Face

We believe every face is beautiful. Our goal isn't to "change" the way you look, but rather, to accentuate the radiance and beauty that is unique to you. As we age, our face undergoes changes due to life, weather, stress, and natural aging. At UPS, we have a number of surgical and non-surgical options to help you bring your best face forward.

Characteristic changes are observed in the face with increasing age. Wrinkles and skin laxity occur in the forehead, around the eyes, and in the cheek and neck. At the same time there is sagging of the deeper structures of the face including the cheek fat pad and the neck muscles. The changes that occur in the forehead and eye region, as well as the procedures to correct them, are reviewed in those respective areas of our web site. In the mid face the most prominent changes include: wrinkled skin, drooping cheeks, deepening of the crease adjacent to the mouth, and the development of jowls. In the neck there is progressive softening of the jaw line and the development of loose skin and muscular bands beneath the chin. These changes are best corrected with a facelift.

During a facelift the deeper structures, such as the cheek fat pad and neck muscles, are re-suspended under significant tension to obtain a long lasting correction. The excess skin is then removed and the remaining skin is gently re-draped to achieve a more natural appearance. This helps avoid the “wind swept” appearance and distortion of the hairline that was common with earlier facelifting techniques.

The incisions are carefully concealed within the hair and around the ear. With this operation it is possible to achieve prominent, smooth cheeks with a clean jaw line and a tight neck. This procedure is commonly performed in conjunction with a brow lift and blepharoplasty (eyelid surgery) to create a harmonious rejuvination of the upper and lower face. Individuals with severe neck laxity or an under projecting chin can benefit from the simultaneous placement of a chin implant.

Patients who are in good health can undergo this type of surgery in our office surgery center and be allowed home that night. You will be seen the day following your surgery for a quick check up and again at five to seven days for removal of stitches. Two weeks of recovery is generally necessary before returning to work and four to six weeks before engaging in strenuous activity.

To obtain the best results from your facial surgery Drs. Keller, Lovett and Blakemore strongly recommend that you begin a skin care program. The skin care treatments and products will help prepare your face for surgery. You may schedule a consult with our skin care specialist for a regimen designed for your skin type.

We also suggest a pre-op facial approximately one week prior to surgery and a series of lymphatic drainage facials beginning about a week to ten days post-op. These facials will help reduce your swelling, pain and bruising. They also smooth and soften scar tissue and speed recovery time. Ultrasound Vitamin C treatments may also be beneficial in combination with the facials. Your physician will tell you when this is necessary.

Your first two post-op facials are complimentary. It is suggested that you consult with your skin care specialist for the treatment program that will help you achieve your optimal result.

This is an extremely gratifying procedure with dramatic results. If you have additional questions regarding the facelift procedure please call the office for a brochure or schedule a consultation.

Upstate Plastic Surgery carries Jane Iredale Cosmetics which can help you return to your active lifestyle as early as possible.

The midface lift is the latest procedure designed to rejuvenate the central part of the face. This procedure is best for relatively young patients who have developed sagging of the cheek and deepening of the crease adjacent to the mouth, but who do not have significant aging of the jaw line and neck. The operation is performed through small incisions in the mouth, scalp and often the lower eyelids. If you have additional questions please contact the office for more information.

The "mini-face lift" addresses aging of the face. For patients who do not require as much correction this procedure offers the advantage of shorter incisions. This operation is best for patients who have a loss of elasticity in the skin and soft tissue of the face, but not the neck. This procedure may also be combined with a midface lift, fat grafting or injectable fillers to further rejuvenate the midface.

Eyelid tuck or blepharoplasty is performed to eliminate a tired, aged look. This is done by removing excess skin and bulging fat restoring a more open youthful appearance to the eyes. For women this will allow much easier application of eye makeup by eliminating the over hanging skin. The scars are well hidden and the results are striking. These procedures are sometimes performed in conjunction with a brow lift to more harmoniously rejuvenate the entire upper third of the face.

