GLOSSARY OF TERMINOLOGY

Abdominoplasty (Tummy Tuck)
Sometimes after multiple pregnancies or large weight loss, abdominal muscles weaken, and skin in the area becomes flaccid. Abdominoplasty can tighten the abdominal muscles and, in some instances, improve stretch marks. In both men and women, the procedure will remove excess skin and fat. Generally, an incision is made across the pubic area and around the umbilicus (navel). When skin laxity and muscle weakness is confined to the lower part of the abdomen, a modified abdominoplasty that limits tissue removal and muscle repair to the area below the umbilicus may be performed. This usually leaves a shorter scar and no scarring around the navel.

Alexandrite Laser (see GentleLASE® Laser)
Uniform light at wavelength 755 used for laser hair removal, sunspot, and vein treatments.

Alpha Hydroxy Acids
Alpha hydroxy acids are derived from foods, such as fruits and milk, and can improve the texture of skin by removing layers of dead cells and encouraging cell regeneration.

Arm Lift (see Brachioplasty)

Augmentation Mammoplasty (see Breast Augmentation)

Benelli Lift (see Tacking)

Blepharoplasty (see Eyelid Surgery)

Body Lift
A body lift is surgery performed to correct excess loose and sagging skin. Surgical body lifting improves the shape and tone of the underlying tissue that supports fat and skin. Incision patterns vary based on the area or areas treated as well as the degree of correction and patient and surgeon preference. Body lift procedures include abdominoplasty, thigh lift, brachioplasty (arm lift), and breast lift surgery.

BOTOX
BOTOX® Cosmetic is a simple, non-surgical, treatment that can temporarily smooth moderate to severe frown lines between the brows. BOTOX® Cosmetic is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows to form over time.

Brachioplasty (Arm Lift)
Brachioplasty improves the contours of the upper arm area with incisions typically placed in the inner arm region.

Breast Augmentation (Augmentation Mammoplasty)
Breast augmentation 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. An incision is made either under the breast, around the areola (the pink skin surrounding the nipple) or in the armpit. A pocket is created for the implant either behind the breast tissue or behind the muscle between the breast and the chest wall.

Breast Enhancement (see Breast Augmentation)

Breast Lift (Mastopexy)
Frequently, a woman elects this surgery after losing a considerable amount of weight, or losing volume and tone in her breasts after having children. The plastic surgeon relocates the nipple and areola (the pink 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. Scars are around the areola, extending vertically down the breast and horizontally along the crease underneath the breast. Variations on this technique, in some cases, may result in less noticeable scarring.

Breast Implants
A breast implant is a prosthesis used in cosmetic surgery to enhance the size and shape of a woman's breasts (known as breast augmentation) or to reconstruct the breast (for example, after a mastectomy). Implants are breast-shaped pouches that are saccular in shape, made of a silicone outer shell, and filled with silicone gel or saline (salt water), are used. These implants are currently the only ones available in the United States.

Breast Reduction (Reduction Mammoplasty)
Breast reduction involves removing excess breast tissue and skin, repositioning the nipple and areola (the pink skin surrounding the nipple) and reshaping the remaining breast tissue.

Buccal Fat Pad
Buccal fat pads are located above the jawline near the corner of the mouth. They can be removed in individuals with excessively round faces to give a more contoured look, sometimes referred to as the “waif look”. However, plastic surgeons warn that, in some individuals, removal of the buccal fat pads can lead to a drawn, hollow-cheeked look as aging progresses.

Buttock Lift
Excess fat and loose skin in the buttock area can be reduced by performing a buttock lift in combination with lipoplasty (liposuction). Incisions required for skin removal can often be hidden in the fold beneath the buttocks.

Cannula
A hollow tube attached to a high-vacuum device used to remove fat through liposuction. The plastic surgeon manipulates the cannula within the fat layers under the skin, dislodging the fat and “vacuuming” it out.

Capsular Contracture
Capsular contracture is the most common problem associated with breast implants. It occurs when naturally forming scar tissue around the implant shrinks and tightens, making the breast feel firmer than normal and sometimes causing pain and an unnatural appearance of the breast.

