SATISFACTION
Safety and Value

Reconstructive Plastic Surgery

Like some other surgical specialties within medicine, Plastic Surgery is not confined to a specific organ system or type of procedure. Plastic Surgery attempts to restore both form and function once lost be it secondary to a birth defect, injury, disease or aging.

 

Plastic Surgery can be divided in to procedures that are “reconstructive” and those that are “cosmetic”, but this classification is artificial. For example, there are many conditions which appear to be both reconstructive and cosmetic in nature such as the repair of a newborn’s cleft lip and the reconstruction of a new breast following a mastectomy. The basic surgical principles and techniques of Plastic Surgery were developed out of necessity in an effort to manage traumatic injuries, but it is these same principles and techniques that allow us to perform safe and effective cosmetic surgery.

 

In addition to their cosmetic practice, our surgeons maintain a busy reconstructive practice that treats a wide variety of conditions. Some of the common services we provide include:

  • Breast cancer reconstruction
  • Breast reduction surgery
  • Skin cancer excision
  • Biopsies of various soft-tissue nodules and tumors
  • Scar revisions
  • Management of burns and complex wounds
  • Treatment of Facial fractures and other facial injuries
  • Hand surgery

Some Of The More Common Hand Conditions We Treat Are

  • Carpal tunnel syndrome
  • Trigger fingers and tendinitis
  • Dupuytren’s Contracture
  • Ganglions and other nodules, cysts and tumors
  • Arthritis
  • Traumatic hand fractures, tendon lacerations and other injuries
The consultations and surgery provided for these and many other conditions is usually insured by our provincial health care system. If you feel as though you might benefit from seeing one of our doctors please discuss it with your Family Doctor and have them make a referral.

Body Contouring

Our Vancouver body contouring program is part of the Richmond Hospital’s multi-disciplinary bariatric services team; a team dedicated to treating obesity and its related sequel – everything from diabetes and hypertension to the physical and psychological challenges that accompany massive weight loss.
 
One way or another, you’ve lost weight, you feel better, and you are healthier – perhaps your blood pressure is better or you are no longer a diabetic – yet still the weight loss journey might feel somewhat incomplete. Despite adopting a healthier lifestyle and returning to a much lower or even normal BMI, patients are trapped in their old skin, now deflated, loose and hanging, which can limit improvements in appearance and self-image. Body contouring after massive weight loss is how we can address these issues.

Tummy Tuck (Abdominoplasty)

Abdominoplasty with the addition of liposuction is a powerful tool for resculpting the body’s midsection. Whether it be a result of weight loss, following pregnancy or a C-section , the resulting abdominal bulge and scarring can be dramatically reduced, revised and tightened to recontour this area with dramatic results.

Body Lift

For patients who have undergone extensive weight loss or those with significant skin excess, a body lift procedure incorporates abdominoplasty or “tummy tuck” with removal of excess skin and fat from the back and flank regions giving a circumferential “lift” of the midsection of the body.

Arm Lift (Brachioplasty)

For those patient concerned with laxity or sagging in the upper arm area, an “arm-lift” or brachioplasty may be indicated in order to remove the excess skin and fat in order to tighten and reshape the contour of the upper arm.

Liposuction

Removing fat through minimal incisions allows for reducing and reshaping specific areas of concern leaving minimal to no visible scars. It is often used in addition to other body contouring procedures to address and refine problem areas.

Male Chest Contouring (Gynecomastia)

A common problem in males for which excess breast tissue and subcutaneous fat is removed and resculpted in order to obtain a more aesthetically pleasing contour of the male chest with minimal scarring.

Post-Bariatric Body Contouring

Body contouring after massive weight loss
Our Vancouver body contouring program is part of the Richmond Hospital’s multi-disciplinary bariatric services team; a team dedicated to treating obesity and its related sequel – everything from diabetes and hypertension to the physical and psychological challenges that accompany massive weight loss.

One way or another, you’ve lost weight, you feel better, and you are healthier – perhaps your blood pressure is better or you are no longer a diabetic – yet still the weight loss journey might feel somewhat incomplete. Despite adopting a healthier lifestyle and returning to a much lower or even normal BMI, patients are trapped in their old skin, now deflated, loose and hanging, which can limit improvements in appearance and self-image. Body contouring after massive weight loss is how we can address these issues.

