you attempt to look up.

Following FACELIFT surgery, there is a numbness of the cheeks and around the ears from six weeks to one year, This numbness gradually goes away, but is part of the normal healing process. Minor lumps may be felt beneath the skin, and the face and neck may feel stiff for six to twelve weeks.

You are not expected to know everything about how you will heal after surgery; however you are expected to use good common sense.

I hope that this explanation helps explain what you can anticipate following your surgery. Please follow your instructions, but use your own common sense as well to help us help you heal the way we both want.

To achieve the best breast shape often requires lifting the breasts to a youthful position.  With weight loss, pregnancy, breast feeding and the aging process, gravity continually affects the position of the breasts.  The skin becomes loose, and the underlying breast tissue descends to a lower position on the chest wall.  Breast lift, or mastopexy, is performed to tighten the skin and lift the breasts higher to give a tighter more youthful shape.  There are several types of mastopexy incisions to accomplish this result, and the amount of loose skin and how low the nipples are positioned on the breast will determine which lift procedure will ultimately result in the best end result for each person.

Facelift surgery, or Cervicofacial rhytidectomy is performed to correct the changes which have occurred with the normal process of aging. Facial skin can sag from natural aging, from weight loss, from the effects of smoking and sun exposure or other various reasons. With a successful facelift, the tightening of the facial skin and supporting tissues can “turn back the clock” and provide a more youthful appearance.

The ideal candidate for a facelift is a person who is at or near their ideal body weight. With strong bony features of the face, there is no need to augment the bone structure, however if you have a “weak chin” or small cheekbones, Dr. Bandy may discuss the options with you at the time of your consult, to consider a small implant to amplify these features. The best patient for a facelift is a non-smoker and has not had a history of excessive sun exposure or skin cancer. If you do smoke, you will be asked to refrain from smoking for at least three weeks prior to surgery to prevent possible complications.

In the individual who smokes, is overweight or who does not have prominent facial bones, you can still receive some benefit from a facelift if your expectations are realistic, however you may not have the ideal outcome as seen in the ideal patient. Dr. Bandy will discuss the expectations with regard as to what you can expect with a facelift as it pertains to you individually. Although a successful facelift can turn back the clock, no cosmetic procedure can permanently forestall the effects of aging. Some patients will require additional procedures to achieve the results that they desire, such as a chemical peel or blepharoplasty or eyelid lift. Other procedures that may benefit you are a browlift or laser skin resurfacing.

ANESTHESIA
A facelift is usually performed on an outpatient basis. Although some patients prefer to stay at an aftercare facility, most go home the same day with a responsible friend or family member. The procedure can be performed under a general anesthetic, or can be done with local anesthesia under IV sedation providing a “twilight sleep”.

THE OPERATION
A facelift requires an incision which starts in the temporal area and extends down in front of the ear, curving under and behind the ear and back into the hairline of the back of the head. If a browlift is performed at the same time, the incision may continue over the top of your head to allow lifting of the forehead and eyebrows. The skin is lifted and tightened and some of the supporting tissues deep to the skin may also be tightened. In some instances, the incisions can be much smaller and the surgical dissection performed through very small incisions. This is done when excess skin is not an issue. Liposuction is sometimes done if there is excess fatty tissue under the skin of the neck or jawline. Occasionally if there are noticeable muscle strands in the neck, another small incision is made under the chin so that Dr. Bandy can repair the muscles and provide a tighter neck and jawline.

POST-OPERATIVE COURSE
Swelling and bruising is to be expected and varies from person to person. Typically the bruising is nearly or fully resolved in 10-14 days. Sutures are removed at 3-5 days around the ears, and at about 10-14 days in the hairline. It is extremely important that the newly rejuvenated skin be protected from the effects of the sun by wearing a wide brimmed hat and a SPF sunscreen of 20 or higher whenever going outside. If you are considering a facelift procedure, an individual consultation with Dr. Bandy can provide you with valuable information that can help you decide what is best for you. An appointment can be arranged by calling the office at (310) 214-8400.

Ear Enhancement Surgery- Dr. Amy Bandy Board Certified Plastic Surgeon

Surgery to correct protruding ears may be considered either reconstructive or cosmetic. To determine this, we must consider the function of the external ear. There are two main purposes of the external ear. The first is to help direct sound waves to the external auditory canal, thereby improving our ability to hear. Another important function of a highly visible body part such as the ear is to fall into the normal range of appearance. Ears that protrude straight out from the head do so because of abnormalities in the development of the cartilage of the ear. Such irregularities often attract unwanted attention, and children can often suffer criticism from their peers and be made the center of attention of cruel jokes and name-calling. Although some people overcome denigrating remarks and attitudes, there are more people who fade quickly into the background and hide from the attention. The degree of the deformity can range from mild to severe. The deciding factor on when a child warrants reconstructive surgery to correct their ears, is when their protruding ears are the first things that people notice when they initially meet the child.