Captique®
Captique is a clear gel containing a purified form of hyaluronic acid, adds volume lost during the aging process by temporarily smoothing out facial lines and wrinkles. Captique is injected just under the skin’s surface in order to temporarily correct wrinkles.

Cellulite
Cellulite is the dimpled-looking fat that often appears on the buttocks, thighs and hips.

Chemical Peel
Fine lines and wrinkles around the mouth and on the forehead and cheek areas may be improved with a wide range of skin treatments. A chemical peel solution is applied to the entire face or to specific areas to peel away the skin's top layers. Several light to medium depth peels can often achieve similar results to one deeper peel treatment, with less risk and shorter recovery time. Peel solutions may contain alpha hydroxy acids, tricholoracetic acid (TCA) or phenol as the peeling agent, depending on the depth of peel desired and on other patient selection factors.

Chin Augmentation (Mentoplasty)
Chin augmentation can strengthen the appearance of a receding chin by increasing its projection. The procedure does not affect the patient's bite or jaw. There are two techniques: one is performed through an incision inside the mouth and involves moving the chinbone, then wiring it into position; the other approach requires insertion of an implant through an incision inside the mouth, between the lower lip and the gum, or through an external incision underneath the chin.

Cohesive Gel
This refers to thickness of the silicone implants. All silicone implants are cohesive; however, some are more than others. The most cohesive silicone gel implants available are the form stable cohesive gel 410 implants from Allergan.

Collagen Injections
Collagen is an injectable protein that can be used to treat facial wrinkles. Patients to be treated with collagen should first be tested for any allergic reaction. The results of collagen injections are not permanent, and treatments must be repeated periodically to maintain results.

Cosmoplast™
Cosmoplast is a cosmetic filler made of human collagen used to smooth unwanted lines and wrinkles. It also adds definition to the lip border. Results typically last three to four months and is used frequently in conjunction with hyaluronic acid.

Dermabrasion
Dermabrasion is a procedure in which a high-speed rotary wheel, similar to fine-grained sandpaper, is used to abrade the skin. It may be recommended when there is extensive sun damage and heavy skin wrinkling. In addition, dermabrasion can be used to improve the texture of pockmarked skin resulting from severe acne or chicken pox. Following treatment, the skin should appear firmer and smoother, but permanent pigment changes may occur.

Earlobe Reduction
A simple, 30-minute procedure, earlobe reduction can be performed in a plastic surgeon's office or at the same time as a facelift operation. The earlobe should not comprise more than 25 percent of the total length of the ear. In cases where it exceeds this dimension, an L-shaped wedge is cut away, the earlobe edges are brought together and sutured.

Eyelid Surgery (Blepharoplasty)
Aesthetic eyelid surgery reduces the fat that causes bags beneath the eyes and removing wrinkled, drooping layers of skin on the eyelids. Incisions follow the natural contour lines in both upper and lower lids, or can be done through the lining of the lower eyelid, providing access to skin and fatty tissue. The thin surgical scars are usually barely visible and blend into the eyes' natural lines and folds.

Facelift (Rhytidectomy)
A facelift can reduce sagging skin on the face and neck. Incisions are placed in the hairline and then pass in front of and behind the ears; the exact design of incisions may vary from patient to patient and according to the surgeon's personal technique. When necessary, removal of fatty deposits beneath the skin and tightening of sagging muscles is performed. The slack in the skin itself is then taken up and the excess removed. Scars can usually be concealed by hair and makeup.

Fat Injections
Fat withdrawn from one body site can be injected into another—for example, to smooth lines in the face or build up other features such as the lips. In most cases, a percentage of injected fat is reabsorbed by the body, and the procedure must be repeated. Injection of fat to enlarge the breasts is a dangerous procedure and is not recommended because of the possibility of dense scarring that may seriously hinder accurate interpretation of both breast self-exams and mammograms.

