BREAST PROCEDURES

  • Your consultation with Dr. Howard, a board certified surgeon, is a great opportunity to learn what options are available to you and put your mind at ease before scheduling any surgery. Getting the most out of your consultation can be as simple as being prepared and knowing the right questions to ask.

    • Write down any questions you have.

    • Have your medical history information ready, including medical problems that run in your immediate family, and bring it with you. Fill out all paperwork accurately; the more comprehensive, the better!

    • Give a full list of medications and supplements you take and anything you ingest to support your health, including herbs, teas, and vitamins.

    • You can expect your consultation to last approximately one hour; Length can vary based on procedure and number of procedures you are inquiring about.

    Dr. Howard will go over everything in great detail about the procedure(s) you are interested in, including …

    • Are you a good candidate for the procedure(s)?

    • What are the benefits?

    • What are the risks?

    • Where will the surgery take place?

    • What type of anesthesia is required for this procedure?

    • How much will the procedure(s) cost?

    • What will recovery be like?

    A portfolio of procedures performed by Dr. Howard, as well as medical textbook imagery, will also be shared.

    Before you leave we will make sure all of your questions have been answered and you feel comfortable about making your decision to schedule your inquired procedure(s).

    The cost of cosmetic consultation is $75.00.

    If your consultation is deemed medically necessary there is no charge for consultation.

    WE LOOK FORWARD TO MEETING YOU!

    Call today to schedule (605) 334 - 1930

  • One of the more popular cosmetic procedures preformed in the US. Breast Augmentation involves the use of a breast implant to improve breast aesthetics. This procedure increases breast fullness and projection. It can also be used to restore breast volume after changes created by age, weight loss, pregnancy, or breastfeeding. Most patients agree that Breast Augmentation enhances one’s self-image and confidence. Most patients are thrilled with their results and start recommending it to their friends.

    WHAT BREAST AUGMENTATION CAN DO

    • Increase fullness, roundness, and projection of your breasts

    • Improve the balance of your breast to hip contour ratio

    WHAT BREAST AUGMENTATION CANNOT DO

    • It will not correct severely drooping breasts

    • A breast lift may be required in addition to augmentation for correction of sagging breasts

    YOU MAY BE A GOOD CANDIDATE FOR BREAST AUGMENTATION

    • You are physically health, not pregnant, or breastfeeding

    • You are over the age of 18 for saline augmentation and over the age of 22 for silicone augmentation

    • You are bothered by the feeling that your breasts are too small

    • You dissatisfied with your loss of breast shape following weight fluctuation, pregnancy, breastfeeding, or aging

    • You are unhappy with the part of your breast being “empty”, lacking fullness/roundness

    • Your breasts are asymmetrical

    • One or both of your breasts have failed to develop normally

    WHAT TO EXPECT…

    YOUR CONSULTATION VISIT

    During your first visit you will meet with Dr. Howard. He will discuss the concerns and expectations you have for enhancing your appearance. He will provide you with a basic understanding of the procedure and recovery. This discussion requires visiting about your health history, implant choice, incision location, pocket utilization and the risk/limitations inherent to this surgery. A full 60 minutes is allotted for this consultation so there is plenty of time to have your questions answered. At the end of your visit, pricing information will be provided, an opportunity to schedule your procedure as well as your pre-op visit to finalize implant/operative planning.

    THE DAY OF SURGERY

    For your comfort and safety your procedure will be performed at an accredited surgical hospital. Dr. Howard, the nursing team, and anesthesia providers will all visit with you prior to surgery. All members of the team strive to provide discreet and professional care from the moment you walk in to the hospital until your discharge only a few hours later.

    The surgery itself takes approximately one hour. This is the time it takes to preform meticulous dissection and implant selection. General anesthesia is provided for this procedure and local anesthetic is utilized to help improve postoperative pain levels.

    RECOVERY

    After surgery you will have your postop supportive bra placed and taken to the recovery room. Dr. Howard will then visit with your family or friends that are with you that day. After successful recovery from anesthesia you will be released from the surgical hospital. At the time of your discharge nursing staff will review postop instructions and prescription medications with you and your caregiver.

    A follow-up appointment for the clinic will be made for approximately one week after surgery. During that time or whenever a concern arises, we encourage you to call the clinic so our team can help you confidently navigate your recovery.

  • Breast Reduction is a surgical procedure that is used to remove excess breast tissue and overlying skin to alleviate musculoskeletal discomfort and disproportion associated with symptomatic macromastia. Symptomatic macromastia can create both physical and emotional distress for patients. Physical concerns include: back pain, skin irritation, shoulder pain, indentions from bra straps and restricted physical activity. The physical symptoms associated with macromastia can occur daily and greatly impact one’s quality of life. Unfortunately, non-operative interventions often fail to consistently or substantially alleviate these problems. Additionally, patients can suffer emotional distress related to body image dissatisfaction as a result of their large breasts.

    Symptomatic macromastia is often well recognized by insurance providers. We have had great success at getting our patients approved and covered, by their insurance company for this procedure. Women who don’t meet insurance-based requirements can still undergo a Breast Reduction or Breast Lift surgeries through a cosmetic surgical route. (Please see our page on Breast Lift procedures for more information on Breast Lift.)

    WHO IS A CANDIDATE FOR BREAST REDUCTION?

    • Healthy women who can undergo an extensive surgical procedure and recovery

    • Women who are non-smokers and have a stable/healthy BMI

    • Women who have large pendulous breasts which are contributing to numerous physical complaints, consistent with symptomatic macromastia

    HOW CAN I IMPROVE MY CHANCES OF BEING APPROVED BY INSURANCE FOR THIS PROCEDURE?

    • Insurance companies depend upon details and documentation

    Details: We will be asking for an in-depth description of all symptoms, their duration, as well as utilized non-operative therapies at the time of your consultation.

    Documentation: Any notes, letters, or treatment courses prescribed by your primary care physician, chiropractor, massage therapist or physical therapists can all be valuable information which will be added to your file, later reviewed by your insurance provider.

    We will work with your insurance provider to ensure that you receive the appropriate medical benefits and coverage.

    WHAT TO EXPECT…

    YOUR CONSULTATION VISIT

    Our team will discuss your proposed surgery so that you have a thorough understanding of the procedure, establish realistic expectations about results as well as recovery. During this time a clinical breast exam, breast measurements, and clinical photography will be taken. Your general health history will be reviewed to ensure that the surgery can be executed safely.

    You will be required to obtain a recent mammogram, within the last year, if you are over the age of 40.

    WILL MY INSURANCE COVER MY PROCEDURE?

    Many insurance companies will cover a reduction procedure if it is determined to be medically necessary and you meet all of the criteria your insurance provider requires. During your consultation our team will establish the level of medical necessity and submit to your provider for “pre-authorization”. If your insurance provider approves this procedure, your surgery will be scheduled to fit into your schedule.

    THE PROCEDURE

    During your Breast Reduction surgery, Dr. Howard will reduce the volume of your breast by removing breast tissue, fat, and skin. Your breast will then be aesthetically reshaped and lifted. The nipple and areola of the breast are repositioned at this time. Finally, all the incisions are closed with dissolvable stitches and no drains are placed.

    Breast Reduction surgery is performed under general anesthesia. Most patients spend the night in the surgical hospital for recovery. While in the hospital, professional staff will ensure you have a safe and comfortable recovery.

    RECOVERY

    Pain and discomfort may linger for a few days. However, the majority of our patients are off prescription strength narcotics quickly; rarely requiring more than a few days’ worth. You will be placed in and wear a post-surgical bra until your follow-up appointment which is usually 1-2 weeks following surgery.

    Most women return to work 10-14 days after surgery. Although, some women may not return for up to four weeks; longer recovery may be required for those patients with physically challenging jobs. It often takes 3 months for the final result, as the breast continues to heal and soften. Detailed post-op instructions and expectations will be provided at the time of your surgery.

  • (MASTOPEXY)

    WHO IS A CANDIDATE FOR MASTOPEXY?

    • Women who have sagging breasts. Where the nipple hangs below the lower crease of the breast.

    • Women who are happy with their breast size when in a bra may be happy with only a breast lift procedure. However, if you wish to increase your breast size and/or achieve a fuller more rounded look. An implant, Mastopexy-Augmentation will likely be recommended.