The gradual sagging of the eyebrows is responsible for many of the changes around the eye associated with aging. Brow ptosis, or sagging, creates excess upper eyelid skin, narrowing of the eye and a tired and angry appearance. A brow lift is a procedure that elevates the eyebrows back to their youthful position. This operation has an enormous impact on the face, giving it a much more youthful and rested appearance. With the aid of an endoscope, this operation can now be done through three small incisions hidden in the hair. The end result is elevation of the brow and reduction of the wrinkles commonly seen between the brows, in the central forehead and around the lateral eyes (crow's feet). This outpatient surgery can be done in the office surgical suite and the recovery time is approximately a week to ten days. This surgery is commonly done in conjunction with eyelid surgery or a facelift and eyelid surgery.

Patients who have high hairlines, or significantly receding hairlines, may benefit from an open brow lift procedure. In this situation an incision is made along the hairline to allow access to the brow. Excess skin is removed and the muscles that cause frown lines are weakened. This results in brow elevation, elimination of wrinkles and can actually lower the hairline to a more normal position.

By virtue of its central location, the nose is a very prominent feature and a major source of dissatisfaction to people regarding their appearance. Individuals unhappiness with the appearance of their nose can be related to congenital issues (large humps, boxy tips, wide noses, excessive length or drooping tips) or post traumatic injuries) or post-traumatic deformities. In addition to cosmetic issues, there can be functional problems with the nose resulting in difficulties breathing. A thorough consultation and extensive preoperative planning are essential to a successful outcome with nasal surgery. During your consultation you will be asked to define the specific concerns you have and the changes you hope to achieve. A careful history covering nasal trauma, prior nasal surgery, allergies, and breathing problems will then be obtained. Finally, a careful examination of the internal and external structures of the nose will be performed. Photographs and computer imaging can be very helpful in this situation, to help demonstrate the effect of various surgical alterations on the shape and appearance of the nose.

The appearance of the nose is strongly affected by the surrounding facial structures. Some individuals who have an under projecting or “weak” chin benefit from a chin implant. This puts the nose in better proportion with the rest of the face and will make the nose look smaller.

Rhinoplasty (nasal surgery) can be performed in the office surgery center, usually under general anesthesia. Surgeries involving significant alterations in the tip of the nose are usually done in an “open” fashion. Technically this means a small incision is made at the base of the thin divider between the nostrils. This allows the surgeon to see the structures he or she is working on directly, giving much greater precision and control. The surgery usually takes about two hours and recovery is ten days to two weeks depending on how extensive the surgery is. A splint is generally worn on the outside of the nose for one to two weeks and internal splints are used if work is done to improve breathing (septoplasty). The swelling typically lasts about a week and the bruising lasts two to three weeks.

Surgery done to correct the effects of trauma (a crooked nose, a deviated septum causing breathing problems) may be covered by your insurance. Typically, you will need documentation of the injury such as x-rays and notes from the emergency room or your physician documenting the injury. Operations performed to change the appearance of your nose are considered cosmetic and will not be covered by your insurance. If you desire cosmetic changes for your nose, but also have breathing problems related to a deviated septum, your insurance may cover the cost of the septoplasty.

Prominent ears, ears that appear to stick out excessively, are the most common reason for surgery. Otoplasty, ear surgery to set the ears back closer to the scalp, is done to correct prominent ears for both men and women. Prominent ears can be a source of embarrassment and teasing from childhood on. This procedure can be done late childhood on through an incision hidden in the crease behind the ear. Protective ear compression is used for approximately 2 weeks and the recovery is quick and easy.

Torn earlobes are another common problem that can be easily corrected. This situation usually results from the use of heavy earrings or accidental trauma. The earlobes will not heal together without surgery. This repair can be done in the office under local anesthesia.

Chin enhancement is a frequently performed surgery that helps restore a harmonious appearance to the face. People who feel they have a weak or under-projecting chin can be treated by placement of a chin implant. Chin augmentation can also be a very useful adjunct to nasal surgery, helping to bring the nose into better proportion with the rest of the face. Chin augmentation can also be very helpful in neck lift procedures to tighten the skin and improve the definition between the neck and chin.