Prior to undergoing surgery, there is a defined process that we must go through to ensure the best possible result. The key elements in the process are:
  • Patient education
  • Development of an operative plan
  • Pre-operative medical work-up
  • The operation(s)
  • Standardized post-operative care
  • Assessment of the final outcome
As part of our body contouring program in Vancouver, we have put effort in to developing each of these phases specifically for the massive weight loss patient.

Vancouver Weight loss patients will meet the surgeon at least twice prior to surgery. The two essential meetings are the initial consultation and a pre-operative visit. A general outline for each of these meetings is described below. Patients are also welcome to arrange more visits in-between these two to discuss any changes in their health, the results of pre-operative investigations or simply to answer any questions.

During the initial consultation we will:
  • Understand your hopes, expectations and concerns
  • Review your past medical history
  • Identify and risk factors
  • Perform a physical examination
  • Take a set of standardized pre-operative photos
  • Make recommendations
  • Discuss the recovery, expected outcome and potential risks
  • Provide a price quote
  • Arrange investigations, lab work and referrals (if required)
Towards the end of your body contouring consultation, as we consider the treatment options, we will also discuss the associated fees and provide you with one or more quotes. The total cost will be made up of several items that may include: prescriptions, post-op garments and supplies, facility fees, taxes, professional fees for the anesthesiologist, professional fees for the surgeon(s). Quotes are largely determined by the length of surgery and not necessarily the type of surgery, for example, not every quote for a lower body lift is the same.

During the pre-operative visit (3-4 weeks prior to surgery) we will:
  • Confirm your priorities for surgery
  • Answer any questions
  • Review results of lab work
  • Review post-op plans
    • Congratulations on your weight loss. Spend some time thinking about what you would like to accomplish through body contouring and we will do our best to help you achieve your goals. We look forward to meeting you. Additional information on post bariatric body contouring surgery including tummy tuck and liposuction in Vancouver area is available here.

Facial Rejuvenation

We provide a wide array of non-invasive cosmetic services focused on preventing and treating the signs of aging. We understand that surgery may not be right for everyone, and that the most appropriate treatment may be a less invasive option. Whether you are looking for preventative anti-aging options or the correction of a focused area, we can provide you with a personalized approach to treatment that may include pharmaceutical grade skin care products, Botox, Fillers, or surgery.

Injectables

Botox Cosmetic
The use of Botox is the most common cosmetic procedure performed in North America. It is used in the rejuvenation of the upper face to treat unwanted crows feet and forehead lines. It can also be used to prevent the formation of deep, permanent skin creases. This is a reversible procedure where the effects generally last 4-6 months.
Injectable Fillers (Juvederm)
Injectable fillers, such as Juvederm, are used as a non-surgical means to reduce the appearance of deep folds and volume loss in the face due to the normal process of aging. Common uses include the treatment of laugh-lines and lip enhancement.

Minor Surgical Procedures

Sometimes a small change can make a big difference. Each of these procedures can be safely and comfortably performed in our office, usually within 30 – 60 minutes.
Mole Removal
Moles and other benign skin lesions can be unattractive, distracting and a source of self-consciousness. Whether they are located on the face or elsewhere on the body, these marks can often be removed with excellent cosmetic results.
Scar Revision
Unattractive scars may be the result of injury, prior surgery, piercings or other causes. Unfortunately, scars can not be completely eliminated, however, they can often be revised or modified so that they are significantly less noticeable. This may be accomplished by making a wide scar thinner, a raised scar flatter, or perhaps by reorienting a poorly positioned scar.
Ear Lobe Reshaping and Reduction
Torn ear lobes or dilated ear piercings can be unsightly. A minor surgical procedure can be performed to restore the shape of the ear lobe and allow the placement of a new piercing 6 months later.

As we age, ear lobes often become longer and wider. An ear lobe reduction can make a dramatic difference by restoring the shape and size of the ear lobe.