    WHAT TO EXPECT…

    YOUR CONSULTATION VISIT

    Dr. Howard will discuss your concerns and expectations about your breast surgery. He will review your individual factors to determine the correct breast surgery to achieve your desired look. Measurements and photographs will be taken to guide our surgical planning. If you desire additional breast volume, we will review implant options. These findings, your goals, and our understanding of surgical principles will allow us to settle on the correct procedure for you.

    THE PROCEDURE

    During your Breast Lift, Dr. Howard will remove excess skin and tighten the surrounding tissue. This process will reshape and support your new breast contour and lift your nipple back towards the center of your breast. A Mastopexy, alone, will not refill the upper part of your breast. If your goal is to achieve a fuller rounder look, Dr. Howard will perform your lift in combination with an Augmentation. Only a Mastopexy/Augmentation procedure can provide a lifted, fuller, rounder breast.

    This procedure is performed at an accredited surgical hospital under general anesthesia. A local anesthetic is injected into your tissues for better postoperative pain control.

    RECOVERY

    You will be placed in a surgical bra after your procedure to minimize swelling and support your breasts as they heal. Detailed post-op instructions and expectations will be provided at the time of your surgery. Your surgeon will visit with your caregivers to discuss how surgery went and how to care for you over the next several days. Your first clinic follow-up will be one week after surgery. Most patients return to work after a week of recovery. Advice and direction on when to return to other activities will be reviewed at your post-op visit.

  • (MASTOPEXY-AUGMENTATION)

    A cosmetic breast surgery utilized to enhance both the size and “perkiness” of the breast.

    WHO IS A CANDIDATE FOR MASTOPEXY?

    • Women who are concerned about sagging/drooping breasts

    • Women who desire a fuller, rounder, larger breast profile

    • Women who are happy with their breast size when in a bra may be happy with only a breast lift procedure. However, if you wish to increase your breast size and/or achieve a fuller more rounded look an implant, mastopexy-augmentation will likely be recommended

    WHAT TO EXPECT… 

    YOUR CONSULTATION VISIT

    Breast Ptosis (drooping/sagging breasts) is a common condition that affects women. The loss of skin elasticity or breast volume can occur secondary to pregnancy, weight loss, or with aging. The end result is breast skin that is overly stretched, and a nipple positioned below your natural crease. This process and its correction will be discussed in detail with you at the time of your initial consultation visit.

    Dr. Howard will discuss your concerns and expectations about your breast surgery. The surgical process will be reviewed in order to help you understand benefits and risks of surgery. He will review your individual factors to ensure that the correct breast surgery is performed to achieve your desired look. During your consultation Dr. Howard will also take measurements and photographs to guide surgical planning to determine the right procedure for you.

    THE PROCEDURE

    During your Breast Lift and Augmentation procedure excess skin is removed, the breast tissue is reshaped and a breast implant is added. The implant provides a more youthful roundness and fullness while the breast lift restores nipple position.

    Like all our breast procedures, this surgery is performed at an accredited surgical hospital. You will be placed under general anesthesia and allowed to fully recover prior to being released to home later that same day.

    RECOVERY

    You will be placed in a surgical bra after your procedure to minimize swelling and support your breasts as they heal. After surgery, recovery nurses will provide you and your caregiver instructions and supplies. Your surgeon will visit with you to discuss how surgery went and how to care for you over the next several days. Your first clinic follow-up will be one week after surgery. Most patients return to work after one week of recovery. Advise and direction on when to return to other activities will be reviewed at your post-op visit.

  • Any breast implant can rupture. Dr. Howard can evaluate, manage and treat all breast implant rupture issues. Medical devices do wear down over time and all will eventually fail. The shell of an implant will usually start to lose integrity after 10 years, or so. Often the implant remains intact despite this loss of integrity. Sudden trauma, as during a mammogram or car accident, can create enough force to fully rupture this implant. Also common, is a “silent” rupture where the event is unknown. Determining if your implant is ruptured depends first on the type of implants you have.

    Saline: A ruptured saline implant is easier to identify. The patient will often notice a rather abrupt decrease in breast size. After the implant ruptures the saline is absorbed by your body and only the rupture shell remains in the breast pocket.

    Silicone: A ruptured silicone implant is trickier to detect. The silicone gel is much thicker and more cohesive than saline implants. It stays in the implant pocket and maintains breast volume. In some cases, the patient is unaware of the device failure. Some patients may pick up on changes in consistency, develop firmness, see redness of the breast, or notice a subtle change in shape on one side.

    If your story or physical findings are less clear cut sometimes imaging can be helpful to determine the integrity of a breast implant. An ultrasound, a cheap and fast study, can usually find a ruptured implant. If that study is equivocal, an MRI is the next study. The MRI is the best to look at implants but can be expensive. Unfortunately, not all insurance companies cover imaging studies. We are acutely aware of this and will perform your workup to ensure optimal cost savings.

    WHAT SHOULD I DO IF I THINK MY IMPLANTS ARE RUPTURED?

    We recommend being evaluated by Dr. Howard at your earliest convenience. Prolonging workup may complicate issues related to ruptured implants. evaluate.

    ONCE WE HAVE DETERMINED THE IMPLANT IS RUPTURED, DO WE NEED TO PERFORM SURGERY?

    While this is not an emergent matter, we recommend removal and replacement in a timely fashion.

    IS THE SURGERY COVERED BY INSURANCE?

    Typically, this procedure is not covered by your medical insurance. Some policies will cover the removal cost. However, replacement of the implants will not be covered. Thankfully, most implant manufacturers have a warranty policy that may provide you with 2 new implants and a stipend to help offset surgical fees. We gladly work with insurance agencies and implant manufacturers to ensure that your procedure costs are as low as possible.

  • The goal of breast reconstruction is to restore one or both breasts to near normal shape, appearance, symmetry and size following mastectomy, lumpectomy or congenital deformities.

    There are a number of factors that should be taken into consideration when choosing which option is best:

    • Type of mastectomy

    • Cancer treatments

    • Patient's body type

    If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size, shape and position of both breasts.

  • Capsular Contracture is a tightening of the scar tissue that forms around your breast implant after surgical augmentation. Rates of capsular contracture after augmentation vary greatly in medical studies but have been reported. Degree of contracture varies between patients. Some individuals may only develop a mild firmness to their breast implants. Others may develop a severe contracture which can cause significant hardness to the implant, pain, and/or distortion of the breast tissue.

    The exact cause of contracture is not known for certain. However, we suspect any number of factors may play a role in this surgical complication. Old blood from significant bleeding or hematoma, has been suspected of creating the inflammatory process of contracture. More and more studies indicate that the likely culprit of capsular contracture is a small bacterial “biofilm”. This small amount of bacterial contamination adheres to the implant and walls itself off from your body. This is thought to then promote a chronic inflammatory state within that capsule and thus a contracture.

    WHAT SIGNS OF CAPSULAR CONTRACTURE SHOULD YOU BE ON THE LOOKOUT FOR?

    • Firmness or changes in implant consistency

    • Distortion in your breasts or breast implant placement

    • Development of breast pain

    We recommend scheduling a consultation with Dr. Howard at your earliest convenience. He will be able to listen to your concerns and evaluate any areas in question. Dr. Howard will discuss options and develop an individualized plan to maximize your results and improvement.

    HOW DO WE AVOID CAPSULAR CONTRACTURE?

    Prevention is the easiest way to “treat” capsular contracture. With that fact in mind, we employ several steps and strategies to lower our patient’s risk of Capsular Contracture.

    • Stopping all medications that may increase risk of perioperative bleeding 2 weeks prior to surgery

    • Prophylactic administration of antibiotic medication

    • Utilization of a breast fold incision (inframammary fold) which has lower long-term rates of contracture

    • Precise surgical dissection of the breast pocket and immediate control of any pocket bleeding

    • Irrigation of the breast pocket with antibiotic solution to remove any blood or loose debris

    • “No touch technique” of your implants with utilization of the Keller Funnel

    WHAT TREATMENT OPTIONS EXIST FOR CAPSULAR CONTRACTURE?

    Nonsurgical approach with oral medications, leukotriene singulair antagonist, may be prescribed to soften a contracture. This may help you avoid surgery or provide improvement until you are ready for surgery.