Liposuction of the chin and neck area is a surgical procedure designed to reduce the excess fat sitting underneath the chin area. The best candidates need to have good skin tone and minimal sun damage. The procedure requires less than a week of downtime with noticeable results right after surgery.

Our hair is one of our most distinguishing features, as well as a sign of youth. Hair also shields us from the heat, cold and the sun’s ultraviolet rays. It is easy to see why the loss of hair and effect on one’s appearance is so concerning to those experiencing hair loss. Hair loss affects over 35 million people in the United States. The most common type is male pattern baldness, or androgenetic alopecia. High levels of androgens or dehydrotestoserone result in hair loss for these patients. There is also a genetic component that can be inherited from either the mother's or father's side. This type of hair loss is usually progressive, but the severity overall is unpredictable. It usually starts in the temporal areas, followed by the vertex of the scalp. Often the rate of loss will slow by age 40, but never stops completely.

Hair loss in women usually follows a different pattern than in men with more diffuse thinning over the top of the scalp. This loss may also be hormone related, as it is in men. This does not necessarily mean that these women have higher levels of hormones, but instead have more sensitive receptors for the hormones in there scalp causing the hair loss. However, there are other cause of hair loss that affect women more commonly than men. Alopecia areata results in patchy areas of hair loss and may be due to an autoimmune disorder. Scarring alopecia is due to the formation of scar tissue in the scalp. This can be from surgery, injury or persistent tight braiding or “corn-rowing” of the hair. Telogen effluvium is sen when a large number of hairs go through the telogen phase at one time. The telogen phase is associated with shedding of the hair. Normally, 10% of hairs are in the telogen phase at one time. Telogen effluvium can be triggered by stress, medications, hormone imbalances or surgery.

Loss of eyebrows is another area where hair restoration surgery can be used with dramatic results. Loss in this area may be due to excessive plucking, traumatic injury, surgical scarring, or even congenital absence. Trestoring the eyebrow with micorgrafts can change the look of one's entire face.

There are 3 phases of hair growth: anagen, catagen, and telogen. Normally 90% of hairs fall into the anagen phase at one time. Here the hair grows at the rate of about 1cm per month. This phase usually lasts 3 years. During the catagen phase, the hair slowly separates from the surrounding tissue and over a 2-3 week period, and then progresses to the telogen phase where loss occurs and the follicle rests. The resting phase typically lasts 3-4 months. This resting phase is also commonly seen after hair restoration. In a patient experiencing hair loss, the rate of loss is greater than the rate of hair growth.

There are some useful medical therapies to complimenthair restoration surgery. Finasteride is an oral medication that blocks the formation of dihydrotestosterone, the hormone that causes hair loss. This can be useful in maintaining one’s hair and limitin gfurther thinning. It is only used in men and is not safe for women, children or adolescents. Minoxidil is a topical medication that is applied to the scalp to stimultate hair growth. This can be used in both men and women. Just like finasteride, it is more effective in the vertex and frontal scalp than the frontal hairline. Minosidil may be used alone or along with finasteride. many patients find that the use of these medical therapies enhance their result with hair restoration surgery.

Hair restoration surgery is a permanent way to improve one’s; hairline and hair density. The operation is done in an outpatient setting with minimal discomfort and minimal recovery involved. Most cases last between 4-6 hours, but this is variable. The donor hair is taken from the back of the scalp and then carefully prepared into follicular units for transplantation. follicular units contain 1-3 hairs each and are transplanted individually to give you the most natural look. The grafts are then inserted into tiny slits in the scalp in a pattern designed by your plastic surgeon. This pattern has both saggital and coronal incisions again making the most natural appearance. we pack the follicular units densley into the scalp with approximately 30-50 FU/cm2 depending on the patient’s donor characteristics. Our closures of the donor site are done with the most advanced trichophytic techniques making them almost imperceptible after healing. The number and placement of hair grafts will be discussed during your consultation. Our doctors will carefully plan an operation that will meet you raesthetic goals and leave you with the most natural appearance. We use the latest micrografting technique that truly mimic your natural hair growth and distribution. Hair restoration surgery is an effective way to improve your appearance and turn back the hands of time.

