Exciting News!

As of March, 2016 Dr. Bharti joins Hunstad Kortesis Plastic Surgery + MedSpa in Charlotte, NC. New and existing patients are welcome to call 704-659-9000 to set up consultations with Dr. Bharti's new office.

Case of the Week: Breast Augmentation with Breast Lift (Mastopexy)

Bf
This 37-year-old female mother of three presented to Dr. Bharti with deflated droopy (ptotic) breasts.  She desired to have a more youthful appearance of her breasts.   She wanted her breasts to be lifted but also wanted to have an increase in her overall size.  She was 5 foot 2 inches in height and weighted 115lbs.  She was seen at several preoperative visits with Dr. Bharti to make sure he understood her goals and expectations. 

She was then taken to the operating room as an outpatient at a surgical center and underwent bilateral breast lift (mastopexy) and bilateral breast augmentation.  The first part of the procedure involved performing the breast augmentation. Using the incisions for her lift that he marked before surgery, Dr. Bharti made a space under her muscle (subpectoral dual plane) and breast tissue for placement of the breast implants.  He selected 350 cc high profile silicone gel breast implants.  The silicone gel implants were smooth round implants.  Dr. Bharti is very careful with placement of the breast implants and avoids any contact with the skin and uses antibiotic irrigation to prevent infection and capsular contracture.  After Dr. Bharti placed the breast implants he then began the procedure for the breast lift. 
Bf2
Dr. Bharti performed a vertical breast lift with a superior pedicle for the nipple areolar complex.  With this technique our patient is left with a scar around her areola and a vertical scar below the areola.  The scar resembles a lollipop.  This technique is one of Dr. Bharti’s preferred breast lift techniques.  Skin is removed and some breast tissue is removed as well to provide a durable lift.  All absorbable sutures utilized.  During the procedure Dr. Bharti sits the patient up on the operating room table to make sure that everything looks appropriate and symmetric. 

After Dr. Bharti completed the procedure the patient’s incisions and breasts were dressed with steri strips and paper tapes, and a supportive surgical bra.  She was given pain medicine and antibiotics by mouth.  She was discharged home from the surgery center the same day as the surgery.  Dr. Bharti checked on her later that night by phone and then evaluated her the following day.  She then returned for several post operative visits at 2 weeks, one month, 3 months, 6 months, and one year after surgery. 
BF3
She has an excellent result and is delighted with her appearance.  We are very proud of her and how well she has done.   













implantsNeed a lift or thinking about breast implants?  Contact us for a complimentary consultation!


Case of The Week: Mommy Makeover

KDMMO3
What is a Mommy Makeover?

A mommy makeover represents the surgical rejuvenation of a woman’s body following the tremendous changes that can occur following the process of childbirth and childrearing.  Multiple plastic surgery procedures are available that restore and improve post-pregnancy bodies.  Procedures are typically combined in a single setting to improve the appearance of your breasts as well as your abdomen.  A mommy makeover can dramatically improve how you look and feel, and may actually be easier to fit into your schedule and budget than you may think.

Breasts can be given a more youthful volume and rejuvenated appearance by using an implant made from either saline or silicone.  Women who have had children and those that nurse will often have breasts that have dropped and have a sagging appearance that may need a breast lift (aka mastopexy) which can be performed alone or combined with an augmentation with an implant to give you added volume and fullness that has been lost in your upper breast. 

Your abdomen is rejuvenated with an abdominoplasty (aka tummy tuck).  There are many variations of an abdominoplasty. A patient may elect to get anything from a mini short scar abdominoplasty to a circumferential abdominoplasty that lifts your buttocks and tightens your abdomen at the same time.  The core concept for an abdominoplasty revolves around removing excess fat and skin that is present in your lower abdomen.  Often the majority of stretch marks of your lower abdomen can be removed as well.  Your abdominal muscles are also tightened to help give your waist more definition and regain your hourglass figure. Liposuction is often used in conjunction with an abdominoplasty to contour your flanks. 
KDMMO
Labiaplasty is becoming a popular surgical procedure for mommy makeovers.  The procedure is performed for functional and aesthetic reasons.  It involves the removal of excess tissue of the labia minora.  Patients report decreased discomfort with exercise, decrease discomfort with intercourse, and an overall improved aesthetic appearance both in and out of tight fitting clothing.  

