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Procedures
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General Guidelines
Here you will find a general explanation about some procedures related to Plastic Surgery. However, only during the consultation and clinical examination will the most appropriate procedure for each individual case be discussed.
The decision to undergo surgery should come from the patient’s own desire. Dr. Bárbara believes her role is to present the treatment options for each case, pointing out the technical limitations and the possible inherent risks of the procedure the patient wishes to undergo. Every procedure, whether surgical or non-surgical, has its specific indications and limitations. It is very important that you openly discuss your concerns and expectations during the consultation.
The increasing lack of time has led many patients to request the combination of surgical procedures. Procedures on the breasts and abdomen, or body liposuction combined with breast implant placement are very common. However, safety in combining these procedures is paramount, and the benefits will always be weighed against the potential increase in the risk of complications.
It is essential to inform the use of any medications (such as aspirin, omega 3, vitamin E, vitamin A, weight-loss formulas, and anti-inflammatories) or drugs during the consultation so that you can be properly advised on whether they should be suspended before surgery. Medications such as aspirin (ASA), anticoagulants like Xarelto, or even arnica cannot be taken before surgery and must be discontinued in advance.
Surgical procedures are performed in hospital surgical centers equipped with the most modern technology and structure to handle any type of intercurrent event. For hospital surgeries, fasting should begin approximately 8 hours prior, starting the night before the procedure. The patient must not ingest even water during this period.
Clinical complications such as deep vein thrombosis, cardiac and pulmonary complications, and the possibility of a new surgical procedure are rare but must be discussed during the consultation. The Brazilian Society of Plastic Surgery website contains important information about the various plastic surgery procedures, their indications, benefits, and risks.
+30 years of experience
During adolescence, many bodily changes occur. Accepting a constantly transforming self-image and maintaining self-esteem can often be difficult and may require psychological support. Thanks to Dr. Bárbara’s great ease in communicating with children and adolescents, a significant percentage of her patients fall within this age group.
It is very important to listen to the teenager’s complaints, understand their anxieties and desires. It is the role of the plastic surgeon to determine the right moment for the adolescent to undergo surgery, since most surgical procedures require more complete bone development. Common surgeries in this phase include the correction of gynecomastia (breast growth in males), prominent ears, nose, and breasts that are underdeveloped or excessively developed.
Often, during the clinical examination, young patients prefer their parents not to be present. This privacy can be necessary, as the presence of parents may lead them to withhold relevant information. This may occur due to inhibition or because they wish to disclose information about the use of drugs, alcohol, smoking, or their sexual life.
This complicity between the patient and the doctor is essential, as the professional can help mediate between the parents and the adolescent.
People who have had excessive sun exposure throughout their lives without adequate protection have an increased risk of developing skin cancer. Skin cancer is also common in individuals who have previously had precancerous lesions or have a family history of the disease. Patients with fair skin, hair, and eyes, as well as those with albinism, are also more likely to develop tumors on the body.
Skin cancer occurs predominantly in adulthood and affects men more frequently than women. Those who have many moles (nevi) scattered across the body should also pay close attention to any changes, such as the appearance of new moles or alterations in the color and shape of existing ones. Screening through dermatoscopy is highly recommended in these cases to determine which lesions require a biopsy or tumor removal.
After diagnosis or indication for biopsy, the plastic surgeon will remove the tumor. In general, small tumors result in barely noticeable scars. However, removal of larger tumors requires reconstructive surgery and will leave more extensive scars. Therefore, it is extremely important that, as a rule, any new sign on the skin or change in a mole or spot that already existed serves as an alert to seek medical attention.
The pursuit of improvements in body contour is common among both men and women, with the abdomen being the most frequent area of concern in both sexes. Abdominal surgery has different indications depending on the degree of change presented by the patient.
In men, it is very common to have fat accumulation in the flanks (sides of the abdomen) and in the lower region, below the navel. In women, this area is particularly prominent because the female silhouette is characterized by waist-to-hip proportions, highlighted by defined waists, low-rise clothing, or direct exposure in tops or swimwear (bikini or one-piece). Additionally, women go through pregnancy — a period in which the body undergoes major changes — and the abdomen is at the center of these transformations. The stretching of the abdominal wall, including skin and muscles, combined with the weight gain that often occurs during this period, frequently causes permanent changes in the abdominal region. Stretch marks, sagging skin, diastasis recti, and the appearance of localized fat deposits are commonly observed after childbirth.
