PLASTIC SURGERY

What can plastic surgery offer to you?

©Roberto Roddi, MD, DMD, PhD, Professor of plastic surgery

 Contents
Breast Augmentation .................................................................................................................................... 2
Breast Lift/ Mastopexy/ Breast Reduction.................................................................................................... 3
Male Breast Reduction.................................................................................................................................. 4
Liposuction.................................................................................................................................................... 5
Tummy Tuck.................................................................................................................................................. 6
Buttock Augmentation / Brazilian Butt Lift / BBL ......................................................................................... 7
Lipofilling/ Nano Fat Transfer ....................................................................................................................... 8
Facial Implants .............................................................................................................................................. 9
Eyelid surgery.............................................................................................................................................. 10
Nose surgery ...............................................................................................................................................11
Lips Correction ............................................................................................................................................ 12
Otoplasty.....................................................................................................................................................13
Facelift.........................................................................................................................................................14
Neck Lift ......................................................................................................................................................15
Neurotoxin/Botox® ...................................................................................................................................... 16
Mommy Makeover ..................................................................................................................................... 17
Female Genital ............................................................................................................................................ 18
O-Shot® ........................................................................................................................................................20
LVR (Laser Vaginal Rejuvenation) ...............................................................................................................21
Treatment of the ED (Erectile Dysfunction)................................................................................................23
Penile Girth Enhancement (autologous fat transfer) .................................................................................24
P-Shot®........................................................................................................................................................25
PRP (Platelet Rich Plasma) Treatments....................................................................................................... 27
Botulinum toxin for the treatment of Vaginismus......................................................................................28
Obagi Blue Peel ........................................................................................................................................... 29
Scars Correction .......................................................................................................................................... 30
Microdermabrasion .................................................................................................................................... 31
Skin Tumors.................................................................................................................................................32
 Breast Augmentation

Breast size is important to many women for a variety of reasons. If you are dissatisfied with you breast
size, augmentation surgery is a choice to consider. Breast augmentation can:

 Increase fullness and projection of your breasts;

 Improve the balance of your figure;
 Enhance your self-image and self-confidence.

Procedural steps:

Common incision locations is in the breast crease. Placement of implants beneath the chest wall muscle
or directly behind breast tissue using pre-filled implants creates desired volume. Breast augmentation is
generally performed under general anesthesia and one or two nights stay maybe recommended.

Recovery:

The results of a breast augmentation are visible immediately. Swelling should subside in a few weeks.

Incision lines will continue to flatten and fade for up to one year.
 Breast Lift/ Mastopexy/ Breast Reduction

A Breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to
reshape and support the new breast contour. Sometimes the areola becomes enlarged over time, and a
breast lift will reduce this as well.

Procedural steps:

Excess skin is surgically removed to raise the nipple and tighten the breast tissue. Incision patterns vary,
depending on degree of excess skin and amount of lifting required as well as patient and surgeon
preference. After your doctor makes the incisions, the underlying breast tissue is lifted and shaped to
improve breast contour and firmness. The nipple and areola are repositioned to a natural, more youthful
height. If necessary, enlarged areolas are reduced by excising skin at the perimeter. Excess breast skin is
removed to compensate for a loss of elasticity.

Recovery:

Swelling should subside in two to four weeks. Breast shape may take one to three months to fully refine.
Incision lines will continue to flatten and fade for up to one year.
 Male Breast Reduction

Enlarged male breasts, also known as gynecomastia, can cause emotional discomfort and impair your self-
confidence. Enlargement of breast tissue in males is characterized by:

 Excess localized fat;

 Excess glandular tissue development;
 A combination of both excess fat and glandular tissue;
 Gynecomastia may present unilaterally (one breast) or bilaterally (both breasts).
Gynecomastia can be surgically treated by removing excess fat, glandular tissue and/or skin. The result is
a better proportioned more masculine-contoured upper body and the freedom and self-confidence to
lead an active life. Male breast reduction is performed with either liposuction, excision, or a combination
of both.

Procedural steps:

Surgical removal of excess tissue is performed by excision and/or liposuction. This procedure can include
areolar reduction.

Liposuction procedural steps:

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone
may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions. The
cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed
from the body by vacuum suction.

Excision procedural steps:

Excision technique are recommended where glandular breast tissue or excess skin must be removed to
correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be
repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions
and surgical preference.