    Surgical management revolves around removal of the contracted capsule and its breast implant. Once these are removed a new implant will be replaced. Your new implant will likely be placed into a new pocket where an acellular dermal matrix may be utilized to secure the implant and lower likelihood of your contracture coming back.

    The leukotriene singulair antagonists are typically used before and after any revision for Capsular Contracture.

    WHAT SHOULD I EXPECT FOR SURGERY AND RECOVERY?

    This revision surgery will be inherently more involved in amount of surgical dissection and time in the operating room. This increase in complexity is reflected by an increase of surgical costs. More time is required in the operating room. New implants and possibly acellular dermal matrix will need to be purchased. Finally, we tell our patients to expect a more prolonged recovery process when compared to their initial augmentation.

  • The goal of a Mommy Makeover is to restore the shape and appearance of a woman's body after childbearing. Many women notice changes in their bodies post-pregnancy.

    A Mommy Makeover is typically performed as a single-stage procedure. There are many techniques used to perform a Mommy Makeover, and many factors are taken into consideration when choosing which techniques are best for you:

    • Desired amount of restoration

    • Placement of the incisions

    • Type of implant used

    WHAT ARE SOME OF THE POSSIBLE PROCEDURES FOR MOMMY MAKEOVER?

    • Breast Augmentation

    • Breast Lift

    • Liposuction

    • Tummy Tuck

    ** Call today to schedule your Consultation with Dr. Howard.

    We believe creating a custom plan based on your goals and unique anatomy is essential to achieving your best possible results; listening and understanding what your individual needs and area(s) of concern are.

  • GYNECOMASTIA

    Enlarged breasts in men.

    Gynecomastia is an increase in the amount of breast gland tissue in boys and men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.

    Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.

    Generally, gynecomastia isn't a serious problem, but it can be tough to cope with the condition. Men and boys with gynecomastia sometimes have pain in their breasts and may feel embarrassed.

    SYMPTOMS

    Most adult men with gynecomastia report no symptoms. Signs and symptoms of the condition may include:

    • Pain, particularly in adolescents

    • Swollen breast tissue

    • Breast tenderness

    • Nipple sensitivity with rubbing against clothes

    WHEN TO SEE A DOCTOR

    See your doctor if you have:

    • Swelling

    • Pain or tenderness

    • Nipple discharge in one or both breasts

    Gynecomastia has few physical complications, but it can cause psychological and emotional problems caused by appearance.

  • This is a rare condition in which the muscles, soft tissues and occasionally ribs do not develop normally. Usually affecting only one side of the body and is seen more commonly in boys than girls. Clinically this manifests in absence or underdevelopment of the breast. The muscles of the chest, the pectoralis minor and major, occasionally the hand and fingers are involved. This is a sporadic condition with no defined inheritance patterns.

    Young ladies present with their mothers with a normally developing breast on one side and the other much smaller. In extreme cases the breast tissue, the nipple and areola and underlying muscle are totally absent. Fortunately total aplasia of the breast and nipple is rare.

    Development of the nipple areola complex is dependent on the underlying expanding and growing breast. When one breast is markedly smaller than the other the nipple areola is also much smaller and will always be that way. The best outcome on making the affected breast most closely match the normal side is to start early. A specially designed implant called a tissue expander is placed as in a breast reconstruction. As the young lady’s body develops saline is added to the tissue expander to match growth. This expansion process stresses on the overlying nipple areola complex to develop more evenly.

    When full growth has occurred the tissue expander is replaced with a permanent implant. The “normal” breast may benefit from procedures to match the constructed breast. Patients and their families must always understand that our tissues change throughout life. The effects of pregnancy, aging, and changes in weight all can affect the body and revision surgeries sometime in life will most likely be needed to maintain optimum balance.

BODY PROCEDURES

  • Your consultation with Dr. Howard, a board certified surgeon, is a great opportunity to learn what options are available to you and put your mind at ease before scheduling any surgery. Getting the most out of your consultation can be as simple as being prepared and knowing the right questions to ask.

    • Write down any questions you have.

    • Have your medical history information ready, including medical problems that run in your immediate family, and bring it with you. Fill out all paperwork accurately; the more comprehensive, the better!

    • Give a full list of medications and supplements you take and anything you ingest to support your health, including herbs, teas, and vitamins.

    You can expect your consultation to last approximately one hour; Length can vary based on procedure and number of procedures you are inquiring about.

    Dr. Howard will go over everything in great detail about the procedure(s) you are interested in, including …

    • Are you a good candidate for the procedure(s)?

    • What are the benefits?

    • What are the risks?

    • Where will the surgery take place?

    • What type of anesthesia is required for this procedure?

    • How much will the procedure(s) cost?

    • What will recovery be like?

    A portfolio of procedures performed by Dr. Howard, as well as medical textbook imagery, will also be shared.

    Before you leave we will make sure all of your questions have been answered and you feel comfortable about making your decision to schedule your inquired procedure(s).

    The cost of cosmetic consultation is $75.00.

    If your consultation is deemed medically necessary there is no charge for consultation.

    WE LOOK FORWARD TO MEETING YOU!

    Call today to schedule (605) 334 - 1930

  • We are proud to offer truSculpt® iD, a non-surgical, body-sculpting treatment!

    truSculpt iD is a safe and effective technology that is clinically proven to permanently eliminate fat cells in stubborn areas around your abdomen and flanks. With truSculpt iD, you can get the body definition you want, even in areas that have been resistant to diet and exercise.

    HOW IT WORKS?

    • truSculpt iD uses innovative Monopolar RF technology to selectively target fat and therapeutically heat it – until fat cells are eliminated by passing through the body naturally.

    • Average of 24% fat reduction is achieved in just one treatment.

    HOW IS THIS DIFFERENT THAN OTHER BODY SCULPTING PROCEDURES?

    • This procedure is versatile and effective to treat a wide range of patients who may not be a candidate for other contouring procedures due to treatment location, skin type, fat thickness and presence of skin laxity.

    • The treatment has minimal discomfort and has been compared to a hot stone massage.

    • There is no visible downtime after the procedure and normal activity can be resumed immediately.

    • Additional treatments may be required to achieve the personalized results you desire. Treatment results are visible after 12 weeks.

    FREQUENTLY ASKED QUESTIONS

    What is truSculpt iD®?

    • truSculpt iD allows you to personalize your ideal body with a revolutionary non-surgical, body-sculpting treatment. Its comfortable, safe, and effective technology is clinically proven to permanently eliminate fat cells in stubborn areas around your abdomen and flanks.

    Am I a candidate for truSculpt iD?

    • Because truSculpt iD is a customized and tailored treatment to meet individual needs, most adult men and women are a candidate.

    Can truSculpt iD be used on all skin types?

    • Yes, this treatment can be done on all skin types and over tattoos.

    How long does a treatment take?

    • Procedure time depends on the size and number of treatment areas. It typically takes 15 to 30 minutes to treat the abdomen and flanks.

    How many treatments will be needed?

    • Multiple areas can be treated in as little as one 15-minute session.

    • Additional treatments may be required to achieve the personalized results you desire.

    What will the treatment feel like?

    • truSculpt iD procedures are typically described as feeling like a hot stone massage. During treatment, the temperature of your skin will rise but remain comfortable. It’s effective, safe, and the results are even and consistent.

    Is there really no downtime?

    • Post-procedure, the treatment area will be warm and flushed for less than one hour. While you may experience mild sensitivity to the touch for a few days, you’ll be able to immediately return to normal activities and exercise.

    When will I see results?

    • Results are visible after just one treatment, with maximum results seen after 12 weeks. Additional treatments may be required to achieve the personalized results you desire.

  • (ABDOMINOPLASTY)

    An abdominoplasty is a procedure that removes excess skin and fat that is concentrated on the lower abdomen. It also tightens the abdominal wall muscles to help promote a flatter abdominal contour. Both men and women can undergo this procedure to reduce the appearance of a protruding abdomen. This surgery is not a substitute for weight loss or other healthy lifestyle choices. Best outcomes are seen in patients who are at a stable weight, physically healthy, and non-smokers. Some of our happiest patients view this surgery as the last step after weight loss and exercise, unlocking the look they’ve always wanted.

    WHO IS A CANDIDATE FOR TUMMY TUCK (Abdominoplasty) SURGERY?