Depending on the degree of skin laxity and excess skin the patient presents, the abdomen can be treated with three main techniques. Liposuction is the most common abdominal surgery and is reserved for treating contour changes related to localized fat deposits.
It can also be combined with skin removal through mini-abdominoplasty or full abdominoplasty. This allows the safe treatment of fat accumulation (also known as lipodystrophy) and skin/muscle laxity in a single surgical stage.
Mini-abdominoplasty is indicated when there is fat accumulation associated with skin laxity in the area below the navel. Separation of the rectus abdominis muscles (diastasis) and umbilical or epigastric hernias are frequently treated during this procedure.
A full abdominoplasty is recommended when there is a greater amount of excess skin and the patient desires a flatter abdomen. In this case, the scars are longer, although they are usually hidden within the bikini line. It is important to note that the navel will need to be repositioned through a circular incision, which remains visible for approximately 18 months.
One option offered by Dr. Bárbara is the reverse abdominoplasty, indicated when laxity is located only in the upper abdomen and the patient already has long scars from a previous mammoplasty. The existing incision in the inframammary fold (breast crease) and the cesarean scar are used to remove the excess skin.
As a last option, in cases where patients have long vertical abdominal scars associated with significant excess skin, a fleur-de-lis abdominoplasty may be indicated.
The proper surgical treatment of lipodystrophy (localized accumulation of fatty tissue) remains a significant challenge for both surgeon and patient. Liposuction was established as a modern technique in 1977, when French surgeon Yves-Gerard Illouz introduced fat aspiration using cannulas connected to a high-powered suction device. This method enabled the safe treatment of multiple body areas, including love handles, inner thighs, knees, double chin, arms, and thighs.
This body contouring procedure has gained increasing popularity due to advances in anesthesia and safer surgical techniques, leading to high patient satisfaction rates. While some clinics perform liposuction on an outpatient basis, Dr. Bárbara considers it a true surgical procedure that requires thorough preoperative evaluation and a safe hospital setting to ensure the patient receives the highest level of care and monitoring.
Very small, well-positioned incisions are used for the introduction of cannulas connected to suction devices. The cannulas are manipulated to promote uniform fat removal.
After the procedure, the use of compression garments or bandages is essential for proper body contouring. Sun exposure will be restricted for at least 2 months. Post-liposuction physical therapy is essential to help prevent excessive fibrosis in the treated area.
Arms with increased volume that prevent the use of tight-fitting sleeves, or excessively heavy thighs, are frequent complaints. Dr. Bárbara recommends performing surgeries in these areas to treat the circumference of the limbs and thereby reduce their size.
Liposuction is the procedure of choice for removing excess fat from these regions. Liposuction is complemented by skin removal in patients where excess skin is evident.
In the case of the arms, this excess skin can be removed through an incision in the armpit or, when the excess is very significant, through an incision along the length of the arm. Excess skin on the thighs can be partially removed through an incision hidden in the groin that extends to the gluteal fold.
After experiencing significant weight loss, whether spontaneous or following bariatric surgery (stomach reduction), the elasticity of the skin and underlying tissues does not keep up with the new silhouette, causing the skin to become loose and “excessive.” This skin, which was greatly stretched during the period of excess weight, no longer fits the supporting framework of the body adequately. The most common complaints are excess skin on the abdomen, legs (especially inner thighs), arms, and neck. In these cases, body contouring surgery improves shape and removes excess fat and skin laxity.
Several techniques were developed, mostly by Professor Ivo Pitanguy, for the removal of this excess skin. The technique called dermolipectomy can be applied to the arms, legs, gluteal region, and abdomen through procedures known as brachioplasty, crural and gluteal dermolipectomy, or correction of “apron abdomen.” A facelift can be used to remove excess skin from the face and neck, and mammoplasty, with or without implants, can be used to improve the appearance of the breasts.
However, it is important to keep in mind that replacing this “envelope” of excess skin with an appropriate amount of skin to cover the new body shape involves extensive and permanent scars. Although laser can be used in an attempt to improve their quality, these scars may remain visible.
In some cases, sagging skin may reappear because the body continues to lose collagen at an accelerated rate due to the significant weight loss. Dr. Bárbara always advises her patients to return for follow-up visits at different stages of the postoperative period for evaluation of their progress.
Throughout history, breasts have been considered a symbol of femininity and, therefore, important for a woman’s self-esteem.
