Cosmetic Surgery Vancouver Washington

Dr. Melvin is a board certified plastic surgeon with the American Board of Plastic Surgery, Inc. and has been in solo practice in the Portland area for over 20 years. He performs most of his surgery as an outpatient at St. Vincent Hospital. In addition, he has an office operating room for patients undergoing facial cosmetic surgery.

Plastic surgery has progressed to the level of being able to offer you what you want. When you come in for a consultation, we will discuss the end result you desire, and I will present the options of which operations would be suitable.

There is no one way, no one right operation; there are always several possibilities, some better than others, all with different risks and involvements. It is during the consultation that we decide together which procedures you like and which is best for you.

You have the choice to look better, less tired, or to lessen the effects of aging. Often it is the small things that make the biggest difference, like removing the bags under your eyes. You can have as little or as much cosmetic surgery as you decide on. I will talk with you regarding the options you have, the positive and negative effects of each surgical procedure, and your expectations. The choice is yours.

• American Board of Surgery

• American Board of Plastic Surgery, Inc.

 

• Medical School:
• University of Otago, New Zealand, M.B., Ch B 1963

 

• University Hospital, Boston, MA, 1965-69

 

Plastic Surgery:
• Norfolk, VA 1971-73

 

Fellowship:
• Hand Surgery - Louisville, KY

 

• American Society of Plastic Surgeons (ASPS)
• American Society of Aesthetic Plastic Surgery (ASAPS)
• International Society of Clinical Plastic Surgeons
• Northwest Society of Plastic Surgeons
• Fellow Royal College of Surgeons
• American Society for Surgery of the Hand (ASSH)
• Medical Society of Metropolitan Portland
• American Board of Independent Medical Examiners (ABIME)

 

 

 

 

The operation to make your breasts larger is a breast augmentation. This is done by lifting up all of your breast tissue, making a space behind the breast tissue, and placing an implant. The amount of soft tissue you have to cover the implant determines how well hidden the implant will be. So if you are thin, it is possible to put the implant underneath your muscle as well, to have more soft tissue covering. Usually you can be whatever size you want to be. I have been doing this operation now for many years, and it still ranks as one of the most successful of procedures, as judged by the satisfaction of patients.

 

 

Patients with large breasts are often uncomfortable. They have problems with backache, painful shoulders, grooving of the shoulders from the pull of the bra straps, and also pain and heaviness of the breasts which is usually worse at the end of the day. The operation to reduce the size of the breasts is called reduction mammaplasty. It is possible to remove as much breast tissue as you like, and I think it is wise for you to consider having small breasts postoperatively, to reduce the stretch and sag as you age.

 

 

This is an operation to reshape and reposition the breasts, which gives a full, round, higher breast. This is a flatter, rounder shape than the other type of breast-lift surgery – which involves more scars, and gives a more projected, cone-shaped breast, and tends to sag more after surgery.
Although the scars with the purse-string type will be only around the areola, the scar will be puckered and wrinkly to begin with, but will improve with time, over many months, and may never totally smooth out. This purse-string stitch is very important. It is used to support the healing wound, and limits spreading of the scar after surgery. Many patients find taking out a wedge on the bottom part of the breast gives a better shape and you have less wrinkling around the areolar. This incision heals very well.

 

 

There is a difference between true ptosis, where the nipple is below the fold and the breast sags down and droops, and a completely low breast where the entire breast is low on the chest wall.
If there is true ptosis, with the nipple below the fold, the nipple has to be raised up and skin removed to tighten the skin-bra. This repositions and reshapes the breast.
There are basically two types of operation to tighten and reshape the breast.
The one with the least amount of scar is where the incision is just around the nipple, and a doughnut-shaped ring of skin is removed around the nipple, and a purse-string type of stitch is used to tighten and pull the skin in and close the wound. While this surgery has only the one scar around the areola, this scar tends to be wrinkled with the skin gathered or pleated around it, and may spread and become wider with time.
The other method is to move the nipple up and remove some skin from the lower part of the breast. This gives a scar around the nipple and in the shape of an inverted “T” under it. This method does give a more cone-shaped breast, with a smaller, tighter skin-bra.

 

 

Some patients have decided they want their breast prostheses removed. The decision may be due a variety of reasons, commonly because their life style has changed, they are older and so have inevitably gained weight, or a smaller breast seems more appropriate for them. Additionally, some patients feel threatened by the hysteria presented in various media about the safety of silicone prostheses

 

 

 

The Facelift operation is used to tighten sagging jowls. This is the only surgery which will do that, and it does so by lifting up the skin of the face, tightening the fat and fascia which is on top of the facial muscles, and then redraping the skin over the tightened tissue.
While a facelift does a good job of tightening the face, the skill in doing the operation lies in having a result that still allows you to look “normal” and not stretched or odd. And while the result may be just what you want, you always have to consider the scars and the hair changes involved.

