At our surgery centers in Visalia and Beverly Hills, you’ll experience the highest quality of patient care complemented by the most advanced plastic surgery techniques. The various cosmetic plastic surgery procedures explained on this site are discussed in general terms and individual needs vary. After reviewing these pages, you are invited to contact Dr. Stevens for a private consultation tailored to your specific concerns.
The surgical procedure to remove excess skin and fat from the middle and lower abdomen is commonly known as a tummy tuck. The surgery can correct lax skin, wrinkling or folds that, in some cases, are attributable to aging, pregnancy or marked weight loss. The most suitable candidates for abdominoplasty are those of good health and ideal weight but who have loose abdominal skin that doesn’t respond to exercise or diet. This surgery should not be considered a substitute for weight loss.
A traditional tummy tuck does produce a permanent scar, however, in many cases the scar is covered with clothing such as bikini panties. If you have experienced scarring from previous abdominal surgery, you may be advised that the resulting scar could be more visible.
While scars are generally inevitable with abdominoplasty procedures, an experienced plastic surgeon can effectively minimize scarring by skillfully making the closure of the wounds as level and as smooth as possible. Backed by years of experience in abdominal surgery, Dr. Stevens’ approach to abdominoplasty never compromises the aesthetic ideal. It is because of this perfectionist attitude that Dr. Stevens’ abdominal surgery patients are afforded consistently excellent results.
Botox® Injection Treatments
The use of Botox® to treat facial wrinkles, sometimes referred to as cosmetic denervation, is regarded as an effective remedy. This injection treatment is focused on wrinkles appearing in the upper third of the face, particularly horizontal forehead lines, crow’s feet lines and the vertical lines between the eyebrows. In addition to its use in reducing facial wrinkles, Botox® has been found effective in treating patients bothered by excessive sweating (hyperhidrosis).
Sometimes misrepresented as a simple, “no-brainer” procedure, Botox® injections are best performed by an experienced and skilled surgeon. With thousands of Botox® injections under his belt, Dr. Stevens has developed the skills and experience to personally handle designer Botox® injections with utmost precision. He has worked closely with his nursing staff, many of whom have been with him for years, to train them in his Botox® injection technique. Furthermore, he emphasizes individualized treatment tailored to each patient’s specific needs rather than using a standardized approach. While this technique requires more attention, time, and skill on the part of the surgeon, it ensures that each patient receives the best results possible with the fewest risks or complications. Additionally, because of Dr. Stevens’ extensive experience and individualized approach to treatment, the need for touch-up injections is rare.
Augmentation mammoplasty is typically performed to enlarge small breasts, underdeveloped breasts or breasts that have decreased in size after a woman has had children. It is accomplished by surgically inserting an implant behind each breast. Usually, an incision is made either under the breast, around the areola (the pigmented skin surrounding the nipple), or in the armpit. A pocket is created for the implant either behind the breast tissue or behind muscle between the breast and the chest wall. Following surgery, you will wear a gauze dressing or surgical bra. Some swelling or discoloration will occur but will disappear shortly after surgery. Vigorous activities, especially arm movement, may be restricted for two to three weeks following surgery.
The most common of the known risks associated with breast implants is capsular contracture, a tightening of the scar tissue around the implant, which results in varying degrees of breast firmness and may cause pain or changes in the breast’s appearance. Other known risks include implant rupture and temporary or permanent changes in nipple or breast sensation. The presence of breast implants requires special mammographic techniques and may compromise the effectiveness of mammography for early cancer detection. Dr. Stevens will discuss with you these and other possible risks that you should consider carefully.
Breast Lift (Mastopexy)
The breast lift operation raises and recontours loose, sagging breasts. Frequently, a woman elects this surgery after losing a considerable amount of weight, or losing volume and tone in her breasts after having children.
In a breast lift, the surgeon relocates the nipple and areola (the pigmented skin surrounding the nipple) to a higher position, repositions the breast tissue to a higher level, removes excess skin from the lower portion of the breast and then reshapes the remaining breast skin. If you have your breasts enlarged as well as lifted, an implant may be placed behind your breast tissue or chest muscle. The most commonly performed breast lift technique results in scars surrounding the areola, extending vertically down the breast and horizontally along the crease underneath the breast. In some cases, variations in the placement of the incisions may be recommended. The breasts will be wrapped in a gauze dressing or placed in a surgical bra immediately after surgery. A supportive bra may be recommended for several weeks following the surgery. Swelling and discoloration will occur around your incisions and subside gradually. You may experience decreased sensation, which is usually temporary, in your nipples or breast skin. Mastopexy scars are permanent but will fade to some extent over time.