Recovery:

Initial swelling should dissipate in two to four weeks. Final results may appear in two to four months.
Incision lines will continue to fade for up to one year. Significant weight gain can reverse results.
 Liposuction
Despite good health and a reasonable level of fitness, some people may still have a body with
disproportionate contours due to localized fat deposits. Liposuction slims and reshapes specific areas of
the body by removing excess fat deposits, improving your body contours and proportion, and ultimately
enhancing your self-image.

Liposuction may be used to reduce localized fat deposits of the:

 Thighs;
 Hips and buttocks;
 Abdomen and waist;
 Upper arms;
 Back;
 Inner knee;
 Chest area;
 Cheeks, chin and neck;
 Calves and ankles.

Procedural steps:

Traditional liposuction surgical suctioning of excess fat deposits

The tumescent, also called super-wet, technique requires an infusion of saline solution with adrenaline
and possibly anesthetic prior to removal of excess fat.

Recovery:
Swelling should subside, bruising should fade and initial results may appear in two to four weeks. Final
results could appear in two to six months. Significant weight gain can cause recurrence of fatty deposits.
 Tummy Tuck

If you want a tighter, flatter abdomen, then a tummy tuck may be appropriate to help achieve your goals.
Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in some cases restores
weakened or separated muscles. This creates an abdominal profile that is smoother and firmer, often
enhancing your body image and confidence.

Procedural steps:

A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of
the abdominal wall where muscles have weakened. A full tummy tuck requires a horizontal incision in the
area between the pubic hairlines and navel. Incision size is largely dependent on the amount of excess
skin to be removed. When a correction is isolated to the area below the navel, a limited or ‘mini tummy
tuck’ with a shorter incision at the pubic bone may be recommended. Liposuction may be performed with
a ‘mini tummy tuck’ where excess fat is the only factor.

Recovery:

Swelling should subside and initial results may appear in two to four weeks. Final results could appear in
eight weeks. Incision lines will continue to flatten and fade for up to one year.
 Buttock Augmentation / Brazilian Butt Lift / BBL

Buttock augmentation surgery involves using fat grafting. This procedure can:

 Increase fullness, roundness and projection of your buttock;

 Improve the balance of your figure;
 Enhance your self-image and self-confidence.

Buttock augmentation surgery is right for someone who does not like the shape of their buttock or is
looking to balance their body. It is performed with fat transfer.

Fat transfer procedural steps:

Liposuction is performed through small, inconspicuous incisions. In general, your surgeon may use
liposuction to remove up to three times the amount of fat than what will actually be injected into the
buttocks. The fat, tissue and blood that were removed through liposuction are then processed. The
syringes are then connected to a special cannula your surgeon will use to add the fat to the buttocks
through small injections all over your buttocks. The results of buttock augmentation are immediately
visible; however you will not see your final results until a year after the surgery, as it takes a while for the
fat to ‘take.’ This procedure offers natural looking and feeling results, but the projection of the buttocks
may decrease over time.

Fat grafting recovery:

You will be asked to avoid prolonged sitting for about two weeks. This is very important because
prolonged sitting will damage the fat. You will also be encouraged to sleep face down or on your side.
When you do have to sit, you will have to sue a pillow or cushion placed behind the legs (hamstring
muscles) to help raise the buttock avoiding the pressure onto the fat grafts.

You will also be provided with a support garment that will apply even compression to the areas that
were treated with liposuction.
 Lipofilling/ Nano Fat Transfer

If you would like to restore facial contours, or reduce the appearance of lines and creases, injection
therapy with soft tissue fillers may be right for you. Your own fat can:

 Plump thin lips;

 Enhance shallow contours;
 Soften facial creases and wrinkles;
 Improve the appearance of recessed scars.

Procedural steps:

Your own fat is injected below the skin surface to fill hollow areas and creases, or plump the lips and back
of the hands. Fat is typically taken from the inner thigh or abdomen.

Recovery:

Swelling should dissipate in a few weeks.

 Facial Implants

If you would like to change the contours of your face, you might want to consider implants. They can
improve proportion and profiles and correct imbalance caused by injury or hereditary traits.

Procedural steps:

Appropriately sized and shaped implants will be carefully selected and placed, most commonly in the
check, chin, jaw or nasal region. Incisions inside the mouth or discreetly placed external incisions create
space in soft tissues for implant positioning and support.

Facial implants are generally performed as an outpatient procedure under local anesthesia with or
without sedation; general anesthesia may be recommended.

