Dr. Eyal Gur
Aesthetic & Reconstructive Plastic Surgeon
Remedy Tours, Friday 12 December 2008 - 00:00:00

Head of Plastic Surgery Department, Medical Center, Israel Head of Microsurgery Unit

Dr. Gur graduated Sackler Medical School, Tel-Aviv University, Israel in 1990. He completed his residency training in Plastic Surgery at Sourasky Medical Center, Tel Aviv, lsrael (1991-1997), Dr. Gur continued his training in Microsurgery in the Toronto General Hospital, Canada(1995-1996) and then in Pediatric Plastic Surgery in the Toronto Sick Children Hospital, Canada (1996-1997).

Dr. Gur is active in a number of professional organizations, including the Israel Medical Association for Plastic and Cosmetic Surgery, American Society for Plastic and Reconstructive Surgeons, American Craniofacial Cleft Palate Association, American Society for Reconstructive Microsurgery and etc. He is an author of almost 100 medical publications in leading medical journals and over 100 lectures.

Dr. Gur's main professional activity is dedicated to:

Facelift
If you are bothered by the signs of aging in your face, a facelift may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:
Sagging in the midface
Deep creases below the lower eyelids
Deep creases between the nose and mouth
Fat that has fallen or is displaced
Loss of muscle tone in the lower face that may create jowls
Loose skin and excess fatty deposits under the chin and jaw
A facelift is designed to correct all of these aging features, restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.

Procedural steps: Typical incisions begin within the hairline, above the temple and continue along or just inside the ear, ending behind the ear. This allows access to tighten underlying tissue, remove excess fat and reduce sagging skin. A second incision under the chin is sometimes necessary. If skin tone is good and only mid-face aging or excess fat in the neck will be corrected, abbreviated techniques with shorter incisions may be used. Liposuction techniques may assist with removal of fat deposits.

Your results: Swelling and bruising should subside within 2-4 weeks. Final results may be apparent in 1-2 months. Incision lines will continue to refine and fade for 1 year.


Eyelid Surgery

Cosmetic eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the upper eyelids, lower eyelids, or both, restoring firmness to the area surrounding the eyes and making you look more rested and alert.

Specifically, eyelid surgery can treat:

Procedural steps: An incision within the natural crease of the upper eyelid allows access to remove excess skin, muscle and underlying fatty tissue. Using an incision inside the lower eyelid, fat is removed or redistributed and muscle modified to correct a baggy lower eyelid. An incision just below the lower lash line allows excess skin to be removed. Laser resurfacing may be used to smooth lower lid skin.

Your results: Bruising should subside in 5-10 days and swelling should subside in 2-4 weeks. Final results may appear in 1-2 months. Incision lines will continue to refine and fade for 1 year.

Breast Augmentation
Breast size is important to many women for a variety of reasons. If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:
Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Implants also may be used to reconstruct a breast after mastectomy or injury.
Procedural steps: Common incision locations include the breast crease, in the underarm, or around the areola (pigmented skin surrounding the nipple). Placement of implants beneath the chest wall muscle or directly behind breast tissue using pre-filled implants or implants filled during surgery creates desired volume. Generally performed as an outpatient procedure under local anesthesia with sedation; general anesthesia may be recommended.
Your results: Immediate. Swelling should subside in 2-4 weeks. Incision lines will continue to flatten and fade for up to 1 year. Implants may need to be replaced: It's important to know that breast implants are not designed to last a lifetime. You should plan for an annual examination by your plastic surgeon to see if the implants need to be replaced.

Breast Lift

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. Procedural steps: Excess skin is surgically removed to raise the nipple and tighten the breast tissue. Incision patterns vary, depending on degree of excess skin and amount of lifting required as well as patient and surgeon preference. Your results: Swelling should subside in 2-4 weeks. Breast shape may take 1-3 months to fully refine. Incision lines will continue to flatten and fade for up to 1 year.

Breast Reduction
Overly large breasts can cause some women to have both health and emotional problems. In addition to self image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional discomfort and self-consciousness often associated with having large pendulous breasts is as important an issue to many women as the physical discomfort and pain. Also known as reduction mammaplasty, this procedure removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts. Tummy Tuck If you want a tighter, flatter abdomen, then a tummy tuck may be appropriate to help achieve your goals. Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in some cases restores weakened or separated muscles. This creates an abdominal profile that is smoother and firmer, often enhancing your body image and confidence.
Procedural steps: A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of the abdominal wall where muscles have weakened. A full tummy tuck requires a horizontal incision in the area between the pubic hairline and navel. Incision size is largely dependent on the amount of excess skin to be removed. Where correction is isolated to the area below the navel, a limited or mini tummy tuck with a shorter incision at the pubic bone may be recommended. Liposuction may be performed with a mini tummy tuck where excess fat is the only factor.
Your results: Swelling should subside and initial results may appear in 2-4 weeks. Final results could appear in 8 weeks. Incision lines will continue to flatten and fade for up to 1 year

Brow Lift

If you have expression lines or other signs of aging in the forehead and brow region which you find bothersome, a brow lift (also called a forehead lift) may be right for you. A brow lift:
A brow lift is designed to correct all of these aging features, restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.
Procedural steps: Brow lift surgery can be performed through multiple limited incisions hidden within the hairline or through a single incision in the natural crease of each upper eyelid. Results of a brow lift may be enhanced through laser resurfacing or a chemical peel that can further improve skin tone and surface appearance. When there is significant excess skin in the forehead, an alternate technique using a wide incision across the top of the scalp may be recommended.
Your results: Swelling should subside in 2-4 weeks. Final results may appear within 1-2 months. Incision lines will continue to refine and fade for up to 1 year.