Fibrel
Fibrel is a synthetic substance which is an alternative to collagen and fat injections for the treatment of facial wrinkles. As with collagen and fat, fibrel treatments must repeated at intervals to maintain correction.

Flash Lamp Pump Dye Laser (see Vbeam)
Uniform light generated at 545 wavelength used for wrinkles, rosecea, angiomas, and facial veins. This type of laser has a long history of use in the medical field and is used for most “red” lesions.

Forehead Lift (Brow Lift)
The forehead lift is designed to correct or improve skin wrinkling, as well as loss of tone and sagging of the eyebrows that often occurs as part of the aging process. The procedure may also help to smooth horizontal expression lines in the forehead and vertical frown lines between the eyebrows. Incisions are placed behind the hairline above the ear and pass over the top of the head. In some cases, incisions may be placed in front of the hairline. Some patients may have the procedure performed with the use of an endoscope, requiring much shorter incisions.

410 Cohesive Gel Implants
The Style 410 Silicone-Filled Breast Implants are the latest style of silicone gel implants. The Style 410 is a textured, teardrop-shaped implant filled with a “cohesive” silicone gel, which is more like a soft solid which helps the implant maintain its shape. Unlike liquid-filled implants, the Style 410 is less likely to leak, wrinkle, fold or ripple. These implants are only available to physicians and their patients involved in the Inamed clinical study.

GentleLASE® Laser
The Candela GentleLASE is a laser used for permanent hair removal laser, and for removal of brown pigments such as freckles, melasma, sun damage, blue veins, and café au lait birth marks.

Gummy Bear
Refers to the form stable cohesive gel implant currently on study by the FDA. Allergan is a leading manufacture of this implant for which there are more than 100 choices. One can match the individual breast in augmentation, revision, and reconstruction. Dr. Peter Capizzi is a co-investigator for the FDA study and has placed many of these implants.

Gynecomastia
Gynecomastia is a condition in which the male's breast tissue enlarges. Increase in tissue usually occurs at times when the male is having hormonal changes, such as during infancy, adolescence, and old age.

Hyaluronic Acid
Hyaluronic acid exists naturally in all living organisms and is a universal component of the spaces between the cells of body tissues (extracellular space). It is a polysaccharide that has an identical chemical structure, no matter whether it is found in simple bacteria or in human beings. Restylane®, Captique®, and Juvéderm® are all forms of hyaluronic acid.

Hydroxyapatite Granules
Hydroxyapatite granules are a bone substitute made from coral that can be used to enhance facial contours, such as forming more prominent cheekbones. The substance also has reconstructive uses in craniofacial surgery. Radiesse® is the brand name for calcium hydroxyapatite.

IPL
Intense pulsed light is frequently misquoted as being a laser, but is not. Light is used to treat sun damaged skin and at times hair removal.

Juvéderm™
Allergan’s hyaluronic acid filler for nasolabial folds, lips, mouth wrinkles, cheeks, and scars. The product comes in both the Ultra and Ultra+ forms lasting for six to 12 months.

Lasers
Lasers can be effectively used to eliminate surface blood vessels on the face that become reddened and enlarged due to sun exposure. The problem is most often seen in fair-skinned individuals who cannot tan or have difficulty tanning. The use of lasers for skin resurfacing is effective in reducing the effects of sun damage. Laser resurfacing is an alternative to chemical peel for some patients. We use the Candela GentleLASE and the Candela Vbeam.

Latissimus
Latissimus surgery is a breast reconstruction surgery after a mastectomy. This procedure takes a section of muscle, fat, and skin that remains attached from the back and tunnels it through the armpit. The flap is attached over the chest wall muscle making a pocket in which an implant can be placed.

Lifestyle Lift® (see Mini Facelift)
A trademark term of the mini facelift.

Lip Augmentation
A permanent method of augmenting the lips is accomplished by surgically advancing the lip forward, with incisions placed inside the mouth. A dermal-fat graft, taken from the deeper layers of the skin, may then be positioned under the mucosa (the lining of the lip) to add additional “plumpness”. Injecting fat collagen or other substances for lip augmentation is another alternative. The correction is not permanent, and injections must be repeated periodically to maintain results.