Several studies have been developed over the last decades by implant manufacturers in search of safer materials and more natural results. Changes in implant shape, the composition of the silicone gel — which has become highly cohesive — and improved barriers in the membranes surrounding these implants have brought a new era to breast augmentation. While breast augmentation through stem cells is not yet a real solution, the use of silicone implants provides an increase in breast size and volume, giving them better shape while contributing positively from a psychological and social standpoint.
Each patient has her own perception of her body and particular desires regarding her breasts. Today, the plastic surgeon has several shapes and types of implants available. This allows for more individualized results. It is important to explain to patients the advantages and disadvantages of each shape, guide them in choosing the size, and confirm that perfect symmetry in breast surgery will not be achieved. Since nature did not make us perfectly symmetrical, the plastic surgeon cannot pretend to be more powerful than nature. What is achieved in surgery is an attempt to reduce differences or imperfections.
A careful preoperative planning is the key to success in any surgery. However, in breast augmentation surgery, in addition to the patient’s desire, several factors such as height, weight, body type, skin quality, and any breast sagging are decisive in choosing the implant to be used. The vast majority of patients seeking breast augmentation do so due to reduced breast volume, which may result from significant weight loss, pregnancy, and breastfeeding. After the end of breastfeeding, breast tissue decreases and is replaced by fibrous tissue, leading to loss of the breast’s appearance. These changes can be intense, leading the patient to request simultaneous correction of breast sagging (ptosis) and volume loss.
The surgery is usually quick (approximately 1 to 2 hours in duration) and requires hospitalization in a contamination-free environment. Physical exercises are allowed up to 30 days after surgery. Bleeding (hematoma), infection, and capsular contracture (formation of rigid scar tissue around the implant) may occur. Scientific research has not reported any proven relationship between breast implants and autoimmune or systemic diseases.
In men, the correction of gynecomastia consists of the removal of breast glands that have a more evident proportion on the chest. The incisions are generally located on the areolas so as not to cause visible stigma.
In women, breast reduction surgery aims to decrease breast size when they are larger and heavier than ideal. Breast development is usually complete around 15 years of age, and can extend until 17. In general, the surgery is performed around 18 years of age, except when a mastologist or endocrinologist indicates greater benefits if the surgery is performed earlier. Postural changes and back pain are very frequent complaints.
Excessive breast growth can reach significant proportions, as in gigantomastia, where the excess breast tissue can reach one kilogram or more in each breast. Breast reduction allows for the correction of postural problems, reduction of back pain, improvement of self-esteem, and quality of life.
The extent and shape of the scar vary according to each case. The criteria used to determine the appropriate technique are chest size, degree of breast hypertrophy, and the patient’s desire. The smaller the breast, the smaller the scar. The inverted T or anchor-shaped scar is the most common type, as it applies to the majority of breasts. However, Dr. Bárbara frequently performs the lozenge or rhomboid technique described by Pitanguy, which allows for smaller or more reduced scars. This technique is indicated in secondary mammoplasties, tuberous breasts, moderate breast ptosis, and medium-sized breasts.
For those who wish to lift the breasts while maintaining their size, mastopexy (breast lift) is recommended. In some patients, the use of a breast implant in association with breast reduction may be indicated. In this technique, part of the breast gland is removed and a silicone implant is placed. The goal is to achieve greater breast projection and maintain filling of the upper pole (“cleavage”).
Mammoplasty is a procedure that lasts, on average, 3 to 4 hours. The surgery is performed under general anesthesia. In most cases, it is possible to return to usual activities between 7 and 15 days after surgery. Arm movements and vigorous physical exercises are restricted for a period that can reach 2 months.
Changes in breast or nipple sensitivity, whether temporary or permanent, are not common but are reported in scientific studies.
Poor healing of the incisions is not a rare event. It is essential that the patient is aware of this fact, as it is independent of the technique used and is based on genetic characteristics and unknown factors that impair good scar evolution. Scar care is long-term and involves the use of silicone sheets, scar improvement sprays, and laser application. It is essential that the patient does not gain weight in the postoperative period to avoid widening of the scars.
Breast cancer treatment involves a multidisciplinary team that includes physicians, nurses, physiotherapists, and psychologists, as psychological disorders can interfere with the perception of reality and decision-making. Recovering self-esteem is an important step toward a smoother recovery when facing a diagnosis that must be taken seriously.