These changes of aging and pregnancy do not necessarily affect all women the same, and there can be different levels of severity of the changes.  Each woman is unique in her needs and desires.  A patient contemplating a mommy makeover should begin the process by searching for a plastic surgeon that offers these procedures.  She should not be afraid to get more than one opinion.  She should feel educated by her surgeon, and take an active role in the decision making process.  Clear communication and understanding between the patient and her plastic surgeon is an absolute to get an ideal result.   Prior to a mommy makeover you should be done having children.  In addition, you should be close to your goal weight and stable at your weight for 3-6 months.  Prior to the surgery there should be a plan made to ensure that you will have the support to recover at home during the immediate post operative period.  It takes between 4-6 weeks before you can perform aggressive aerobic activities and weightlifting.  You should be up and walking within the first day after surgery.  It is very important to walk after your surgery, but you will not be able to lift heavy objects or participate in rigorous activity while you heal.  Moms, this means that you will potentially need some help with your kids if they are young and need to be picked up often or chased around! 

I always tell my patients that to make a good result a great result requires patient effort.  This is especially the case for any body contouring procedure.  After the recovery period an aggressive aerobic and fitness program along with a healthy balanced diet will only further your transformation and make you look even better. 
KDMMO1
Case Presentation: 
The before after pictures in this article are of a 50 year old 157lb 5 foot 5 inch female who wanted to improve the appearance of her tummy and breasts.  She did not want to have increased breast size and therefore did not wish to have breast implants placed.  After multiple preoperative planning visits she had a simultaneous abdominoplasty (tummy tuck) and bilateral mastopexy (breast lift). 

She was taken to the operating room at the hospital as an outpatient.  The first part of the procedure was the tummy tuck.  This was performed under general anesthesia.  During this procedure Dr. Bharti removed the excess skin and fat from the lower abdomen (pannus).  He also tightened her ab muscles (rectus abdominus muscles) using permanent plication sutures.  This serves the purpose of narrowing the waste and getting rid of her abdominal bulge.  Once he finished these portions of the procedure he then flexed her bed to be able to perform closure of the incisions using all absorbable sutures.  Liposuction was then performed of her flanks to further improve her contour.  She had temporary drains that were left in position to remove excess fluid in the immediate healing period. 
KDMMO2
After the tummy tuck was complete, Dr. Bharti performed the breast lift procedure.  Using the marks that he made before surgery, Dr. Bharti repositioned the breast and nipple areolar complex on the chest wall to a more youthful position and removed excess skin.  All absorbable sutures were used in this portion of the procedure as well.  She was then admitted overnight to observe her and make sure her pain was controlled.   Dr. Bharti saw her the night of surgery, and the following morning prior to her discharge home. 


While recovering she had to wear compression at all times on her abdomen and her breasts for a period of 6 weeks using an abdominal binder and surgical bra.  She walked the night of surgery, but avoided any aggressive aerobic activity or heavy weight lifting for 4 weeks.  In addition, for the first 2 weeks she had to walk around in a flexed position and she slept in a beach chair position.  

She was seen for follow up at a number of visits after the surgery including: 1 week, 1 month, 3 months, and 6 months follow up.  She has healed very well and she is thrilled with her result.  We are very proud of her!

Case of The Week: Brazilian Butt Lift

BBL
Body contouring to improve buttock shape is becoming popular in the United States.  Last year, plastic surgeons across the country performed nearly 10,000 buttock augmentations, up from the approximately 8,500 done in 2012, according to stats from the American Society of Plastic Surgeons.  There are several methods to increase and improve buttock shape and volume.  Traditional methods have focused on using buttock implants.  These implants can provide reliable results but there can be some serious complications of infection and implant malposition. 


Buttock augmentation with fat grafting is becoming the state of the art.   A popular name for this method is the Brazilian Butt Lift (often abbreviated as BBL).  This method can give you a larger, more shapely buttocks. A Brazilian butt lift enhances your figure by reducing waist-to-hip ratio without increasing overall body weight.

One of the key advantages of a Brazilian butt lift is that fat used to enhance your backside is taken from your own body.  There is no need for implants, and your donor site will benefit from a slimmer, more contoured appearance. The abdomen, thighs and lower back are common donor sites where fat is removed.  The best candidates for a Brazilian butt lift will possess good physical and emotional health, along with realistic surgical expectations.

Using this technique, Dr. Bharti performs an aggressive liposuction of areas with unwanted fat such as the abdomen, flanks, lower back, and thighs. Using a cannula (thin suctioning tube), Dr. Bharti will break up and suction out excess fat from a donor site on your body through very small incisions.  Multiple small incisions are used so that fat can be removed from all targeted areas in a smooth fashion without leaving contour deformities. 

The harvested fat is then processed and purified. Dr. Bharti will then carefully inject the harvested fat into your buttocks to increase volume and improve the overall shape. Injections will be administered using a fan pattern to ensure the highest possible survivability of the fat.  Fat is injected superficially under the skin and deeper into to the buttock muscles as well.  All incisions will be closed and surgical dressings will be applied to the treatment sites.
BBL2
This 24-year-old 5 foot 4 inch female patient weighing 150lbs presented to Dr. Bharti with the primary goal of increasing the size and improving the shape of her buttocks to have balance with her body.  She was not interested in buttock implants.  She was a healthy and physically fit non-smoker.  She had realistic expectations and met with Dr. Bharti several times before her surgical procedure to make sure she understood the procedure and to ensure Dr. Bharti clearly understood her goals. 

