Plastic Surgery

At Ritz Med Spa, we are proud to call Dr. Ronald Gilmer our medical director and plastic surgeon. Leading our premier plastic surgery facility in the Franklin, TN, Dr. Gilmer has more than 40 years of experience and a reputation for delivering youthful, natural results.

Learn about all of our plastic surgery offerings:

Reach out to Ritz Med Spa to find out if plastic surgery can help you reach your personal goals. Your consultation is complimentary.

Breast Enlargement and TUBA Breast Surgery

Breast augmentation surgery is a safe, effective procedure designed to improve the contour of your body by implanting specially designed materials beneath the breast or chest wall muscles.

To learn more about breast augmentation, please contact our office to schedule a complimentary consultation.

Prior to your surgery, our team will review your full medical history to evaluate your general health. You will also undergo a thorough examination of the breasts to determine the most effective surgical approach. Dr. Gilmer will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and any possible risks or complications.
Before your operation, you may be asked to eliminate certain aspirin-containing drugs, to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily for the same reason. We may also prescribe antibiotics designed to prevent infection a few days prior to surgery.
A breast augmentation is usually performed as an outpatient procedure. Dr. Gilmer may choose from a variety of surgical procedures, depending upon what changes you desire.

This revolutionary procedure is another one of Dr. Gilmer’s “firsts.” The only physician in Middle Tennessee performing TUBA breast surgery, Dr. Gilmer has made breast augmentation surgery much less invasive and a much more desirable option for women. He has been offering the TUBA procedure for his patients since 2001, and now it is unquestionably the most popular method chosen for breast augmentation at Ritz Med Spa.

In the popular TUBA breast procedure, the breast implant is placed through the umbilicus (navel) and channeled beneath the skin in the fat layer, so it can be placed either beneath the chest muscles or on top of the chest muscles. This creates a nicely augmented breast. By far the greatest advantage is this—only one tiny incision is curved around the umbilicus and concealed within the navel cavity, making it totally hidden from sight.

Unlike previous augmentation procedures, TUBA will not leave any scarring whatsoever on the breast, chest wall, or armpits. Additionally, the surgery is done in Dr. Gilmer’s office under local anesthesia on an outpatient basis. Taking only about one hour, TUBA also provides less pain and complications and a faster recovery. Most patients are able to drive and return to light work activity in just two to three days.
TUBA can only be done with saline implants.

The day of your breast enlargement surgery, we recommend bed rest and limited activities. Dr. Gilmer will determine when normal activities can be resumed; however, strenuous exercises and overhead lifting must be avoided for several weeks.

Following surgery, you will wear either bandages or a special garment. Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection.

Dr. Gilmer may recommend massage to keep your breasts supple. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days. And while scars from the incisions are permanent, they will fade significantly with time.
Infection and slow healing are rare; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and his staff will discuss with you before your breast implants surgery. You can minimize complications by carefully following their directions. In some cases, where the breast becomes too firm due to the formation of scar tissue, a second procedure may be necessary.

Breast Lift (Mastopexy)

Whether the result of pregnancy, weight loss, or natural aging, a breast life—or mastopexy—can elevate and reshape sagging or loose breasts. The size of the areola—the dark, pink skin circling the nipple—can also be reduced through the procedure. Mastopexy is often performed in conjunction with breast enlargement surgery.

To learn more about a breast lift, please contact our office to schedule a complimentary consultation.

Prior to your breast lift, a complete medical history is taken to evaluate your general health. Our team will thoroughly examine your breasts to determine the most effective surgical approach. Dr. Gilmer will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and explain any possible risks or complications.

Preoperative instructions often include the elimination of certain aspirin-containing drugs for several weeks before surgery in order to minimize the possibility of excess bleeding. Antibiotics may also be prescribed prior to surgery to prevent infection.

A breast lift can be performed as an outpatient procedure. Dr. Gilmer may choose from a variety of procedures, depending on what changes are desired. Prior to surgery, your breasts are carefully marked to indicate where incisions will be made.

In one of the most popular techniques, incisions are made on both sides of the breast and around the areola. A keyhole shaped incision is then made directly above the nipple. The surgeon works through the incisions to remove excess skin from the lower part of the breast. The nipple, areola, and underlying tissue are then repositioned into a new, higher location to reshape the breast.

A modified procedure, which involves removing skin from the areola and surrounding areas, can be performed on clients who have minimal sagging.

Yes. When breast augmentation is performed in conjunction with mastopexy, an implant is placed in a pocket created under the breast tissue or the muscle of the chest wall. The surgery can last two hours or more, depending upon the procedure.
Following surgery, you will wear bandages or a special garment for a few days. Then, bandages are typically replaced with a surgical bra, which is worn for several weeks. There may be slight variations in the size or shape of the breasts; however, these variations are common even before breast surgery.