Recovery:

Your results will be almost immediate. Initial swelling should subside in two to four weeks, and dissipate
in one to two months, as final results appear.
 Eyelid surgery

Cosmetic eyelid surgery is a surgical procedure to improve the appearance of the upper eyelids, lower
eyelids, or both, restoring firmness to the area surrounding the eyes and making you look more rested
and alert. Specifically, eyelid surgery can treat:

 Loose or sagging skin that creates folds or hides the natural contour of the upper eyelid;
 Excess skin that hangs down from the upper eyelid, sometimes impairing vision;
 Excess fatty deposits that appears as puffiness in the upper eyelids;
 Bags under the eyes;
 Droopiness of the lower eyelids, showing white below the iris;
 Excess skin and fine wrinkles of the lower eyelid.

Procedural steps:

An incision within the natural crease of the upper eyelid allows access to remove excess skin, muscle and
underlying fatty tissue. Using an incision inside the lower eyelid, fat is removed or redistributed and the
muscle is modified to correct a baggy lower eyelid.

An incision just below the lower lash line allows excess skin to be removed. Laser resurfacing may be used
to smooth lower lid skin.

Recovery:

Bruising should subside in five to 10 days and swelling should subside in two to four weeks. Final results
may appear in one to two months. Incision lines will continue to refine and fade for one year.
 Nose surgery

While the shape of your nose is usually the result of heredity, the appearance may have been altered in
an injury prior surgery. Also known as rhinoplasty, surgery of the nose improves the appearance and
proportion of your nose, enhancing facial harmony and self-confidence. Surgery of the nose may also
correct impaired breathing caused by structural defects in the nose. Rhinoplasty can change:

 Nose size, in relation to facial balance;

 Nose width, at the bridge or in the size and position of the nostrils;
 Nose profile with visible humps or depressions on the bridge;
 Nasal tips, that is enlarged or bulbous, drooping, upturned or hooked;
 Nostrils that are large, wide or ruptured;
 Nasal asymmetry.

Procedural steps:

Incisions hidden at the nostril base and/or inside the nose allow access to reshape underlying cartilage
and/or bone. This may include lowering humps, narrowing of nasal bones, shaping of the nasal tip or
nostril size and improving the angle between the nose and the upper lip. This procedure also can correct
breathing difficulties caused by structural irregularities.

Recovery:

You should see a change within six to eight weeks following surgery, with continued refinement for six to
12 months. Cartilage is a flexible and growing tissue; therefore results following surgery are not fully
predictable
 Lips Correction

Plastic surgery may be able to help make your lips more beautiful and give you more self-confidence when
lips are too thick or the red of the lips is too small. We can provide lip enhancement with fat transfer of
fillers, reduction, and lift.

Lip-reduction: reduces the size of thick lips


Through a small incision the plastic surgeon turns the excess red of the lips inwards. The scar is hidden in
the mouth and is therefore invisible. This procedure is performed under local anesthesia. The lips will be
swollen and bruised for few days. After few weeks the definite result is visible.

Lip augmentation:

When a lip is too thin or is the red part of the lips too narrow it is possible to enhance the volume of lips. If
an injection is not effective because the red of the lips is too inverted then it can be enlarged by turning
the red of the lips from the inside of the lips outwards. This is a quick procedure in general performed under
local anesthetic. This procedure can be combined with an injectable filler.

Upper lip rejuvenation:

Wrinkles around the upper lip can be corrected with: dermabrasion, injection with Hyaluronic acid, nano
fat transfer, Obagi Blue Peeling or a combination of different techniques.

Lifting of the upper lip:

With age the upper lip tends to droop so that the red of the lips looks narrower. This problem can easily be
solved with a 'butterfly correction". This procedure lifts the upper lip and has a rejuvenating effect on the
appearance of your mouth and face. The plastic surgeon usually makes a small butterfly-shaped incision.
The scar is hidden in the nostrils. Lifting the upper lip gives a more youthful appearance. The procedure is
performed with a local anesthetic.
 Otoplasty

Ear surgery, also known as otoplasty, can improve the shape, position or proportion of the ear. Otoplasty
can correct a defect in the ear structure that is present at birth that becomes apparent with development
or it can treat misshapen ears caused by injury. Ear surgery creates a natural shape, while bringing balance
and proportion to the ears and face. Correction of even minor deformities can have profound benefits to
appearance and self-esteem.

If protruding or disfigured ears bother you or your child, you may consider plastic surgery. Children who
are good candidates for ear surgery are: healthy, without a life-threatening illness or untreated chronic ear
infections; generally 5 years old, or when a child’s ear cartilage is stable enough for correction, cooperative
and follow instructions well; able to communicate their feelings and do not voice objections when surgery
is discussed.