She was taken to the operating room under general anesthesia as an outpatient.  This was performed at a surgery center.  Dr. Bharti began the procedure with the patient lying on her back.  Dr. Bharti used tumescent fluid anesthesia as well which uses warmed fluid with adrenaline and local anesthesia to limit blood loss and help provide pain relief.  This fluid is injected prior to performing liposuction.  He then performed an aggressive liposuction of her tummy and flanks.  Small 1 cm incisions were used to perform the liposuction.  All of this fat that was removed was kept and used later in the procedure.  After her tummy and flank liposuction was complete, her small 1 cm incisions were closed with absorbable sutures. 

Her position was then changed and she was placed on her tummy on the operating room table.  Dr. Bharti then continued to perform an aggressive liposuction of her posterior flanks and her lower back.  The lower back is a very important area to perform liposuction as it accentuates the upper border of the buttocks and creates a transition zone between the buttocks and the lower back.  After this was done, multiple small incisions were used to gain access to the buttocks and fat injections were carefully performed to both buttocks.  The fat was injected into multiple areas that Dr. Bharti had marked preoperatively to increase the size and projection of the buttocks and to also improve the shape.  The fat was injected into the layers under the skin and also deeper into the gluteal muscles.  Following this all the small incisions were closed.  She was then placed in compression garments and awoken from anesthesia.  She went home later that day.  Our patient had minimal pain that was controlled with medicine by mouth.  Dr. Bharti saw the patient the following day, and continued to follow his patient at 1 week, 1 month, 3 months, 6 months, and at 1 year follow up appointments.   

Compression garmets were maintained for a total of 6 weeks, and the patient avoiding sitting or lying on her buttocks for the first two weeks after her operation.  She has an excellent result, but most importantly this patient is extremely happy!  

If you are interested in this procedure please make sure you see a Board Certified Plastic Surgeon like Dr. Bharti who is certified by the American Board of Plastic Surgery.



Case Of The Week: Tummy Tuck

Slide1 copy copy copy copy copy

This patient  was a 34 year old 5 foot 6 inch female that weighed 158lbs.  She had massive weight loss through diet and exercise.  Her hard work and diligence payed off with her weight loss but she was left with excessive skin and fat of her abdomen.  She decided to have plastic surgery under the care of Dr. Gaurav Bharti because she was very self conscious of her appearance both in and out of clothing and this affected her overall confidence.  After multiple preoperative visits she decided to have a full abdominoplasty (tummy tuck).  

She was taken to the operating room to undergoe this procedure.  This was performed under general anesthesia.  During this procedure Dr. Bharti removed the excess skin and fat from the lower abdomen (pannus).  He also tightened her ab muscles (rectus abdominus muscles) using permanent plication sutures.  This serves the purpose of narrowing the waste and getting rid of her abdominal buldge.  Once he finished these portions of the procedure he then flexed her bed to be able to perform closure of the incisions using all absorbable sutures.  Liposuction was then performed of her flanks to further improve her contour.  She had one drain that was left in position to remove excess fluid in the immediate healing period.  Her drain was removed at her one week follow up.  She was then admitted overnight to observe her and make sure her pain was controlled.   Dr. Bharti saw her the night of surgery, and the following morning prior to her discharge home.

While recovering she had to wear compression at all times on her abdomen for a period of 6 weeks using an abdominal binder.  She walked the night of surgery, but avoided any aggressive aerobic activity or heavy weight lifting for 4 weeks.  In addition, for the first 2 weeks she had to walk around in a flexed position and she slept in a beach chair position. 

She was seen for follow up at a number of visits after the surgery including: 1 week, 1 month, 3 months, and 6 months follow up.  She has healed very well and she is thrilled with her result.  We are very proud of her!

Labiaplasty

Labiaplasty is becoming a popular surgical procedure.  The procedure is performed for functional and aesthetic reasons.  It involves the removal of excess tissue of the labia minora.  I can perform this procedure in the office under local anesthesia.  It can also be done under general anesthesia, and in combination with other surgical procedures.  We use absorbable sutures that do not have to be removed.  Swelling typically subsides by 2-4 weeks.  I have my patients avoid any intercourse for approximately 6 weeks.  My patients have been extremely satisfied after undergoing this “hush hush” procedure.  They report decreased discomfort with exercise, decrease discomfort with intercourse, and an overall improved aesthetic appearance both in and out of tight fitting clothing.  

Gaurav Bharti M.D.
Board Certified Plastic Surgeon
Tags: Labiaplasty