The procedure is done under general or local anesthesia. After the breasts and abdomen are cleansed and draped using sterile technique, the anesthesia is introduced and a small incision is made inside the top part of the belly button (the umbilicus) which is a natural scar that resulted from the closing of the umbilical cord at birth.  Dr. Patino prefers this approach because he can easily hide the scar inside the navel and no incisions are made on the breasts or into the breast tissue. Dr. Patino uses this small opening to pass a slender instrument through the fatty tissue underneath the skin to a location behind the breast either above the pectoralis major muscle or bellow it.  The test implants are then inserted and over inflated to create the cavity for the implants. These test implants are then deflated to the size that you have requested. The breasts are then inspected for symmetry and adequate position. The test implants are removed and the un-inflated implants are placed in the pocket and filled with sterile saline solution to the size that you have selected. Once Dr. Patino is satisfied with the appearance of the breasts, the filling tubes are removed and the incision in your belly button is closed with absorbable stitches.

Advantages of the transumbilical approach:

- No scars on your breasts, nipples or axillas.
- One single small inconspicuous scar in a naturally scared area (the belly bottom)
- Takes less than one hour
- Less breast trauma risk
- Less bleeding risk specially when done under local anesthesia
- Faster Recovery
- Less risk of injury to the fourth intercostal nerve (nipple sensation)
- No risk of injury to the axillary artery or nerve

The procedure is usually done in a Surgical Center under general or local tumescent anesthesia. After the abdomen is cleansed and draped using sterile technique, the anesthesia is introduced and an incision is made on the bikini line. The skin and underlying fat are lifted from the “fascia” (layer covering the abdominal cavity) all the way up to the lower rib area. The umbilicus is removed from the skin and left attached to the fascia. Any bleeding vessels may need to be closed by suture ligature or by burning them with a special instrument called an electrocoagulator. If the fascia is noted to be weak, the abdominal wall is then tightened with strong non-absorbable sutures. The area is then irrigated with sterile saline and usually an antibiotic. The area is then checked again for bleeding. The excess skin and fat is removed. Care is taken to avoid dog ears at both ends of the incision which usually runs from one hip bone to the other. Once Dr. Patino is satisfied that there is no bleeding, the belly button is re attached to the skin. Two small plastic drains are then placed and connected to two small plastic bulbs in order to minimize any fluid buildup. The incision is closed in layers and a sterile dressing and compression garment is applied.

Advantages if done under Local Tumescent Anesthesia:

- It's Safer
- There is less risk of developing blood clots in your legs because you can move your legs
- There is less risk of a Pulmonary Embolism (Blood Clots in your Lungs) because you are not paralyzed under general anesthesia
- and you can move your legs
- There is less risk of bleeding because adrenaline is used to clamp down the blood vessels prior to surgery
- There is less risk of death because general anesthesia carries a higher risk
- There is less Nausea and Vomiting because systemic anesthesia is not used
- There is less Post Operative Pain because the tumescent local anesthesia last through the next day
- It's more affordable
- You'll have a faster recovery

The procedure is usually done in an outpatient facility under local tumescent anesthesia with or without IV sedation. After the areas of concern have been identified, cleansed and draped using sterile technique, the anesthesia is introduced. Tiny incisions are made in several inconspicuous locations on the skin. A small cannula is inserted through the tiny incisions. Large volumes of saline solution with local anesthesia and adrenaline are infused (the tumescent technique) into the fatty areas being treated. After an interval of time the blood vessels clamp down in response to the infused adrenaline. This will minimize any bleeding Dr. Patino uses very small cannulas, connected to a vacuum machine to gently remove the unwanted fat and reveal more attractive contours. The tiny incisions are usually left open in order to drain and minimize any fluid buildup.

If you decide to have liposuction, it may be the ideal time to consider a fat transfer to your breasts, your buttocks, your lips, or the folds located on either side of the nose. Fat taken from the liposuctioned area can be injected (fat grafted) to almost any area. Lips are the most requested areas to be enhanced using this method. Fat offers a natural feel and movement but a variable amount of the fat transferred will be reabsorbed. Individual results vary. We do not consider fat grafting a permanent solution following a single treatment, however permanent results are often seen with a series of treatments.

The procedure is usually done in an outpatient facility under local anesthesia. The donor area is selected from the back and or the sides of the head which are genetically programmed to be permanent hairs. This area is shaved, cleansed and draped. Local anesthesia with adrenaline is introduced. The adrenaline is used to clamp down the blood vessels and minimize bleeding. Sterile saline solution is then infused to separate the major blood vessels and nerves from the scalp. The donor scalp is then removed and divided into grafts of 1,2,3 and 4 hairs called Follicular Units . This is done under the microscope. Any bleeding vessels may need to be closed with suture ligature or by burning them with a special instrument called an electrocoagulator. The donor area is closed into a single line and covered with the surrounding hair so that it can not be detected even the same day of the surgery. Dr. Patino advices his patients to let their hair grow as long as possible prior to the surgery in order to hide the donor incision. Local anesthesia with adrenaline is used over the balding or thinning areas where coverage is desired (the recipient areas). Dr. Patino then uses a tiny micro blade to make multiple 1mm and 1.5 mm incisions over the recipient areas. Dr. Patino uses his artistic and surgical skills to make these incisions randomly and in the same direction of any existing hairs. The hairline is done in a similar manner being careful to make it irregular instead of a straight line so that the result is a very natural and virtually undetectable hair restoration. The one hair grafts are usually placed over the hair line and the two, three and four hair grafts are inserted behind it where more density is desired. The follicular unit grafts are meticulously inserted using special forceps. The final result will take about six months because the transplanted grafts were shaved and the hair normally grows at a rate of one half inch per month.