During the consultation with the mastologist, patients can already discuss and receive information about the treatment. Some tumor resections may involve the removal of only a small portion of the breast, in which case reconstruction may not be necessary. Although in most cases breast reconstruction leaves scars and may not fully restore the original appearance of the lost breast, this technique significantly improves quality of life. During the consultation with the plastic surgeon, it is possible to understand which technique is most suitable for your case, how many surgical stages will be required, the expected aesthetic results, and the possible complications that may occur.
Reconstructions can be performed using the patient’s own tissues or through techniques that use expanders or breast implants. A combination of these techniques may also be indicated. The use of breast implants (prostheses) in reconstruction and fat grafting are current trends.
Contraindications to breast reconstruction include the patient’s decision not to undergo reconstruction or the presence of a serious medical condition that implies greater anesthetic and surgical risks.
The nose occupies the central portion of the facial anatomical complex and contributes significantly to overall facial aesthetics. The appearance of the nose is generally hereditary.
A nasal deformity cannot be considered in isolation; the balance between all elements of the face must be evaluated. Often, conditions such as a small chin or low malar projection (cheekbones) lead the patient to complain of a large nose (rinomegaly), when in reality the nose is of normal size.
Rhinoplasty is the surgery that can change the size and shape of the nose. This procedure is indicated only after facial growth is complete, which usually occurs from around 15 years of age onward.
Rhinoplasty is one of the most challenging surgeries for the plastic surgeon, as it requires an accurate sense of harmony combined with in-depth knowledge of anatomy and surgical technique. On the other hand, there are limitations between the patient’s expectations and the surgeon’s ability to fulfill them. It is essential that there be synergy between the patient and their plastic surgeon.
Techniques previously performed have been modified in order to achieve more natural results. Currently, the surgery seeks nasal remodeling based on the fundamental principle that nasal support structures must be preserved — what we call structured rhinoplasty. This makes the surgery more conservative and maintains the aesthetic and functional balance of the nose. This new concept ensures that the osteocartilaginous skeleton of the nose resists the scarring process over the years.
Access to the nose can be made from inside the nostrils (the most frequently performed approach) or through a small incision in the columella, at the base of the nose (open rhinoplasty). The dorsum, tip, and nasal bones can be treated, with the latter being fractured to allow the nose to become more harmonious.
Some patients already have functional disorders. In addition, it is important to keep in mind that any surgical procedure that changes the shape of the nose will produce some alteration in its physiology. Evaluation by an otorhinolaryngologist (ENT) and tests that investigate nasal function help us avoid accentuating or worsening pre-existing conditions. In general, rhinoplasty can correct or improve breathing difficulties caused by structural abnormalities of the nose, such as a deviated septum, which often leads to poor sleep quality, reduced sense of smell and taste, and decreased breathing quality. During the preoperative evaluation, imaging exams such as computed tomography can help diagnose a deviated septum and assist in surgical planning.
Healing is a slow process. It may take several months for the swelling to subside and up to a year and a half for the final result to be fully perceived.
Some patients who seek aesthetic correction of the ears may also present alterations of the inner and middle ear, as well as other conditions such as hemifacial atrophy, facial paralysis, cleft lip and palate, syndactyly, and congenital clubfoot. Microtia is among the alterations that can be corrected through reconstructive plastic surgery.
Prominent ears are the most common congenital abnormalities affecting the auricular pavilion, affecting approximately 5% of the population.
The exact cause of the deformity is not fully understood, but heredity is frequently observed. In contrast to many other congenital alterations of the auricular pavilion, the size of the ear in this clinical condition is usually normal and compatible with the child’s age.
Between five and seven years of age, the so-called preschool period, is the ideal time for surgery, as the ear is already fully formed and close to adult size. There are cases in which some children stop attending school for fear of teasing. However, the ideal is for the child themselves to express the desire to correct the aesthetic defect, in order to avoid future trauma. The surgery can also be performed later in life.
The scar from this surgery is imperceptible, as it is located behind the ear, in the groove where it joins the skull. Since this is an area of very thin skin, the scar itself tends to be barely noticeable. However, in rare cases, keloids have been reported in this region.
The technique used by Dr. Bárbara is effective and prevents the deformity from returning. It was originally described by Pitanguy as the “island technique” and was modified by the surgeon so that the contours of the ear are delicate and the surgery is not noticeable. Postoperative care is quite simple. In the first few days, in order to avoid local trauma, the ear is protected with a headband, similar to those used for playing tennis or in ballet classes.