Breast reduction to correct overlarge, sagging breasts is normally classified as a reconstructive procedure, since oversize breasts interfere with normal function and physical activity by causing back pain, postural problems, deformities of the back and shoulders, skin rashes under the breasts and breast pain. However, plastic surgeons also view breast reduction surgery as an operation with an important aesthetic component; in addition to alleviating physical problems, it can improve the shape of the breasts and nipple areas. Breast reduction also can enhance the overall appearance by making the breasts more proportional to the rest of the body.
This surgical procedure involves removing excess breast tissue and skin, repositioning the nipple and areola (the pigmented skin surrounding the nipple) and reshaping the remaining breast tissue.The operation requires a general anesthetic, and you will most likely be hospitalized for a short time. Although Dr. Stevens will make every effort to keep your scars as inconspicuous as possible, the usual incisions ultimately will leave permanent, noticeable scars in the lower portion of the breasts. Variations in the placement of incisions may be recommended in some cases. After surgery, the breasts may be wrapped in gauze or placed in a surgical bra. You will have to wear a supportive bra for several weeks to promote healing. Loss of sensation of the nipples and breast skin is possible but may improve gradually. You should avoid strenuous exercise and overhead lifting for several weeks after surgery.
A facial filler treatment is the use of an injection of JUVÉDERM®, RADIESSE®, or SculptraAesthetic under the skin to reduce facials lines, wrinkles and some types of scars. Facial filler injections can also be used to achieve fuller, more sensuous lips. Specifically, facial filler treatments are effective in treating crow’s feet (periorbital lines), worry lines (forehead lines), smile lines (nasiolabial folds), frown lines (glabellar lines), some facial scars and acne scars, the lips, including the skin above and below (oral commissures and vermillion ridges), and enlargement of the lips (lip augmentation).
The use of facial fillers has been in clinical practice for over 15 years and advances in both facial filler products and techniques continue to be realized. However, many experts attest that the most successful injection treatments are determined less by the use of new products than by the skill that a surgeon develops over the years.
Unlike some plastic surgery outpatient facilities where facial filler injections may be delegated to others, Dr. Stevens performs the injection treatments himself. Having the procedure performed by an experienced and highly skilled surgeon such as Dr. Stevens, you are assured that you will receive the best possible results. Further, studies have shown that one of the more common risks associated with the procedure, that is, overcorrection, is significantly lessened when the injections are administered by a highly skilled physician.
Ear Surgery (Otoplasty)
The surgical procedure to position protruding ears closer to the head or to reshape the ears is otoplasty. Changing the position or shape of the ears usually will not affect hearing.
While ear surgery is successfully performed on adults, it can be a highly gratifying procedure for preschool age children with protruding ears. Otoplasty can be performed on children as young as age four, the time when ears are mostly developed. If the surgery is performed before the child enters school, the emotional and psychological trauma of classroom teasing and ridicule can be avoided.
Few risks are associated with otoplasty and when performed by a qualified, experienced surgeon, it can produce satisfying, predictable results. Dr. Stevens is not only recognized for his exacting surgical expertise in otoplasty, but his ambulatory surgical center provides the necessary environment for safe ear surgery for the pediatric as well as for the adult patient.
Endoscopic Plastic Surgery
Endoscopy is a surgical technique that involves the use of an endoscope, a special viewing instrument that allows a surgeon to see images of the body’s internal structures through very small incisions. Endoscopic surgery has been used for decades in a number of different procedures, including gallbladder removal, tubal ligation, and knee surgery. However, in the world of plastic surgery, endoscopic instruments have recently been introduced.
Plastic surgeons believe the technique holds great promise, but further study is needed to establish its effectiveness, especially over the long-term. As important research continues, endoscopy is being used on a limited basis for both cosmetic and reconstructive procedures.
Eyelid Surgery (Blepharoplasty)
Blepharoplasty, also known as eyelid surgery, is the surgical procedure to correct drooping eyelids, pouches beneath the eyes and excess folds around the eyes. During the procedure, excess skin and fat on upper and lower eyelids is removed.
Blepharoplasty is often performed in conjunction with other facial procedures such as the facelift and forehead lift. The procedure can change the appearance of the face by creating a more rested and alert look, however it cannot eliminate dark circles under the eye nor banish crow’s feet.