Lip Lift
A technique that surgically lifts the corners of the aging mouth can eliminate the pronounced droop and unhappy facial expression that often develops with advanced age. By cutting away small diamonds of skin just above the corners of the mouth, the vermilion (border of the lips) is raised into a slight smile.

Lip Reduction
To reduce the lips, a small strip of the mucosa (the lining of the lip) is surgically removed to narrow the lips to the desired proportion. The small scars on the outside of the lips are barely noticeable.

Lipodissolve™
A procedure involving injection of multiple products that are not FDA approved for dissolving of fat. This procedure can be dangerous to the liver and result in unwanted asymmetries.

Lipoplasty (Liposuction)
Lipoplasty allows the plastic surgeon to remove localized collections of fatty tissue from the legs, buttocks, abdomen, back, arms, face and neck using a high vacuum device. The procedure leaves only minute scars, often as short as one-half inch in length or less. The use of refined equipment allows removal from delicate areas such as calves and ankles. Lipoplasty removes fat, but it cannot eliminate dimpling or correct skin laxity. If a patient's skin has lost much of its elasticity, the plastic surgeon may recommend a skin tightening procedure such as a thigh lift, buttock lift or arm lift, all of which leave more extensive scars.

Malar Augmentation (Cheekbone Augmentation)
The cheekbones may be built up by placing an implant over them. This is usually performed through an incision within the mouth, but it may be done through a lower eyelid or brow lift incision.

Mastopexy (see Breast Lift)

Mini Breast Lift (see Tacking)

Mini Facelift
A limited incision facelift that can involve only lifting the mid face or the neck through limited dissection. The results can be varied and not has great as a classic facelift.

Mixto SX
The Mixto CO2 Fractional Laser is a CO2 laser light that is computerized and treats the skin at specific points. This shortens downtime and allows for contraction in the untreated areas. It is excellent for improving scars caused from acne.

Neck Lift
A procedure using an incision behind the ears in the hairline with limited dissection to improve the neck.

Otoplasty (Ear Surgery)
The ears are positioned closer to the head by reshaping the cartilage (supporting tissue). This is usually accomplished through incisions placed behind the ears so that subsequent scars will be concealed in a natural skin crease. Otoplasty can be performed on children as early as age five or six.

PAL
Power-Assisted Liposuction is the use of a reciprocating cannula to remove fat. It can be easier on the tissue depending on the area.

Peel (Buffered Phenol)
Buffered phenol offers yet another option for severely sun-damaged skin. One such formula uses olive oil, among other ingredients, to diminish the strength of the phenol solution. Another slightly milder formula uses glycerin. Buffered phenol peels may be more comfortable for patients, and the skin heals faster than with a standard phenol peel.

Perlane®
A hyaluronic acid filler made by Medicis, said to last longer than Restylane®.

Phenol
The chemical phenol is sometimes used for full-face peeling when sun damage or wrinkling is severe. It can also be used to treat limited areas of the face, such as deep wrinkles around the mouth, but it may permanently bleach the skin, leaving a line of demarcation between the treated and untreated areas that must be covered with makeup.

Platysma
The muscle which, when tight and firm, gives the neck underneath the chin and jawline its youthful contour. The platysma muscle can be tightened during a facelift or as a separate procedure.

Ptosis
Dropping or drooping of an organ or body part.

Quicklift™ (see Mini Facelift)
A trademark term of the mini facelift.

Radiesse®
Calcium hydroxyapetite crystals in the form of an injectable. Each crystal is encapsulated by a dissolvable product which resorbs in approximately six months. Originally used for vocal cords it is now used for nasolabial folds.

Restylane®
RESTYLANE® is a crystal-clear, biodegradable NASHA (Non-Animal Stabilized Hyaluronic Acid) gel, which is injected into the dermis in tiny amounts with a very fine needle. The result is instantaneous, producing a long-lasting, natural enhancement, gentle and safe to the skin. Most patients use Restylane to plump up their lips, nasal labial folds, or other facial areas.