Teenagers and adults who are good candidates for ear surgery are: healthy individuals who do not have a
life-threatening illness or medical conditions that can impair healing; individuals with a positive outlook and
specific goals in mind for ear surgery.

Discomfort immediately following ear surgery is normal and can be controlled with pain medication. There
may be an itchy feeling under bandages. It is essential that bandages remain intact and are not removed
for one week, for any reason. Failure to do so may result in loss of some of the correction and may require
a secondary surgery. Ear surgery offers almost immediate results in cases of protruding ears, visible when
the dressings that support the new shape of the ear during initial phases of healing are removed. With the
ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well
hidden within the natural creases of the ear.

The results of more extensive ear surgery and reconstruction may appear in stages over time.
 Facelift

If you are bothered by the signs of aging in your face, a facelift may be right for you. A facelift is a surgical
procedure to improve visible signs of aging in the face and neck, such as:

 Sagging in the midface;

 Deep creases below the lower eyelids;
 Deep creases between the nose and mouth;
 Fat that has fallen or is displaced;
 Loss of muscle tone in the lower face that may create jowls;
 Loose skin and excess fatty deposits under the chin and jaw.

A facelift is designed to correct all of these aging features, restoring a more youthful, rested appearance
with uplifted contours and improved tone in facial skin and underlying muscle.

Procedural steps:

Typical incisions begin within the hairline, above the temple and continue along or just inside the ear,
ending behind the ear. This allows access to tighten underlying tissue, remove excess fat and reduce
sagging skin. A second incision under the chin is sometimes necessary. If skin tone is good and only mid-
face aging or excess fat in the neck will be corrected, abbreviated techniques with shorter incisions may
be used. Liposuction techniques may assist with removal of fat deposits.

Recovery:

Swelling and bruising should subside within a few weeks. Final results may be apparent in one to two
months. Incision lines will continue to refine and fade for one year.
 Neck Lift

If you are concerned about the loss of youthful contours in your face and neck, or you notice excess
wrinkling of the neck skin, a “turkey wattle” or double chin, and jowl lines and you are not yet ready for a
full facelift, a neck lift may be right for you. A neck lift, or lower rhytidectomy, is a surgical procedure that
improves visible signs of aging in the jawline and neck, such as:

 Excess fat and skin relaxation in the lower face that creates jowls;
 Excess fatty deposits under the chin;
 Loose neck skin;
 Muscle banding in the neck, which created abnormal contours.

Procedural steps:

Depending on the degree of change you’d like to see, your neck lift choices include a traditional neck lift
incision or a limited incision neck lift. A traditional neck lift incision often begins in the hairline at the level
of the sideburn, continues down and around the ear and ends in the posterior hair. Fat may be sculpted
or redistributed from the jowls and neck. The tissue underlying the neck skin is repositioned, and
commonly the platysma muscle is tightened. Skin is redraped over the uplifted contours and excess skin
is trimmed away. A separate incision under the chin is sometimes necessary for liposuction of this area
and for repair of the muscle. Sutures or skin adhesives close the incisions.

A limited incision neck lift may involve incisions only around the ear. While the incisions are shorter, the
results may be more limited. Incision lines are closed with sutures. Sutures may be dissolving or may need
to be removed after a few days.

Recovery:

It may take several weeks to moths for swelling to fully dissipate and up to six months for incision lines to
mature. Once healed, the incision lines from a neck lift are usually well concealed within the hairline and
in the natural contours of the ear. Your final result should not only provide a more youthful and rested
appearance, but also help you feel more confident about yourself.
 Neurotoxin/Botox®

Botulinum toxin is a purified substance that’s derived from bacteria. Commonly known types of botulinum
toxin type A injections include Botox®, Neuronox®, etc. Injections of botulinum toxin blocks muscular
nerve signals, which then weakens the muscle so it can’t contract. The end result is diminished unwanted
facial wrinkles. Botulinum toxin can be used to help smooth: crow’s feet, forehead furrows, frown lines.
Smiling, frowning, squinting, and even chewing can eventually lead to one of the most common signs of
aging: wrinkles. They can make you appear tired or even angry when you are not. One of the quickest and
safest remedies to remove wrinkles is an injection of neurotoxin. Botulinum toxin can be combined with
other cosmetic skin procedures such as chemical peels, dermal fillers, Thermage, etc. to further improve
your results. This combination of therapies can even help to prevent the formation of new lines and
wrinkles.