Cosmetic Surgery

Eyelid Surgery
Your eyes are a central feature of your appearance and if they are affected by age-related changes prematurely they may cause you to look older than you would like. Upper eyelid surgery often incorporates the removal of excess skin which helps to elevate and define the upper eyelid crease, creating a more youthful appearance. Age related changes of the lower eyelid can manifest in many ways and as a result lower eyelid surgery may include many different techniques.
Brow Lift
Few patients identify a sagging or low-sitting brow as a contributing factor to their aged, sad or angry look. When the eyebrows descend they lose their characteristically youthful shape and they exaggerate the presence of excess skin in the upper eyelids. A Brow Lift elevates and re-shapes the eyebrows restoring the normal boundaries of the peri-orbital region.
Face and Neck Lift
Face and neck lifts aim to achieve a natural correction of age-related changes, such as hollow cheeks, jowls and sagging necks, without creating an ‘operated’ or ‘wind-swept’ look. This is no longer a skin only operation, advanced facelift techniques focus on re-establishing the position and volume of the cheek and the contour of then neck, without relying on over-tightening of the skin.

Breast
Enhancement

Coastal Plastic Surgery offers breast enhancement and other cosmetic surgeries to patients in Richmond, Vancouver and the surrounding area. Breast enhancement is one of the most common cosmetic operations that our plastic surgeons perform.

Patients often choose to have a breast enhancement in order to:

  • Enhance breast size.
  • Enhance breast shape.
  • Correct breast asymmetry.
  • Restore the size, shape, and feel of breasts that have been altered by pregnancy.
  • Restore the size, shape, and feel of breasts that have been altered by weight loss.
  • Reconstruct a breast following breast cancer treatment.

Breast Enhancement FAQ

Breast enhancement is one of the most common cosmetic surgical procedures. The plastic surgeons at Coastal Plastic Surgery will answer the questions you have and provide additional information so that you can make an informed decision. Our doctors know that an informed patient can make better choices which will help to ensure a great result. Our patients are primarily from the greater Vancouver area, and the most common questions they ask us are:
What happens during the consultation?
Key topics during the consultation include: your expectations and desired result; your general health; key variables in breast enhancement (implant type, implant size, implant position and incision location) and how they will affect your outcome; the operation; post-operative instructions; and, potential risks.
How do I get the breast size and shape I want?
With an understanding of your desired result, and after measuring and evaluating your breast characteristics, your plastic surgeon will help you choose the procedure and the breast implant type that is best for you.
What does the surgery involve?
The surgery is performed at an accredited private surgical facility in Vancouver. On the day of surgery, you will be interviewed by the operating room nurses and the anesthesiologist. You will also see your surgeon prior to the operation. During the operation patients are asleep and completely unaware. The operation takes 1-2 hours and patients wake up in the recovery room. Within a few hours you will be ready to go home and before you leave a nurse will review your post-operative instructions.
What is the recovery time after the breast enhancement surgery?
Our surgeons take steps to ensure that the recovery is as comfortable and as quick as possible. Following surgery you will be discharged home the same day. Patients should be able to resume light activities the following day. Medication to manage any discomfort may be helpful for a few days. Most patients are able to return to work within a week, however this depends on the job description. Low impact cardio can be resumed after 2 weeks, most other exercises after 4 weeks, and lastly, core exercises and upper body weights after 6 weeks.
How are the fees for breast enhancement surgery determined?
The fees for each patients surgery are a combination of facility fees for the surgery center, professional fees for the surgeon and the anesthesiologist, the cost of the breast implants and the post-surgical bra. Taxes may be applicable. The fees are not the same for every patient and depend primarily on the length of the operation and the type of implants chosen.
Coastal Plastic Surgery will answer all you questions about breast enhancement so that you are fully aware of what you can expect each step of the way.

Breast Enhancement With Lift

Aging affects all parts of the body but among the places where the signs are most visible are the breasts. Sagging, loss of firmness and folds of extra skin are normal over time. Other reasons for these changes are:
  • Pregnancy
  • Breastfeeding
  • Sudden or excessive weight loss
  • Disease
  • Hereditary factors
Besides these issues, increase in the size of the areola and nipples pointing down often occur. While breast lifts can alleviate some of these problems, they cannot help in tackling the loss of fullness and the scooped out appearance of the breasts. Breast enhancement with breast lift offers a complete solution to all these problems. Breast enhancement involves the use of implants to add volume to the breasts and improve the shape.

Coastal Plastic Surgery in Vancouver is a multispecialty plastic surgery clinic where breast lift, breast enhancement and combined breast enhancement with breast lift surgery are among its specialties. The procedure for breast lift depends on individual factors and personal preferences about the amount of lift desired. The most common way is to use 3 incisions to remove the excess skin. The first is made around the areolas, the second is made from the areola to the crease under the breast and the third along the natural curve of the breast crease. Once excess skin is removed the nipple and areola are moved higher.