The day of surgery, we recommend bed rest with limited activities. Dr. Gilmer will determine when normal activities can be resumed; however, strenuous exercise and overhead lifting must be avoided for several weeks.

Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from the incisions, although permanent, will fade significantly in time.

Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection.

Complications of infection and blood clots are rare; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and our team will discuss with you. You can minimize complications by carefully following directions.

Breast Implant Removal / Breast Explant

Breast explant with Capsulectomy involves removing the implant with its surrounding capsule. This is an en bloc removal. The procedure is very tedious and requires skill and experience to perform correctly. The implant and capsule are freed off the ribs and muscle and removed from the body. If there is any other foreign bodies (sutures) or any evidence of a silicone rupture or leak, this is thoroughly cleaned and washed before the incision is closed. If the pectoralis muscle needs to be repaired it is done at the time of the procedure.

To learn more about a breast implant removal, please contact our office to schedule a complimentary consultation.

Patients who no longer desire to have their implants and those that wish to remove all the capsule from their breast pocket.

Over the years, Dr. Gilmer has helped many patients with the breast explant procedure and below are helpful details to know regarding the explant surgery.

Procedure Length: 2.5 hours
Conscious Sedation: Combination of medicines to help you relax (a sedative) and to block pain (an anesthetic)
Incision:
Under the breast fold (8 – 9 cm). The old scar will be cut out.
Implants: Returned to the patient
Muscle Repair: Performed at the same time as the explant
Sutures used: All dissolvable
Drains: One drain in each breast. Typically removed within three to five days.
Dressings: Ace wrap until drains are removed. Can shower on the second day after surgery.
Recovery: No heavy lifting greater than 10 lbs. for the first several weeks. Full recovery without restrictions at four weeks.

Breast Implant Illness or BII is a general term given to patients who are concerned their breast implants could be contributing to other medical issues they are experiencing. The condition is thought to be caused by an inflammatory response of the body to the foreign devices (breast implants). Often patients have seen several doctors for these conditions and are often told they can’t find any medical cause for their issues. Because of those concerns many patients seek a surgeon for removal of the implants and anything in contact with the implants (the capsule). It is important to search out a surgeon with experience with BII patients and a surgeon with the skill sets to perform the explant in a proper and safe way.

At this time, there isn’t enough scientific data to explain how common this is or why some women have issues while others do not. The FDA recently had a hearing discussing breast implants, BII, and BIA-ALCL. There is currently ongoing research and panels looking more into the connection between breast implants and breast implant illness.

Patients with BII may experience one or more of the following symptoms and should consult a doctor for consultation:

  • Joint pain
  • Muscle pain
  • Fatigue
  • Brain Fog
  • Memory Loss
  • Hair loss
  • Skin changes
  • Weight gain
  • Anxiety
  • Insomnia
  • Difficulty concentrating
  • Limb numbness/tingling
  • Vertigo
  • Fevers / chills
  • Muscle weakness
  • Temperature intolerance
  • Sensitivity to light or sound
  • Dry skin / hair
  • Recurrent illness or infections
  • Skin changes
  • Depression
  • Decreased libido
  • Breast pains
  • Mood swings
  • Food intolerance
  • Swelling or inflammation
  • Heart palpitations
  • GI issues such as irritable bowel or bladder

Breast Reduction (Reduction Mammoplasty)

From pain and discomfort to dissatisfaction with physical appearance, many of our clients choose breast reduction surgery—or mammoplasty—to improve body contour, reduce pain, and improve quality of life.

If you want to learn more about breast reduction surgery, contact Ritz Med Spa to schedule a complimentary consultation.

Prior to breast reduction surgery, a complete medical history is taken to evaluate your general health. We’ll then examine your breasts thoroughly to determine the most effective surgical approach. Dr. Gilmer will describe the type of anesthesia to be used, the procedure, and what results might realistically be expected, as well as any possible risks or complications.
Preoperative instructions often include the elimination of certain aspirin-containing drugs for several weeks before surgery in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily. Antibiotics may be prescribed for a few days prior to surgery to prevent infection.

A breast reduction is usually performed as an outpatient procedure. Dr. Gilmer may choose from a variety of surgical procedures, depending upon what changes are desired. Prior to surgery your breasts are carefully marked to indicate where incisions will be made.

Brassiere pattern skin reduction is one of the most common techniques used at Ritz Med Spa. Using this technique, vertical and horizontal incisions are made around the nipple area, and excess fat, tissue, and skin are removed from the sides of the breast. Following the removal, the nipple, areola, and tissue below are relocated, but not detached. Small sutures are used to close the incisions.

After breast reduction surgery, you will wear bandages or a special garment for a few days, which are usually replaced with a surgical bra that you’ll wear for several weeks.

The day of surgery, we recommend bed rest with limited activities. Dr. Gilmer will advise you about when normal activities can be resumed; however, strenuous exercise and overhead lifting must be avoided for several weeks.