Injections of botulinum toxin may seem like a simple procedure to you, since it’s just a few shots. But it’s
actually both an art and science that only an experienced healthcare professional should do.

A very thin needle is used to inject small amounts of botulinum toxin into specific muscles.

By carefully choosing specific muscles, your healthcare provider weakens only the wrinkle-producing
muscles, preserving your natural facial expressions.

Botulinum toxin treatment injections usually take less than 15 minutes.

The number of injections you need will depend on your facial features and the extent of your wrinkles.
Crow’s feet, for example, usually demand two to three injections. Furrows above your brow could take
five or more. Botulinum toxin risks and safety information. You may resume normal activities immediately.
 Mommy Makeover
After pregnancy, many women are not satisfied how their body looks. Pregnancy has changed the shape
and skin on and around their breasts and abdomen and these women find that it is very difficult to return
their body to their pre-pregnancy shape. In spite of dieting and very serious exercise, many find that loose
skin of the abdomen will not tighten and their breast are smaller and have started to droop. To return to
their pre-pregnancy look, they choose a mommy makeover surgery.

This surgery usually includes a tummy tuck to remove excess skin and tighten the abdominal wall muscle,
reshaping with liposuction. In addition, most women receive a breast augmentation, breast lift or both.

Procedural steps:

A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of
the abdominal wall where muscles have weakened. A full tummy tuck requires a horizontal incision in the
area between the pubic hairline and navel. Incision size is largely dependent on the amount of excess skin
to be removed. When a correction is isolated to the area below the navel, a limited or “mini tummy tuck”
with a shorter incision at the pubic bone may be recommended. Liposuction may be performed with either
a full or a “mini tummy tuck” where excess fat is a factor.

During the breast lift part of the surgery, excess skin is surgically removed to raise the nipple and tighten
the breast tissue. Incision patterns vary, depending on the degree of excess skin and the amount of lifting
required as well as patient and surgeon preference.

Recovery:

You will definitely need help for the first few days after this surgery. You will need assistance with
childcare. You will not be able to drive for several days. Your surgeon will ask you to refrain from vigorous
physical activity for a few weeks. It is important to follow your surgeon’s instructions. They are essential
to the success of your surgery. It’s important that the surgical incisions are not subjected to excess force,
swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on
how to care for yourself.
 Female Genital

Aesthetic female genital surgery involves surgery on normal female external genitalia. We can provide
different procedures:

 Labioplasty;
 Labia minora reduction/symmetrizing;
 Volume restoring vulva/reduction;
 Hoodectomy;
 Monsplasty;
 Hymenoplasty;
 G-spot amplification;
 Narrowing vaginal opening;
 Botulinum toxin for treatment of vaginismus;

Labioplasty:

Labioplasty is a surgical procedure that will reduce or reshape the labia minora. In some instances, women
with large labia can experience pain during intercourse, or feel discomfort during everyday activities or
when wearing tight-fitting clothing. Others may feel unattractive. The purpose of a labiaplasty is to better
define the inner labia. Sometimes the labiae are asymmetric and it is possible to reshape them and
normalize the aesthetical appearance.

Labia Majora correction:

With age the volume of the vulva can decrease because of the fat atrophy. This problem is also present in
other part of the body. Correction of this blemishing is possible with enhancement with fat
transfer and/or skin excision when the loss of volume is responsible of skin excess.

Hoodectomy:

A woman's clitoris is pointed outward towards the vaginal opening and increases in size when a is sexually
aroused. Often times, the skin covering the clitoris may be too tight, which can lead to a disfigured shape
and sexual dissatisfaction. In some cases, the clitoris can become completely covered by the fold of skin
and cause extreme numbness or no feeling at all. This type of vaginal rejuvenation surgery allows the
clitoris to prominently expand and swell during sexual intercourse, and look more pleasing to the eye. A
small incision is made through the skin of the clitoris to remove the outer skin that is covering the clitoris.
Mons plasty:

Mons plasty It is a surgical procedure used to reduce and tighten the Mons Pubis; it can include reshaping
with liposculpture techniques/lift-suspension

Hymenoplasty/Virginity restoration:

The hymenoplasty procedure consists of surgically tailoring the hymenal remnants so that they can be
sutured together with absorbable interrupted sutures to narrow the vaginal orifice

G-spot amplification:

The G spot or Gräfenberg spot is a highly erogenous zone inside the vagina that enlarges when directly
stimulated. The erotic zone can be found on the anterior wall of the vagina along the course of the
urethra, surrounded by erectile tissue. The procedure is mostly focused on a functional improvement: it
is believed to enhance the sexual stimulation to the G spot through increased projection of the G-spot
into the vagina. The amplification is performed by hyaluronan injections. Most of these procedures can
be done under local assisted anesthesia/sedation or general anesthesia.

