Often times, drooping eyebrows, and a wrinkled forehead are the first signs of aging. Inevitably, looking ( but not feeling ) tired or sad results. An “Endoscopic-browlift” is used to correct a drooping browline, reduce forehead wrinkles, and elevate the upper eyelids. The result is a refreshed, youthful appearance without that “operated-on” look. 

The surgery involves a few (two to five) relatively small incisions within the hairline. An “endoscope” (a thin cable attached to a video camera) is inserted and the muscles, nerves and other tissues are manipulated, and modified. The upper eyelids are elevated, the entire forehead is repositioned, and the eyebrow arch is re-established. The procedure usually lasts one to two hours and is performed on an outpatient basis. 

The term, ‘Facelift’ describes a variety of procedures used to tighten, elevate, re-drape, or re-distribute any combination of muscles, skin, and fat of the neck, jaw, cheeks, and forehead. The operation must be customized to satisfy the specific needs of each individual patient. The surgery can be performed on an outpatient basis, although many patients prefer the luxury of an overnight stay. In an attempt to hide the incisions, they are placed in areas where they are least likely to be noticed, such as behind the ears, or within the hairline or scalp. Bruising and swelling typically resolve in ten to fourteen days. 

Many patients ask, “How long do the results last?” 

Although the results are lasting, a facelift does not stop the clock. It merely sets it back several years! Healthy living, good nutrition, sun precaution, and cessation of smoking will add to the overall benefit one reaps from having a facelift.

Otoplasty is performed to set back a person’s ear which are basically too prominent. These are normally performed on children, although it is not uncommon for adults to have this procedure. The minimum age is 5 years. The recovery period for both children and adults is 5-7 days.

Typical modifications may include lowering the “hump,” elevating and/or thinning the tip, and narrowing the bridge. If the nose is wide, it may be necessary to narrow the nose by fracturing and re-positioning the bones. A cast is often placed on the outside, and soft rubber splints on the inside. These are removed in 5-7 days.

Drooping upper lids and puffy bags under the eyes are features that make you look old and tired. A Blepharoplasty, or “eyelid lift” is a common procedure in patients over 40, although some patients in their thirties develop premature saggy lids and fat pads, and can benefit from this operation. A Blepharoplasty tightens muscles, removes and/or repositions fat, and excises excess skin from the eyelids. The effect is a more rested, youthful brighter appearance.

Blepharoplasty can be performed on the upper lids, lower lids or both. The procedure takes approximately one to two hours depending on the extent of the surgery. Post-operative discomfort is minimal and the first 24 hours should be spent lying down, with cool packs on the eyes. You should expect some swelling and bruising following the surgery, which typically resolves within one to two weeks.

Often time performed in conjunction with a rhinoplasty, a mentoplasty will modify the projection and size of the chin. Many patients with a prominent nose also have a recessed chin, and the combination of rhinoplasty and mentoplasty is a winning combination.

The procedure of chin augmentation can be performed with an artificial chin implant, or (as preferred by Dr. Branfman) the bone can be cut, advanced, and secured in the new position. These procedures are performed through incisions inside the mouth, thereby leaving no external scars.

Small breasts may be due to under-development, weight loss, or atrophy after pregnancy. Breast enlargement is performed with the placement of breast implants (either saline or silicone) beneath the breast tissue and either above or below a muscle. A small (less than four cm) incision is made either in the fold beneath the breast, at the junction of the dark areola tissue and lighter skin, or through the armpit. There is not one ‘right way’ to do the operation , just as no key fits every lock . All patients are evaluated individually, and different techniques are discussed.

Breast augmentation is performed on an outpatient basis. You can usually return to work in 3-5 days; recommence most activities by 2 weeks, and at 6 weeks, vigorous exercise is resumes. Breast implants were invented by a human being, and are made in a factory. They will not last forever. But, then again, either will we!