Pain connected with the mammoplasty procedure is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection.

Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from incisions, although permanent, fade significantly with time.

Complications of infection and slow healing are rare; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and our team will review with you prior to surgery. You can minimize complications by carefully following directions. Some clients who experience poor healing may require additional treatment.

Liposuction

If you have stubborn, unsightly bulges that diet, exercise, and flattering clothes simply cannot erase, liposuction may help you reach your beauty goals.

In women, fat deposits occur most frequently from the waist down, on hips, the buttocks, and outer thighs (saddlebags). Fat deposits on men tend to accumulate above the waist, on the abdomen and sides of the waist (love handles).

With liposuction surgery, both men and women can improve the contours of their bodies through a relatively simple and safe technique. Liposuction surgery involves the removal of fat cells from the body and may be used alone or in conjunction with other procedures, such as a facelift or “tummy tuck.”

Dr. Gilmer is considered one of the best liposuction surgeons in Franklin, TN, and the Nashville area. Contact our team to learn more about liposuction surgery, and to schedule a complimentary consultation.

Liposuction is designed for those who have specific areas of localized fat deposits and who have tried unsuccessfully to eliminate them through diet, exercise, and weight loss.

Men and women in good physical condition with healthy skin elasticity are the best candidates for liposuction surgery. When the procedure was first introduced, only younger people were considered to be good candidates; however, recent improvements in the liposuction technique have made it possible to treat patients of all ages. If you want to learn more about liposuction, you will be personally assess by the physician to determine if are a suitable candidate for liposuction surgery.

While the procedure is not designed to correct general obesity, any area where excess fat deposits have accumulated can be treated. These include the chin, neck, jowls, cheeks, arms, inner and outer thighs, buttocks, knees, hips and abdomen. Men with enlarged breasts—called gynecomastia—can also benefit from this technique.

Prior to surgery, a complete medical history is taken to evaluate your general health. A thorough examination is also conducted. Dr. Gilmer will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and any possible risks or complications.

Preoperative directions may include the elimination of aspirin-containing drugs, which may minimize the possibility of excess bleeding. Antibiotics may be prescribed prior to surgery to prevent infection. Photographs are taken before and after surgery in order to evaluate the final results. The areas to be contoured are marked with a special marking pen.

Liposuction surgery can be performed in our office as an outpatient procedure. Pre-medication is administered to help you relax. When performing what is known as the “tumescent” procedure, Dr. Gilmer injects a large amount of diluted local anesthetic solution into the area. This procedure has the advantage of reducing pain and bruising in the area.

Dr. Gilmer then makes a small incision in the skin and inserts a tube (cannula), either attached to a high-pressure vacuum suction or to a syringe system. The fat is loosened from surrounding tissue by moving the tube back and forth and is then removed or vacuumed from the body with the suction device. Dr. Gilmer will determine the amount of fat to remove be feeling the skin and pinching the tissue.

After the incisions are closed, a compression dressing or bandage is applied to the area to prevent bleeding, reduce swelling, and support the affected area. The procedure can last from 30 minutes to several hours depending upon the amount of fat removed.

Dr. Gilmer actually created the Gilmer Technique. Using this method, a special cannula is used to loosen the fat prior to suctioning, which helps to create a smoother appearance than traditional methods.

After your surgery, a bandage is applied to the treated area. The dressing remains in place for seven to 10 days, depending upon the extent of the surgery and your individual healing process. A surgical compression garment may also be worn.

Because liposuction surgery does not involve large incisions and extensive cutting, pain is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection.

Most of our clients are completely ambulatory immediately following surgery, but rest is recommended for the initial postoperative period. Patients are usually able to return to normal activities within one week, although vigorous physical activity is discouraged for several weeks.

Some swelling and discoloration can occur after liposuction surgery, but usually disappear within a month. Scars, which fade significantly with time, are for the most part, inconspicuous because they are made within the natural creases of the body whenever possible.

Complications connected with liposuction surgery are rare; however, an uneven skin surface, bleeding, infection, numbness and discoloration can occur. Some of these conditions correct themselves in time—others respond to medications. There are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and his staff will discuss with your prior to surgery. You can minimize complications by carefully following directions.

It is important to remember that liposuction surgery, while not a cure for generalized obesity, is an excellent procedure that can benefit those who want to remove unsightly fat from localized areas. Patients who choose this type of surgery must have realistic expectations about the outcome and understand that final results may not be apparent for up to one year.

Eyelid Surgery, Forehead Lift, and Brow Lift

The eyes are virtually expressionless structures; it’s the contour of the skin—the tissue, muscle, fat, hair, and lashes around the eyes—that convey expression. Wrinkles and deep lines and puffiness of the lids begin to develop with the passage of time. Exposure to the sun and genetic predisposition can also be contributing factors. The result can be marked changes in expression causing a tired or older appearance, which can even lead to anxiety and visual impairment.