Breast

At some point in life, many women consider breast augmentation, reduction, or reconstruction. Our highly skilled team of doctors has successfully worked with thousands of women to help them achieve their specific goals. If you have had a mastectomy due to breast cancer, we offer reconstruction procedures customized for you.

Breast augmentation is an extremely popular procedure designed to enhance the size and shape of your breast. There are a variety of reasons for undergoing an augmentation, including small breast, breast ptosis (sagging with age), loss of volume due to childbearing or weight loss, and congenital breast asymmetry. Augmentation can help restore an aesthetically pleasing breast in all of these situations. Three different surgical incisions can be utilized:

  • Axillary (under arm)
  • Infra-mammary (under the breast)
  • Peri-areolar(around the nipple)

We perform all of these, including the axillary approach which eliminates all scars from the breast.

Cosmetic augmentations are performed utilizing saline or silicone gel filled breast implants which are available in several styles (moderate, moderate plus profile and high profile). The implant style and size that would be most appropriate for you is determined during your consultation.

Silicone gel implants are now available for primary cosmetic augmentations, provided the patient is at least 22 years of age.

In our practice, the silicone implants can be inserted through the same small incision as a saline implant. Our own physician developed a device that allows a “no touch” method to insert gel implants. The Keller Funnel has been used all over the U.S. and in several other countries to facilitate silicone gel breast augmentations as well as reduce infection rate.

The implants are generally placed beneath the muscle of the chest wall which gives a softer, more natural appearance.

This procedure can be done in our office surgery suite under general anesthesia and takes approximately 45-90 minutes. Recuperation takes about 5-7 days and possibly longer if your job requires heavy lifting.

Drs. Keller, Lovett and Blakemore would like to suggest massage therapy following your breast surgery.

Massage therapy will aid in reducing swelling, pain and bruising postoperatively. It can also alleviate the muscle spasms some patients may experience. This will help reduce the amount of muscle relaxants and pain medication you require. In addition, our massage therapists are experienced in scar massage which assists in minimizing the appearance of your surgical scars. A postoperative massage is suggested 7-10 days following your surgery.

Your first postoperative massage is complimentary and you are encouraged to consult with your massage therapist about designing a specific program to expedite your recovery and optimize your results.

Keller Funnel

Every decision you make surrounding your breast augmentation surgery is important. The fact that you are reviewing this information means you are interested in the very latest products and techniques available. The Keller Funnel was designed by our own Dr. Kevin Keller (plastic surgeon) to improve delivery of silicone gel implants during breast augmentation procedures.

Designed to facilitate the delivery of silicone gel implants during augmentation mammaplasty, The Keller Funnel is now used by trained surgeons throughout the United States, including all three of our surgeons. Inventor and our very own plastic surgeon Kevin Keller, M.D. developed the cone-shaped, nylon device with a special interior coating that allows doctors to easily propel an implant into place with minimal force. Experienced users of the Keller Funnel have realized the multiple benefits for both patients and surgeons.

Because every woman is different and individual results may vary, you should speak to your surgeon about the merits of the Keller Funnel that may include:

  • Shorter incision lengths
  • Improved comfort and faster healing
  • No touch technique
  • More choices for incision placement
  • Reduced force on the implant and incision

When contacting to learn more about The Keller Funnel, please feel free to request our "Patient Education Brochure", we'll be happy to send you one, alternatively please also feel free to visit: www.kellerfunnel.com

A breast lift, also known as a mastopexy, is a procedure designed to correct sagging of the breast. Ptosis, or sagging, can be due to aging, weight loss and child bearing. Re-shaping and lifting the breast is accomplished by removing excess skin.