Fat grafting, or lipofilling, is a procedure that aims to transfer the patient’s own fat from one area of the body to another. The study of the function of fat cells, including the stem cells present in fat tissue, has increased its indications. The cells are injected into the area of the body that will be augmented or treated. The areas that most commonly receive these grafts are the buttocks, face, and breasts.
To perform this procedure, liposuction is performed to harvest fat from a specific part of the body. Changes in the fat injection method using more appropriate cannulas have provided greater safety during the fat transfer procedure.
Dr. Bárbara has published book chapters based on her positive experience with gluteal augmentation using this technique. She emphasizes that skin quality improves significantly in the areas that receive fat grafts.
In recent years, the use of fat in breast surgery — whether for breast augmentation or reconstruction — has gained prominence. The old concern that fat could hinder the diagnosis of a possible cancer recurrence or even stimulate tumor growth has been replaced by scientific studies that have confirmed its safety and effectiveness.
Not limited to the treatment of simpler conditions, Dr. Bárbara has experience with skin disorders such as pyoderma gangrenosum, keloids, stretch marks, cellulite, hemangiomas, piloerector muscle leiomyoma, giant hairy nevus, and burn sequelae. With publications in these areas of expertise, she always seeks to offer the most modern and effective therapies.
Face and neck rejuvenation procedures encompass both minimally invasive treatments (summarized below) and surgical options. The best approach should be chosen together with the patient, based on their individual needs and expectations.
Procedures
Dermal filling is a generic term for the technique that uses products aimed at correcting minor imperfections in the skin, fat, and lips. Through fillers, wrinkles can be reduced, lips can be enhanced, and scars can be camouflaged.
Dr. Bárbara advocates the use of biodegradable chemical substances such as hyaluronic acid for filling facial grooves and wrinkles, lip augmentation, and treatment of dark circles. She also recommends calcium hydroxyapatite (Radiesse) for collagen biostimulation in the face and neck. Non-biodegradable implants such as PMMA (methacrylate) are permanent and may cause complications such as more severe autoimmune reactions, which is why she does not use them.
During the procedure, discomfort can be reduced through the application of topical anesthetic or nerve block to minimize the pain of the injections.
The average time for reapplication is six months and varies according to proximity to menopause. In younger patients, the product can maintain results for up to one year after application.
Botulinum toxin is an injection that blocks the nerve cells in the treated area, thereby preventing muscle contraction — in other words, it relaxes the muscle. This makes the skin smoother and gives the face a more serene appearance. Although botulinum toxin does not prevent skin aging, the area that receives this medication shows an improvement in skin appearance. The reduction of expression wrinkles is evident.
It is ideal for wrinkles around the eyes, on the bridge of the nose (bunny lines), chin, glabella (region between the eyebrows), barcode lines around the lips, forehead, and neck. Results are visible between two to five days after application. Muscle function returns after some time. Therefore, a new application is recommended every four to six months at most.
People using thyroid hormone, testosterone, or those who engage in more vigorous or frequent physical exercise will experience a shorter duration of the toxin’s effect.
The skin can be treated through chemical peels such as crystal peeling and dermabrasion, or through lasers that perform the so-called “resurfacing.”
The laser works by reorganizing and improving skin density.
Its major advantage is the more uniform treatment of the face, since other methods focus on treating wrinkles and excess skin, while peeling allows for an overall improvement in the quality of the entire facial skin coverage.
Dr. Bárbara is a proponent of safe technological innovations and has been using lasers to rejuvenate the skin of the neck and hands, as well as to treat scars, since their approval by ANVISA for use in Brazil in 1994. Currently, with fractional technology, Erbium and CO₂ lasers are used with greater safety and faster return to daily activities.
Dermabrasion is a procedure that sands the skin to give it a more uniform appearance. A diamond-tipped instrument attached to a high-rotation device is applied to the skin to remove the outer layers, seeking to smooth and level the skin surface.
Dermabrasion is indicated for patients with facial scars associated with acne, accidents, previous surgeries, or fine facial wrinkles, such as those around the mouth.
Healing tissue is treated with dressings or antibiotic ointments to reduce crust formation. It is not possible to work after the procedure. Complete healing generally occurs within 7 days. Sun avoidance and the use of appropriate products are recommended on a case-by-case basis.
Also known as Percutaneous Collagen Induction with Needles (PCIN), microneedling is a procedure that uses a small device consisting of several paired micro-needles that puncture the layers of the skin to stimulate the improvement and new formation of collagen that supports the skin. This treatment can be used for stretch marks, spots such as melasma, skin aging, acne scars, sagging skin, and even hair loss.