Facial Implants
If you would like to change the contours of your face, you might want to consider implants. They can improve proportion and profiles and correct imbalance caused by injury or hereditary traits.
Procedural steps: Appropriately sized and shaped implants most commonly in the cheek, chin, jaw or nasal region will be carefully selected and placed. Incisions inside the mouth or discreetly placed external incisions create space in soft tissues for implant positioning and support. Generally performed as an outpatient procedure under local anesthesia with or without sedation; general anesthesia may be recommended.
Your results: Almost immediate, initial swelling should subside in 2-4 weeks and dissipate in 1-2 months as final results appear.

Injectable Fillers
If you would like to restore facial contours, or reduce the appearance of lines and creases, injection therapy with soft tissue fillers may be right for you. Injectable fillers can:
Procedural steps: A pharmaceutical filler substance or your own fat is injected below the skin surface to fill hollow areas and creases, or plump the lips and back of the hands. Fat is typically taken from the inner thigh or abdomen.
Your results: Swelling should dissipate in 2-5 days, or 1-2 weeks with fat injections. This procedure produces temporary results, lasting a few months to several years or more, based on the filler used, treatment site and individual patient factors. Some products may be permanent.

Gynecomastia
Enlarged male breasts, also known as gynecomastia, can cause emotional discomfort and impair your self confidence. Gynecomastia is characterized by:
Gynecomastia may present unilaterally (one breast) or bilaterally (both breasts) Gynecomastia can be surgically treated by removing excess fat, glandular tissue and/or skin. The result is a better proportioned, more masculine-contoured upper body and the freedom and self confidence to lead an active life.
Procedural steps: Surgical removal of excess tissue is performed by excision and/or liposuction. This procedure can include areola reduction.
Your results: Initial swelling should dissipate in 2-4 weeks. Final results may appear in 2-4 months. Incision lines will continue to fade for up to 1 year. Significant weight gain can reverse results.

Liposuction
Despite good health and a reasonable level of fitness, some people may still have a body with disproportionate contours due to localized fat deposits. These areas may be due to family traits rather than a lack of weight control or fitness. Liposuction slims and reshapes specific areas of the body by removing excess fat deposits, improving your body contours and proportion, and ultimately enhancing your self-image. These techniques may be used to reduce localized fat deposits of the:
Procedural techniques: There are three common variations to the procedure:
Your results: Swelling should subside, bruising should fade and initial results may appear in 2-4 weeks. Final results could appear in 2-6 months. Significant weight gain can cause recurrence of fatty deposits.

 Reconstructive procedures
Breast reconstruction
Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition. The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed. Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image. Breast reconstruction is a good option for you if:
  • You are able to cope well with your diagnosis and treatment
  • You do not have additional medical conditions or other illnesses that may impair healing
  • You have a positive outlook and realistic goals for restoring your breast and body image
Breast reconstruction typically involves several procedures performed in multiple stages. It can:
  • Begin at the same time as mastectomy, or
  • Be delayed until you heal from mastectomy and recover from any additional cancer treatments Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.
Although breast reconstruction can rebuild your breast, the results are highly variable:
  • A reconstructed breast will not have the same sensation and feel as the breast it replaces.
  • Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
  • Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.

Reconstructive technique
Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.

Reconstruction with the patient's own tissue
A TRAM flap uses donor muscle, fat and skin from a woman's abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound. Alternatively, your surgeon may choose the DIEP or SGAP flap techniques which do not use muscle but transport tissue to the chest from the abdomen or buttock.

A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact. Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.

Reconstruction with Silicone implants
Tissue expansion stretches healthy skin to provide coverage for a breast implant
Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a more lengthy reconstruction process. It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin. A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.

Surgical placement of a breast implant creates a breast mound
A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction. Your surgeon will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.

Grafting and other specialized techniques create a nipple and areola
Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola

Facial Paralysis Reconstruction

Paralysis of the facial mimetic muscles causes loss of voluntary facial movement, loss of involuntary facial expression, and dysfunction in facial tone. It is a devastating condition with profound functional, aesthetic, and psychological consequences. Symptoms include ocular dryness and tearing, speech difficulties, oral incontinence, impairment in mastication, and obstruction of nasal airway. Significant emotional distress is the result of facial disfigurement, impaired communication and social dysfunction. Facial paralysis manifests as a spectrum of conditions, presenting as either unilateral or bilateral, and ranging from partial to complete weakness. Etiology is either congenital or acquired, the latter including neoplasms, trauma, infection, iatrogenic, and idiopathic causes. Reanimation of the paralyzed face focuses on restoration of form and function. The goals are to achieve protection of the eye, facial symmetry at rest, voluntary symmetric-facial movement, and to restore involuntary mimetic facial expression. Perhaps the most significant unit for reconstruction, from a functional and aesthetic perspective, is the mid-face which is responsible for smiling and for tone of cheeks. Reconstruction may be achieved by several methods. The advanced reconstructions we apply for facial paralysis is the transfer of nerves and muscles to the paralyzed face in order to achieve a functioning smile on that side.

Tissue Expander Reconstruction for Congenital Nevi, Scars and Contractures


Cleft Lip and Palate

Microsurgery




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