Blepharoplasty surgery, commonly known as a forehead lift and brow lift, eliminate many of these problems. To learn more about an eye lift, brow lift, or forehead lift, please contact us to schedule your complimentary consultation.

Designed to correct sagging eyelids, pouches beneath the eyes, and excess folds around the eyes, an eye lift procedure removes excess skin and fat on upper and lower eyelids. This procedure is often performed in conjunction with other surgical procedures including face lift, eyebrow lifts, and forehead lifts.

Brow lifts are designed to raise eyebrows and reduce ridges and furrows on the forehead, creating a smoother, more youthful appearance. As with blepharoplasty, this procedure is frequently done in conjunction with other surgeries.

Prior to eye lift surgery, a complete medical history is taken in order to evaluate your general health. A thorough examination of the eye and face is made to determine the most effective surgical approach. The amount, distribution and type of excess skin to be removed is carefully noted. Dr. Gilmer will describe the anesthesia to be used, the procedure, what results might realistically be expected, and any possible risks or complications.

Preoperative directions may include the elimination of certain aspirin-containing drugs, which may minimize the possibility of increased bleeding. Antibiotics may be prescribed for a few days prior to surgery to prevent infection. The areas to be excised are marked and photographs are usually taken before and after surgery in order to evaluate the final results.

Blepharoplasty can be performed on an outpatient basis under local anesthesia.

Following natural lines and creases, Dr. Gilmer makes very fine incisions from the inner to the outer edge of the eyelid. In selected cases incisions can be made inside the eyelid. The upper eyelid is worked on first, with the incision made in the fold of the lid.

On the lower eyelid, the incision is made directly below the eyelash. Excess fat and skin are then removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is gently applied to the area. Small sutures are used to close the incision and special ointments and dressings may be applied. The procedure can take from one to two hours, depending upon the extent of the surgery.

Antibiotics may be continued for several days following eye lid surgeries, and sutures are removed within one week. Some swelling and bruising occur, but subside in a few days. Dr. Gilmer may prescribe ice compresses and/or eye exercises to reduce swelling and regain mobility. Some women may be allowed to use eye makeup within 10 days to two weeks after surgery, but are cautioned to cleanse the area thoroughly after each use. Dr. Gilmer will advise you about when normal activities can resume; however, strenuous exercise must be avoided for several weeks following surgery.

After an eye lift, excessive drying of the eyes can occur, but this condition can be alleviated with medication. There may be sensitivity to bright light and wind, in which case the use of dark glasses in recommended. Sensory changes, such as numbness and itching may occur during the healing process. Final evaluation may not be possible for several months following surgery. Complications connected with brow lifts and forehead lifts are relatively few and minor; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and his staff will communicate to you before the procedure. You can minimize complications by carefully following their directions.

Nose Surgery (Rhinoplasty)

Many of our clients undergo nose surgery to improve the angle, reduce the size of the nose, or remove a bump. Both profile and frontal face views can be altered through rhinoplasty, and the surgery can be performed in conjunction with procedures designed to relieve nasal obstructions.

Nasal reconstruction or rhinoplasty was one of the first cosmetic procedures ever developed and is among those most frequently performed today. Rhinoplasty is a surgical procedure that removes, rearranges or reshapes bone or cartilage in the nose.

Learn more about rhinoplasty surgery by contacting our office to schedule a complimentary consultation.

Prior to surgery, a medical history is taken in order to evaluate your general health, and a careful examination is conducted. Dr. Gilmer will discuss with you how the nose should look in relation to your other facial features. It is important for you to understand that the goal of the surgery is not to achieve perfection, but rather to improve the appearance.

We will photograph your nose so Dr. Gilmer can best evaluate the appropriate procedure to achieve the desired results. Our team will also discuss with you the type of anesthesia to be used, the procedure, and any possible risks or complications.

Preoperative instructions may include the elimination of certain drugs, which contain aspirin, in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed before surgery to prevent infection.

Rhinoplasty can be performed as an outpatient procedure under local anesthesia.

The procedure is determined by the type of correction to be made. In most cases involving a reduction in size or shape of the nose, the removal of a hump or the improvement of an angle, incisions are made inside the nose. Working through these incisions, Dr. Gilmer is able to cut bone and cartilage, the soft, movable tissue inside the nose, to reshape it.

To remove a nasal hump, a special file or chisel is used. A narrower nasal bridge is then formed by bringing together the bones on either side of the face. In patients in whom the size of the nasal tip is too large, cartilage is removed through the inside incision. The angle between the nose and the upper lip can be improved by elevating and trimming the septum, the dividing wall between the two chambers of the nose.

