ROBERT HARVEY MD

Procedures






 

 

SURGICAL OPTIONS:

 

FACELIFT AND NECKLIFT 

Dr. Harvey is an expert surgeon in helping patients look refreshed and natural using surgical techniques for the face that he has perfected through years of experience.  As a leading provider of cosmetic procedures, Dr. Harvey ensures that patients achieve optimal surgical results in a safe state-of-the-art facility located in the Nob Hill area of San Francisco.

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FACELIFT & NECKLIFT Q&A
 

What is a Face Lift?

Facelift surgery will vary from patient to patient as each face has its own unique structure. A facelift is a surgical procedure used to counteract the visible signs of the aging process. This works by:

·        Correcting the sagging in the middle of the face
·        Repositioning the fat which has fallen in the face
·        Improving jowls to create a more defined and youthful jawline
·        Removing loose skin from the face
·        Tightening the facial muscle tone

During the surgical operation, an incision is made at the temples and ends towards the bottom of the hairline. After any excess fat is removed the skin is then tightened across the face to give a smoother and more youthful appearance. 

What is a Neck Lift?

A neck lift is a surgical procedure that works to tighten the muscles of the neck, removes excess fat, and excess skin which gives a more youthful appearance to the neck. Depending on the amount of skin which needs to be removed, the techniques will vary. The extent of muscle tightening needed will also be a factor affecting the neck lift technique used.

What can I expect as far as results?

Following surgery, as the inflammation subsides, the skin of the face or neck should look younger and refreshed. Following surgery, most patients have some swelling and bruising which will subside greatly in a matter of days and continue subsiding for about 3 to 4 weeks. Dr. Harvey will provide aftercare instructions for the face and neck as they heal. This can include a daily routine of sun protection, avoiding tight clothing which must be pulled over the head, and other recommendations designed to promote recovery. Dr. Harvey will be sure to work with you to create a treatment plan designed to help you achieve the best possible results.

When should I consider a Face Lift or Neck Lift?

When considering a facelift, it is very important to not only choose a surgeon with whom you feel confident, but to also choose one based on education, training and certification.  Being a member of the American Society for Aesthetic Plastic Surgery (ASAPS), you can be assured that Dr. Harvey is highly qualified and experienced. ASAPS members must be board certified by the American Board of Plastic Surgery and are members of the American Society of Plastic Surgeons. Be cautious as there are other similar sounding ‘Societies’ out there and it is not against the law for a physician who is board certified in another specialty to perform Aesthetic Plastic Surgery. In fact, it is possible for any given specialty to form a society of its own members which can cause great confusion for the patient.

A well-performed facelift is the pinnacle of a skilled Board Certified Plastic Surgeon. Another term for a facelift is rhytidectomy. Depending on the specifics of the procedure it may also be labeled a lower face lift with neck lift. Another term you might hear is a smas facelift wherein the platysma muscle is tightened during surgery. Each of these surgical procedures is designed to correct some or all of the following:

·        Aged face
·        Loose sagging skin of the face and neck
·        Deepening folds in the cheek, jowl and neck areas.

The ideal result is one that is subtle and natural-looking. Less is more when performing an optimal face lift. The goal is for you to look like a better version of yourself. 
For those who wish to address the signs of aging without going under the knife, or for those who would like to put surgery off, a liquid face lift is a viable option. From an aesthetic standpoint, the results can be quite impressive.  Through the use of injectable dermal fillers (e.g. Restylane, Juvederm, Radiesse) and relaxers (e.g. Botox and Dysport), a re-contouring and smoothing of the face can be achieved. Excessive fat under the chin can now be addressed as well with an FDA approved injectable treatment called Kybella. In order to maintain the results that injectables provide, periodic touch-ups for some treatments may be necessary.

What is a Brow Lift?

The browlift is also known as forehead lift.
You may be a candidate for a brow lift if any of the following are present: (This procedure is often performed in conjunction with a facelift.)
• You have sagging eyebrows resulting an appearance you are not happy with
• You have deep horizontal creases across your forehead or deep furrows between your brows
 

EYELID SURGERY 

For patients dealing with eyelid issues of a cosmetic nature, Dr. Harvey offers aesthetic surgery of the eyes (very often in conjunction with the face).  Patients in the San Francisco, California area and beyond are encouraged to see Dr. Harvey at his location in the Nob Hill area for eyelid surgery.