    • Patients who are concerned with loose or sagging abdominal skin

    • Patients with excess fatty deposits in their abdomen

    • Women with weakened or separated abdominal muscles as a result of pregnancies

    • Patients who have had a substantial weight loss and have been at a stable goal weight for several months

    WHAT TO EXPECT…

    YOUR CONSULTATION VISIT

    During this initial visit, Dr. Howard will review your health history and any previous surgeries. He will then discuss your areas of concern and goals for surgery. At this point, we will discuss the steps and decision-making process of an abdominoplasty procedure. This discussion will include possible risks, anticipated recovery time, and answers for any questions you may have. A physical examination will be performed; photos and measurements will also be taken during your consultation. Physical findings will be utilized to ensure the safest and most suitable procedure is preformed to help achieve your goals.

    An hour is scheduled for your consultation visit. This time allows for a thorough evaluation and an opportunity to get all your questions answered. At the end of your consultation price information will be provided as well as an opportunity to schedule your pre-op and procedure.

    THE DAY OF SURGERY

    For your comfort and safety your procedure will be performed at an accredited surgical hospital. You will get to meet nursing staff and anesthesia providers prior to your surgery. Dr. Howard will also visit with you prior to surgery to review your surgical plan and perform surgical marking. All members of this team will work to provide a discreet, comfortable, and professional level of care from the moment you check in until your discharge.

    The surgery itself will be done under general anesthesia and take approximately 3 hours. During this time, meticulous dissection and closure is performed. Operative site is closed over drains and local anesthetic is placed to help improve postoperative pain control. All incisions are covered with surgical bandage and an abdominal binder is placed for post-op comfort and support.

    RECOVERY

    Most patients will spend the evening in the hospital following this procedure. Staying in the hospital affords you around the clock care, excess to iv pain medications, and the support of knowledgeable nursing staff. Dr. Howard will visit with your friends/family that came to be with you for your surgery. Typically, you are comfortable and ready for discharge the following morning after being seen by Dr. Howard. At the time of this discharge, nursing staff will review specific post-op instructions and medications with you and your caregiver.

    We ask you to stay in your compression garment as much as possible following your procedure. Your abdomen will feel swollen and sore for a few days following surgery. This discomfort should be readily controlled with the medications prescribed for you. You will need assistance getting around and doing normal activities of daily living. We will encourage you to get up and walk around frequently after surgery to promote healing and reduce your risk for developing blood clots.

    A follow-up post-op appointment in clinic will be made for the week after surgery. Follow-up appointments will be utilized to remove any sutures, drains, and ensure your recovery is on track. We like to see patients frequently during the first several weeks following your procedure. During your recovery we encourage you to call our clinic whenever a question or concern arises. We want you to have a stress-free recovery focused on allowing your body time to heal. Everyone’s recovery is unique to their experience. However, most patients will be ready to return to work in 1 week. We ask that you avoid any strenuous activity for 6-8 weeks following surgery. Your result will likely be evident sometime between 3-6 months.

  • A thigh lift is a surgical procedure performed to remove excess skin and fat that is concentrated within one’s legs. Not only is tissue removed but a youthful lifting and contouring of the thighs is performed simultaneously. Both men and women can undergo this procedure to address body contouring concerns. This is another procedure that is often performed after significant weight loss to help restore a more desirable shape and tone to the legs.

    Best outcomes are seen in patients who are at a stable weight, physically healthy, and are non-smokers. Some of our happiest patients view this surgery as the last step after weight loss and exercise in unlocking the look they have always wanted.

    WHO IS A CANDIDATE FOR THIGH LIFT SURGERY?

    • Patients who are concerned with loose or sagging skin/fat around their legs and thighs

    • Patients with excess fatty deposits between their legs and/or right above their knees

    • Patients who have had a substantial weight loss and have been at a stable goal weight for several months

    WHAT TO EXPECT…

    YOUR CONSULTATION VISIT

    During this initial visit, Dr. Howard will review your health history and any previous surgeries. He will then discuss your areas of concern and goals for surgery. At this point, we will discuss the steps and decision-making process of an thigh lift procedure. This discussion will include possible risks, anticipated recovery time, and answers for any questions you may have. A physical examination will be performed; photos and measurements will also be taken during your consultation. Physical findings will be utilized to ensure the safest and most suitable procedure is preformed to help achieve your goals.

    An hour is scheduled for your consultation visit. This time allows for a thorough evaluation and an opportunity to get all your questions answered. At the end of your consultation price information will be provided as well as an opportunity to schedule your pre-op and procedure.

    THE DAY OF SURGERY

    For your comfort and safety your procedure will be performed at an accredited surgical hospital. You will get to meet your nursing staff and anesthesia providers prior to your surgery. Dr. Howard will also visit with you preoperatively to review your surgical plan and preform surgical markings. All members of this team will work to provide a discreet, comfortable, and professional level of care from the moment you check in until your discharge.

    The surgery itself will be done under general anesthesia. During your surgery, meticulous dissection and closure is performed. The operative site is closed over drains and local anesthetic is placed to help improve postoperative pain control. All incisions are covered with a surgical bandage and then a compressive garment is placed for postop comfort and support.

    RECOVERY

    Some patients will choose to spend the evening in the hospital following this procedure, but not all. Staying in the hospital affords you around the clock care, excess to iv pain medications, and the support of knowledgeable nursing staff.

    If you are required or choose to stay overnight in the hospital, typically, you are comfortable and ready for discharge the following morning after being seen by Dr. Howard. At the time of this discharge, nursing staff will review post-op instructions and medications with you and your caregiver.

    You will be asked to stay in your compression garment as much as possible following your procedure. Your legs will feel swollen and sore for a few days following surgery. This discomfort should be readily controlled with the medications prescribed for you. You will need assistance getting around and doing normal activities of daily living. We will encourage you to get up and walk around frequently after surgery to promote healing and reduce your risk for developing blood clots.

    A follow-up appointment in clinic will be made for the week after surgery. Follow-up appointments will be utilized to remove any sutures, drains, and ensure your recovery is on track. We like to see patients frequently during the first several weeks following your procedure. During your recovery we encourage you to call our clinic whenever a question or concern arises. We want you to have a stress-free recovery focused on allowing your body time to heal. Everyone’s recovery is unique to their experience. However, most patients will be ready to return to work in 1 week. We ask that you avoid any strenuous activity for 6-8 weeks following surgery. Your result will likely be evident sometime between 3-6 months after surgery.

  • (BRACHIOPLASTY)

    Brachioplasty, also known as an Arm Lift, reshapes and lifts the underside of your arms. This procedure sculpts your arm, from elbow to armpit, into a more desirable smoother/smaller contour. Like many contouring procedures this surgery is designed to compliment the results achieved from healthy diet and exercise.

    WHO IS A CANDIDATE FOR ARM LIFT SURGERY?

    • Healthy, non-smoking patients with a healthy stable weight who are concerned about their arm’s appearance

    WHAT IS NEXT…

    YOUR CONSULTATION VISIT

    This is your time to meet the staff Dr. Howard. We will review your past medical and surgical history. Please bring a list of the medications and supplements you are currently taking. This history coupled with a physical examination are collected in order to ensure you are a proper candidate for a safe procedure. Photographs and measurements will also be collected for reference during your surgery.

    If you don’t have much excess skin under your arm, a simple liposuction procedure may be all you need. However, if you carry a modest amount of excess arm skin and fat, it may be necessary to utilize both liposuction and a direct excision of tissue from the elbow to your armpit.

    During this full hour of your appointment you will come to better understand your upcoming surgery, the inherent risks and likely benefits. We strive to have well informed, prepared and excited patients prior to any cosmetic procedure.

    THE DAY OF SURGERY

    Arm Lift surgery is performed in 2 hours. Dr. Howard will also visit with you pre-operatively to review your surgical plan and perform surgical markings. This surgery will be done under a general anesthetic. During this time all the liposuction, resection and meticulous closure is performed. Post-operatively, you will be placed in a compression garment to support your tissues while they heal. We rarely use surgical drains following an arm lift surgery.

    RECOVERY

    The contours of your arms will be remarkably improved immediately after your surgery. You can expect to have some swelling and discomfort afterwards. You will be asked to wear a compression garment for several weeks after surgery to help with swelling. Local anesthetic and oral pain medications are used to manage any post-op discomfort.