O-Shot®

This area is further in the vagina and behind the cervix, also known as the “deep spot.” This position can
be found in a certain position where both parties are situated in a particular manner.

Dr. Charles Runels, the inventor of the O-shot® procedure, believes the treatment boosts both libido and
sexual satisfaction after injection of Platelet Rich Plasma (PRP).
 O-Shot®

This area is further in the vagina and behind the cervix, also known as the “deep spot.” This position can
be found in a certain position where both parties are situated in a particular manner.

Dr. Charles Runels, the inventor of the O-shot® procedure, believes the treatment boosts both libido and
sexual satisfaction after injection of Platelet Rich Plasma (PRP).

The procedures has also been suggested for many other medical indications:

 Decreased libido (sex drive) and ability to orgasm;

 SUI (Stress urinary incontinence);
 Atrophy (dryness);
 Lichen planus;
 Lichen sclerosus;
 Scars (episiotomy or other surgical procedures).

Anesthesia: Normally done under local anesthesia combined with oral sedation.

Risks: Because PRP (Platelet Rich Plasma) is derived from autologous blood there is no chance
of having an allergy or immune reaction. Indeed in the literature, side effects or complications of PRP
injection are extremely rare. The main risks include local infection (< 1% chance) and temporary pain at
the site of injection.

If HA is injected, the side effects are the most commonly seen, which are usually transient. The
may be including edema, erythema, itching. The symptoms disappear spontaneously in a very
short time.
Recovery: There is minimal recovery or limitations after the O-Shot®. The clitoral and labial area can
be numb for a few hours after treatment from the lidocaine. Expect mild inflammation, redness, and
swelling for a few days. Patients are requested to wait 48 hours after treatment to resume sexual activity
or use of tampons.

Results:International patients surveys report statistically very high positive response. Those with poor
response could be related to other issues going on, like scar tissue or more probably hormone deficiency.
 LVR (Laser Vaginal Rejuvenation)

Laser vagina Rejuvenation is a short outpatient procedure designed to enhance sexual gratification. The
trauma to the vagina from delivery can cause tear in the birth canal and further weakened by additional
deliveries and age leading to vaginal looseness and decreased sensation.

Purpose:

The focus of the procedure is restoration to a more youthful, “pre-pregnancy” state by reconstructing the
vagina external and internal vagina diameters. With the tightened vagina and enhanced sensation comes
better sexual gratification.

Anterior Laser Vaginal rejuvenation repairs the structure around the vagina to tighten the wide vaginal
cavity. Posterior LVR can be performed at the same time.

In addition, other medical indications can be treated.

SUI – Stress urinary incontinence:

Urinary incontinence is any involuntary leakage of urine no matter the amount.

Atrophy:

Although vagina self-lubricates arousal spikes hormones leading to additional lubrication allowing smooth
intercourse. When this lubrication dries out known as vaginal atrophy, burning, post-coital bleeding and
pain during intercourse can occur. Anxiety, allergic reaction can contribute to the cause but it is almost
always caused by low estrogen level. This means during menopause, pregnancy, use of anti-estrogen
drugs are a few of the root causes.

Anesthesia:

No anesthesia is necessary. To relax the patient, an anti-anxiety medication (e.g. Valium 10mg) together
with painkiller are given orally 30 minutes prior to the procedure.

Procedural steps:

This non-invasive Laser vaginal Tightening uses laser to restore the youthful vagina and improve stress
urinary incontinence by promoting collagen production and remodeling around the full circumference of
the vagina and its surrounding structures and ligaments.
Risks:

There are very few side effects as it uses the same protocols as applied to all other laser treatment.
Contraindications includes active infection, use of blood thinners and connective tissue disorders and
medications that can interfere with the healing process.

Recovery:

There is no downtime and all activities are resumed a day after the procedure although sexual intercourse
must be avoided during the first 24-48 hours after the treatment.

Result:

According to multiple studies, the treatment is associated with a high satisfaction rate of over 90%.
 Treatment of the ED (Erectile Dysfunction)

ED is the “inability to get or keep an erection firm enough to have a sexual intercourse”, also called
“impotence”.

Different causes could be evocated both medical and psychological. Diabetes, obesity, alcohol/drugs
use/abuse, smoking, hypertension, neurological disorders, stress, etc.

