Mommy makeover
 Cosmetic Surgery of the face
Facial rejuvenation
 Cosmetic breast surgery
 Body contouring/liposuction
Laser Liposuction/Cool Lipo
Labiaplasty
Breast reconstruction after cancer surgery
Varicose veins and broken vessels removal
Peripheral nerve surgery

Cosmetic surgery of the face

 

Ear setback (otoplasty) - photos | FAQ
This procedure is designed to correct unsightly protruding ears or ear asymmetry by “setting them back”

Nose reshaping (rhinoplasty) - photos | FAQ
This procedure is designed to change the shape and appearance of the nose to achieve more desirable, acceptable shape of the nose or to correct post traumatic changes and deformities

Chin enlargement (mentoplasty) - photos | FAQ
This procedure is designed to correct a receding chin and provide a more vibrant, attractive look. It sometimes provides better facial profile balance and is frequently performed simultaneously with nasal surgery (rhinoplasty).

Facial rejuvenation

Face/neck lift - photos | FAQ
This procedure is designed to reduce the signs of aging. Depending on patients’ preoperative appearance and desires, it may involve more or less advanced approaches

Eyelid lift surgery (blepharoplasty) - photos | FAQ
This procedure is designed to remove heaviness from the upper eyelids and to correct “baggy” appearance of the lower eyelids

Forehead/Brow lift (Endoscopic brow lift) - photos | FAQ
This procedure is designed to remove heaviness of sagging eyebrows, reduce forehead and frown wrinkles and to elevate brows and eyelids, resulting in a refreshed, less tired look.

Cosmetic breast surgery

Breast enlargement (augmentation) - photos | FAQ
Is usually suggested for women with smaller, under-developed breasts or on women who have experienced undesirable change in breast size or shape due to pregnancy, weight loss or aging process.
Breast augmentation is generally very successful at making breast larger and makes them appear fuller and better shaped. Usually, enlarged breasts look very natural and less saggy. Depending on the original breast shape, some women may require additional surgeries, such as breast lift, to achieve most desirable results.
During the initial consultation Dr Turowski will discuss your concerns and will outline the plan for treatment. He will explain technical intricacies of the procedure and will help you decide which incision option and size of the breast will best meet your cosmetic goals. 

Breast lift (mastopexy) - photos | FAQ
This procedure is designed to reshape and elevate the sagging or drooping breast (as a result of weight loss, natural aging process, congenital deformity or changes following pregnancy and breast feeding). Mastopexy may be combined with a small breast reduction or augmentation procedure.

Breast reduction - photos | FAQ
These procedures are designed to reduce size of the breasts. Large breasts are frequently associated with upper back/neck pain, shoulder grooving, under breast skin irritation. Therefore, most of these procedures are potentially covered by health insurance. Each patient has to be individually approved by her insurance company.

There are several techniques of breast reduction procedure. Generally they are either conventional inverted “T” techniques or vertical  “lollipop” type surgery. Both are great ways to reduce breasts and have advantages and disadvantages. Dr Turowski utilizes both techniques for breast reduction. The choice which technique is used depends mostly on the size/shape of patient’s breasts and her desires for size change. This is usually discussed in detail during a personal consultation.  

Inverted nipple correction - photos
Some women are either born with inverted nipples (or nipple) or develop this deformity over time or as result of breast feeding. Although functionally it is rarely a problem (can prevent breast feeding ability), it may be a source of social discomfort and anxiety. Inverted nipples can be corrected during an easy to go through procedure performed under local anesthesia in Dr Turowski’s office. The procedure leaves no conspicuous scarring and is easily tolerated without down time.

Correction of breast asymmetry - photos
Most women have some minor asymmetries of the breasts. These usually do not cause any concerns and are as typical as minor asymmetry of the face. However in some cases these asymmetries maybe very significant and may be causing significant degree of anxiety. These can be corrected through a variety of procedures, including breast reduction, augmentation or lift. The decision which procedure is optimal for particular patient can only be determined during a personal consultation with Dr Turowski and through a discussion of patient’s goals.