There are 2 types of implants that can be used if breast enhancement is also to be done:
  • Saline implants
  • Silicone implants
Both have their own advantages and the doctors at Coastal Plastic Surgery in Vancouver will discuss the options with the patient before a decision is made. While the implants may be inserted using the same incisions made for the breast lift, other incisions may be required depending on the size, shape and exact location of the implants. The surgeons at Coastal Plastic Surgery ensure that scarring is kept to a minimum.

Depending on the type and number of incisions made and your overall health, you may be able to return home on the same day as the surgery or you may be required to stay in the hospital overnight. Post breast enhancement with breast lift surgery recovery is a straightforward procedure.
  • Any pain or discomfort that may be present for the first few days is controlled by medication.
  • The drainage tubes inserted at the time of the surgery are removed.
  • Rest is required for a few days – this will vary from person to person and Coastal Plastic Surgery will tell you how long you can expect to have to stay at home.
  • Once the initial rest period is over normal office work can be resumed, but excessive physical activity or strain will need to be avoided for 6 to 8 weeks.
The exact nature of the breast enhancement with breast lift surgery, the results to be expected and the recovery period will vary from person to person. The doctors at Vancouver’s Coastal Plastic Surgery will cover all these issues during the consultation process.

Breast Implants

Breast implants have been used to change the size, shape, and feel of breasts since 1962. A culture of continuous improvement has resulted in a series of modifications and improvements to breast implant design and manufacturing methods. Today’s silicone and saline implants have been thoroughly studied and are Health Canada and FDA approved just like any other medical device.

In conjunction with the improvements in the quality and safety of today’s breast implants, the manufacturers have expanded the number of available implant types to help ensure that patients have the options they need to create a highly customized result.

The breast implant style that is chosen can have a powerful influence on the final outcome. In other words, two breast implants of the same size, but of different styles, can produce very different results. For example, the look and feel created by a 300cc smooth round high profile saline implant would be quite different than that of a 300cc textured shaped moderate-profile cohesive gel implant. Matching implant styles and sizes to your preferences and tissue characteristics is a crucial part of the breast enhancement process. The plastic surgeons at Coastal Plastic Surgery in Vancouver are well prepared to guide you through this process to help ensure a great result and your overall satisfaction.

Post-Pregnancy

After childbirth and subsequent breast-feeding, women are often faced with sagging and loss of volume in the breasts. Hormonal changes cause the breasts to increase in size during pregnancy and once breast feeding is discontinued, the breasts tend to lose volume, change shape and sag. The skin on the breasts often becomes loose and extra folds may develop. Post-pregnancy breast enhancement can remove these problems and can not only return your breasts to the pre-pregnancy state but also add to their original size and volume.

A common question is how long you should wait before undergoing post-pregnancy breast enhancement. Post-pregnancy breast enhancement is among the many specializations of Coastal Plastic Surgery in Vancouver and this is something that will be covered during the consultation process. While each case will be considered and evaluated individually, in general:
  • The typical pregnancy lasts for 9 months and it can take another 9 months for the breasts to return to normal after which surgery is recommended.
  • Post-pregnancy breast enhancement should not normally be done for a least 6 month after breast feeding stops.
  • Some of the fatty tissue that accumulates in the beasts during pregnancy takes 6 to 12 months to disappear and the enhancement should be done after that.
The surgeons at Vancouver’s Coastal Plastic Surgery will discuss all these and other issues during the consultation period to ensure that the post-pregnancy breast enhancement is done at the right time. The nature of the surgery, the expected recovery period and the costs involved will also be discussed so that you are fully aware of all aspects of the procedure.