    You will be allowed to go home the same day as your surgery. Most patients return to work 7-10 days after this type of procedure. Details of your recovery and post-op care will be provided at the time of your discharge from the surgical hospital. We will plan to see you back in clinic after a week to ensure all is going as expected in your recovery. Several visits over the next few weeks will allow us to help guide you through your post-op recovery, optimize you results, and get you back to normal activities sooner.

  • A Panniculectomy is a surgical procedure designed to remove excessive skin and fat from your lower abdomen. Specifically, it is performed to remove the tissue that folds over your waist line and hangs over your groin and legs. This is a surgery performed on individuals many times after massive weight loss. This weight loss may have been achieved with diet, exercise, or bariatric surgery. The skin and fat that hangs off your waistline may be creating issues with hygiene, pain, mobility, and clothing fitting. Additionally, you may feel this area is unsightly and makes you less excited about your body’s new contours after weight loss. A Panniculectomy can be a wonderful compliment to all of your hard work and the next step in your weight loss journey.

    WHO IS A CANDIDATE FOR PANNICULECTOMY?

    • Any healthy individual who has significant excess skin and fat in their lower abdomen after massive weight loss.

    • Individuals with difficulties related to their abdominal pannus (poor hygiene, skin breakdown, skin infection, etc.)

    • Patients who are may be near or on good trajectory towards achieving their goal weight.

    • Many times your bariatric surgeon will have a good idea when this surgery would be best for you.

    WHAT IS NEXT…

    YOUR CONSULTATION VISIT

    During this initial visit, Dr. Howard will review your health history and any previous surgeries. We will visit in depth about your weight loss journey and goals. At this point, we can discuss the steps and decision-making process and timing of your panniculectomy surgery. We want to make sure that you are in ideal shape for surgery and it’s done at the right time for you.

    Dr. Howard will review possible risks, anticipated recovery time, and answers for any specific questions you may have. A physical examination is then performed where photos and measurements will be taken. These physical findings will be utilized to ensure the safest and best procedure is preformed to help you achieve your goals.

    A full hour is scheduled for your initial visit. This time allows for a thorough evaluation and an opportunity to have all of your questions and concerns addressed.

    THE DAY OF SURGERY

    For your comfort and safety your procedure will be performed at an accredited surgical hospital. You will get to meet all of your nursing staff and anesthesia providers prior to surgery. Dr. Howard will also visit with you pre-operatively to review your surgical plan and preform surgical markings. All members of this team will work to provide a discreet, comfortable, and professional level of care from the moment you check in until your discharge.

    The surgery itself will be done under general anesthesia and take approximately 3 hours. During this time, meticulous dissection and closure is performed. Operative site is closed over drains and local anesthetic is placed to help improve post-operative pain control. All incisions are covered with a surgical bandage and then an abdominal binder is placed for post-op comfort and support.

    RECOVERY

    Some patients after a panniculectomy, elect to spend the evening in the hospital following this procedure. Staying in the hospital affords you around the clock care, excess to iv pain medications, and the support of knowledgeable nursing staff. Dr. Howard will visit with the friends/family that came to be with you for your surgery.

    If you are required or choose to stay overnight in the hospital, typically, you are comfortable and ready for discharge the following morning after being seen by Dr. Howard. At the time of this discharge, nursing staff will review specific post-op instructions and medications with you and your caregiver.

    We ask you to stay in your compression garment as much as possible following your procedure. Your abdomen will feel swollen and sore for a few days following surgery. This discomfort should be readily controlled with the medications prescribed for you. You will need assistance getting around and doing normal activities of daily living. We will encourage you to get up and walk around frequently after surgery to promote healing and reduce your risk for developing blood clots.

    A follow-up appointment in clinic will be made for the week after surgery. Follow-up appointments will be utilized to remove any sutures, drains, and ensure your recovery is on track. We like to see patients frequently during the first several weeks following your procedure. During your recovery we encourage you to call our clinic whenever a question or concern arises. We want you to have a stress-free recovery focused on allowing your body time. Everyone’s recovery is unique to their experience. That is why we will want to be involved with your individual recovery process. However, most patients will be ready to return to work in 1 week. We ask that you avoid any strenuous activity for 6-8 weeks following surgery. Your result will likely be evident sometime between 3-6 months.

  • Liposuction is a surgical procedure where excess fatty tissue is removed from unwanted areas. Recent refinements in technique and equipment allows Dr. Howard to “sculpt” a new and improved contour to areas such as your neck, arms, chest, hips, waist, backs, knees and more.

    WHO IS A CANDIDATE FOR LIPOSUCTION SURGERY?

    Liposuction is not a replacement for healthy lifestyle choices and/or weight loss

    • Ideal candidates are at a stable healthy weight but have pockets of excess fat that fail to respond to appropriate diet and exercise

    • Those who understand the limitations of liposuction and have realistic expectations for their body

    • Non-smokers who continue to lead healthy lifestyles

    • Many of our patients have a “familial” weight distribution. An area where fat builds up and won’t go away. Often these areas of concern are common to you and your close relatives-suggesting a hereditary tendency

    WHAT IS NEXT…

    YOUR CONSULTATION VISIT

    During your visit, Dr. Howard will discuss your areas of concern and your goals for surgery. He will review your medical history, previous surgeries, and current medications. From there, he will determine the location of fat deposits and assess the condition of your skin in these areas. This investigation will allow us to talk about outcomes and alternative procedures available to you. For instance, we may determine that a tummy tuck would provide a more powerful result for you, instead of liposuction, based on abdominal wall tone or overlying skin quality.

    Dr. Howard will discuss surgery and recovery in detail. This discussion will include going over the risks and complications of your proposed surgery.

    THE DAY OF SURGERY

    For your comfort and safety your procedure will be performed at an accredited surgical hospital. You will get to meet all of your nursing staff and anesthesia providers prior to your surgery. Dr. Howard will also visit with you pre-operatively to review your surgical plan and preform surgical markings. All members of this team will work to provide a discreet, comfortable, and professional level of care from the moment you check in until your discharge.

    The procedure involves inserting a narrow cannula through several small incisions in and around your treatment areas. The fatty layer of tissues is then injected with tumescent solution. This medication solution helps Dr. Howard remove fat, limit bleeding, and decreased postoperative discomfort.

    RECOVERY

    After your surgery the small incisions are closed, and compressive garments are placed to the treated areas. It is unlikely that you will require any surgical drains if you are just undergoing liposuction. However, all patients will be placed in compression garments. These specialized garments help your skin conform to its new contours and reduce post pain and swelling. While you are in recovery, Dr. Howard will visit with the friends and family who came with you to surgery.

    Most patients go home the same day as surgery. Nursing staff will ensure you are safe and comfortable to go home. They will review post-op instructions and go over your prescription medications with you and your care provider. Most patients will go home with a short course of narcotics for pain control and a few days’ worth of antibiotics to prevent infection.

    We ask you to stay in your compression garment as much as possible following your procedure. Your treated area will feel swollen and sore for a few days following surgery. This discomfort should be readily controlled with the medications prescribed for you. You will need assistance getting around and doing normal activities of daily living. Expect some drainage from your liposuction incisions and bruising. The drainage usually subsides in a couple of days and the bruising fades in a week or two. We will encourage you to get up and walk around frequently after surgery to promote healing and reduce your risk for developing blood clots.

    A follow-up appointment in clinic will be made for the week after surgery. During your recovery we encourage you to call our clinic whenever a question or concern arises. We want you to have a stress-free recovery focused on allowing your body time. Everyone’s recovery is unique to their experience. That is why we will want to be involved with your individual recovery process. However, most patients will be ready to return to work in 1 week. We ask that you avoid any strenuous activity for 6-8 weeks following surgery. Your result will likely be evident sometime between 3-6 months.

  • This is literally a pain in the backside. Patients with pilonidal disease suffer from chronic irritation, spoilage, infections and abscess formation in the skin over the tailbone. Drainage procedures, wound care with dressings and/or packing these wounds can go on for weeks. The wound care is not something you can do by yourself and this only incurs more expense.

    Simple incision and drainage procedures can be effective and are a first line treatment. Strong consideration should be made early on for laser hair removal as the presence of thick coarse body hair is an issue in many, though certainly not all patients.

    Recurrent disease is treated with surgical excision of the area; the wound may be left open requiring prolonged daily wound care for weeks. Vacuum assisted closure devices, or VAC, also are used, again for weeks. Dressings are changed 3 times a week but the patient must carry the vacuum pump with them at all times.