Facelift Surgery (Rhytidectomy)
The surgical procedure to improve sagging skin and jowls by removing excess fat, tightening muscles and redraping the skin is termed rhytidectomy or facelift surgery. Because a facelift mostly affects the lower part of the face, it is often combined with other facial surgeries such as a brow lift, blepharoplasty (eyelid surgery), facial liposculpture, or rhinoplasty (nose surgery).
Facelift surgery can be undertaken at any time after the appearance of the signs of aging. For those with premature aging changes, a facelift may be indicated as early as age 35. However, most patients are in the age range of 40 to 65 years when considering their first facelift.
A successful facelift demands the surgeon’s highly detailed and objective evaluation of an individual’s face and neck. Not only does Dr. Stevens conduct a meticulously thorough evaluation of each individual before facial surgery but he takes the time to actively listen to each person’s needs and expectations. This highly individualized and exacting approach allows Dr. Stevens to select the techniques used during the facelift procedure which give the best and longest lasting results.
A forehead lift or “brow lift” is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines. Dr. Stevens may decide to use the conventional surgical method, in which the incision is hidden just behind the hairline; or he may perform the procedure using an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions. Both techniques yield similar results — smoother forehead skin and a more animated appearance.
A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.
Gynecomastia (Breast Reduction for Men)
Many men have gynecomastia — enlarged, female-like breasts– caused by excess glandular tissue or fat. Glandular tissue must be cut out, usually through a small incision near the edge of the areola. Fatty tissue can be removed by liposuction. A small, hollow tube is inserted through a tiny incision, leaving a nearly imperceptible scar. Following surgery for gynecomastia, the patient has a more masculine chest contour.
Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body’s new contours. Surgery may be discouraged for obese men, or for overweight men who have not first attempted to correct the problem with exercise or weight loss. Also, individuals who drink alcoholic beverages in excess or smoke marijuana are usually not considered good candidates for surgery. These drugs, along with anabolic steroids, may cause gynecomastia. Therefore, patients are first directed to stop the use of these drugs to see if the breast fullness will diminish before surgery is considered an option.
Laser Hair Removal
Now there is a better solution for unwanted hair…laser hair removal.
You may be surprised to learn that just about your entire body is covered with hair. Because most of this hair is fine and pale, it usually isn’t visible to the naked eye. In fact, you may be surprised to know that the largest number of hair follicles is actually on your forehead. But when darker, coarser hair appears in places we don’t like or expect — like on the face, abdomen, breasts or arms — or prevents us from wearing certain clothing, it may be time to consider laser hair removal.
If you are considering laser hair removal and have questions or want to make an appointment to discuss how you might benefit from a treatment, you’re invited to email Dr. Stevens or contact the Plastic Surgery and Laser Center.
Laser Skin Resurfacing
In laser resurfacing, sometimes called “laser peel,” a carbon dioxide (CO2) laser is used to remove areas of damaged or wrinkled skin, layer by layer. The procedure is most commonly used to minimize the appearance of fine lines, especially around the mouth and the eyes. However, it is also effective in treating facial scars or areas of uneven pigmentation. Laser resurfacing may be performed on the whole face or in specific regions. Often, the procedure is done in conjunction with another cosmetic operation, such as a facelift or eyelid surgery.
Laser resurfacing is still a very new procedure. However, it has been shown that in some cases, this surgical method produces less bleeding, bruising and post-operative discomfort than is typically seen with other resurfacing methods. Laser resurfacing is performed using a beam of laser energy which vaporizes the upper layers of damaged skin at specific and controlled levels of penetration. It’s clear that laser resurfacing may offer a number of advantages over other resurfacing methods: precision, little (if any) bleeding and less post-operative discomfort. However, laser resurfacing isn’t for everyone. In some cases, an alternative skin resurfacing treatment, such as dermabrasion or chemical peel, may still be a better choice.
A procedure introduced in the United States in 1982, liposuction can remove localized collections of fatty tissue in several areas of the body. By using a high vacuum device, the surgeon can suction fat from the legs, buttocks, abdomen, back, arms, face and neck. The increasing popularity of liposuction is due to the effectiveness of the technique (in the hands of a qualified surgeon) and the fact that it leaves only tiny scars, often as short as one-half inch in length or less.