The extent of the scars depends on how significant the sagging is. At a minimum the scar will encircle the nipple/areola region. With increasing amounts of excess skin, additional incisions become necessary extending from the areola to the fold under the breast, and within the fold under the breast. The incisions typically heal well, leaving very acceptable scars.

If you wish to restore the lost volume to the breast as well as to reshape them, the best results will be obtained with a combination of a lift and an augmentation with a breat implant. This procedure can be performed in the surgery center as an outpatient. Recovery time is brief and most individuals can return to work within a week.

Drs. Keller, Lovett and Blakemore would like to suggest massage therapy following your breast surgery. Massage therapy will aid in reducing swelling, pain and bruising postoperatively. In addition our massage therapists are experienced in scar massage which assists in minimizing the appearance of your surgical scars. A postoperative massage is suggested 7-10 days following your surgery.

Large breasts are commonly associated with a wide variety of unpleasant symptoms including:

  • Neck/back/shoulder pain
  • Deep grooves from bra straps
  • Skin rashes/infection
  • Poor posture
  • Difficulty exercising
  • Inability to obtain proper fitting clothing

Breast reduction surgery is designed to decrease the size and weight of the breast, thereby alleviating these symptoms. When the breast is reduced, it is also lifted and the nipple restored to the front of the breast. Most scars are red initially, but fade to a fine white line over a period of months.

This surgery is normally done on an outpatient basis and most people can return to work and regular activities within two to three weeks. The surgery may be covered by your insurance company if it is deemed to be medically necessary.

Drs. Keller, Lovett and Blakemore would like to suggest massage therapy following your breast surgery. Massage therapy will aid in reducing swelling, pain and bruising postoperatively. In addition our massage therapists are experienced in scar massage which assists in minimizing the appearance of your surgical scars. A postoperative massage is suggested 7-10 days following your surgery. Patients may return to work in 1-2 weeks.

Congenital breast asymmetry is a common condition affecting many women. As a young woman develops she may notice a difference in shape and/or size between her two breasts. A combination of the techniques described on this page can often be used to improve the appearance of the affected breast, as well as restore symmetry with the opposite side. Insurance coverage for these procedures vary by insurance company. A consultation with one of our doctors is needed to determine what procedures will be necessary for an individual patient.

Today, almost all patients with breast cancer are candidates for breast reconstruction. In most instances the reconstructive procedure is begun immediately following the mastectomy. This markedly reduces or eliminates the period of time during which the patient must live without a breast. Immediate reconstruction has repeatedly been shown to be safe and much better for the individuals’ emotional well being. Your surgical oncologist and plastic surgeon will work together to design the best operation for you.

Breast reconstruction is performed using either a synthetic implant, natural tissue borrowed from another part of the body, or a combination of both. Implant reconstruction is done in two phases: an initial operation when the tissue expander is placed under the chest wall muscle immediately after the mastectomy and a second operation when the tissue expander is removed and a permanent implant is placed. The tissue expander is an unfilled implant with a valve, which allows it to be slowly inflated in the office after surgery. The permanent implant is a saline or silicone gel filled prosthesis that comes in a variety of shapes and sizes. The implant used is chosen to best match the opposite breast. The advantages of this approach include a more rapid recovery and there are no additional scars off of the breast.

Breast reconstruction using your own tissue involves moving skin, fat and muscle from another area to replace the breast tissue. The lower stomach is the most common area to borrow tissue from, but the back can be used as well.

Body

Body image plays a huge role in our society. And it’s highly subjective. Body type is as unique and varied as each individual. We have worked with many people—both men and women—to help them attain the desired body goals they seek, through both surgical and non-surgical procedures. Our expert team will identify the best solution for you.

The common perception of beauty has undergone a gradual but dramatic change over the past 30 years. The emphasis placed by modern society on a lean, youthful appearance is largely responsible for the increase demand for surgical procedures to re-contour the trunk and legs by removing excess deposits of fat.