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Eyelid Surgery Q&A

What is eyelid surgery?

Eyelid surgery is performed as a cosmetic, procedure. Generally, aesthetic operations are done to alter the look of the person’s eyes, most often due to the signs of aging. They can also be used to improve conditions affecting the function of the eyes. For patients with vision concerns because of sagging eyelids, the operation can be especially beneficial. Eyelid surgery operations are not done to the eye itself, but rather, the skin above and/or below the eye.  A blepharoplasty, also referred to as an eye lift, is the most common type of operation done.

Who is a good candidate for eyelid surgery?

People who are in good health are generally the best candidates for the eyelid surgery. Most of the time the operations are performed on people who are 35 years old and older. If you are suffering from droopy eyelids as part of a genetic condition, the operation can be done sooner to improve vision. Dr. Harvey will go over the operation techniques available with you to make sure you receive the best results.

You may be a candidate for eyelid surgery if you have any of the following:
·        if you have excess, hanging skin covering the natural fold of the upper eyelids
·        If you have loose skin hanging down from the upper eyelids over the eyelashes
·        If your upper and lower eyelids appear puffy, making your eyes look tired and aged
·        If you have deep grooves under your eyes

Are the results permanent?

An operation performed on the upper lid can last for roughly 5 to 7 years whereas the lower eyelid operation will rarely need to be done a second time. Surgery will involve a short time in the recovery room and you will need a responsible adult to drive you home. Though the operation will take care of any sagging or drooping of the eyelid, natural aging around the eye will resume. If drooping returns following the operation, a forehead lift can be helpful. Eyelid surgery can increase a patient's confidence regarding the appearance of the eyes, however, it will not alter the individual’s facial structure at its core.
 

NOSE SURGERY (Rhinoplasty)

Dr. Harvey helps patients in and around the San Francisco area improve their appearance and confidence by offering a wide array of cosmetic options when it comes to the nose.

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Nose Surgery Q&A
 

What is a rhinoplasty?

A rhinoplasty, or nose surgery, is used to reshape the proportions and structure of the patient’s nose and can address issues which can hinder breathing. The issues a nose surgery can correct include:
·        Large upturned nostrils
·        Asymmetry of the nose
·        Nostril position
·        Visible humps or dimples in the nasal profile
·        An enlarged, upturned, hooked, or drooping nasal tip
·        Wide bridge

It is important to note that no part of the human face is not entirely symmetrical . When taking this into consideration, the goal is to make the nose appear properly proportioned and more balanced.

What results should be expected with nose surgery?

During a rhinoplasty, incisions are made inside the nose in order to access the bones and cartilage. As a result, these incisions are not visible following the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added to rearrange and reshape the nose. Although changes are evident immediately following surgery, it may take up to 12 months for results to be fully realized.

What will nose surgery recovery be like?

A splint or packing is placed in the nose to promote healing and hold the new shape of the nose. Your face may be bruised or swollen and feel puffy for several days. This swelling is typically more present in the morning. Cold compresses can help minimize the swelling and reduce pain. You may need to keep your head elevated for the first few days after surgery. The doctor will give patients aftercare instructions and prescription medication for pain relief. It takes about 10 to 14 days before most of the swelling and bruising dissipates.

When should I consider nose surgery?

You might consider having nose surgery for any of the following reasons:
·        You feel your nose is too large (or too small) or misshapen
·        You feel your nose does not suite your face
·        You are experiencing breathing issues

 

LIPOSUCTION 

Through liposuction, Dr. Harvey helps patients who wish to improve their body contour by providing this safe procedure at a state-of-the-art hospital facility.

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Liposuction Q&A

What is liposuction?

Liposuction is a surgical operation commonly performed on both men and women that is used to slim, reshape, and contour the body by extracting excess fat deposits. The procedure can be combined with other operations such as a tummy tuck. Liposuction can be used for removing fat deposits in the:
·        Abdomen, waist and flanks
·        Calves and ankles
·        Cheeks, neck, and chin
·        Hips and buttocks
·        Inner knee
·        Chest area
·        Upper arms
·        Thighs
·        Back

What do I need to know before undergoing liposuction?