 

 

A Mid-Facelift lifts the cheek fat up onto the cheekbones – where it used to be when you were young. This helps to flatten the cheek folds around the mouth, giving a younger, softer and happier look. It helps take away that “ down-in-the-mouth” look. A mid-facelift makes you look younger; a facelift less saggy.

 

 

This operation is designed to benefit people with sagging neck skin, and those with neck folds. A neck lift may be a single operation, or as part of a face lift procedure, and when combined with a facelift the excess skin can be removed by lifting up all of the neck skin and redraping over the tightened neck muscles. If only a neck lift is desired, then only the underlying muscle is tightened and the excess fat is removed. This usually effectively divides any bands from the chin to the neck, redefining the jawline. If excess skin needs removing, the operation can be expanded to include the removal through a scar behind the ear.

 

Many people have a fullness, or collection of fat, under the chin. This fat is easily removed with suction, usually under local anesthetic, in the office operating room. The incision is placed under the earlobe, and a small cannula is then passed down along the neck to under the chin, removing fat from the neck, along the jaw line, and under the chin.

 

 

When we meet someone we are looking at their eyes. Eyes are the first thing we see of people, and that can determine how we think of them. Do they look bright and happy, or tired and sad? Much of these feelings are expressed in the way our eyes, or really our eyelids, are viewed.For instance, puffy lower eyelids, or “bags under the eyes”, make a person seem tired, old, worn out, or a party person who doesn’t get enough sleep. Whereas the opposite, tight, flat, lower eyelids are typical of a young person or one who is smiling.

 

 

Puffy lower eyelids make a person seem tired. The puffiness is due to bulging fat pads. When the excess from these fat pads is removed, the lower eyelid can contract and tighten and smooth out, giving a more relaxed and rested look.

 

 

A browlift operation can be done with only small incisions in the scalp. While the coronal browlift removes a strip of scalp, thus lifting the brow, that leaves a long scar in the scalp. With the use of an endoscope, we do the same operation through several small incisions. By not removing skin, the brow is not lifted as much, but by freeing the brows from the underlying bone, and weakening the muscles which pull the brows down, the natural muscles which elevate the brows do so in a natural unimpeded way. This is what an endoscopic browlift does – lifts the brows using small incisions in the scalp, smooth the frown lines, and lessen the descent of the brow when frowning.

 

 

A Coronal Brow Lift is used to raise the brow and smooth the forehead, the frown lines and the upper eyelid skin. If there is excess upper eyelid skin it is much better to raise the brow rather than remove the eyelid skin. Because the incision is placed back on the scalp, the whole forehead skin area will stretch back down again after the surgery, so the eyebrows will descend some. They will, however, be higher than before surgery.

 

 

The face is built-up with skin and soft tissue stretched over a bony framework. The facial highlights we see as attractive and photogenic features come from bony prominences, such as the bridge of the nose, cheek bones, and chin. The concept of facial implants is a method of augmenting these prominences by adding to them with a synthetic implant.

 

 

The operation to change the shape/size of your nose is called Rhinoplasty. Some people like the shape of their nose and merely want their nose to be smaller; while others like parts of their nose and have some parts changed. During the consultation we will decide what it is you want, and what is likely to fit well with your face structure.

 

 

 

Liposuction has become one of the most frequently done surgeries in the country. The ability to lose some of the fullness caused from fat is a remarkable benefit compared to the small risk involved. But as with most things, the more you ask for, the more you risk, and the less likely you are going to be satisfied. So as a generality, I say that the smaller you are, the better the result; the smaller the area you have done, the better the result. With small areas the operation can be done under a local anesthetic in the office operating room, and the area can become completely flat – such as under the chin, the so called “double chin”.

 

 

An Abdominoplasty operation tightens the abdomen. Sometimes the abdomen is lax, or pouchy, all over; or more often, just the lower part is the problem, with the upper part quite flat. So the operation can be adjusted to deal with whatever part you want tightened. If the extra skin is down low then only a lower incision or scar is needed. If skin above the umbilicus needs to be tightened, then you will also have to have a scar around the umbilicus. When the skin is lifted up, the underlying muscle will be tightened separately as well as the skin.

 

 

Labioplasty is the operation to reduce the size of the labia. Usually it is the internal labia which are excessive; and usually the problems experienced are those of irritation – the catching and rubbing from friction.