Male breast reduction (gynecomastia correction) - photos | FAQ
 Occasionally, the size of a man’s breast is larger than desired. If you are self-conscious about the appearance of your breasts, various procedures have been designed to correct this imperfection. Most contemporary procedures involve ultrasonic liposuction for shape correction. Utilizing this advanced liposuction technique helps avoid unsightly scarring from surgical excisions.

Body contouring/liposuction

Liposuction - photos | FAQ
Liposuction remains the most popular cosmetic procedure according to the recent statistics provided by The American Society of Plastic Surgeons. The procedure enjoys such popularity because it allows safe and effective removal of unwanted, stubborn fat deposits through very small inconspicuous incisions. Liposuction was developed in the early eighties and since then underwent many refinements including introduction of lipoplasty, liposculpture, tumescent liposuction and ultrasonic liposuction.

Tummy tuck (abdominoplasty) - photos | FAQ
It is a surgical procedure designed to flatten a protruding abdomen by tightening the muscles in the abdominal wall while removing excess fatty tissue and skin. It is usually required in a situation of post-pregnancy changes or after massive weight loss. The procedure underwent many improvements over the years. Ideal shape is achieved by performing either a mini-abdominoplasty or so called lateral tension abdominoplasty. Most of the time it is combined with ultrasonic liposuction.

Body lifting (torso, arms, thighs), weight loss correction surgery - photos
Body lifting procedures were originally designed for the correction of the excess skin in a massive weight loss situation caused by patient’s gastric bypass surgery. However, over time, after these techniques were refined, the procedures started to be useful for the  patients with cosmetic surgery needs. In selected cases these techniques can be very useful for the correction of loose skin and contour deformities. The most powerful is so called “belt lipectomy”, which involves removal of the “spare tire” around the waist, leading to not only tightening of the abdomen and flanks but also buttock and thigh lifting.

Liposculpture
Liposculpture is the natural extension of the liposuction techniques. It utilizes ultrasonic liposuction in selected targeted areas and injection/transplantation of the fat into depressed areas. It can be utilized for the correction of the figure imperfections and posttraumatic or surgical deformities


Labiaplasty

Labia Reduction & Cosmetic Enhancement - FAQ
Labiaplasty is a cosmetic genital surgical procedure that will reduce the size or change the shape of the small lips on the outside of the vagina (the labia minora). Many women are born with large or irregular labia. Others develop this condition after childbirth or with aging. The appearance of the enlarged labia can cause embarrassment with a sexual partner or loss of self esteem. Some women just want to look "prettier" like the women they see in magazines or in films. Chronic labial irritation can sometimes develop in women who wear tight clothing. Discomfort can occur with sex, sports or other physical activities. Labiaplasty can greatly enhance the cosmetic appearance of the outer vagina giving many women greater confidence and self esteem. Women whose labia become irritated and painful will often find relief after surgery.

Breast reconstruction after cancer surgery

Although the name of our practice New Horizons Center for Cosmetic Surgery suggests that our physicians specialize only in cosmetic surgery, Dr Turowski and Dr Lu are fully- trained plastic surgeons who are committed to providing the most advanced and comprehensive breast reconstruction after mastectomy or lumpectomy.

We understand that the diagnosis of breast cancer often presents an emotional and physical strain on you and your family, and we want you to know that we will work in concert with your team of physicians to provide the highest quality of care available in a compassionate manner. You can be assured that our priorities are aligned with you and your cancer doctors, with the top priority to cure your cancer.