    Excision and closure with flap techniques such as rhomboid flaps and the bascom cleft lift procedures have advantages in fewer operations, hopefully one or two, limited hospitalization time and excellent cure rates. Recurrence rates as low as 1% has been found in larger studies. Plastic surgery training places great emphasis on wound management and flap procedures.

  • Scars cannot be removed but they can be modified to render them as inconspicuous as possible. Scars that are widened have a different texture and appearance than surrounding skin. Scars that are raised or depressed cast shadows that draw attention to them. Long standing scars are generally best treated with surgical scar revision. The old prominent scar is excised and the resulting defect carefully brought together with meticulous technique. Tissues heal with a scar but one that is generally much less noticeable than the old.

    Fresh scars whether from repair of an injury, scar revision or from a surgical procedure can all benefit from proper wound management. Treatment protocols involve a combination of scar massage and topical products to help calm the injury and promote optimum healing. Silicone products, placed over the scar have been shown to be effective at reducing their visual impact.

    As long as scars are red, pink or purple massage and topicals can help. Mature pale scars may require surgical revision for improvement.

    Widened scars can be excised partially to narrow them, therefore lessening their visual impact. Very large scars can be made smaller with serial partial excisions scheduled about 3 months apart. This process takes advantage of the skin’s ability to stretch and remodel. Certain types of birthmarks can be candidates for this type of treatment as well.

    As all scars and birthmarks are different a consultation and evaluation can determine what approach would be best.

  • The goal of a Mommy Makeover is to restore the shape and appearance of a woman's body after childbearing. Many women notice changes in their bodies post-pregnancy.

    A Mommy Makeover is typically performed as a single-stage procedure. There are many techniques used to perform a Mommy Makeover, and many factors are taken into consideration when choosing which techniques are best for you:

    • Desired amount of restoration

    • Placement of the incisions

    • Type of implant used

    WHAT ARE SOME OF THE POSSIBLE PROCEDURES FOR MOMMY MAKEOVER?

    • Breast Augmentation

    • Breast Lift

    • Liposuction

    • Tummy Tuck

    ** Call today to schedule your Consultation.

    We believe creating a custom plan based on your goals and unique anatomy is essential to achieving your best possible results; listening and understanding what your individual needs and area(s) of concern are.

  • Mohs surgery is a procedure used to treat skin cancer. This surgery involves cutting away thin layers of skin. Each thin layer is looked at closely for signs of cancer. The process keeps going until there are no signs of cancer.

    The goal of Mohs surgery is to remove all of the skin cancer without hurting the healthy skin around it. Mohs surgery allows the surgeon to be sure that all the cancer is gone. This makes it more likely that the cancer is cured. It reduces the need for other treatments or more surgery.

    During Mohs surgery, medicine to numb the area is usually given so that you don't feel pain. Most people can go home after surgery and don't need to stay in a hospital.

  • Are you tired of shaving, plucking, or dealing with unwanted hair? Laser hair removal is a simple in office procedure that can leave you with silky smooth skin. Taking away these problematic dark hairs can boost your confidence and simplify your morning routine. This procedure works for both men and women. Treatment plans vary based on amount of hair, size of treatment area, and skin type.

    **Several sessions are required for best results.

    Ask us about scheduling a FREE CONSULTATION. We will help tailor to your specific needs and areas of concern with the right treatment plan.

FACE PROCEDURES

  • Your consultation with Dr. Howard, a board certified surgeon, is a great opportunity to learn what options are available to you and put your mind at ease before scheduling any surgery. Getting the most out of your consultation can be as simple as being prepared and knowing the right questions to ask.

    • Write down any questions you have.

    • Have your medical history information ready, including medical problems that run in your immediate family, and bring it with you. Fill out all paperwork accurately; the more comprehensive, the better!

    • Give a full list of medications and supplements you take and anything you ingest to support your health, including herbs, teas, and vitamins.

    You can expect your consultation to last approximately one hour; Length can vary based on procedure and number of procedures you are inquiring about.

    Dr. Howard will go over everything in great detail about the procedure(s) you are interested in, including …

    • Are you a good candidate for the procedure(s)?

    • What are the benefits?

    • What are the risks?

    • Where will the surgery take place?

    • What type of anesthesia is required for this procedure?

    • How much will the procedure(s) cost?

    • What will recovery be like?

    A portfolio of procedures performed by Dr. Howard, as well as medical textbook imagery, will also be shared.

    Before you leave we will make sure all of your questions have been answered and you feel comfortable about making your decision to schedule your inquired procedure(s).

    The cost of cosmetic consultation is $75.00.

    If your consultation is deemed medically necessary there is no charge for consultation.

    WE LOOK FORWARD TO MEETING YOU!

    Call today to schedule (605) 334 - 1930

  • (OTOPLASTY)

    Otoplasty can be cosmetic or reconstructive. The ear may not form correctly. This can produce issues from an unusually shaped ear to an ear that never formed correctly, a condition known as Microtia. Microtia is associated with other defects of the ear structure and is an area of treatment all to itself.

    Newborns sometimes have issues with their ears when the cartilage has not "firmed up" at birth and they exhibit "floppy ears" or "folded ears". Other conditions include Stahl's ear and cup ear deformity as well as others.

    Baby's ear cartilage is affected by high maternal hormones and the ears may remain soft and easily deformable. There are now treatments based on simply splinting the ears for the first few weeks of baby's life until the hormones stabilize and the cartilage firms up. Once the cartilage has firmed up splinting will probably not work and surgery may be the only option. Also sprinting may not always produce the optimum results.

    Otoplasty can be done at any age after the ears have reached 90% of their full size — usually after age 5 — through adulthood.

  • EARLOBES TORN FROM EARRINGS?

    DON’T WANT GAUGED EARS ANYMORE?

    We repair split earlobes.

    • Earring caught on the phone

    • Inquisitive baby latched on pulled them out

    • You have decided the “gauge” look doesn’t fit you anymore or perhaps you are considering joining the military and your ears won’t pass muster

    Split or gauged earlobes can be corrected in our office using a local anesthesia. Sutures are removed in seven days. We recommend waiting 4-6 weeks of healing time before getting your ears re-pierced. Restore your ears to normal.

  • Skin care products, Botox, dermal fillers and phototherapy, IPL and lasers are all wonderful tools in the search for maintaining a more youthful appearance. Unfortunately, they have their limitations and when the visual effects of loss of facial fat, “sagging and drooping” of facial structures, skin changes from natural aging, sun damage or the just the effects of heredity cannot be addressed by these non-invasive procedures we look to see what can be accomplished with surgery. Face lift, neck lift, mini facelift, brow lift, endoscopic of traditional coronal brow lift as well as procedures for the eyelids, blepharoplasty, all can produce major changes in one’s appearance.

    Each patient’s facial structure, their bone structure, skin elasticity and redundancy and underlying fat and ligaments are unique. It is not possible to say a classic Cervicofacial Rhytidopasty or “new and improved” Miniplasty is best for you without an evaluation and personal consultation from a well trained and experienced surgeon. In this way the best results may be achieved based on the one’s individual body structure and needs.

  • Facelift procedures have evolved over years with many modifications and improvements so that they do much more than lift the skin; “Layered” procedures done today tighten the underlying layers of the face and neck, i.e., platysma and SMAS layers so that “jowling” on the jaw line and skin of the neck can be tightened and improved resulting in a more youthful appearance. Mini facelifts do the same thing, but on a mini scale and work best for patients in their 40’s looking to improve very defined issues.

  • (BLEPHAROPLASTY)

    When we are introduced to someone for the first time names and pleasantries are exchanged and we look each other in the eyes. And that is where that so important first impression is made. And that is where subtle, or not so subtle, changes in appearance can be achieved. Removing the redundant upper eyelid skin, correcting a “droopy” tired appearance or removing bags caused by unwanted fat under the eyes can result in a much more refreshed and brightened presentation. And this is where most patients should consider starting. The most significant change for the least downtime may be achieved by addressing the eyelids first in most patients.

  • A Brow Lift, also known as a Forehead Lift.

