Plastic Surgery

Overview

Plastic Surgery is dedicated to the restoration of function and form. Reconstructive and cosmetic surgery are specialties within the field of Plastic Surgery.

Cleveland Clinic Akron General offers patients a full range of reconstructive and cosmetic services. When you choose Cleveland Clinic Akron General for your plastic surgery needs, you can be confident that our specialists are highly skilled, board-certified surgeons with significant experience in reconstructive and cosmetic surgery.

Reconstructive surgery

The word “reconstructive” means to rebuild. Reconstructive surgery is a type of plastic surgery and is a procedure that restores your body after an injury, after a disease or it corrects defects you were born with. It not only restores your body, but your comfort and confidence. Nearly one million reconstructive surgery procedures are performed each year.

Reconstructive surgery procedures and services include, but are not limited to:

Breast reconstruction.
Post-mastectomy pain.
Hand surgery and hand reconstruction.
Lymphedema surgery and lymphatic reconstruction.
Post-amputation pain.

Cosmetic surgery

Cosmetic surgery is another type of plastic surgery. The goal of cosmetic surgery is to alter or improve a person’s appearance. Healthcare providers can do cosmetic surgery on any part of the body.

There are many types of cosmetic surgery procedures which range from minimally invasive outpatient procedures to complex surgical operations. Some procedures take place in a provider’s office or an outpatient facility. Others require a hospital stay.

Cosmetic surgery procedures and services include, but are not limited to:

Cosmetic facial surgery.
Injectables.
Breast surgery.
Body contouring.
Hair loss treatments.
Migraine and headache treatment.

Reconstructive Surgery

Breast Reconstruction

Cleveland Clinic Akron General breast reconstruction surgeons offer a wide range of innovative options and procedures for breast reconstruction surgery.

Patients recently diagnosed with breast cancer face survival concerns as well as body image and self-esteem issues. The decision of whether to have breast reconstruction after a mastectomy or lumpectomy (also known as partial mastectomy) is intensely personal.

Following a mastectomy, there are a wide variety of reconstructive options. The breast can be reconstructed using the patient’s natural tissue (referred to as autologous reconstruction) or using implants or expanders. The decision as to which option is best is determined based on a patient's personal desire, cancer staging, as well as body and health condition.

Both implant-based and autologous procedures have advantages and drawbacks, and both types of reconstruction may be compromised by subsequent radiation therapy. For women considering reconstruction, it is imperative that they consult with a plastic surgeon early in the treatment planning, as part of their multi-disciplinary breast cancer team. Most reconstructive efforts require stages of operation and are coordinated along with the cancer treatment.

In addition, Cleveland Clinic Akron General is one of the few centers that provide options for improving sensation following mastectomy. As part of the mastectomy, nerves supplying the breast skin and nipple are divided. These can be reconstructed at the time of the mastectomy using cadaveric nerve grafts. This may improve sensation following mastectomy and may even reduce post-mastectomy nerve pain.

Cleveland Clinic Akron General breast surgeons offer a wealth of experience in this specialized care. They provide not only a high quality of medical care but also the individualized attention you need to weigh your options. Our surgeons offer excellent support to patients with breast cancer and understand the need to achieve a cure and to regain self-image.

Post-Mastectomy Pain

A mastectomy involves the removal of the soft tissue, nerves, and blood supply to the breast, therefore, making it similar to amputations of other body parts. Following mastectomy, chronic nerve and phantom pain is a common problem that is thought to be due to the fact that a cut nerve no longer has a place to go or a function to do. Historically, this has been treated with medications alone. Recent advances show that surgery is a useful treatment for certain patients. These procedures can be performed at the time of mastectomy or in a delayed fashion.

Hand Surgery and Hand Reconstruction

Cleveland Clinic Akron General hand and upper extremity surgeons and therapists work together with the goal of reducing or eliminating pain and restoring as much normal form and function as possible.

As a team, our plastic surgeons collaborate with physicians from other medical and surgical specialties, such as Orthopaedics, to offer our patients comprehensive care for their hand and upper extremity needs with the goal of providing the best treatment or surgical plan to optimize look, as well as the return of function.

Hand surgery and rehabilitation is commonly done for injuries and cumulative problems. This is most often performed as an outpatient surgery, except in the case of a major reconstructive procedure.

For a hand injury, a Cleveland Clinic Akron General hand surgeon will first examine you to review the extent and severity of the problem. Together with your family, the surgeon will discuss possible treatment options, as well as details and expectations for recovery. Our goal is to restore the form, function and appearance of the hand as much as possible, as well as reduce or eliminate any pain being experienced. Before surgery, the surgeon will review an estimated recovery time length and rehabilitation process, as well as help answer any questions you might have regarding desired outcomes or when you will be able to return to your normal activities.