The patterns of fat accumulation vary between men and women, with women typically accumulating fat in the lower trunk, hips, upper thighs, and buttocks. In contrast, men tend to accumulate fat predominantly around the flanks and abdomen. Male breast enlargement can also occur as a result of weight gain.

Re-contouring and flattening of the abdomen is one of the most frequently requested procedures in our office. The protruding abdomen that many individuals develop can be due to muscle weakness, pregnancy, weight gain or significant weight loss. Correction of these changes is accomplished with either liposuction or abdominoplasty (also called a tummy tuck). Liposuction is most appropriate for people who have mild to moderate amounts of excess fatty tissue, good muscle tone, and skin quality with few or no stretch marks. An abdominoplasty, on the other hand, is extremely effective at tightening the abdominal muscles, and eliminating excess fatty tissue, loose skin and stretch marks. Reversing the changes of the abdomen associated with pregnancy is best accomplished with a tummy tuck, and the procedure can be safely performed in conjunction with gynecologic or urologic surgery. Liposuction can be utilized during an abdominoplasty to provide additional contouring in the flanks or to address excess fatty tissue in the thigh region.

Recovery is about 2 weeks and may be longer if your job requires heavy lifting. "Pain pumps" are available in our surgery center and provide significant pain relief during the early postoperative period. The pump slowly releases a local anesthetic controlling your pain without side effects. Drs Keller, Lovett, and Blakemore would also like to suggest massage therapy following your body re-contouring surgery. Massage therapy will aid in reducing soreness, swelling and bruising speeding up your healing process. Your first massage is complimentary in our media-spa.

A belt lipectomy is the latest surgical procedure designed to circumferentially recontour the waist. In addition to the benefits seen with an abdominoplasty, this procedure lifts sagging thigh and buttock tissue and increases the definition of the waist. This is an excellent operation for those who have had significant weight loss and now have loose skin. Although this operation requires slightly more operating room time, there is not significant increase in recovery time.

An arm lift or brachioplasty is a surgical procedure designed to reshape the upper arm. Fluctuations in weight ,as well as the aging process can reduce the elasticity of the skin causing a drooping, sagging appearance. While exercise is helpful in tightening the underlying muscle, it does not tighten the skin. A brachioplasty will enhance your appearance with a smoother, tighter upper arm. This operation may be safely combined with other cosmetic surgeries. The procedure is done outpatient in our AAASF certified surgery center, and recovery is approximately 1 week for most patients. Massage therapy will aid in reducing soreness, swelling and bruising speeding up your healing process. Your first massage is complimentary in our media-spa.

A thigh lift is a surgical procedure used to reshape the upper thigh. Good candidates include patients who have experienced weight loss, as well as those who have inherited their shape. The operation wild reduce excess skin and fat in the upper thigh resulting in a smoother and better proportioned contour. It can be safely combined with other cosmetic procedures. The procedure is done as an outpatient in our AAASF certified surgery center, and recovery is approximately 1 week for most patients. Massage therapy will aid in reducing soreness, swelling and bruising speeding up your healing process. Your first massage is complimentary in our media-spa.

Buttock augmentation is a procedure that has been gaining popularity over the past decade. The most common way to achieve this is with fat grafting utilizing your own tissue to enhance your look. This is also commonly referred to as a "Brazilian Butt Lift". Good candidates for this procedure include those who feel their buttocks are too small or are unhappy with their shape. The procedure can be combined with liposuction to balance your overall figure and restore a more youthful curve to your profile. This procedure is done as an outpatient in our AAAASF certified surgery center, and recovery is approximately 1 week for most patients.


UPS is accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). At our surgical center, you can feel confident that you are receiving the best quality care with each of our doctors. While choosing the right surgeon is of paramount importance, equally important is the facility in which the procedure is performed. The AAAASF looks to factors such as emergency readiness, equipment standards, and cleanliness in deeming a facility safe for surgical procedures. We are proud to be included in this list, and proud of the reputation we have earned over the years with the people we treat.