    • Reduces the wrinkle lines that develop horizontally across the forehead, as well as those that occur on the bridge of the nose, between the eyes

    • Improves frown lines, the vertical creases that develop between the eyebrows

    • Raises sagging brows that are hooding the upper eyelids

    • Places the eyebrows in an alert and youthful position

    Some individuals are genetically prone to develop a sagging forehead producing low set eyebrows. This can be improved upon by repositioning the forehead skin with either a traditional coronal brow lift or by endoscopic method. Each has its own advantages and indications.

  • (RHINOPLASTY)

    Rhinoplasty is surgery that changes the shape of the nose. The motivation for rhinoplasty may be to change the appearance of the nose, improve breathing or both.

    The upper portion of the structure of the nose is bone, and the lower portion is cartilage. Rhinoplasty can change bone, cartilage, skin or all three.

    When planning rhinoplasty, we will consider your other facial features, the skin on your nose and what you would like to change. If you're a candidate for surgery, we will develop a customized plan just for you during your consultation.

    Sometimes part or all of a rhinoplasty is covered by insurance.

  • SEPTOPLASTY

    Septoplasty is a surgical procedure to straighten the bone and cartilage dividing the space between your two nostrils (septum). When the septum is crooked, it's known as a deviated septum. A deviated septum can make it harder to breathe through your nose and can increase the risk of sinus infections due to poor drainage.

    During septoplasty, your nasal septum is repositioned to the middle of your nose. This may require your surgeon to cut and remove parts of your nasal septum before reinserting them in the proper position.

    Once a septoplasty is healed, you'll likely find it's easier to breathe.

  • CLEFT LIP AND CLEFT PALATE

    Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don't close completely.

  • Mohs surgery is a procedure used to treat skin cancer. This surgery involves cutting away thin layers of skin. Each thin layer is looked at closely for signs of cancer. The process keeps going until there are no signs of cancer.

    The goal of Mohs surgery is to remove all of the skin cancer without hurting the healthy skin around it. Mohs surgery allows the surgeon to be sure that all the cancer is gone. This makes it more likely that the cancer is cured. It reduces the need for other treatments or more surgery.

    During Mohs surgery, medicine to numb the area is usually given so that you don't feel pain. Most people can go home after surgery and don't need to stay in a hospital.

    Defects left by the excision of skin cancers can be challenging to close. The eyelids, nose, lips and ears are sites where the open wound left from the excision will be more challenging to deal with. Dr. Howard has been trained and has robust expertise in the multiple approaches that can be best utilized for the best possible reconstructive plan for the affected part of the face.

  • Are you tired of shaving, plucking, or dealing with unwanted hair? Laser hair removal is a simple in office procedure that can leave you with silky smooth skin. Taking away these problematic dark hairs can boost your confidence and simplify your morning routine. This procedure works for both men and women. Treatment plans vary based on amount of hair, size of treatment area, and skin type.

    **Several sessions are required for best results.

    Ask us about scheduling a FREE CONSULTATION. We will help tailor to your specific needs and areas of concern with the right treatment plan.

OTHER PROCEDURES

  • The goal of chronic wound treatment is not just to heal your wound, but to prevent a recurrence, maintain your mobility, and prevent further complications.

    Most wounds heal over time with proper care, but in some cases, the healing process slows down, leading to a chronic or non-healing wound. Factors such as advanced age, poor circulation, diabetes, and other conditions can interfere with the healing process. Wounds that won’t heal can result in pain and limited mobility and this can impair your day-to-day enjoyment of life.

    Non-healing or chronic wounds can become a major health risk, especially for older people and those who have additional health conditions. That’s why it is so important to evaluate and treat wound. Dr. Howard specialize in treating non-healing wounds caused by:

    • Burns

    • Diabetes

    • Kidney disease

    • Osteomyelitis (bone infection)

    • Ostomy

    • Peripheral vascular disease

    • Pressure sores

    • Soft tissue radiation injury

    • Steroid dependence

    • Trauma

    • Venous insufficiency (problems with leg veins sending blood back to the heart)

    • Wounds of arterial, venous, or lymphatic origin

  • Even relatively minor burns can leave scars and people who have been burned over large parts of their bodies often must deal with scarring that is disfiguring. Reconstructive surgery can reduce scarring and restore appearance to the affected area.

    CAN BURNED SKIN BE REPAIRED?

    Minor burns should heal with little to no scarring. Deeper burns can be treated with skin grafts and pressure clothing to minimize scars.

    WHEN DOES A BURN REQUIRE SURGERY?

    Third degree wounds are deepest and appear whitened, black, or dry, leather like skin. They require surgical debridement and skin grafting if larger than two centimeters.

    CAN PLASTIC SURGERY REMOVE BURN SCARS?

    Surgery will not be able to remove a patient's burn scars entirely, but it will help improve basic functions and make scars less noticeable.

  • SKIN GRAFTING AND RECONSTRUCTIVE SURGERY

    After surgery to remove a large basal or squamous cell skin cancer, it may not be possible to stretch the nearby skin enough to stitch the edges of the wound together. In these cases, healthy skin can be taken from another part of the body and grafted over the wound to help it heal and to restore the appearance of the affected area. Other reconstructive surgical procedures, such as moving 'flaps' of nearby skin over the wound, can also be helpful in some cases.

  • REPAIRING TRAUMATIC FACIAL INJURIES

    For deep cuts or lacerations to soft tissue, abrasions and/or fractures of the bones of the face, ER doctors will likely refer patients to a plastic and reconstructive surgeon, such as Dr. Howard who specializes in facial fracture and facial trauma procedures.

    GOALS OF FACIAL TRAUMA TREATMENT?

    The objectives of treating someone with facial trauma using plastic and reconstructive surgery are:

    • Restore normal facial functions affected by the facial trauma, such as focusing, blinking, smiling, chewing, speaking and swallowing

    • Optimize appearance

    WHAT IS FACIAL TRAUMA?

    Facial trauma is bone or soft tissue damage to the face caused by motor vehicle accidents, assaults (including gunshots), sports injuries, falls, chemical exposures, thermal burns or animal bites. Because the human face is an intricate area containing many bones, blood vessels, nerves, muscles and sensory organs, if untreated, facial trauma may cause a permanent loss of function (seeing, chewing, speaking, swallowing) and disfigurement if not treated. Working together, emergency doctors, other practitioners, plastic and reconstructive surgeons, like Dr. Howard, can lessen this risk of permanent complications.

    TRAUMATIC INJURIES TO THE FACE

    Depending on the type of injury, facial trauma can cause severe bleeding and swelling, a bruised face, and distorted appearance of the facial features.

    FACIAL SOFT TISSUE INJURIES

    These may include:

    • Torn skin or scalp (facial laceration) that raises the risk of bleeding, infection and scarring

    • Cuts and scrapes to the face

    • Facial burns, either thermal (from heat or cold) or chemical.

    • Eye injuries

    • Nerve damage that can affect sensation or a person’s ability to smile, blink, move their eyes to focus, swallow, bite, or chew

    • Laceration of the tongue, which can impair the person’s ability to eat, swallow or speak

    • Damage to salivary glands. Over 100 of these glands are found in the face and keep the mouth moist for eating and speaking

  • WHAT IS A SKIN GRAFT?

    Skin grafting is a type of surgery. Providers take healthy skin from one part of the body and transplant (move) it. The healthy skin covers or replaces skin that is damaged or missing. Skin loss or damage can result from burns, injuries, disease or infection. Providers may recommend a skin graft after surgery to remove skin cancer.

    The type of skin graft, length of procedure, and healing time depends on the condition and wound size. Most skin grafts are successful. Sometimes, the body does not take the graft, and a person may need a second graft.

    WHY YOU WOULD NEED A SKIN GRAFT?

    A surgeon may recommend a skin graft when a wound is too big to close by other means and when other methods, such as stitching, are not enough.

    Common reasons for a skin graft include:

    • Burns and scar contracture release

    • Skin loss from skin infection or disease

    • Ulcers (bed sores, venous ulcers, and diabetic ulcers)

    • Reconstructive surgery

    • Open fractures

    • Wounds from cancer removal

    • Cosmetic reasons

    • Traumatic wounds

    • Amputation

    WHAT ARE THE ADVANTAGES OF A SKIN GRAFT?