Common hand conditions include:

Trigger Finger/De Quervain's
Also known as stenosing tenosynovitis, this is a condition in which the tendon becomes “stuck” within a “tunnel.” This commonly is associated with finger “locking” and pain, usually in the morning. It can also be associated with a painful nodule. De Quervain's is a similar condition involving the “thumb side” of the wrist associated with pain especially with repetitive motions. Both can be treated with either injections or surgery.
Dupuytren’s Disease
A genetic condition associated with progressive flexion contracture caused by excessive scar tissue. This most commonly affects the small and ring fingers and can have skin changes including “pits” or nodules. This can be treated with either injections or surgery.
Carpal Tunnel Syndrome
A common hand condition usually associated with numbness, tingling and pain that occurs frequently at night. This is a progressive condition in which one of the major nerves to the hand (the median nerve) is not getting enough blood supply. This can be treated with either injections or surgery.
Cubital Tunnel Syndrome – a similar nerve compression syndrome to carpal tunnel but affecting the ulnar nerve at the elbow. This causes numbness and tingling of the ring and small fingers as well as loss of dexterity in the fingers. Early treatment involves splinting and behavioral modifications. Surgery is usually a very effective treatment.
Arthritis
This condition is associated with loss of the normal joint structures resulting in “bone on bone” contact. This results in pain, decreased range of motion, and a “grinding feeling.” Common areas include the base of the thumb and wrist. This can be treated with either injections or surgery.
Masses of the hand or wrist
Most masses of the hand are benign conditions. A common condition includes ganglion cysts, sometimes referred to as “bible cysts.” These are cysts of joint fluid usually related to arthritis or trauma. This can be treated with either injections or surgery. Other masses or lesions of the hands may require additional testing prior to developing a treatment plan.
Trauma
This can include damage to any of the “functional” aspects of the hand e.g. tendons, nerves and bones. Injuries can involve one or all three of these structures. After evaluation, your surgeon will discuss the treatment options and come up with a joint decision-making plan.

Hand Therapy

If hand therapy is required after your surgery, our hand therapists will work with you to help you restore the normal function of your hand, as well as minimize pain.

Lymphedema Surgery and Lymphatic Reconstruction

Lymphedema is caused by damage, or less commonly, the absence of the lymphatic system. Often occurring following cancer treatment, lymphedema may result in progressive swelling of a limb, the genitalia or head and neck. This swelling may limit function, cause discomfort, predispose patients to recurrent skin and soft tissue infection, and negatively impact self-image. Those affected with lymphedema often spend hours per day managing their condition.

The goal of our lymphedema program is to provide the highest quality, compassionate, cutting-edge care for patients with lymphedema and lymphatic dysfunction. Led by plastic surgeons with specialized expertise in microsurgical and super microsurgical reconstructive techniques, our multidisciplinary team is composed of certified lymphedema occupational and physical therapists, vascular medicine specialists, surgical, medical and radiation oncologists, interventional radiologists, bariatric surgeons and dermatologists.

Treatment

Surgical treatments for lymphedema continue to evolve and can provide significant improvement in form and function. Therapeutic lymphatic surgery now benefits those with early lymphatic dysfunction as well as those with late-stage lymphedema.

Supermicrosurgery

Lymphaticovenous Bypass

Microsurgery

Vascularized Lymph Node Transplant
Vascularized Lymph Vessel Transplant
Combined VLNT/VLVT with Microsurgical Breast Reconstruction

Volume Reduction Surgery

Minimal Access Tissue Excision/ Liposuction
Excision of Skin Excess

Post-Amputation Pain

Following amputation, chronic nerve and phantom pain is a common problem and is thought to be due to the fact that a cut nerve no longer has a place to go or function to do. Historically, this has been treated with medications alone.

Recent advances show that surgery is a useful treatment for certain patients. These procedures can be performed at the time of amputation or in a delayed fashion. All reasons for amputation are amenable to these treatment options including trauma, vascular and/or oncologic. Upper and lower extremities can be treated. Additional care may include imaging and or injections. All procedures involve identification of the cut nerves and repair of the cut ends.

Regenerative Peripheral Nerve Interfaces (RPNI)
This includes identification of the cut nerve and removal of any abnormal nerve/scar tissue. A piece of a muscle that no longer has a function is removed and the nerve end sutured into the muscle. The nerve then provides blood supply and innervation to the muscle. Studies show contraction of the muscle using ultrasound for some nerves. This gives the nerve a “new home” and “something to do.”
Targeted Muscle Re-innervation (TMR)
Similar to RPNI, this includes identification of the cut nerve and removal of any abnormal nerve/scar tissue. However, instead of repairing the nerve to a piece of muscle, it is connected to either a non-functional nerve and/or nerve graft. This also gives the nerve a “new home” and “something to do.”

The choice of procedure is based on multiple factors and will involve a joint decision-making process with the surgeon.

Cosmetic Surgery

Cosmetic facial surgery

Facial surgery enhances your appearance by improving visual appeal, symmetry and/or proportion. Cleveland Clinic Akron General plastic surgeons offer a wide range of procedures including facelifts, lip lifts, neck lifts, cosmetic nose surgery and many more.

