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.

Viewing entries tagged Plastic Surgery

Labiaplasty: What to Know

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Involving a woman’s most personal area, labiaplasty is not often commonly discussed openly nor freely. As Dr. Bharti says, “it’s often regarded as a ‘hush hush’ procedure that people don’t really want to talk about”. Due to its delicate nature, it is thus understandable that woman do not fully understand the intricate details of labiaplasty.

Restoring Confidence: Abdominoplasty (Tummy Tuck)

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Body contouring of the mdisection is a very popular prcoedure.  Multiple methods exist to improve the contour of the midsection.  This case example shows before and after pictures of a patient who underwent a full abdominoplasty with lower back & flank power assisted liposuction.  She also had a bilateral lifting breast procedure done at the same time.  She is one month post op from her surgery.  Her results are excellent but will continue to improve with diet and exercise.  She is delighted with her result and we thank her for being an amazing client.  

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The 5 Most Popular Plastic Surgery Procedures of 2013

Breast Augmentation Still the Leader

Plastic Surgery Tennessee

Spoiler Alert! The American Society of Plastic Surgeons (ASPS) has released their 2013 statistics early this month and to nobody’s great surprise, breast augmentation hits the number one spot yet again. This makes it a total of eight years in a row that the breast enhancement procedure has finished as the most popular procedure in the country. Talk about dominance.

Case Of The Week: Arm Lift (Brachioplasty)

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This patient was a 39-year-old 5 foot 4 inch female that weighed 120lbs.  She had massive weight loss of greater than 100lbs after gastric bypass surgery.  After the massive weight loss she was left with significant excess skin and fat of her upper arms.   She decided to have plastic surgery under the care of board certified plastic surgeon Dr. Gaurav Bharti.   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 an arm lift (brachioplasty). 

She was taken to the operating room in an outpatient surgery center to undergo this procedure.  This was performed under general anesthesia.  During this procedure Dr. Bharti removed the excess skin and fat from her upper arms.  At the beginning of the procedure Dr. Bharti injected local anesthesia to help with pain control and prevent blood loss.  He then injected tumescent fluid and then performed liposuction of the upper arms.  He then in a very careful and stepwise fashion removed the excess skin and fatty tissue closing the surgical wounds rapidly.  All of the sutures used were absorbable.  No drains were necessary.  Steri strips were applied to the incisions, and then a compression wraps were placed.  She was then awoken from anesthesia and discharged home later that day.   Dr. Bharti saw her in clinic the following morning.  She had minimal pain or swelling, and no reports of any numbness. 
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While recovering she had to wear compression garmets at all times on her arms for a period of 4 weeks.   She was seen for follow up at a number of visits after the surgery.  At her most recent follow-up visit she has healed well and is very happy with her result. 

If you're self-conscious about your arms or feel restricted to wearing certain clothing, arm lift surgery may be able to improve your confidence and body image.

Case of The Week: Mommy Makeover

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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. 
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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. 
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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. 
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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

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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.
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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

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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!

IS YOUR PLASTIC SURGEON BOARD CERTIFIED?

As a patient, you have to be very careful in seeking out an aesthetic surgeon.  Many practicitioners will falsely title themselves as plastic surgeons or cosmetic surgeons without every having any formal training in their residency or fellowships.  A plastic surgeon must be Board Certified by the American Board of Plastic Surgery.  The American Board of Plastic Surgery holds all of its members to the very highest standards.  Not only do its members have to pass a written exam, but the members must practice for over one year before they can be board certified.  All of the cases performed in the first year are reviewed and then the candidate must then sit for a very rigourous oral examination over 3 days.  The failure rate for the oral examination for plastic surgery is near 25%.  This is very important for patients because not everyone can become a board certified plastic surgeon.  They have to meet the highest standards in safety, ethics, technique, and skill.  Do your homework, and make sure your provider is a board certified plastic surgeon.  You owe it to yourself to seek out the best trained inviduals who can provide you with safe and reproducible results.   

What is the Mommy Makeover?

It is essential that you as a mother take care of your family but also take care of yourself.  As a mother you must recognize that your perceived self worth is integral to the strength of your family. It is not self-centered or vain to take care of your self.  It is not wrong to feel beautiful, sexy, and confident.  A positive self-image will not only benefit you, but it can improve your interactions with loved ones, colleagues, and friends. 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.

It is very important to understand that plastic surgery is a personal choice and should be done for your self, and not to fulfill someone else’s desires or to try to fit an ideal image. 

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. 

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 reasts 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.  This will help give you cleavage in your clothes that you may have lost. 

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 on 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. 

Some patients will also elect to have surgery on their vagina. A labiaplasty cane be done to remove excess tissue of the labia minora and improve the aesthetic appearance of the outside of your vagina. 

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 you 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. 

To all the mothers that read this article, I say thank you for being the amazing women you are.  You owe it to yourself to feel and look your best!