A consultation with Dr. Harvey should be the first step when considering liposuction. During the consultation, you'll discuss the options, risks, benefits, and costs associated with the procedure. At this time, you should also tell Dr. Harvey of any medications or supplements you might be taking and ask any questions that you might have. It will also be important to remember that liposuction is designed for those who have not been able to achieve results with diet and exercise alone. These healthy habits will need to continue following the procedure to ensure the results last.

What results can I expect from liposuction?

Following surgery, Dr. Harvey will provide the patient with detailed instructions for home care. He may also prescribe medications to support healing.  Once the initial inflammation and fluid retention from the surgery has gone down, results will be evident.  As time goes on and individuals age, some of the firmness can reduce. Generally, compression bandages or garments can help after surgery. Patients will be instructed as to when they should return for a follow-up appointment and provided with information helpful in prolonging the results.

When should I consider liposuction or other body adjustments?

You might consider liposuction if:
• You experience localized deposits of fat which can occur in various areas of the body, including but not limited to – stomach, flanks, love handles, back fat, excess chest/breast fat in men (gynecomastia), outer bra underarm area ‘pooching’, thighs, buttocks, knees and ankles
• You have lost a considerable amount of weight but still have that stomach ‘pooch’
• You would like to see a more contoured body shape
• Your skin elasticity is good

UPPER ARM LIFT
Also known as brachioplasty.
You might consider an upper arm lift if:
• You have excess hanging skin and/or fat in your upper arm region that cannot be tackled with liposuction alone. This issue is sometimes referred to as ‘bat wings’
• You have lost a considerable amount of weight resulting in sagging excess upper arm skin

MOMMY MAKEOVER* (refer to Mommy Makeover section for more detailed information)
This is a term that includes multiple procedures on a post pregnancy body. This surgery may include a tummy tuck, liposuction and breast surgery (breast augmentation, breast lift, or breast reduction).
You may wish to consider a Mommy Makeover if:
• Your body has gone through changes post-pregnancy that you would like corrected
• You would like to regain some of your pre-pregnancy body contour
• You would like to look and feel better in clothing
 


TUMMY TUCK (Abdominoplasty)

A Tummy Tuck is suitable for men and women who may find the procedure useful for tightening their abdominal muscles and reducing skin resulting in a flatter, and more flattering stomach.

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Tummy Tuck Q&A

 

What happens during a tummy tuck?

A tummy tuck, also known as an abdominoplasty, is a surgery designed to tighten the abdominal muscles by removing the excess skin and fat from the area. In most cases, weakened muscles are also dealt with which creates an abdominal profile that is smoother and firmer. A tummy tuck cannot correct stretch marks, although these may diminish if they are located on the areas of excess skin that will be excised.

What is a “mini-tuck”?

The term “mini tuck” refers to a short scar abdominoplasty. The scar is placed below the bikini line and is only slightly larger than a C-section scar. Suitable candidates have a “pouch” of skin and fat located in the lower abdomen.  This pouch is frequently the result of pregnancy, and despite diet and exercise the patient cannot get rid of the skin and fatty tissue.

What is the procedure like?

The procedure begins with an incision made near the bikini line. Excess skin and fatty tissue is then removed. After the muscles are tightened, the skin is pulled tight and carefully re-draped. In order to preserve a natural appearance, the navel is typically repositioned.

What should be expected during recovery?

At the completion of the surgery, drains will likely be placed into the abdomen to prevent fluid collection. Typically, they will remain for about 7-10 days following surgery. To promote healing, a compression garment is usually worn for about two weeks after the procedure. Dr. Harvey will provide you with aftercare instructions on how to keep the incision and drains clean. He will also prescribe and provide instruction for any medication necessary such as pain medications or muscle relaxers. The abdomen will be sore for a few days, but most patients take 10 to 14 days to recover and to return to normal activities.

When should I consider a tummy tuck?

You may wish to consider a tummy tuck if:
·        You have excess skin, folds, and/or fat in the abdominal area that has not improved with weight loss
·        You have lost a considerable amount of weight leaving behind excess abdominal skin
·        You have post-pregnancy loose skin
·        You have weakened abdominal muscles (often due to pregnancy)
·        You are not happy with your stomach contour in clothing
 

BREAST SURGERY
 

Breast surgery can be done for cosmetic reasons or to help improve a persistent issue.  Dr. Harvey can provide breast surgery options that will help you achieve an ideal appearance.

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Breast Surgery Q&A

What kinds of breast surgery are available?

