Dr. Robert Vitolo has been described as having “the eye of the artist and the hands of a seasoned surgeon, whose skills make your vision of beauty, a reality." He is certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. Additionally, he is a Fellow of the American College of Surgeons and the International College of Surgeons. He is a licensed physician in New York and New Jersey and has three office locations in the New York City and New Jersey area.
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As we age, we gain insight, confidence, and wisdom — and pay for it with wrinkles, creases, and sagging. But through modern cosmetic techniques such as Scar Less (TUBA) breast enlargement, mommy makeovers, and facelifts, you can look better than ever. Haute Beauty expert Dr. Robert Vitolo, a world-renowned plastic and cosmetic surgeon, performs transumbilical breast enlargement through a Scar Less technique. Haute Beauty sat down with Dr. Vitolo to talk about how he began to perform these procedures and what really makes them unique.
Haute Beauty: What are “Scar Less” cosmetic surgical procedures?
Dr. Robert Vitolo: Essentially, it is a way of rethinking years-old techniques and bringing them into the 21st century through advancements in surgery and the development of new techniques. I have taken common surgeries, such as breast augmentation, brow and face lift, and rhinoplasties and am able to accomplish the same results without leaving visible or minimal scarring.
HB: When were you introduced to the Scar Less technique?
RV: About 20 years ago, general surgeons started to change the climate of doing gall bladder surgery through endoscopic technique, so why weren’t we able to use the same concept in breast enlargement? Scars are telltale signs of breast augmentation, no matter where you put them, they are visible. In the Scar Less technique we make a small incision in the bottom of the belly button and insert empty safe saline implants through that incision under the existing breast tissue. We then fill the empty saline implants from outside of the body with saline (saltwater) solution and the empty implants enlarge making the breast larger. When we make
an incision through the belly button it results in scar on a scar, basically becoming imperceptible to the eye.
HB: What is your most popular Scar Less procedure?
RV: Probably breast augmentation. Prior existing techniques don’t allow for the scars to be hidden. I have worked to develop other techniques based on the original no-scar breast enlargement, but breast enlargement is the most popular technique because it is the most-requested procedure in cosmetic surgery.
HB: You are like an artist with a canvas. You put tons of precision, thought, and knowledge into these procedures. How do you take a highly personalized approach to each patient?
RV: Every woman’s breasts are unique. The first thing I do when I examine a woman for breast enlargement is I point out the discrepancies in size, shape, and position. I aim to get [the] breasts as symmetrical and natural looking as possible. Once a woman has a breast enlargement, [she] will notice these asymmetries unless we work to correct it through the Scar Less technique.
The Scar Less breast enlargement technique is unique in plastic surgery, and it can only be performed with safe saline implants. Since I perform many of these procedures weekly, we stock all the different sizes and contours of implants in our surgicenter. This allows us to accurately select the proper size and contour of the implant to be used rather than the implants that were typically ordered for doctors that were performing a procedure.
When I perform a Scar Less breast enlargement, I begin by having a patient choose a photograph of what they want to look like. After selecting a photograph, both the patient and I are on the same page and during the procedure we refer to the photograph and compare the augmented breasts to the photograph. By using this technique, I am able to create a breast that the patient has already selected in the photograph.
I don’t preselect the size and contour of the implant as most plastic surgeons do. Before we insert the actual implant, we use what is called a “sizer”, “a single-use temporary implant that is available in all shapes and sizes, that is not meant for permanent insertion.” We put a sizer in each breast and through the fill tube that comes out the belly button we inflate each sizer with saline solution, the sizer gets larger and the breast tissue expands outward. By doing this technique we have created a pocket for the implant that is the exact size that is necessary [without creating] any bleeding or damage to the tissue as the implant slowly expands and pushes the tissue under the breast out of the way. We adjust the volumes of the temporary implant sizers with the patient in a sitting position and then slowly remove the saline until the breast looks like the photograph that the patient selected. We then know the exact volume and implant profile that will create that look. We then select that implant from our inventory and insert the real implants.
The difference between the Scar Less technique that I perform is that the procedure usually takes 30 minutes, but 20 minutes of that time is spent determining how much saline to put in each implant. That allows [us] to not guess the size and shape of the implant being inserted before the surgery is performed [while allowing] us to select the right implant volume and profile for each patient.
Based on years of experience and thousands of breast enlargements, I have been able to estimate how much of the breast will change after the surgery. That is the art of the procedure, one has to be able to create a picture of the breast before it exists and factor in how much the breast will change over the next few months and take into account all the factors that can create the final results.
HB: Other than minimal scarring, what are the additional benefits of Scar Less breast augmentation?
RV: The Scar Less breast enlargement technique usually takes a total of 30 minutes. These are the advantages. There is no visible scar and almost no bleeding from this procedure. Most patients can go back to work or their normal activities within a day or two because of the minimal trauma inflicted on the body. The pain level is minimal; although we give patients a supply of strong pain medication, very few women take more than one the first night and beyond.
HB: As discussed, you use the Scar Less technique for other procedures. What other procedures do you perform with the Scar Less technique?
RV: The Endoscopic Brow and Mid-face procedure is a facelift with no visible scars. And that is because all the small incisions are hidden in the hair. There is usually no bruising with these procedures and most patients can return to work in four to five days, where a standard open facelift usually takes two weeks or more before acceptable healing to be in public.
In the Scar Less Closed Rhinoplasty that I perform, there is no scar that is visible on the outside of the nose. Typically, with an open rhinoplasty where the surgeon makes an incision on the tissue between the nostrils and lifts up the tissue to visualize the underlying structures, there is a scar that is left where that incision was made.
In the Scar Less Eye Lid Surgery on the lower eye lids that is designed to remove the excess fat pads, I do not make an incision underneath the eyelashes and lift the skin up to access the fat beneath. I make an incision inside the eyelid and remove the excess fat from that incision. The beauty of this is that there is no scar and most patients do not develop any bruising after the surgery, and they can also return to work in usually one day.
HB: Is there a reason you continued to perform Scar Less procedures?
RV: All our procedures are designed to create the best, longest-lasting result for the patient without creating unwanted scars. The last thing any surgeon wants is to have an unsatisfied patient. I never want to be in that position, so our entire practice is geared toward satisfying a patient with natural-looking surgeries.
HB: What is your philosophy for having a satisfied patient?
RV: My entire practice is geared around satisfied patients and giving them a result that they desired. We specialize in natural-looking cosmetic surgery without creating any telltale scars in the process. From the minute a patient enters my office they are greeted warmly by my small but very experienced staff; basically you can call our practice a boutique practice. I spend a great deal of time investigating what the patient’s short-term and long-term goals are. We design a plan for not only the current surgery but also possible surgeries in the future. We take into account the patients’ desires and also their budgets and try to maximize their results for what they are able to afford. My philosophy is “If you want something done well, you have to do it yourself.” I don’t delegate any ask in my practice to other physicians, physician assistants or nurses. Every stitch that I put in, I personally take out. Every filler I inject, I inject myself. Many years ago, I learned to ensure that you have the best possible results, you are the one that has to perform the procedure and its follow-up, and myself and my staff are geared toward making every patient’s experience a memorable one.
