Dr. Bruce Freedman
Plastic Surgery Associates of Northern Virginia


I am developing "bags" under my eyes. How can I get rid of them?

Protruding fat pads around the lower lids create the appearance of "bags". Removing the fat and tightening the skin improves the overall appearance around the eyes. Two different techniques are available depending on age and skin elasticity. The first uses an incision under the lower lid lashline. The fat is removed and excess skin is excised. In the second technique, an incision is made inside the lower eyelid and the fat removed. Another alternative is the use of a skin resurfacing laser to tighten the skin.

I am slightly overweight. Would I be a good candidate for liposuction?

Liposuction was originally used as a body contouring procedure to remove well-defined deposits of fat from individuals around their ideal body weight. Recently, liposuction has been safely and effectively utilized as part of an overall process to improve body size and shape. Tumescent and ultrasonic liposuction allow larger amounts of fat to be removed on an outpatient basis. To obtain best results, a person should be in good health and have good skin elasticity.

I had acne as a child. Is there a laser procedure that will help to improve my skin?

Skin resurfacing lasers are probably the most effective surgical method for improving facial skin tone, removing wrinkles, and decreasing scars left by acne or chicken pox. The carbon dioxide (CO 2 ) and erbium lasers are used to precisely remove the top layers of skin. This process will smooth out the irregularities and stimulate new skin and collagen production. Your result is a fresh and healthier appearance.

Is it possible to remove unwanted body hair using a laser?

In 1997 the FDA approved the laser for the removal of unwanted body hair. We use an Alexandrite infrared laser system (Cynosure Apogee) to treat this. The laser energy is absorbed by the hair pigment damaging the hair follicle, resulting in decreased hair growth. We have successfully treated men and women for hair on the face, backs and chests, underarms, and legs. Several treatments are necessary for optimal results due to variations in hair growth and individual hair patterns.

I have developed unsightly "spider veins" on my cheeks, nose, and legs. What can I do to get rid of them?

There are several treatments available including laser, sclerotherapy (acid injection), and coagulation (electric needle). In our practice we prefer the laser because it's quick, doesn't involve needles, and there's minimal discomfort. Studies have shown an average of 85% improvement after 1-2 treatments on the face and after 3-4 treatments on the legs.

I'm a 22- year-old male with fullness in my chest. What can I do to get rid of this embarrassing condition?

This condition is called gynecomastia (female-like breasts) and can be caused by a hormonal imbalance, genetic predisposition, or being overweight. In the absence of an underlying medical problem, gynecomastia can be treated by removing excess fat with liposuction. If the breast gland itself is large it can also be removed using a small incision around the nipple. After surgery, the chest skin tightens leaving a better contoured chest.

I've heard of people having tummy tucks to improve their abdomen, but is there anything available for someone with a sagging, drooping buttocks?

Gluteoplasty is a surgical procedure available for those individuals who are concerned with the size and shape of their buttocks. This procedure combines liposuction of the posterior thigh with removal of the excess tissue around the lower part of the buttocks. Following surgery people note a more pleasing appearance and fit into their clothes and bathing suits much better.

I have heard about Vitamin C as an anti-aging agent. How does it work?

Vitamin C, when stabilized as L-ascorbic acid, is biologically active with both regenerative and anti-oxidant properties. It has been shown to help restructure collagen fibers, activate collagen synthesis, capture harmful free radicals, and regenerate Vitamin E. After daily application of Vitamin C cream for three months, clinical skin improvement has been demonstrated with reduction in fine lines and increased skin tone and elasticity.

Could you tell me about the current methods to enhance lip size?

Different "filling materials" are now available to increase the volume of a person's lips. The organically derived materials, collagen and cadaveric fascia, are injected as a paste and are gradually absorbed. A person's own fat can be taken from another area of their body and reintroduced into the lips. Some of the transplanted fat survives and remains permanently. Synthetic materials such as Gortex have also been used. The permanent implants require small incisions and tends to feel firmer. Each product has its own benefits and limitations; these can be discussed with your physician during your personal consultation.

After having breast enlargement, can a woman increase the size of her breast implants if she wishes?

Yes. If a woman desires larger breasts, the previous implants can be exchanged with new larger implants. The volume and size of the new implants will be increased by approximately 150-200 cc (or 6 to 7 ounces) for each cup size of increase desired. The previous incision can generally be used and the existing pocket enlarged to accommodate the bigger implant. The level of discomfort and recovery time following this type of revision is usually much less than that associated with the first operation. Ten years ago I had a facelift. But recently, I have noticed the reappearance of some wrinkles.

Do I need another facelift to improve my condition?

If your problem is confined to skin wrinkles, photo-aging and minimal skin laxity, laser skin resurfacing can be beneficial. Without incisions, the laser precisely removes the superficial layers of damaged skin, effectively reduces wrinkles, and increases collagen production in the skin. This improves skin firmness and tone, which results in a more radiant appearance. We use both the CO2 and Erbium lasers to accomplish this aspect of facial rejuvenation.

What type of anesthesia will I have for my surgery?

In our certified in-office operating suite, your anesthesia will be provided by a board certified anesthesiologist from Horizon Anesthesia.  The type of anesthesia will be either intravenous sedation or general anesthesia.  You will have ample time on the day of surgery to meet with your anesthesiologist and to discuss the anesthesia plan.  In addition, your anesthesiologist will have a detailed discussion with you regarding the side effects of anesthesia.  The most common side effects from anesthesia include nausea, sore throat, and muscle aches.  We will give you medication to minimize the likelihood of nausea.  All patients are carefully monitored throughout their procedure and recovery, and we adhere to all standards of care developed by the American Society of Anesthesiologists. All of your questions will be answered.  Our primary focus is to provide for your safety and comfort during and immediately after your procedure.

Similar protocols apply if you have your surgery at a local area hospital.

If you have a question that do not appear on this page please email them to


View More