Plastic and Reconstructive Surgery: What Are My Options to Look Better?

Cosmetic procedures can fix sagging skin, belly bulges and more

Cosmetic procedures can fix sagging skin, belly bulges and more


As we age, our bodies begin to show the effects of time, gravity and life in general. Formerly firm skin begins to lose its tightness and elasticity, resulting in wrinkles, droopy skin and saggy body parts. Pregnancy can stretch skin and leave a stubborn belly bulge. Diet and exercise can help, but only so much.


In this video, San Diego Health host Susan Taylor talks with Salvatore Pacella, MD, head of Plastic and Reconstructive Surgery at Scripps Clinic Del Mar, about how plastic and reconstructive surgery can help you reclaim some of your skin tone and body shape.


There are cosmetic surgery procedures to address concerns from head to toe, and most are far less invasive than they were decades ago. Minimally invasive surgical techniques and new technologies have resulted in procedures that require fewer and smaller incisions, shorter hospital stays and faster recovery times; in fact, some procedures can be done on an outpatient basis. Most are not covered by insurance unless they are medically necessary.


Here is a look at the most common cosmetic surgeries.

Eye lift

An eye lift addresses droopy or saggy eyelids by removing excess skin from the upper lid. If the excess skin interferes with peripheral or side vision, an eye lift can correct that problem and may be covered by insurance.


“In addition, we tend to lose fat in the upper eyelid as we age,” says Dr. Pacella. “So sometimes we can take a little fat from the abdomen and put it in the eyelid to rejuvenate the upper eyelid.”


Patients may have bruising or dry eyes for a week or two following the procedure, but side effects are generally minimal.

Brow lift

Sagging eyebrows can make you look tired or worried and contribute to saggy eyelids. A brow lift, also known as a forehead lift, involves a small incision that’s hidden right within the hairline to raise the brows to a more natural position, as well as lift the eyelids and smooth forehead lines in the process.


Both eye and brow lifts are outpatient procedures.

Lower face and neck lift

As we age, the skin on the lower half of the face and the neck can become loose and saggy, often known as “turkey neck.” Dr. Pacella notes that aging may not be the only factor.


“We’re always looking down at our phones, and that tends to exacerbate the neck quite a bit,” he says. “A lower face and neck lift can really do an extensive job of tightening up the neck.”

This procedure, which is also done on an outpatient basis, takes three to four hours.

Breast lifts and implants

Breastfeeding, weight loss and just aging in general can cause the breasts to lose volume and elasticity, resulting in changes in shape and size. Breast implants can restore fullness, while a breast lift can raise the breasts to a more natural position.

Tummy tucks and treatments

Many women are left with a slight bulge around the abdomen after pregnancy that remains despite diet and exercise. If you’re not overweight but still can’t get rid of the bulge, an abdominoplasty or tummy tuck may be something to consider. Performed under general anesthesia, a tummy tuck involves an incision that goes from hip to hip along the area normally covered by your undergarments or bikini. The surgeon lifts and removes the excess abdominal skin and may also tighten the abdominal muscles.


“Your belly button stays in exactly the same place, and then we sculpt and re-stretch the skin around it so that the skin can be nice and flat and tight,” says Dr. Pacella. “It’s an outpatient procedure, but it can take about four weeks to recover.”


Stretchmarks are another common concern following pregnancy or rapid weight loss or weight gain. They’re caused by a loss of collagen underneath the skin, and while laser treatments may help fade them, surgery may be the only way to completely remove the affected skin. A tummy tuck can address stretchmarks on the lower abdomen.

Risks and side effects

Like any surgery, plastic and reconstructive surgeries have risks, such as infection, excess bleeding, and problems with anesthesia.


“Surgery is serious, and I think it is exceptionally important, if you seek plastic surgery, to do so from a board-certified plastic surgeon who has gone through all of the education and training, and is operating in accredited facilities that are affiliated with a hospital,” says Dr. Pacella. “One of the benefits of doing it at Scripps is that we’re a large health system. We do all our surgeries within a certified operating room and have board-certified anesthesiologists with us at all times. Patient safety is key.”