Reconstructive plastic surgery can help restore appearance and function to patients who have congenital or acquired defects as a result of birth defects, developmental abnormalities, trauma or injury, cancer and tumors, burns, or other diseases. It is generally performed to improve function and is usually covered by health insurance.
Cosmetic plastic surgery is performed to enhance or reshape body structures to improve a person’s appearance and/or self-esteem. Elective cosmetic surgery is not covered by insurance.
The plastic surgeons in the Plastic Surgery Division at St. John's Hospital provide a wide variety of reconstructive and cosmetic surgery services. Many procedures can be done as an outpatient in the Outpatient Surgery Center in St. John’s Pavilion, while more extensive procedures may require an inpatient stay.
All patients begin their relationship with St. John’s Plastic Surgery Division by an in-person office consultation with the doctor of their choice.
Below is a short description of some of the services provided by our board-certified surgeons, who may also offer more specific treatments and procedures that are not described below. Body Contouring Breast Enlargement Breast Lift Breast Reconstruction Breast Reduction Cleft Lip & Palate Eyelid Surgery Facelift Hand Surgery Liposuction Nose Surgery Tummy Tuck Body Contouring
Body contouring helps restore a more youthful or shapely appearance. Leg and arm skin can be lifted and/or tightened using incisions in the groin or armpit. The buttock, waist and stomach can be reduced, lifted and tightened with a belt lipectomy procedure, removing a wide strip of skin and fat all the way around the waist. Body contouring procedures are often enhanced using liposuction. Some contouring procedures in massive weight loss patients are covered by insurance, most, however, are not. Breast Enlargement (Augmentation Mammoplasty)
Young patients with small or asymmetrical breasts or women whose breasts have lost volume following childbirth often seek a breast enlargement procedure. This surgical procedure is done by placing saline or silicone gel filled implants either beneath the breast itself or under the pectoralis muscle and the breast. Implants can be placed through an incision beneath the breast or around the areola. This is an outpatient procedure that is usually not covered by health insurance. Breast Lift (Mastopexy)
Surgery performed to lift and reshape the breast is called a mastopexy. Breast deformity can be congenital or acquired. Many patients' breasts “droop” with age or with volume loss following child birth/nursing. The nipple may descend below the breast mound creating a very saggy appearance. During a breast lift the breast tissue can be lifted on the chest wall, and the breast is reshaped to reposition the nipple over the breast mound. The breast volume is preserved and can be enhanced with a small implant. This is an outpatient procedure and is not covered by insurance. Breast Reconstruction
Breast cancer occurs in one of every eight women. Surgical treatment often requires a mastectomy. Breast reconstruction can be accomplished at the same time as the mastectomy or at a later date. The breast can be reconstructed using a breast implant alone or by using the patient’s own tissue, taken either from the back or the abdomen. The type of reconstruction possible varies with each patient. Sometimes the remaining breast may require a lift or small implant to create symmetry with the reconstructed breast. Nipple and areola reconstruction is also possible, usually as a secondary procedure. This procedure is covered by health insurance. Breast Reduction (Reduction Mammoplasty)
Patients with very large breasts often suffer with neck, shoulder and back pain. They may experience skin irritation on the undersurface of the breasts and upper chest wall, especially in the summer months. Heavy breasts can cause grooving over the shoulders from the bra straps and the patients’ quality of life is often altered making exercise and other routine activities difficult. Reduction mammoplasty reduces the size of the breasts and improves their overall appearance. The patients’ back, neck and shoulder pain is usually eliminated and they are able to wear normal clothes and have an improved quality of life. The procedure is usually covered by health insurance. Cleft Lip and Palate
Cleft and/or cleft palate are among the most common birth defects affecting 1 in 700 children born in North America. A cleft lip results when the upper lip does not form properly or completely, and a cleft palate occurs when the roof of the mouth does not fuse completely. Cleft lip and/or cleft palate repair aims to restore both function and a more normal appearance. These procedures are covered by health insurance. Eyelid Surgery (Blepharoplasty)
Surgery performed to improve the appearance of the eyes and restore a more youthful look is called a blepharoplasty. The skin of the upper and lower eyelids increases as we age. Fat around the eyes may increase and bulge forward creating what is commonly called “bags,” especially in the lower eyelids. The excess eyelid skin and fat can be removed and the underlying support structures tightened to improve the appearance of the eyes. The surgical incisions are hidden in the fold above the eye and along the lower lid lash line and are very difficult to see. This procedure is not covered by health care insurance, unless the excessive upper eyelid skin reduces the upper field of vision, in which case, insurance will cover the cost for the upper lids only. Facelift (Rhytidectomy)
A more youthful and rested appearance can be achieved by pulling the face and neck skin and underlying support tissue back up to its former position. Surgical incisions are made in the hairline and around the ears to hide the scars. This procedure is performed as an outpatient, often in conjunction with removal of excess eyelid skin (blepharoplasty) and is not covered by health insurance. Hand Surgery
There are a variety of hand related injuries, diseases, and birth defects that cause hand and wrist pain and impair strength, function, and flexibility. Common diseases and surgical procedures related to the hand include carpal or cubital tunnel release, trigger fingers, ganglions, masses, wrist pain, arthritis, fractures, Dupuytren’s Disease, tendon surgery and congenital hand surgery. Surgical procedures can help improve the function or physical appearance of the hand. Liposuction
This procedure is done to remove excess fat deposits, usually in normal sized patients, in areas which have been unaffected by diet or exercise. These uncorrected fat deposits commonly called “cellulite” are most common on the hips, lower abdomen, upper thighs, beneath the chin or along the flank and upper back. This procedure uses a series of small incisions and suction cannulas to suck away unwanted fat and to improve the overall body contour. This procedure is usually done as an outpatient and is not covered by health insurance. Nose Surgery (Rhinoplasty)
Rhinoplasty is done to improve the appearance of the nose. Improvement in the size and shape of the nose toward a more appealing appearance is done by reshaping the underlying bone and cartilage, usually through incisions inside the nose and occasionally across the skin supporting the nasal tip, just above the upper lip. Rarely, some skin must be trimmed or removed. Nasal airway obstruction due to a deviated septum or other cause can also be corrected at the same time. The surgery is performed as an outpatient and is usually not covered by health care insurance, unless there is a history of previous nasal trauma or there is a functional airway obstruction. Tummy Tuck (Abdominoplasty)
Surgery performed to remove excess skin and fat from the lower abdomen is called an abdominoplasty. This procedure is usually performed in men or women who were once heavy and have lost weight or in women who have developed loose lower abdominal skin and fat following childbirth. In these patients, the underlying abdominal wall muscles may be stretched apart creating a prominent midline bulge. The surgical procedure, usually performed as an outpatient, removes the abdominal wall skin and fat from just above the belly button and then stretches the upper abdomen skin down to firm and tighten the appearance of the abdomen. The old belly button is brought through the redraped skin leaving a scar across the lower abdomen, which can be hidden under panties or a swimsuit. The divergent abdominal wall muscles are sutured together in the midline during the procedure to further tighten the abdomen. This procedure is usually not covered by health insurance, except in cases where it is deemed medically necessary after massive weight loss.