The procedure can be performed in the office or to complement surgeries. Local anesthesia is applied, although some areas are more sensitive than others.
There are small points of bleeding immediately after the treatment. Since the skin may become quite red or show purplish spots, we recommend that patients remain more socially restricted during the first 3 days. Vitamin C serum and other creams are applied for 1 to 2 weeks after the treatment.
For younger patients who do not yet want surgery on their face, absorbable lifting threads can elevate areas of the face and, although for a short period of time, slightly reduce facial sagging. The main function of these threads is to stimulate collagen production. Areas that can be improved include the nasolabial folds (smile lines) and the cheekbones. These threads can also be used to improve facial contour, jawline, and neck.
The threads are inserted individually at strategic points on the face and neck with the help of a needle. The procedure is minimally invasive, performed in the office with the patient awake and under local anesthesia.
Although the procedure is outpatient and the patient can return to work on the same day, there will be slight swelling in the areas where the threads are placed and possibly small bruises at the needle entry points.
Results begin to be noticed after 15 days. There will be small raised and slightly wrinkled areas at the end of the thread placement site. This “crumpled” appearance subsides within up to 30 days.
Calcium hydroxyapatite (Radiesse) is an absorbable product that can be applied to various parts of the body to provide support and attempt to improve skin quality where sagging is beginning to appear or where stretch marks have damaged the skin texture. As a collagen biostimulator, its effects occur over the course of applications. The best results are observed 6 to 7 months after application. This product can be applied to the hands, face, neck, abdomen, arms, and legs. The application protocol consists of 5 sessions with 1-month intervals between them.
The eyes, due to their expressiveness and functional importance, are a frequent reason for seeking Plastic Surgery. A heavy or tired appearance leads some patients to be misjudged, with people associating it with habits such as excessive alcohol consumption or insomnia.
The most visible signs of aging in the orbito-palpebral region include vertical lengthening of the eyelid, the appearance of malar bags (malar festoons), protrusion of fat pads, and accentuation of the infra-palpebral depression, popularly known as dark circles. In addition, we emphasize the thin thickness of the eyelid skin, which plays an important role in the aging of this area.
In an attempt to aesthetically improve these changes, various surgical techniques and the use of fillers such as hyaluronic acid have been employed, providing improvement of dark circles and sunken eye appearance. The laser is particularly useful in treating skin aging in this area and, when combined with absorbable fillers (hyaluronic acid), can lead to effective improvement in skin quality.
From a surgical perspective, blepharoplasty (plastic surgery of the eyelids) has become one of the most commonly performed aesthetic procedures. The goal is to achieve natural-looking results while preserving the shape of the eye and the expressiveness of the gaze. Although it may seem like a simple procedure, it is important to understand that this surgery has limitations. It is not possible to remove all the excess skin that we believe exists on the eyelids. The eyelids play a crucial role in protecting the cornea, which is the main structure of the eye.
In addition, eyelid surgery in general does not correct distortions caused by dynamic wrinkles. There are techniques that aim to cut muscle fibers in the lateral region of the eyes to try to reduce their strength. Whether due to the short duration of this effect or the aggressiveness of the technique, botulinum toxin is currently the most widely used option for treating these wrinkles.
Facial and neck rejuvenation surgery has evolved from small incisions to more comprehensive procedures. This surgery aims to reduce sagging of the face and neck, reposition fat pads that shift over time, improve facial muscle tone, and correct excess fat under the chin (double chin area). A facelift does not stigmatize the patient. The surgery does not change the facial expression, does not stretch the mouth, and does not pull the eyes. On the other hand, the surgery does not prevent the aging process from continuing.
Understanding that the treatment of the face and neck goes far beyond simply “pulling” the skin, Dr. Bárbara is one of the most sought-after plastic surgeons for face and neck surgeries. She uses a technique based on the principles of the “round lifting” described by Pitanguy. This technique ensures natural and effective results and has been modernized to include efficient treatment of the facial muscles, which lose tone over time, as well as to restore facial volume if it has been lost during the aging process.
The doctor does not limit herself to offering surgery alone. Whenever necessary, she complements the facelift with skin treatments using lasers, botulinum toxin, fat grafting, and fillers, as well as procedures such as eyelid surgery or forehead lift. This way, harmonious and natural results can be achieved.