PDE5 inhibitors

A phosphodiesterase type 5 inhibitor is a drug used to block the degradative action of cGMP-specific
phosphodiesterase type 5 on cyclic GMP in the smooth muscle cells lining the blood vessels supplying
the corpus cavernosum of the penis.

Treatment goals:

 Increased libido;
 Improved sense of well-being
 Penile Girth Enhancement (autologous fat transfer)

Penile girth enhancement it refers to adding thickness to the penis, which is usually done by removing
fatty tissue from other areas of the body where it is found in excess, such as the abdomen, and injecting
it under the skin of the penis.

Purpose:

Penis enlargement by a mini-invasive surgery, by the transfer of autologous fat is an easy way by which
men can increase their self-esteem. This is actually the safest procedure to painlessly and very gently
increase the penis size, specifically the thickness.

Anesthesia:

Local anesthesia with oral sedation or general anesthesia.

Procedural steps:

After harvesting of the fat tissue (liposuction technique) and purification of the fat, it is added to the
periphery of the penis and thus enlarged. The procedure is not painful and lasts two hours.

The recommended recovery after liposuction is not more than three days, but sexual abstinence is
recommended for 14 days.

Risks:

Bleeding, hematoma, infection, fat necrosis, reabsorption of the fat graft, scarring and asymmetry.

Recovery:

The recommended recovery after liposuction is not more than three days, but sexual abstinence is
recommended for 14 days.

Result:

The surgery will increase width and length of the penis, long-term boosted self-esteem, more masculine
look and feel, increased attractively and enhanced sexual potency.

Depending of the technique used and to the patients, part of the transferred fat can be reabsorbed
average 30%. The procedure can be repeated. Final results are evaluated about 12 weeks after the
procedure.
 P-Shot®

The P-Shot® is a cutting-edge sexual enhancement process designed to rejuvenate the penis and
enhance the growth of new tissues to achieve improved erections. This is also beneficial to men who
have succumbed to prostate cancer, an enlarged prostate, post-surgical effects, and diabetes leading to
loss of sexual function.

It is a contemporary medical procedure that effectively assists with erectile dysfunction (ED), unlike
other treatment methods.

The P-Shot® (Priapus Shot) is a sexual rejuvenation procedure invented to bring lasting improvements to
men’s sexual wellness. In the P-Shot® procedure, it is the own body giving the platelet-rich plasma (PRP)
making it a more natural approach to treat erectile dysfunction. The P-Shot® delivers results that cannot
be realized by other treatment options (including “creams” and “pills”).

Purpose:

The P-Shot® is indicated in erectile dysfunction and for men wanting to experience stronger, longer, and
firmer erections. It’s effects last for one year.

Some of the P-Shot® results include:

 Increased penile blood flow and circulation;

 Enhanced firmness of erection;
 Increased sexual stamina;
 Enhanced pleasure and sensation;
 Enhanced sexual capabilities;
 Increased strength and appearance where needed;
 Resolved or improved discomfort from prostate;
 Better straightened length and instant largeness of penis;
 Corrected damages resulting from diabetes;
 Restored self-confidence.

It is the only non-surgical method to increase penis girth, and its effects can last at least for a year,
which makes the cost effective when compared to male enhancement surgery.

Procedural steps:

The Priapus Shot is a quick, usually painless, non-surgical procedure.

First numbing is applied to the penis, then a simple blood draw is done. After processing the blood and
obtaining the PRP (Platelet Rich Plasma), the PRP is injected into the shaft and the head of the penis.
There is no recovery time.

Anesthesia:

Normally done under local anesthesia and oral sedation.

Risks:

Because Platelet Rich Plasma is derived from own blood, there is no risk of having an allergy or immune
reaction. Indeed in the literature, side effects or complications of PRP injection are extremely rare. The
main risks include local infection (< 1% chance) and temporary pain at the site of injection.

Recovery:

There is minimal recovery or limitations after the P-Shot®. The treated area can be numb for a few
hours after treatment from the lidocaine. Expect mild inflammation, redness, and swelling for a few
days.

Sexual activities can be resumed 48 hours after the treatment.

Result:

Full results are expected in a few months. According to multiple studies, the treatment is associated
with a high satisfaction rate of over 90 percent. The procedure can be repeated.
 PRP (Platelet Rich Plasma) Treatments

PRP is blood plasma that has been enriched with platelets therefore it contains more platelets than the
volume that is typically found in your blood. With the high presence of platelets which contains growth
factors, this blood preparation has long been used to promote bone healing and tissue repair. Athletes
such as Tiger Woods have used this treatment long before it had been discovered for its anti-aging
properties.