Liposuction is neither a substitute for proper diet and exercise nor a cure for obesity. To get the most from this procedure, you should be of average weight with extra fat localized in specific areas. It is also important that you have healthy, elastic skin with the capacity to shrink evenly after surgery. Since liposuction removes only fat, it cannot eliminate dimpling or correct skin laxity. The tumescent technique, superficial liposculpture and other variations of conventional liposuction may be recommended by your surgeon, depending on your specific needs and the surgeon’s preferred methods of treatment. If your skin has lost much of its elasticity, your plastic surgeon may recommend a skin tightening procedure (thigh lift, buttock lift or arm lift). These procedures are effective but leave more extensive scars.
Nose Surgery (Rhinoplasty)
Rhinoplasty is the surgical procedure to reshape the nose to improve its appearance or correct a deformity. People most often choose surgery to change the size and shape of the bridge and tip of the nose. Rhinoplasty is one of the most common cosmetic procedures performed today, with thousands of men, women and teens choosing to have nasal surgery each year.
Not every surgeon has the same level of experience with rhinoplasty. While it is one of the most frequently performed procedures, it requires a surgeon with the requisite skill as well as a sensitivity to aesthetics to achieve a natural looking nose. Having performed over hundreds of consistently successful rhinoplasty procedures over the past decade, Dr. Michael Stevens is recognized as one of the most skilled and highly respected surgeons experienced in this procedure.
Plastic Surgery Considerations for Men
Society places a high value on looking young and fit. Today, men of all ages and all walks of life are requesting plastic surgery for cosmetic reasons. Men’s goals include a more balanced nose, a rejuvenated face, a trimmer waistline. The procedures used to achieve these goals must take into consideration factors such as skin thickness, beard growth, or body type.
Good communication between you and the plastic surgeon you select for your procedure is essential when planning your surgery. In your initial consultation, you’ll be asked to explain in detail why you want the procedure and how you hope to look and feel afterward. It’s important to set aside any awkwardness you might feel, and speak candidly about the changes you’d like to see. You should feel completely assured that you and your surgeon understand one another. Your doctor will also evaluate your health, conduct a physical exam, take pre-operative photographs, and explain which surgical techniques are most appropriate for you. You’ll discuss the type of anesthesia to be used, the type of facility where the surgery will be performed, the possible risks, and the costs involved. Additionally, extensive information about the particular procedure you plan to have will be provided during your consultation. While going over the steps of the procedure, your doctor will discuss a number of issues that may influence your surgery. Make sure you fully understand these considerations.
Skin Health (ZO® Skin and Blue Peel)
Discover the beauty of healthy skin.
Real beauty truly does come from within. It comes from the lovely glow of fresh, smooth, firm skin. Nourished by natural moisture and supported by good circulation. Time, sun, stress, environmental assaults – they all take their toll. But they do not have to win.
Your skin is a living organ with the amazing ability to renew itself. Every six weeks, it can regenerate itself literally from the inside out. Healthy skin knows how to replace damaged cells and stimulate the growth of new, vibrant skin.
All your skin needs is the right kind of treatment to help it remember how.
This isn’t about skin care. It’s about skin health.
Ideal results are not achieved by anything you can buy in a store. Many existing skin care products affect only the surface of your skin and cover over the underlying problems. The only way to truly rejuvenate your skin is to reach below the surface and work at the cellular level. That’s where the health – and beauty – of your skin is decided. And that takes the knowledge and guidance of a physician, supervising a medically prescribed skin health care system.
Decorative tattoos have a history dating back at least 5000 years. The desire to remove them has probably existed just as long. Early attempts to remove tattoos have had less than desirable results. The use of dermabrasion, salabrasion, and Argon or C02 lasers have left behind scars in place of the tattoo.
The advent of Q-Switched lasers has permitted the removal of most tattoo inks with a very low risk of scarring. The Medlite Q-Swtiched Nd:YAG laser is the newest in this class of lasers. The Medlite can significantly lighten or remove many tattoo inks, and is particularly advanced in the removal of blue, black, and red inks. The Medlite laser removes tattoo ink with the energy of light. Just as natural sunlight is made up of light wavelengths of many colors, a laser is a device which is designed to produce one or more specific wavelengths of light. These wavelengths are either absorbed, reflected, or simply passed through objects. Tattoo ink is removed by using a specific wavelength which passes through the skin but is absorbed by the ink. The rapid absorption of light energy causes the tattoo ink to destruct, where it is then removed by the body’s natural filtering systems.