Breast surgery can be performed to increase fullness and improve symmetry of the breasts, or to restore breast volume lost after weight reduction, or pregnancy. This is generally referred to as breast augmentation. Breast surgery may also help following surgery performed for breast cancer. Breast lifts and reductions, on the other hand, can improve the placement of existing breast tissue and sometimes lessen the mass.

What can I expect during surgery?

For a breast augmentation, a saline or silicone filled implant is placed under the skin of the breast to produce the desired shape and size. The implant may be placed above the muscle or beneath it, depending on which is most appropriate in your particular case. 

What should be expected during recovery?

After any type of breast surgery, the chest is wrapped in a gauze dressing and supported with an elastic bandage or support bra. A support bra will need to be worn 24 hours a day for the first week or two following the surgery. In most cases, you go home the day of surgery after a few hours of recovery in post-op observation. Upon release, you will receive detailed instructions regarding proper home care.  There may be swelling for the first 24 to 48 hours, and the breasts will most likely be tender for a couple of weeks.

When should I consider breast surgery?

BREAST AUGMENTATION
Also known as augmentation mammoplasty, breast enlargement, breast implants.
You may wish to consider breast augmentation if:
·        You feel your breasts are too small or smaller than you would like
·        You have lost breast volume due to pregnancy or age
·        You are not pleased with your breast shape
·        You would like to feel better about yourself in clothes
·        You have asymmetry that you would like improved

BREAST LIFT
Also called a mastopexy. In some cases, implants are placed during this procedure as well.
You may wish to consider a breast lift if:
·        Your breasts are sagging post-pregnancy or due to age
·        Your breast tissue has lost elasticity post-pregnancy or due to age
·        You want to look better in clothing
·        A breast augmentation alone will not give the result that you would like

BREAST REDUCTION
Also known as a reduction mammoplasty.
You may wish to consider a breast reduction if:
·        Your breasts are too large for your frame
·        Your breasts are larger than you would like
·        You don’t like the way you look in clothing due to large breasts
·        You are self-conscious due to the large size of your breasts
·        You experience back pain and/or shoulder pain due to excessive breast size
·        One breast is much larger than the other
·        Your breasts have gotten larger and saggy with age
 

MOMMY MAKEOVER

Women who want to restore their body, as is the case quite often post pregnancy, can benefit from what is commonly called a Mommy Makeover.

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Mommy Makeover Q&A

What is a Mommy Makeover?

A Mommy Makeover is actually a group of cosmetic operations which are used to restore a woman’s body to a pre-pregnancy, younger looking appearance. This surgery typically includes a tummy tuck, liposuction, and breast augmentation. When you are having trouble getting back to a pre-pregnancy body, and exercise plus diet haven’t given you the results you desire, a Mommy Makeover can often help achieve the final changes contributing to a more youthful and trim you.

What is a Tummy Tuck?

A Tummy Tuck, or what is technically known as an abdominoplasty, is a surgical procedure which reduces sagging skin in the stomach area. After losing a great deal of weight from around the midsection post-pregnancy, the skin on the abdomen can often sag or become “flabby.” A tummy tuck takes away the extra skin which is left over and tightens the underlying abdominal muscles. This is different from liposuction, which sucks away fat, although both procedures can be performed during a Mommy Makeover. The tummy tuck compliments liposuction surgery because the excess skin is removed and the underlying structure of the stomach is toned.

What is Liposuction?

Liposuction is a surgical procedure wherein excess fat deposits are removed resulting in a slimming and reshaping.  The procedure is often combined with additional operations when a Mommy Makeover is used. Following surgery, once the initial inflammation and fluid retention has dissipated, your results will be visible and long-lasting.
Liposuction is typically used for removing fat deposits in the:

·        Waist and abdomen
·        Calves and ankles
·        Chest area
·        Cheeks, neck, and chin
·        Upper arms
·        Inner knee
·        Thighs
·        Hips and buttocks
·        Back

What is Breast Augmentation?

Following pregnancy, breasts often lose volume.  A breast augmentation can help restore shape and volume.  Sometimes, a mastopexy, or breast lift in addition to implant placement is advised if there is ptosis, or sagging of the breasts.