In some cases, it is necessary to narrow the base of the nose. This procedure involves removal of skin from both sides of the nostrils at the center. In order to improve the contour of the noses of some patients, it is sometimes necessary to add tissue. Nose surgery can last from one and one half hours to two hours or more depending upon the extent of surgery.

Following surgery, a lightweight splint is applied to maintain the new shape of the nose, which is usually removed within one week. Nasal pads may be inserted at the time of surgery to protect the septum. This packing is removed within one or two days. Before and even after the packing is removed, there is frequently some stuffiness of the nose, particularly when work has been done in the nasal septum. Dr. Gilmer will advise you when it is safe to gently blow the nose.

Pain connected with nose surgery is minimal to moderate and is controlled with oral medication. Bruising around the eyes occurs, but begins to fade within a few days. Discoloration usually disappears in two to three weeks. Swelling around the treated areas slowly diminishes and can be reduced by keeping the head in a slightly elevated position when reclining. Cold compresses may be recommended, and some slight swelling may be present for as long as two to four months.

During the healing process after a nose job, great care must be taken to protect the nose from injury. Eyeglasses should be adjusted in order to minimize pressure on the nose. The physician advises if contact lenses can be worn. Although patients are usually up and around one or two days after the rhinoplasty, strenuous exercises, particularly those which might elevate blood pressure, must be avoided for several weeks. Dr. Gilmer will determine when normal activities can resume.

The amount of improvement is individual and depends upon the extent of surgery. In some cases, such as when a badly misshapen nose is reconstructed, dramatic results may be obtained. On the other hand, the removal of a slight bump may produce very subtle, yet satisfying results. Final results may not be apparent for up to one year.

Each year, thousands of rhinoplasties are successfully performed on people who want to change the size or shape of their noses. Complications connected with rhinoplasty are rare; however, there are some inherent risks connected with every surgical procedure. Our team will explain possible risks and complications.  You can minimize complications by carefully following directions given by Dr. Gilmer and his staff.

Nose surgery is not usually performed until a person has reached the mid-teenage years, when growth is nearly complete.

Buttocks Augmentation, Butt Implants, and Fat Transfer Surgery

The butt augmentation procedure, often called a “Brazilian Butt Lift,” results in perky, youthful, prominent buttocks, with a more sensual body profile. Brazilian Butt augmentation and lifts are popular in Hollywood among those who want to improve the shape and increase the size of their buttocks by lifting and enhancing its contour, which improves proportional balance and firmness.

To learn more about the butt augmentation, fat transfer to buttocks, and butt implants surgeries offered at Ritz Med Spa, reach out to us for a complimentary consultation.

The ideal candidates for a Brazilian butt lift procedure are those who are physically healthy and are at normal weight. The skin must have elasticity and the patient must have realistic goals.

Your initial shape, the size of the buttocks, and skin quality are important variables to evaluate prior to determining the best type of butt augmentation procedure for you. During your consultation, we’ll review these variables to help you decide what type of augmentation is right for your specific shape. It’s our goal to provide a newly improved shape that is complementary to the rest of your body.

Butt augmentation surgery is typically performed on an outpatient basis and will take approximately 90 minutes to four hours, based on several factors, including the amount of fat that needs to be removed, how many areas there are to be treated, and the buttocks’ size and shape desired. The most common technique performed, is the tumescent liposculpting procedure, which uses (your own) fat transfer to the buttocks.

Tumescent fluid, which is derived from a combination of local anesthetics and adrenaline, is injected into the treated area. This fluid, in addition to numbing the treated area, makes the fat easier to suction through a cannula or blunt, tubular instrument.

During a fat transfer to the buttocks, syringes are connected to a special cannula, used to carefully inject fat into the buttock muscle and deep fat of the buttocks to give the buttocks the classic Brazilian Buttock look. All fat removed during this procedure is sterile collected and processed.

Before surgery, you will need to provide any important medical history, such as a list of all medications, herbs, vitamins and any other supplements or medications. Your recovery time can be shortened and your risk of complications can be lessened by doing the following:

  • Stop using Aspirin, Vitamin E, St. John’s Wort, Naprosyn, or any other type of blood thinner, to lessen the risk of excessive bruising or bleeding or other complications
  • Quit smoking for at least two weeks before and one week after your surgery, so as not to impair circulation and healing; Nicotine can impair circulation and healing
  • Abstain from alcohol in excess for two weeks before the procedure and one week after
  • Drink plenty of water in the days before your procedure

There is expected to be some bruising, swelling, and pain after your procedure. Loss of sensation in the treated areas is normal; however, your nerves will begin to restore feeling and sensation shortly. Swelling may last for a period of several months and pain medicine will be prescribed to control any discomfort. Be sure to contact your doctor if there is any severe pain.

Follow these tips to make your recovery easier and more comfortable:

  • Be sure to have someone available to take you home and take care of you for at least the first 24 hours, following this procedure.
  • Fill all prescriptions and place them within reach of your bed or other resting area.
  • Be sure to have sufficient pillows, hand towels for drainage and a spare compression nearby.