Retin-A
Retin-A cream or lotion may be applied to enhance the overall texture of the skin and is often prescribed as a pre-treatment prior to a facelift or chemical peel.

Rhytidectomy (see Facelift)

Sciton BBL
The Sciton Profile BBL photofacial system is a broadband light treatment specially designed for the treatment of sun damaged skin. It is excellent for the face, neck, chest, and hands.

Sclerotherapy
This procedure treats spider veins of the legs and small varicose veins with the use of a saline or alcohol based solution. The process takes 20-30 minutes depending on the size of the treatment area.

Silicone
The most common product worldwide used for breast implants. A silicone polymer forms the actual solid container for saline in the saline (saltwater) implants.

SMART Liposuction
The use of a laser to heat fat and change the fat from solid to an emulsion. The technology does not remove fat. The fatty liquid is removed by traditional means.

SMAS
The superficial musculoaponeurotic system (SMAS) is a layer of tissue that covers the deeper structures in the cheek area and is in continuity with the superficial muscle covering the lower face and neck, called the platysma. Some facelift techniques lift and reposition the SMAS as well as the skin.

Superficial Syringe Liposculpture
Use of a syringe to withdraw fat, instead of vacuum suctioning pumps, allows for less blood loss and speedier postoperative recovery. Superficial syringe liposculpture is performed on the layer of fat just beneath the skin.

Tacking
Can be a “mini” breast lift, Benelli lift, or circumareolar breast lift. The procedure involves removing 2-3 cm of skin usually around the nipple-areola area. It is frequently used with a breast implant, saline or silicone.

TCA
Trichloroacetic acid is used for peeling of the face, neck, hands and other exposed areas of the body. It has less bleaching effect than phenol, and is excellent for “spot” peeling of specific areas. It can be used for deep, medium or light peeling, depending on the concentration and method of application.

Thermage®
A radiofrequency machine that heats soft tissue in an attempt to decrease wrinkling. The enthusiasm for this procedure has markedly diminished over the past five years.

Thigh Lift
A thigh lift can be performed to tighten sagging muscles and remove excess skin in the thigh area. Because a thigh lift leaves noticeable scars in the inner or outer thigh area that some patients find undesirable, it is not a frequently performed procedure.

Tissue Expansion
Tissue Expansion is a procedure for breast reconstruction following mastectomy. A pocket is created between the chest wall and the chest muscle to hold the balloon expander. The expander is gradually filled over a period of one to two months by injecting saline through a small port, which gradually stretches the skin and muscle. Once the breast mound is to the desired size, the expander is removed and replaced with an implant filled with either saline or silicone. The nipple/areola area is reconstructed by using tattooing and pieces of skin.

TRAM
The TRAM procedure is used for breast reconstruction following mastectomy. The procedure takes a section of abdominal muscle, fat, and skin that is still attached to its blood supply (pedicled tram) and tunnels it up to the chest area. It is sewn in place to build a “breast mound”. With the muscle-sparing pedicled tram, one third (33%) of the muscle is used. This conserves 70% of the abdominal muscle traditionally described for this procedure. The nipple/areola area is reconstructed by using tattooing and pieces of skin.

Transconjunctival Blepharoplasty
Transconjunctival blepharoplasty (eyelid surgery) is performed by making an incision from inside the lower eyelid. It avoids any scarring on the lower lid. It is a useful technique when only fat, and not skin or muscle, needs to be removed from the eyelid area.

Tumescent
The use of saline with lidocaine and epinephrine injected into fat prior to liposuction. This allows for decreased bruising and easier removal of tissue.

Vbeam
The Candela Vbeam® Laser is the gold standard in the treatment of vascular lesions, such as broken facial capillaries and rosacea as well as in the treatment of red acne scars, surgical or burn scars, angiomas, port wine birth marks, psoriasis and wrinkles.

Wise Pattern Lift or Reduction
The use of an anchor style incision for lifting for reducing the breast.