Although you may have already been referred to, or have seen another plastic surgeon for a consultation regarding breast reconstruction, you should consider a second opinion from a plastic surgeon specializing in this type of surgery. The decision-making process and overall surgical experience that is vital for the success of these highly complex surgeries are of upmost importance. Therefore, it is important to become fully informed and make an educated decision:
  • When considering your choices in breast reconstruction, you should weigh the pros and cons of having surgery performed at a large teaching institution, where you may be operated on by a surgeon-in-training under the supervision of an attending surgeon. This is in contrast to a private hospital, where all your surgery and care will be performed personally by very experienced attending surgeons.
  • Smaller institutions that specialize in breast cancer treatment usually offer a more personalized approach to care and yet have the same high standards offered by its larger counterparts.
  • At a consultation, you should be able to view multiple postoperative photographs of actual patients, who have undergone similar procedures in all stages of the reconstructive process.
  • If desired, you should be able to contact previous patients who have underwent similar procedures to hear real stories of their recovery and healing process.
The goal of reconstructive surgery is to restore what has been removed by various approaches based on your preferences and appropriateness of the surgery. During your consultation, we will discuss in detail the available options for breast reconstruction, taking into consideration your medical history, need for adjunctive treatments such as chemotherapy and radiation, and personal preferences. Based on this information, we tailor a plan and coordinate surgery with your breast surgeon. If you do not have a breast surgeon, we will be able to refer you to several surgeons specializing in breast cancer surgery. This is of paramount importance, since the final results of an immediate breast reconstruction depend greatly on the teamwork of the breast cancer surgeon and plastic surgeon. It is our goal to provide you with as much information as possible to assist in making an informed decision about breast reconstruction.

Many decisions need to be made to decide which reconstructive option is most appropriate for you. Most breast reconstruction can be performed at the time of the mastectomy, or in other words, “immediate breast reconstruction”; however, there are rare circumstances where a “delayed breast reconstruction” may be recommended, depending on if you will require other treatments after the mastectomy. If the reconstructive surgery was not performed during the initial mastectomy surgery, depending on circumstances, delayed breast reconstruction can usually be performed as soon as several weeks after the original surgery. We have also performed breast reconstructions as late as 30 years after the initial mastectomy. Barring any coexisting major medical problems, the age of the patient is usually not a limiting factor.

The reconstructive options available differ in their approach, amount of time for the initial surgery, length of hospitalization and recovery time, and need for future procedures. In general, breast reconstruction, from creation of a breast mound to nipple and areola reconstruction, requires staged procedures, although the subsequent procedures usually are minor outpatient or in-office surgeries with significantly shorter recovery times. To provide our patients an exceptional experience and for their convenience, most of these secondary procedures can be performed in our private fully- accredited state-of-the-art surgery center.

BREAST RECONSTRUCTION OPTIONS | FAQ

Broadly speaking, breast reconstruction can be divided into “implant-based” reconstruction or “autologous”(your own tissue) reconstruction. However, there are reconstructions, such as the latissimus dorsi flap from your back, that incorporates both your own tissue with an implant to create a breast of appropriate volume based on your preferences or to match the other remaining breast.

IMPLANT-BASED RECONSTRUCTION photos
A breast implant is a round or teardrop-shaped shell, filled with saline (salt-water) or silicone gel. The implant is placed behind the pectoralis major chest muscle in a manner similar to what occurs during breast augmentation surgery.

In a select group of women, implants may be placed as a one-stage process, where a permanent implant is used at the time of the mastectomy. However, most women require a two-stage process, using a tissue expander before the permanent implant is placed.

A tissue expander is an implant with a valve/port that can be filled with saline to stretch the remaining chest skin and soft tissues to make room for the breast implant. The tissue expander is placed under the pectoralis major muscle at the time of your mastectomy. After the incisions have healed, a small valve/port is accessed and saline is injected into the expander during several office visits, usually over a 6-8 week period of time. This gradual stretching creates more skin and soft tissue, not unlike how the skin of the abdomen stretches during a pregnancy. The tissue expander is filled until it is slightly larger than the desired size to assure that the skin and soft tissue can accommodate the permanent implant. At a second surgery, the tissue expander is replaced with a permanent saline or silicone implant.