 

NON SURGICAL OPTIONS

 

BOTOX & FILLERS

Botox and fillers are some of the most widely used treatments in dealing with unwanted lines and wrinkles.  Dr. Harvey is a highly trained physician with many years of experience in the use of these injectables.  Patients are encouraged to come in and discuss an appropriate treatment plan geared towards his or her specific needs.

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Botox® & Fillers Q&A

What is Botox® and Dysport®?

Both of these products are similar, nonsurgical treatments used to reduce the appearance of lines and wrinkles on the face. These injections work by temporarily relaxing the facial muscles that cause wrinkles. The treatment is frequently used for frown lines, crow's feet, and forehead creases. Another use for these products is reduction in profuse sweating in areas such as the palms and underarms.

What are facial fillers?

Facial filler is an umbrella term that refers to multiple products that are used to correct moderate to severe wrinkles by injecting small amounts under the surface of the skin. Fillers can also be used to augment or plump lips, volumize and smooth creases and folds in the face, and raise depressions in the skin left behind by scars. Dr. Harvey will help you to determine which facial fillers would be best for your treatment. Products commonly used include Juvederm®, Restylane®, and Radiesse®.

What can I expect from the procedure?

These treatments can take anywhere from 10 to 30 minutes from start to finish depending upon the area of the face being treated. These treatments do not provide permanent solution and follow up treatments may be desired. Both Botox® injections and fillers are relatively safe when administered by a trained professional. Discuss with Dr. Harvey each of the procedures to fully determine the best option of treatment for you. Patients under the age of 18 or those who are pregnant, breastfeeding, or who have a neurological disease are not candidates for treatment. For more information, contact the office to schedule a consultation with Dr. Harvey.

When should I consider injectables?

BOTOX® and DYSPORT® (also known as botulinum toxin type A)
You may want Botox or Dysport if:
• You have deep lines between your eyebrows (the lines that make you look angry)
• You have asymmetry of your brows

FILLERS (dermal fillers)
Juvederm
Juvederm Voluma
Juvederm Vollure
Juvederm Volbella
Restylane
Restylane Lyft
Restylane Silk
Radiesse
Belotero

Fillers are appropriate if:
• You want to have a more youthful contour in the face and jaw area.
• You would like a slight lift in the mid-face area without invasive surgery
• You want to fill those lines and creases (including smile lines) that form with age
• You wish to enhance your lips in an aesthetically pleasing way

KYBELLA (under chin fat reducer)
Kybella is the first of its kind FDA approved injectable treatment specific for the reduction of fat under the chin area that both men and women experience.
You may wish to consider Kybella if:
• You do not wish to undergo more invasive procedures for this fat removal
• You feel this under-the-chin fat makes you look heavier and older than you are
• You want a more defined jaw line
• You eat well and exercise and the fullness under your chin remains
 

For Men

Many of the above covered procedures pertain to both men and women, however Dr. Harvey understands the difference in the desired outcomes. He takes into account the cosmetic goals of each patient and adjusts his treatment accordingly.  When you meet with Dr. Harvey, he will highlight what is important to men when considering their aesthetic appearance.  In addition to many of the above listed procedures such as facelift, blepharoplasty (eyelid surgery), and rhinoplasty, the following highlighted surgeries discuss aspects specific to the male body:

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GYNECOMASTIA

(male breast reduction)

The goal of gynecomastia treatment is to reduce breast size in men who are concerned with the presence of excessive breast tissue. Reduction methods include liposuction, excising excess glandular tissue or using a combination of liposuction and excision. In choosing a board-certified plastic surgeon, gynecomastia can effectively and safely show improvement and in some instances be corrected completely.

When to Consider Gynecomastia Treatment
• If you are reluctant to remove your shirt in public, to swim, to participate in sports or to exercise at a gym
• If you want to improve your overall body proportions
• If you experience psychological discomfort associated with large breasts
• If you want to increase your social confidence
 

LIPOSUCTION

(lipoplasty or body contouring)

Liposuction surgery sculpts your body, eliminating unwanted pockets of exercise-resistent and diet-resistant fat from the buttocks, hips, love handles, thighs, calves, ankles, chest area (see Gynecomastia above), back, arms and neck. 

When to Consider Liposuction
• If you have localized areas of fat deposits that are disproportionate with the rest of your body
• If you would like more definition or a more pronounced contour in certain areas of your body
• If your skin elasticity is good (liposuction removes fat, but does not tighten skin)