The effects of ‘breast maturity’, i.e., time, gravity, weight changes, hormonal fluctuations, pregnancy, and breast feeding, have an obviously detrimental effect on breast appearance. As these changes take their toll, the skin loses its elasticity, the breasts lose their shape and firmness and become ptotic (saggy). Mastopexy is the general term for any procedures used to reduce ptosis. Depending on the amount of tissue loss, and the degree of ptosis, several techniques may be used to improve the condition, all of which involve some combination of:

• • Skin tightening
  • Skin excision
  • Gland repositioning
  • Nipple elevation

The most common techniques include:

• • Periareolar mastopexy (Removing excess skin around the nipple only)
  • Vertical mammoplasty ( Removing skin around and below the nipple, and elevating the nipple)
  • Inverted T ( Tightens the entire skin “brassiere,” including at and above the fold)
  • Mastopexy with augmentation ( Tightens skin, repositions nipple, and replaces lost volume with the placement of breast implants. )

The length of the surgery and extent of scarring depends on the chosen procedure.

Large, uncomfortable breasts can be a burden, both physically and emotionally. Back pain, shoulder discomfort, and posture abnormalities result in an overall pain in the neck . They can compromise self-esteem, and dominate a woman’s body.

Contemporary breast reduction techniques not only remove excessive breast tissue, resulting in a more proportionate and comfortable size, they also can result in an attractive figure, more youthful appearing breasts, and a boost in self- confidence.

According to Dr. Branfman, the reconstruction of a breast after mastectomy is the epitome of plastic surgery. It is an amalgam of medicine, surgery, anatomy, psychology, reconstructive surgery, and aesthetic plastic surgery. Dr. Branfman has been performing breast reconstruction since 1989, and spent time under the guidance of the masters at both St. Joseph Hospital, and M.D. Anderson Cancer Center.

Breast Reconstruction can be performed immediately (i.e. in conjunction with mastectomy) or delayed (i.e., months or years later). Various techniques are available, including:

• • Tissue Expansion (Placing and slowly filling temporary implants that gradually stretch the tissues, which are replaced with more permanent implants a few months later.)
  • Latissimus Dorsi Flap (Using a back muscle and skin to form a breast. Usually, an implant is necessary as well.)
  • TRAM Flap (Utilizing a patient’s abdominal fat and skin to form a natural feeling and looking breast, without the need for a breast implant.)

A consultation will provide you with extensive information and details regarding the many available options for post-mastectomy breast reconstruction.

54 Year Old Patient Several Years After Mastectomy

One Year After Breast Reconstruction

Five Years After Breast Reconstruction

LIPOSUCTION is a technique which can contour and debulk localized areas of fat that are disproportionate with the rest of your body, resulting  in more definition and a sleeker contour.

Although traditional liposuction is an effective tool, Dr. Branfman prefers Nutational Custom Acoustic Liposuction, also known as  Tickle Lipo. The technology uses  3D acoustic energy which is more comfortable for the surgeon and less traumatic for the patient.

The instrumentation vibrates ultrasonically which allows the device to glide through tissues and remain cool during the procedure posing less risk to surrounding tissue than ultrasonic and laser liposuction procedures.

Regardless of which technique is used, Liposuction is not a weight-loss procedure!

It is a technique which, when combined with proper diet and exercise, can shape and contour areas of diet-resistant fat.

In order to control quality and cost of surgery, Dr. Branfman joined a small group of surgeons and established “The Surgery Center of Victoria”, a privately owned free-standing outpatient surgical facility. This facility houses the regions only Custom Acoustic Nutational Infrasonic Liposuction equipment.

For more detailed information, click here to view an article on Tickle Lipo, or here to view a video.

Generally referred to as a “tummy tuck,” abdominoplasty removes excess fat and skin from the abdomen. The procedure may also help to flatten the abdomen by tightening underlying muscles.

The most common candidates are women after multiple pregnancies, and both men and women who, after weight loss, are left with loose redundant abdominal skin.

If you are in generally good physical shape but are concerned about abdominal fat deposits or loose skin that does not respond to diet and exercise, the procedure can reduce a protruding abdomen. Abdominoplasty will produce a permanent scar, the size of which varies depending on the extent of the procedure.