The advantage of this type of reconstruction is that the initial surgery is shorter, on average adding only 1-2 hours to the mastectomy surgery and typically requiring only a single day of hospitalization. Since this technique does not involve removal of tissue from another site of your body, it does not create any additional scars or potential “donor-site morbidity” (see below for more details).

The disadvantage of this approach is that it typically involves a tissue expander, which requires at least 2 surgical stages and multiple visits to our office during the expansion process. There are instances where this may be more challenging for the patient than a recovery from a latissimus dorsi flap reconstruction (see below). In addition, an implant does not have the same shape and “feel” of a natural breast, so that it may make matching the opposite breast more difficult (for patients only having a unilateral or one-sided mastectomy). As opposed to other types of reconstruction this type of surgery may produce a higher risk of early complications when performed as immediate breast reconstruction. In the short-term, the implant can become infected or malpositioned, which may require surgery to correct these problems. In the longer-term, implants may eventually require subsequent procedures to replace them due to capsular contracture, rupture, or malposition.

AUTOLOGOUS TISSUE RECONSTRUCTIONS photos
Breast reconstruction can be performed without implants, using a “flap” of your own tissue. A “flap” entails a combination of skin, fat, and/or muscle that is taken from one portion of your body and moved to your chest to create a breast. The advantages of using your own tissues are that it typically has a more natural shape and “feel” of a native breast, and that it typically avoids the use of an implant. It also offers immediate reconstruction of the breast shape that usually requires only minor adjustments during secondary procedures. The disadvantages of this approach are that it requires a longer surgery and recovery time, and creates an additional scar on your body, with the potential for “donor-site morbidity.” The main autologous reconstructions use tissues from the back or abdomen and are described below.

Latissimus Dorsi Flap photos
A latissimus dorsi flap involves taking the skin, fat, and latissimus dorsi muscle from your back (in the area below your scapula or shoulder blade) and tunneling it through the axilla or armpit to create a breast. Sometimes it is possible to use this flap without implants in order to achieve the desired size. However, this technique often is used in conjunction with a tissue expander or implant to reconstruct the breast.

Why use a latissimus flap if you are going to use an implant anyway? There are several reasons. Using a latissimus flap with an implant typically has a more natural shape and “feel” than an implant alone. One way to describe this effect is for you to imagine putting an implant under a bed sheet. With only a thin sheet over the implant, all of the contours of the implant are visible and the implant can be readily felt. On the other hand, if the implant is placed under a thick comforter, the implant is there only to provide volume, and is not as visible or palpable. The former analogy describes an implant-only based reconstruction, while the latter analogy describes the latissimus flap with implant reconstruction. In addition, placing the skin, fat, and muscle over an implant may reduce complications relating to infection and radiation therapy.

Therefore, the advantages of the latissimus flap are that it decreases some of the risks of using an implant, it typically is easier to match the opposite breast with this approach, and it replaces deficient skin and soft tissue which may be missing or damaged after the mastectomy and/or radiation treatments. In cases of immediate breast reconstruction, the patient emerges from the mastectomy and reconstructive surgery almost completely restored to a natural (or sometimes better) size and shape as compared to having a mound of tissue present if an expander is utilized. After the initial surgery, there often is no additional expansion necessary. Therefore the recovery period is usually surprisingly easier than for an expander/implant reconstruction, because there is no need for the sometimes-painful injections and stretching associated with the expansion process. We utilize this technique in all age groups (young and old) with tremendous success. We believe it is optimal for women looking for a relatively quick recovery and very satisfactory results without the disadvantages of prolonged expansion and problems of implant exposure.

The disadvantages of this approach are that it requires a longer surgery, and it results in an additional scar on your back where the flap is obtained (although this scar is usually well hidden by your bra). The loss of muscle function is usually well compensated by the other muscles of the shoulder and back.