You should be up and walking within one day of your surgery. There will be some draining of excess fluid from access points for the first couple of days, and there may be some blood-tinged fluid.

It is important that you avoid sitting on your bottom as much as possible, for the first two weeks, and you should sleep on your abdomen or sides. Your weight should be rested on your thighs, rather than your buttocks.

You can resume showering on the second or third day. Normal activities should not be resumed for at least one week, following the procedure. A special compression garment should be worn for up to one month. And, any strenuous physical activities should be limited during the two to three weeks following your procedure. Then, you can gradually return to regular activities, including walking, lifting, exercising, and sex. High-impact activities should be avoided for about one month.

Final results of your liposculpting are typically seen after several weeks. Maintain a healthy diet and exercise, and any weight gain will be evident in areas that were not liposuctioned. Liposculpting procedures are performed through small incisions and scarring should be minimal.

Buttock implants are used to fill out the buttocks area, specifically to augment the gluteus maximus muscle area, which produces a more desirable shape to the gluteus. The buttocks region is a part of the body that is not easily enlarged or shaped by weight training or diet. There are a variety of different buttock implants you can choose depending on your size, shape, and desires for your body type. We’ll use these factors to determine the shape and size of the buttock implants.

When undergoing silicone butt implants, a single incision is made overlying the tailbone. Buttocks implants are then positioned to give as natural look as possible.

This area of the body is required for walking, sitting, and many other movements, so clients might experience greater pain during the recovery period than some other cosmetic surgery procedures, and the recovery time is usually longer. Pain medications are typically prescribed, but after five to seven days, clients are usually able to be up and about, walking, sitting, and moving around more comfortably. Swelling and bruising generally are minimal. Full physical activities are usually permitted within one month after surgery.

There may be considerable discomfort for the first several days, due to the difficulty in turning in any position. It is very important that someone be with the patient at least overnight, and more than likely for the next several days, to help the patient to get out of bed and prepare meals, etc.

Local anesthesia will be administered, and a two to three-inch incision is made between the buttocks in the midline. A pocket is made in the buttock muscle (gluteus maximus), just large enough to insert the implant into this pocket. The same is done for each buttock. Careful examination of both sides of the buttocks will assure that the results look natural and symmetric. Dissolvable stitches are placed in the skin incision, on which a bandage is placed, which provides compression to the buttocks. The bandage helps reduce discomfort and swelling. The client will be able to leave the office withing approximately one hour following surgery.

The taped dressing usually can be removed in two to three days following surgery. The patient will then be able to take showers and normal movements will be much more comfortable. Some risks of this surgery may include infection, bleeding, nerve and/or muscle damage, slippage, asymmetry, and wound dehiscence.

Results can be seen immediately, but the buttocks will look more natural and become softer, as the muscle stretches during the next several months after surgery.

The patient may engage in full activities, including gym, bicycling and running, about six weeks following surgery; however, it may take up to six or eight months until the results feel as if the results of the surgery is part of the body.

Facelift (Rhytidectomy)

As we age, our skin begins to sag, skin folds become more prominent, particularly around the chin, on the jaw line and on the neck. A rhytidectomy—or facelift—can give a youthful appearance by tightening and removing excess skin on your face, neck, and muscles.

Often a rhytidectomy is performed in conjunction with other facial cosmetic surgeries, such as a brow lift and forehead lift, eye lift, liposuction, or nose surgery.

A facelift can be performed any time after signs of aging appear. Find out if you are a candidate for a facelift by contact Ritz Med Spa to schedule a complimentary consultation.

Prior to your facelift, we’ll evaluate your medical history and perform a careful examination to determine your general health. Dr. Gilmer will explain realistic results, the type of anesthesia to be used, the procedure, and any possible risks or complications. Photographs are taken before and after surgery to gaugue improvements. It’s our goal to produce a pleasing, natural appearance.

Preoperative instructions may include the elimination of certain aspirin-containing drugs for two weeks before surgery to minimize the possibility of excess bleeding. And, antibiotics may be prescribed to prevent infection. You may also be asked to shampoo your hair the night before surgery.

Facelift surgery can be performed in our office as an outpatient procedure under local anesthesia. Pre-medication is usually administered to relax the patient.

In the basic procedure, we work on one side of the face at a time. Incisions are made inside the hairline at the temple, running in the ear the around the earlobe and behind the ear, ending in the hair of the scalp. Loose skin is separated from underlying tissue, which is pulled up and back. Then,  excess skin is removed. Connective tissue and sagging muscles are tightened, and in some cases, fat deposits are removed from beneath the chin and neck, which may necessitate an additional small incision under the chin. Tiny sutures are used to close the incisions. A rhytidectomy may take from three to five hours or more (depending if other procedures are performed at the same time).