Face Lift (Rhytidectomy): Extensive face and neck lift procedures are options, as well as minimally invasive approaches involving incisions in front of the ear.
Mid-face Lift: Elevates sagging cheek tissue with minimal incisions around the hairline and ear.
Lip Lift: Improves visible signs of facial aging by enhancing the appearance of the upper lip.
Neck Lift: Removes excess neck skin through an incision behind the ear. Alternatively, an incision can be made under the chin without any skin removal.
Forehead/Eyebrow Lift: Repositions low or sagging eyebrows. Conventional “open” method is possible, as well as an endoscopic lift, which employs smaller incisions.
Eyelid Surgery (Blepharoplasty): Upper and lower eyelids may be addressed with minimal incisions in the crease of the upper lid, below the eyelashes or hidden inside the lower eyelid.
Cosmetic Nose Surgery (Rhinoplasty): Overall size, tip, bridge and nostrils are addressed through incisions hidden inside the nose or made across the tissue that separates the nostrils.
Cosmetic Ear Surgery (Otoplasty): Performed through an incision behind the ear, the surgeon removes cartilage until the ear can be bent back toward the head.
Facial Implants & Chin Surgery: Structural balance is fostered through cheek and lower jaw implants, chin surgery, lip augmentation and/or liposuction to correct a double chin.

Injectables

There are a number of injectable fillers available for those who want to reduce the signs of aging but who aren’t ready for cosmetic surgery. Fillers can plump thin lips, restore facial volume and fullness, soften facial creases and wrinkles, or improve the appearance of recessed scars. These treatments can be done in a short office visit with little or no recovery time.

Dermal Fillers: Dermal fillers can plump thin lips, enhance shallow facial contours, soften facial creases and wrinkles, or improve the appearance of recessed scars.
Neuromodulators (Botox/Dysport/Xeomin): A purified protein injectable filler that is FDA-approved for the temporary treatment of frown lines.
Fat Injection: Injections of fat harvested from your own body can enhance facial fullness, fill deep creases, soften wrinkles, plump lips and build up shallow contours.
Double Chin Surgery (Kybella®): Kybella was approved for use in 2015 and has revolutionized the way we treat a ‘double chin’.

Breast surgery

Your breasts often change over time, losing their youthful shape and firmness. Or you may have very large breasts that cause body image issues and even physical pain. Cleveland Clinic Akron General offers breast augmentation, breast lift and breast reduction procedures.

Breast Augmentation: Breasts of fuller shape and size are realized through saline or silicone implants placed either under or over the chest muscle.
Breast Lift (Mastopexy): Raises and firms the breasts by removing excess skin and tightening the surrounding tissue.
Breast Reduction: Removes excess tissue and skin to achieve a breast size in proportion with your body, alleviating discomfort associated with overly large breasts.

Body contouring

Body contouring refers to procedures that change the shape, or contour, of a part of your body by removing excess skin and underlying fat. Procedures include liposuction, tummy tuck and panniculectomy, body lift, arm lift, thigh lift and more.

Liposuction: Removes excess fat from a wide variety of areas, including the chin and neck, hips, abdomen, inner and outer thighs, knees and ankles and buttocks.
Tummy Tuck (Abdominoplasty) & Panniculectomy: A tummy tuck removes excess abdominal fat and skin; typically, also reestablishes weakened or separated muscles. Panniculectomy addresses excess skin below the belly button due to weight loss.
Surgery After Significant Weight: Loss Fine-tunes body areas after significant weight loss through a variety of body contouring procedures.
Body Lift: Excess sagging fat and skin are removed to treat conditions caused, in part, by poor tissue elasticity.
Arm Lift: Removes excess hanging skin from the underarm and reshapes the under portion of the upper arm – from the armpit area to the elbow.
Thigh Lift: Reshapes the thighs by reducing excess skin, and in some cases fat, for smoother skin and better-proportioned contours.
Buttock Lift: A buttock lift improves and/or removes excess, sagging buttock and thigh skin resulting from weight loss, aging and gravity, or genetics.
Labiaplasty: This typically involves the removal of excess tissue with the goal or improving any cosmetic concerns as well as decreasing pain and irritation.
CoolSculpting^®: The CoolSculpting fat-freezing procedure is completely non-surgical, so you can typically return to work and normal activities immediately.

Hair loss treatments

Hair loss, or alopecia, is very common and many conditions can cause it. Cleveland Clinic Akron General offers procedures that alleviate hair loss, promote hair growth and enhance your appearance. The type of hair loss, as well as the patient’s circumstances and desires, determine which hair replacement procedure is most suitable.

Hair Replacement Surgery/Hair Transplant: Hair replacement (implant) surgery techniques that treat hair loss due to genetic or hormonal reasons in male pattern baldness.
Platelet Rich Plasma (PRP) Therapy: Therapy that promotes healing in injured joints may help restore your lost hair.

Migraine and headache treatment

Migraines and other types of headaches have been associated with irritation and/or compression of the nerves in the head and neck. Similar to other types of nerve compression, these can be addressed by releasing the “pressure” or removing “compressive” structures. Appropriate testing is necessary prior to deciding the right treatment for you including a headache log and possible in-office injections.

Our Team