The surgery itself involves:
  • Using either silicone or saline implants. Coastal Plastic Surgery will brief you on the benefits of both so that an informed choice can be made.
  • The use of general anesthesia in most cases.
  • Incisions to be made around the areolas, under the breast or under the arms. This will vary from case to case and the surgeons as Coastal Plastic Surgery will determine which is the best way for you.
  • The insertion of drainage tubes in the breasts to allow the incisions to dry and heal quickly.
  • Either the same day return home or an overnight stay in the hospital, depending on exact nature of the surgery and your overall physical condition.
Recovery from post-pregnancy breast enhancement is simple and not time-consuming.
  • Once you return to your home you will need to rest for a few days.
  • The gauze that is used as a protective cover for your breasts will be removed, as will the drainage tubes.
  • You will normally be able to return to normal office work within a week.
  • Excessive physical exercise and strain will have to be avoided for between 6 to 8 weeks.
Coastal Plastic Surgery will cover all aspects of post-pregnancy breast enhancement with you in their Vancouver office so that you are able to make informed decisions, plan your schedule for the recovery period and know what kind of results you can expect.

Vancouver Breast Enhancement

The consultation begins with a discussion about preferences and the options available to you for breast enhancement. Following that, an examination is completed and measurements are taken to document your tissue characteristics. With your preferences and tissue characteristics in mind, the doctor will then make a recommendation regarding implant style, implant size, incision location and implant position relative to the muscle. As different options are considered, for example different breast implant styles or sizes, the implication of those choices will be discussed. This discussion should be informative and should facilitate a common understanding of both the limitations of breast enhancement surgery and your expected outcome.

Surgery takes place at an accredited private surgical facility in Vancouver. Every effort is made to ensure your comfort and safety. The procedure is performed under general anesthesia and takes one to two hours. Following the operation, patients are monitored in the recovery area for a few hours prior to being discharged home.

Detailed post-operative instructions will be provided. The incisions are closed with dissolving sutures and patients are able to shower 24 hours after surgery. Dressing changes and drain tubes are not required. Although everyone experiences surgery differently, prescription pain medication is often not required and most patients can return to normal daily activities within 48 hours.

The plastic surgeons at Coastal Plastic Surgery are specialists in breast enhancement surgery and view it not only as a surgical procedure but also as an important life-changing event that has the ability to change the way you feel about yourself, the clothes you wear, the places you go and perhaps even the people you meet. No matter what your motivation is for breast enhancement, the process begins with a consultation. Let us help you discover the breast enhancement that is right for you.

Vancouver Breast Lift

For some women their primary concern is not breast size but rather breast shape. Breast ptosis (drooping) is the usual problem and can be characterized by varying degrees of sagging of the breast, nipple descent, deflation, loose skin, and a lack of firmness. In the presence of adequate breast volume a breast lift, or mastopexy, is the procedure of choice. This procedure typically involves re-positioning the breast higher on the chest wall, re-shaping the breast tissue to restore firmness and shape, as well as removal of any excess skin.

The results of a mastopexy can be dramatic, however, the creation of lasting fullness in the upper part of the breast (if desired) usually requires an implant. If this is a priority then it may be appropriate to combine a breast lift with the placement of an implant, a procedure known as an Augmentation-Mastopexy. This procedure should also be considered for those women who have breast ptosis and inadequate breast volume, in which case, a mastopexy alone would result in a breast that is too small.

Similar to a breast augmentation, both a mastopexy and an augmentation-mastopexy are performed in a private surgical facility in Vancouver. The procedures last 2-4 hours and patients are discharged home the same day.

Breast Reduction in Vancouver and Richmond BC

Breast reduction surgery incorporates the removal of excess breast tissue with a breast lift, when necessary, in an effort to create a smaller more youthful breast. This is a commonly performed procedure aimed at relieving physical or psychological symptoms such as discomfort, poor posture or a self-consciousness about one’s appearance. When it is performed for these reasons it is an insured service provided by our provincial healthcare program. As such, most patients are referred to us by their Family Doctor. It is one of the most common procedures performed by Dr. Watts, Dr. Reid, and Dr. Loizides and our office routinely receives referrals from doctors in the Richmond, Vancouver, Delta, Northern BC and the Yukon.

Our surgeons offer variations of the common surgical techniques in use today including the short scar vertical technique (Lollipop) and the Inverted – T technique. The recommendation for one of these techniques will be based on your physical characteristics.

The procedure is performed at either the Richmond Hospital or Delta Hospital. Patients are asleep during the surgery which lasts approximately 2 hours. Most women are discharged home the same day. Prescription pain medication may be required for a few days. Patients who require time off work usually take between one to two weeks off. Low impact exercise can be resumed after 2 weeks and all activity restrictions are removed at 4 weeks.