After facelift surgery, loose bandages are applied to the area, which are removed within a few days. Pain connected with the surgery is minimal to moderate and is controlled with oral medication.

Dr. Gilmer will determine when sutures are removed. Sutures may be removed in stages to minimize scarring. Scars from the incisions fade significantly with time and are inconspicuous because they are made within natural creases of the face.

Swelling and discoloration disappear within one or two weeks. Swelling can be reduced by keeping the head in a slightly elevated position when reclining. A tightness or numbness of the treated area may be present for some time, and there may be slight changes in the normal hair pattern around the incision. A limited amount of blood collection under the skin may occur temporarily but does not affect the overall results.

For several weeks after surgery, you should avoid the sun as much as possible and to wear sunscreen when going outside. Healing is gradual and final results may not be apparent for several weeks. The amount of improvement varies, depending on your initial condition and the extent of surgery. In most cases, a single procedure achieves the desired results, though additional procedures may be needed. Most of our facelift clients are delighted with their more attractive, rested appearance.

Each year thousands of rhytidectomies are successfully performed. Complications connected with facelift surgery are rare; however, there are certain inherent risks connected with every surgical procedure. Dr. Gilmer and our team will review any possible complications with you prior to surgery. You can minimize complications by carefully following directions given by Dr. Gilmer and his staff.

Hymen Reconstruction Surgery (Hymenoplasty)

The hymen is a membrane that surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia. The size of the hymenal opening increases with age. After a woman gives birth, she may be left with remnants of the hymen, called carunculae myrtiformes, or the huymne may be completely absent. Hymenoplasty is a procedure that can repair the hymen as if sexual relations have never occurred, and it is often performed for cultural, religious or social reasons.

To learn more about hymenoplasty at Ritz Med Spa, please contact our office to schedule a complimentary consultation.

Chin Augmentation (Mentoplasty)

A chin augmentation—or mentoplasty—is a surgical procedure that improves the appearance of the chin by altering the facial contours by adding size to or moving forward a receding chin. In some cases, a chin augmentation is done in conjunction with liposuction surgery of other cosmetic facial procedures, such as a rhinoplasty or facelift.

To learn more about chin augmentation surgery, contact Ritz Med Spa to schedule your complimentary consultation.

The best candidates for chin augmentation are individuals with receding chins and a normal dental bite. For those with a bite dysfunction, jaw surgery, in conjunction with mentoplasty, may be necessary.

Prior to a chin augmentation, a complete medical history is taken in order to evaluate your general health, and a careful examination of your face is conducted. Dr. Gilmer will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and any possible risks or complications. Photographs will be taken before and after surgery to evaluate the amount of improvement.

Preoperative instructions may include the elimination of certain aspirin-containting drugs to minimize the possibility of excess bleeding. Antibiotics may be prescribed for a few days prior to surgery to prevent infection. Before surgery, the areas to be worked on are carefully marked.

Chin surgery can be done in our office on an outpatient basis. Medication to relax you may be administered prior to surgery.

There are two basic procedures used in mentoplasty:

  • The chin bone is moved forward by an incision that is made inside the mouth. The surgeon, working through the incision, uses special instruments to cut through the chin bone. The lower portion of the bone is then moved forward and sutured into place. Small sutures are used to close the incision, and external bandages are applied to the area.
  • A plastic chin implant is used to create a more prominent jaw. In this technique, the incision is made either inside the mouth or externally, under the chin. A plastic prosthesis, sized exactly to fit the patient, is placed in a pocket above the chin bone and beneath the muscles. Sutures are used to close the incision and pressure bandages are applied. The procedure may take from two and one half to three hours or more depending on whether other procedures are done at the same time.

Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection. Bandages are usually removed within a week. Most clients are up and moving around the day of surgery; however, strenuous activities must be avoided for some time. Dr. Gilmer will advise you on when normal activities can resume based on the extent of surgery and your personal healing process.

Some temporary swelling and bruising of the face are to be expected. Keeping the head slightly elevated when reclining and applying cold compresses may help reduce swelling. Chewing may be difficult for ten days to two weeks and numbness around the treated area may occur for a period of time. Brushing the teeth is sometimes difficult for several days.

Scars from the incisions fade significantly with time and are, for the most part, inconspicuous because of the location. Complications are rare; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer will discuss with you. You can minimize complications by carefully following directions given by Dr. Gilmer and his staff.

Abdominal Reconstruction Surgery (Abdominoplasty)

A protruding abdomen results from weak abdominal muscles, weight gain, pregnancy, or loose skin from weight loss. This condition does not respond well to diet or exercise because the skin and underlying muscles have been stretched. An abdominoplasty can flatten a protruding abdomen by tightening of abdominal wall muscles and removing excess fatty tissue and skin.