Our awareness of body image regarding our facial features is usually evident by the age of five. This is exactly when children are starting school and making new friends and establishing how they fit into the world around them. If children begin name-calling, this can negatively affect the important self-image that the child is building of himself. The ear has completed 85 percent of its growth by the age of three. There is very little growth of the ear after age 10. Correction of the protruding ear is generally carried out from age 4 onward, depending on when the patient presents for surgery. More adults are opting to correct protruding ears for cosmetic reasons and the results can be quite gratifying, allowing for more of a variety of hairstyles than they previously felt comfortable with.

There are a number of factors in the development of the ear cartilage that affect the shape of the ear. In the majority of cases, there is a combination of too much cartilage in the central “bowl” area called the concha, combined with a lack of natural folds that develop in the area called the antihelix. There are other deformities of the ear that range from complete absence of the external ear to “cupping”or constricted ears. These are deformities that are addressed differently than the protruding ear. There are a variety of surgical techniques that address the protruding ear, and the appropriate procedure will depend on the degree of excess cartilage, the failure of antihelical folding and which of these two problems dominates the defect.

THE CONSULTATION
During your initial consultation with Dr. Bandy, your specific requests and desires are discussed and an individual examination is performed to determine the appropriate surgical procedure to be performed. Dr. Bandy will make recommendations and discuss your individual procedure and expected outcome in detail. This is your chance to ask questions, and verify if the procedure is right for you or your child.

THE OPERATION
Most otoplasties are performed on an outpatient basis, coming to the surgical facility the day of surgery and returning home the same day. Young children will require a general anesthetic and some older patients may prefer this as well. The incision for the surgery is generally hidden behind the ear or in the folds of the ear. The procedure is aimed at recontouring the cartilage to the normal configuration and this is attained by removing excess cartilage in some cases, and by placing permanent buried suture to fold the ear framework in other cases. It may be necessary to wear an elastic headband for a period of time after the procedure to allow healing. As with any surgical procedure, there are possible complications, and although rare, these will be discussed with you in detail at the time of your initial consultation. To arrange for a personal consultation with Dr. Bandy, call the office at (310) 214-8400.

Today women have many choices available to them when considering breast augmentation.  Some women never develop to be the shape and size that they desire, and seek surgical enhancement to augment their natural breasts. Additionally, many women experience loss of breast fullness post partum or after breast feeding or weight loss and have noticed that their breasts have lost their shape and have flattened and moved lower on their chest wall.  Depending on how much droop or “ptosis” exists, they have a choice between implants alone to fill the lost volume, or a breast lift in addition to the breast augmentation.  Occasionally when there is sufficient breast tissue remaining but excess sagging skin is the problem, a “lift” is all that is required to return to the more youthful, fuller, higher positioned breast.  This is performed by excision of only excess skin and relocation of the breast tissue to a higher position.  This procedure preserves all breast tissue, therefore the breasts retain their size but attain a better shape higher on the chest wall.

     More than 2 million women have breast implants either for reconstruction or for enlargement.  Women today who are 22 years or older have a choice between saline and silicone gel implants which come in a variety of implant sizes and contours.  The majority of women who have breast implants have not experienced any serious adverse effects and have been very satisfied with their results.  Women who are considering breast augmentation surgery should be thoroughly advised of all the possible risks involved and have the ability to discuss in detail with her surgeon what look they are looking to achieve, as well as any questions or concerns they may have.  When referred from our blog site, Dr. Bandy offers a complimentary individual evaluation for women considering breast enhancement surgery, either breast reduction, breast lift or breast augmentation. To schedule a consultation, call Dr.Bandy’s office at 310-214-8400 or 949-574-0574. Dr. Bandy is Board Certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic and Reconstructive Surgeons and a Fellow of the American Academy of Surgeons.

 It has been said that “the eyes are the window of the soul”, portraying the inner being of the person.  But the eyes can also be the area that reveals the first signs of aging such as crows feet and excess lax skin and muscle that droop and contribute to a tired, aged appearance.  Bags under the eyes are the result of a loosening of the “orbital septum”, a thin layer of tissue that separates the orbital fat from the muscle and skin above it. 

 As this tissue weakens, the fat “herniates”, or pushes against the septum causing a bulging of the fat and a tired un-rested look.  This problem does not haunt only the aging population, but is a common family trait that can be seen in many people from their early youth.  With traditional eyelid surgery, the excess fat, skin and muscle can be removed to create a smoother, more rested appearance.  If only excess fat needs to be removed, this can often be done without a skin incision, thereby leaving no visible scar.  

 The fat pockets are addressed through a small incision in the conjunctiva which is the tissue on the inner surface of the eyelid.  Through this approach, the fat is gently teased out and re-distributed to produce a smoother, more rested look.  This procedure can be done under a local anesthesia with minimal to no downtime from work.  To determine if you are a candidate for this procedure, a complimentary consultation with Dr. Bandy can answer most of your questions.