Vampire face lift

PRP Facelift also known as “Vampire Facelift” is a revolutionary way of regenerating the soft tissues of the
face. With age, the skin of the face tends to shrink and sag in specific areas due to loss of collagen. The fat
pads that support the shape of lips, brows, and cheeks lose their magic, and your youthful, rosy glow
diminishes.

The vampire facelift is changing the world of cosmetic surgery and restores the youthful volume and shape
of the face.

Hair loss

PRP therapy is also being used as a treatment for hair loss because it is believed that the growth factors
present in PRP can stimulate hair follicle growth and the practice had shown very promising results.
 Botulinum toxin for the treatment of Vaginismus
Vaginismus - is involuntary contraction of muscles around the opening of the vagina in women with no
abnormalities in the genital organs. The tight muscle contraction makes sexual intercourse or any sexual
activity that involves penetration painful or impossible.

Using Botox to treat vaginismus involves several injections of the drug. Botox is injected into multiple
areas of the bulbospongiosus muscle. This is the muscle that wraps around the entrance to the vagina.
Additional injections may be used to relax other muscles, if they are contributing to the vaginal spasms.

Botox treatment is usually not done on its own. Instead, it cans also combined with sexual counsellors and
the use of dilators so that people can become comfortable with penetration. The Botox injections last for
between 2 and 4 months. However, the effects of the treatment may last longer than that. This is likely
due to a combination of anxiety reduction and retraining of the muscles. The Botox provides the initial
relaxation and lack of pain on penetration that allows the body to become used to the sensations without
tensing up.
 Obagi Blue Peel

A peeling uses a chemical solution to smooth the texture of your skin by removing the damaged outer
layers.

Although chemical peels are used mostly on the face, they can also be used to improve the skin on your
neck, hands and other parts of the body. A chemical peel is one of the least invasive ways to improve the
appearance of your skin. Sun exposure, acne, or just getting older can leave your skin tone uneven,
wrinkled, spotted or scarred.

A chemical peel can help improve:

 Acne or acne scars;

 Age and liver spots;
 Fine lines and wrinkles;
 Freckles;
 Irregular skin pigmentation;
 Rough skin and scaly patches;
 Scars;
 Sun-damaged skin.
 Scars Correction

Scars revision surgery is meant to minimize the scar so that it is more consistent with your surrounding
skin tone and texture. Scars are visible signs that remain after a wound has healed. They are unavoidable
results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to
scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that
affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding
healthy tissue or particularly noticeable due to their size, shape or location.

Your treatment options may vary based on the type and degree of scarring and can include:

 Simple topical treatments;

 Minimally invasive procedures;
 Surgical revision with advanced techniques in wound closure.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed
poorly, a scar cannot be completely erased.
 Microdermabrasion

Microdermabrasion treatments uses a minimally abrasive instrument to gently sand your skin, removing
the thicker, uneven outer layer. This type of skin rejuvenation is used to treat light scarring, discoloration,
sun damage and stretch marks.

Microdermabrasion can:

 Improve age spots and black heads;

 Improve hyper pigmentation (patches of darkened skin);
 Exfoliate your skin, resulting in a refreshed appearance;
 Lessen the appearance of stretch marks;
 Reduce fine lines and wrinkles;
 Reduce enlarged pores;
 Treat acne and the scars left by acne.

Procedural steps:

Image a very fine sandblaster and you’ll get a picture of how microdermabrasion works. It uses
microparticles, or a diamond-tipped wand, to remove the top layer (epidermis) of younger skin and
stimulate new skin growth. Microdermabrasion helps to thicken your collagen, which results in a younger
looking complexion.

Recovery:

There is no down tie or recovery period. Your polished new look should be long-lasting, depending on the
severity of your skin damage and the number of treatments you receive. Many people have two
microdermabrasion treatments per month at first and then one per month as part of a maintenance plan.
 Skin Tumors

A cancer diagnosis is very difficult to accept. Understanding that treating your skin cancer may result in
scars or disfigurement can also be troubling. Your plastic surgeon understands your concerns and will guide
you through treatment and explain the resulting effect on your health and appearance.

Skin cancer, much like any form of cancer, may require surgery to remove cancerous growths. Your plastic
surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve
your health and your appearance.

Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer
without dramatically changing your appearance.