TRAM Flap photos
The TRAM flap stands for a “Transverse Rectus Abdominus Myocutaneous” Flap. Put simply, it uses your abdominal skin and fat based on blood vessels that travel through the rectus abdominus muscle (sometimes known as your “six-pack” muscle). There are many variations of this type of flap which indicates the method by which Dr Turowski or Dr Lu move the abdominal tissue up to the chest to create the breast. In a “pedicled” TRAM, the tissue is moved to the chest by a subcutaneous tunnel in the lower portion of your breast. In a “free” TRAM, the abdominal tissue is transferred to the chest by using microsurgical techniques to reconnect the blood vessels that provide nourishment to the tissues.

The advantages of the TRAM are that it removes abdominal tissue to reconstruct the breast, which improves your abdominal contour after surgery (similar to an abdominoplasty or “tummy tuck”). In addition, it avoids the use of an implant, has a more natural look and “feel,” and is durable.

The disadvantages of this approach are that it requires a longer surgery with a longer recovery time than for both an implant-based or latissimus flap reconstruction, it creates a scar across your lower abdomen (similar to the scar after a tummy tuck), it may result in some abdominal muscle weakness, and it is possible to develop bulging or a hernia at the site where the flap is taken from.

DIEP and SIEA Flap photos
The DIEP and SIEA flaps stand for the “Deep Inferior Epigastric Perforator” and “Superficial Inferior Epigastic Artery” flaps, respectively. These flaps fall under the category of “perforator” flaps, which are advanced microsurgical procedures that attempt to spare the abdominal muscles. The advantage of using these flaps is that it spares the abdominal wall fascia and muscles, and may reduce the incidence of weakness, hernia/bulging, and post-operative pain. The disadvantages of the DIEP and SIEA flaps are that is a significantly longer operative procedure, and has the risk of problems with the microsurgical connections of the blood vessels.

SURGERY ON THE OTHER BREAST photos
In some patients who are receiving a unilateral mastectomy, to achieve optimal results we may recommend surgery on the contralateral or opposite breast in order to make the breasts more symmetric. This may involve a breast reduction, breast lift, or breast augmentation. Fortunately, these procedures are covered under insurance under the “Women’s Health and Cancer Rights Act of 1998.”

NIPPLE AND AREOLAR RECONSTRUCTION photos
After the breast mound is created with a flap and/or implant, the nipple and areola are reconstructed in a subsequent outpatient or office procedure. The nipple is made by surgically rearranging a small portion of the skin and fat of your reconstructed breast, and the areola is tattooed in a separate procedure.

BILATERAL BREAST RECONSTRUCTION photos
In some circumstances, bilateral breast removal or mastectomy may be recommended by your oncologist or breast surgeon. This may either be for treatment of a bilateral breast cancer or as a prophylactic measure in high-risk patients. Breast reconstruction in this circumstance often allows Dr Turowski or Dr Lu more control over the reconstruction and to achieve outstanding and symmetrical results. We have utilized bilateral implant reconstructions, bilateral TRAM flaps, and bilateral latissimus dorsi flaps with great success.

Varicose veins and broken vessels removal - photos

Venous insufficiency is a condition where blood pools in the vein rather than being efficiently pumped back to the heart. Leg problems are widespread throughout the world affecting approximately 50-60% of the population. What most people do not know is that approximately 90% of leg disorders originate within the vein. If you have tired, aching, swollen legs, swollen ankles or the beginning of varicose veins , it is time to learn how to improve the health of your venous circulation. Vein problems can progressively worsen over time and can affect your health and well-being for the rest of your life. Anything that slows down the flow of blood, changes or damages the vein wall or venouse valves, or thickens the blood can lead to venous insuficiency.

Venous insufficiency can lead to varicose veins, phlebitis (inflammation of the veins), thrombophlebitis (clots in the inflamed veins), blood clots and changes in the skin including leg ulcers. These can be not only cosmetically displeasing but also medically significant and a danger to your health.