    Skin grafts can replace lost skin, improve the appearance of damaged skin and restore function. This surgery is an effective treatment for skin loss that results from many different conditions. Benefits include:

    • Closing large wounds

    • Treating skin loss due to reasons such as infection and cancer surgery

    • Replacing lost or extensively damaged skin

    • Restoring or improving function

    • Improving cosmetics

  • If you have a tear or cut in your skin, tissue and/or muscle, you may need laceration repair, which includes cleaning, preparing and closing the wound.

    WOUNDS THAT NEED MEDICAL LACERATION REPAIR HAVE:

    • Exposed muscle, fat, tendon or bone

    • Dirt and debris in the wound, even after cleaning

    • Feeling as if something is in the wound

    • Bleeding continues after applying direct pressure for 10-15 minutes

    • Jagged or uneven edges

    • Depth more than 1/8 to 1/4 inch deep

    • Location on area of high stress (joints, hands, feet, chest)

    • Possible intense scarring

    All lacerations heal with scars. The degree of scarring varies and is influenced by:

    • A personal history of excessive scar (keloids) formation

    • Location, type and size of the wound

    If a noticeable scar does result, plastic surgery may be used to decrease the scar’s appearance.

  • During a fat transfer breast augmentation, cosmetic surgeons use liposuction to remove fat cells from your body. They then inject the purified fat cells into your breasts, increasing the cup size. A fat transfer breast augmentation poses fewer risks than augmentation with breast implants. You may also get a breast lift to firm up breasts that sag.

    WHAT IS FAT TRANSFER BREAST RECONSTRUCTION?

    A fat transfer breast reconstruction uses fat from your body to enlarge your breasts. Surgeons suction fat cells from several areas of your body. They then inject the fat cells into your breasts. Your breasts get bigger while the areas of your body that lost fat cells get smaller.

    WHAT IS THE DIFFERENCE BETWEEN BREAST AUGMENTATION AND BREAST RECONSTRUCTION?

    Breast augmentation is for healthy people who want to improve their appearance. It isn’t medically necessary. You can use breast implants or fat transfer for breast augmentation.

    Breast reconstruction takes place after breast cancer surgery. It recreates one or both breasts after a mastectomy (breast removal). You must get breast implants for breast reconstruction.

    WHAT ARE THE BENEFITS OF FAT TRANSFER AUGMENTATION OVER BREAST IMPLANTS?

    Fat transfer breast augmentation is a natural way to enhance breast shape and size. Liposuction is used to remove fat from your belly, hips, back, legs or arms. These areas of your body become smaller. Fat cells are then injected into your breasts to make them bigger. Because breasts have a lot of fatty tissue, adding more fat gives the breasts a natural look and feel.

    Breast augmentation using breast implants involves artificial shells filled with silicone gel or saline (sterile saltwater); Implants are placed underneath your skin.

  • Pilonidal disease is a chronic skin infection in the crease of the buttocks near the coccyx (tailbone). It affects about 70,000 people in the US annually and is more common in men than women. Most often it occurs between puberty and age 40. People who are overweight and who have thick, stiff body hair are more likely to develop pilonidal disease.

    The cause for pilonidal disease is not completely understood. Hair often grows in the cleft (crease) between the buttocks. These hairs can traumatize and penetrate the skin at the top of the buttock crease. Hairs can get caught under the skin in this area. This can result in irritation, infection, and formation of an abscess.

    Treatment depends on the disease pattern. Once diagnosed and any active inflammation or infection is taken care of the primary therapy is keeping the area free of hair (topical depilatories, shaving, laser hair removal). The treatment for an abscess is drainage. An incision is made that allows pus to drain, reducing inflammation and pain. This procedure can usually be done in office using local anesthetic. If there is significant inflammation of the skin antibiotics may be prescribed. Keeping hair out of the area (shaving, laser, etc.) can be utilized to help treat both active and chronic disease. Complex or recurring infections are treated surgically.

  • A forehead lift is also known as a brow lift lift. As we age, unsightly wrinkle lines may appear on the forehead. Frown lines between the brows can make us look angry or "too serious." Skin relaxation may cause the eyebrows to drop, hooding our upper eyelids and making us look tired. If you are bothered by these signs of aging in the brow region, a brow lift may be right for you.

    WHAT A FOREHEAD LIFT WILL DO?

    • Reduces the wrinkle lines that develop horizontally across the forehead, as well as those that occur on the bridge of the nose, between the eyes

    • Improves frown lines, the vertical creases that develop between the eyebrows

    • Raises sagging brows that are hooding the upper eyelids

    • Places the eyebrows in an alert and youthful position

    YOU MAY BE A GOOD CANDIDATE FOR FOREHEAD LIFT SURGERY IF YOU:

    • Are physically healthy

    • Nonsmoker

    • Have a positive outlook and realistic goals

    Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery. The final results of your surgery will appear over the next few months. Although good results are expected from your procedure, there can be no guarantee. Life-long sun protection will help to maintain your rejuvenated appearance by minimizing sun damage. A healthy lifestyle will also help extend the results of your surgery.

BREAST AUG AUGMENTATION REDUCTION IMPLANTS RECONSTRUCTION GYNECOMASTIA LIFT GEL SILICONE SALINE BOTOX OTOPLASTY SEPTOPLASTY MASTOPEXY NERVE INJURY SIOUX FALLS BROOKINGS MITCHELL THE BODY GARAGE DR HOWARD TATTOO IMPLANT

BREAST PROCEDURE VIDEOS

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BODY PROCEDURE VIDEOS

EYE EYELID BLEPHAROPLASTY GRAFT WOUND CLEFT LIP BOTOX NOSE JOB FACELIFT FOREHEAD CHIN RESURFACING HAIR REMOVAL MOHS SKIN CANCER BLEPH RHINOPLASTY FACICAL FRACTURE SCAR LESION LACERATION DOCTOR MEDICAL SIOUX FALLS THE BODY GARAGE LIPOSUCTION COSMETIC

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Featured Service

  • The Body Garage Plastic Surgery and Medical Spa is proud to offer truSculpt® iD, a non-surgical, body-sculpting treatment!

    truSculpt iD is a safe and effective technology that is clinically proven to permanently eliminate fat cells in stubborn areas around your abdomen and flanks. With truSculpt iD, you can get the body definition you want, even in areas that have been resistant to diet and exercise.

    HOW IT WORKS?

    • truSculpt iD uses innovative Monopolar RF technology to selectively target fat and therapeutically heat it – until fat cells are eliminated by passing through the body naturally.

    • Average of 24% fat reduction is achieved in just one treatment.

    HOW IS THIS DIFFERENT THAN OTHER BODY SCULPTING PROCEDURES?

    • This procedure is versatile and effective to treat a wide range of patients who may not be a candidate for other contouring procedures due to treatment location, skin type, fat thickness and presence of skin laxity.

    • The treatment has minimal discomfort and has been compared to a hot stone massage.

    • There is no visible downtime after the procedure and normal activity can be resumed immediately.

    • Additional treatments may be required to achieve the personalized results you desire. Treatment results are visible after 12 weeks.

    FREQUENTLY ASKED QUESTIONS

    What is truSculpt iD®?

    truSculpt iD allows you to personalize your ideal body with a revolutionary non-surgical, body-sculpting treatment. Its comfortable, safe, and effective technology is clinically proven to permanently eliminate fat cells in stubborn areas around your abdomen and flanks.

    Am I a candidate for truSculpt iD?

    Because truSculpt iD is a customized and tailored treatment to meet individual needs, most adult men and women are a candidate.

    Can truSculpt iD be used on all skin types?

    Yes, this treatment can be done on all skin types and over tattoos.

    How long does a treatment take?

    Procedure time depends on the size and number of treatment areas. It typically takes 15 to 30 minutes to treat the abdomen and flanks.

    How many treatments will be needed?

    Multiple areas can be treated in as little as one 15-minute session.

    Additional treatments may be required to achieve the personalized results you desire.

    What will the treatment feel like?

    truSculpt iD procedures are typically described as feeling like a hot stone massage. During treatment, the temperature of your skin will rise but remain comfortable. It’s effective, safe, and the results are even and consistent.

    Is there really no downtime?

    Post-procedure, the treatment area will be warm and flushed for less than one hour. While you may experience mild sensitivity to the touch for a few days, you’ll be able to immediately return to normal activities and exercise.

    When will I see results?

    Results are visible after just one treatment, with maximum results seen after 12 weeks. Additional treatments may be required to achieve the personalized results you desire.

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