If you are interested in learning more about abdominoplasty, please contact Ritz Med Spa to schedule a complimentary consultation.

An abdominoplasty is not a substitute for weight loss. The objective of abdominal reconstruction surgery is to improve the contour of the body by flattening and narrowing the abdomen. The best candidate for the surgery is some who has normal weight, but weak abdominal muscles and excess skin and fat. Age, obesity, and smoking habits are some of the factors to be considered when evaluating you as a candidate for this procedure.

Prior to surgery, we’ll perform a thorough medical examination and collect a complete medical history to evaluate your general health. You and Dr. Gilmer will discuss realistic expectations for the procedure, the type of anesthesia to be used, the procedure, and any possible risks or complications. Photographs will be taken before and after surgery to evaluate the amount of improvement.

Preoperative instructions may include the elimination of certain aspirin-containing drugs to minimize the possibility of excess bleeding. Antibiotics may be prescribed prior to surgery to prevent infection. You may also be asked to bathe with an antiseptic soap for several days prior to surgery.

An abdominoplasty is usually performed under local anesthesia. Premedication may be administered to relax you. Although there are several procedures you may choose, Dr. Gilmer frequently uses the Avelar procedure. There are several benefits to using this procedure including:

  • Less bruising and bleeding
  • Quicker recovery time than traditional methods of abdominoplasty
  • Opitmal fat removal using liposuction (better results than typically seen in standard full abdominoplasty)
  • No need for post-op drains
  • Faster healing time for clients

Using the Avelar technique, tumescent liposuction is performed under local anesthesia to remove fat, while keeping blood vessels intact. We will create a small incision, instead of a large flap, which is used in the traditional technique.

Although clients are usually up and moving around on the same day of surgery, Dr. Gilmer will instruct you about when normal activities can resume, based on the extent of surgery and your personal progress. Bruising and swelling, which occur around the treated area, will disappear within a few weeks. Scars from the procedure remain, but will fade significantly in time.

Each year, thousands of successful abdominoplasties are performed. The amount of improvement depends on the individual, the extent of surgery, and the patient’s skin tone, body build, and healing process. Complications connected with the procedure are rare; however, there are inherent risks connected with every surgical procedure. Possible risks and complications will be thoroughly discussed with Dr. Gilmer and his staff prior to surgery. You can minimize complications by carefully following their directions.

Surgery of the Ears (Otoplasty)

Otoplasty, sometimes described as “pinning back” the ears, is designed to change the shape and contour of the ears. It may be performed on anyone over the age of five or six years old, the age at which the ear growth is almost complete. For those children with severely protruding ears, it is recommended that the surgery be performed at an early age, before they are subjected to psychological stress related to the condition.

To find out if an otoplasty is a good option for you or your child, please contact Ritz Med Spa to schedule a complimentary consultation.

Prior to getting your ears pinned back, a careful examination is conducted and a thorough medical history is taken to evaluate your general health. You or, in the case of a minor, a family member, will discuss with Dr. Gilmer how the ears should look and what can realistically be expected. The type of anesthesia to be used, the procedure, and possible risks and complications are also discussed. Photographs are usually taken before and after surgery. Preoperative instructions may include the elimination of certain aspirin-containing drugs for several weeks before the procedure to minimize the possibility of excess bleeding. Clients may be asked to shampoo their hair with antiseptic shampoo the night before surgery.

Otoplasty can be performed in our office, as an outpatient procedure under local anesthesia. The area is numbed and the patient remains awake, so pre-medication may be administered to relax you.

There are several surgical procedures designed to bring the ears closer to the head. In a basic procedure, an incision is made at the back of the ear to expose firm pliable tissue called cartilage. Dr. Gilmer may fold down the cartilage and use sutures to keep the folds together or remove excess cartilage. After reshaping the cartilage, the incisions are closed with small sutures and the ears are covered with bandages. The procedure can take up to two hours or more depending upon the extent of surgery.

Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Bandages are removed within a few days, but may be replaced with a lighter head dressing. Wearing a tennis headband for a period of time to hold back the ears may also be recommended.

Bruising around the area occurs, but fades within a few weeks. Some temporary swelling occurs, but keeping the head elevated when reclining can alleviate this condition.

You may be advised to sleep on a soft pillow, but not directly on the ears. Six to eight days after surgery, you may be allowed to shampoo your hair. Scars from the incisions fade significantly in time and are, for the most part, inconspicuous because the incisions are made within the creases of the ears.

Although patients are usually up and around one or two days after surgery, Dr. Gilmer will advise you when to resume normal activities based on the extent of surgery and your healing process.

Each year thousands of successful otoplasties are performed. Occasionally a second procedure is necessary if an ear begins to protrude again. Complications of infection are rare; however, there are certain inherent risks connected with every surgical procedure, which Dr. Gilmer and his staff will discuss with you prior to surgery. You can minimize complications by carefully following directions.