Bella Cosmetic Surgery

Shapely Mommies Raise Happier Kids

search influence — Tue, 07 Feb 2012 16:28:29 +0000

Mommy makeovers typically include breast augmentation, liposuction, and tummy tuck. Maryland mothers often opt for this combo in order to get back their girlish figures. Childbearing can be hard on a woman’s body and the changes that occur aren’t easily fixed with diet and exercise alone. Mommy Makeovers, performed by board certified plastic surgeons such as Michael Chiaramonte, MD, FACS, of Bella Cosmetic Surgery, have become popular ways to get one’s shapely figure back.

Why are so many mothers opting for makeovers? During pregnancy, the external skin in the belly and breasts get stretched out and excess fatty deposits are stored. The inner girdle of connective tissue also relaxes, which allows the organs to pooch out. Breasts lose fullness and volume, especially after breastfeeding. While breast milk provides the perfect nutrition for growing babies, moms are a bit nonplussed with the way their breasts look after weaning the tots. All the low fat menus and aerobics classes in the world won’t be able to repair some of motherhood’s physical aftereffects. With a plastic surgeon’s expertise, tummies can become firm again and breasts returned to their previously perky state. Excess fatty pockets that haven’t budged can be removed, too, with liposuction. Maryland makeovers are most suited for candidates who are within twenty pounds of their ideal weight, are non-smokers and aren’t planning to have any more children.

How much recovery time will moms need to plan for? For a breast augmentation, Maryland moms should rest assured that the downtime will be minimal. If combined with the liposuction, Maryland mothers should be prepared for a longer recovery. Add a tummy tuck, Maryland mommies should plan for an overnight stay in the hospital or recovery center. Although driving will be possible in about one week, it will take six weeks to fully recover. Mothers who are tired of looking frumpy and want to feel good about their bodies again should contact a board certified plastic surgeon to discuss the options for breast augmentation, tummy tuck and liposuction. Maryland moms who are shapely feel more confident and are able to raise happier kids.

Considering breast augmentation? Maryland residents should know not all implants are created equal.

search influence — Thu, 02 Feb 2012 20:31:37 +0000

You may have heard recent news highlighting safety issues and a recall of breast implants made by a French manufacturer, Poly Implant Prothese (PIP). CNN recently reported:

French authorities announced last month that the government would pay for the removal of the bankrupt company’s implants, which a British medical group says were made from nonmedical grade silicone believed by the manufacturers to be made for mattresses.

The World Health Organization (WHO) placed a ban on PIP implants in 2010, when authorities in Europe learned that PIP was using substandard silicone gel in the manufacturing of the PIP implants. In fact, the WHO completely withdrew PIP silicone breast implants from the entire European Union (EU), as well as other non-EU countries. This withdrawal included a suspension of all marketing, distribution and export of PIP implants. PIP went bankrupt shortly after the ban. Hundreds of thousands of women in Europe, South Africa, Latin America, and elsewhere have received PIP implants. Needless to say, those who have PIP implants are concerned.

The French Regulatory Authority (AFSSAPS) has determined, through regulatory testing, that PIP implants have a higher than expected rate of rupture and leakage. In fact, AFSSAPS found that the non-approved silicone gel contributed to tissue irritation and, when leaking, an increase in inflammation and pain. The AFSSAPS has recommended that women with PIP implants have them removed as a preventive measure.

PIP implants were sold in the United States until the year 2000. If you think you might have PIP implants, please click here for more information from the WHO.

Rest assured, however, there is good news if you’re considering a breast augmentation! Maryland-located Bella Cosmetic Surgery uses implants that are made in the U.S. with medical grade silicone. Further, they are made according to strict quality manufacturing requirements, and are subject to strong regulatory testing. Our manufacturer follows FDA guidelines for bio-compatibility testing, for additional safety.

At Bella Cosmetic Surgery, there is no exception to high standards and quality products for our procedures, including breast augmentation. Maryland residents know that it’s important to Dr. Chiaramonte, and the entire Bella Cosmetic Surgery staff, that otheir health comes first. If you have any questions or concerns, please feel free to call our office at 301-567-6767.

Even X-Factor Judges Need Breast Augmentation

search influence — Tue, 24 Jan 2012 16:47:01 +0000

For women considering breast augmentation, Maryland plastic surgeon, Dr. Michael Chiaramonte of Bella Cosmetic Surgery is board certified and experienced to perform the procedure. There are several reasons why women decide to get breast implants. Sometimes they’ve lost their shape due to pregnancy and childbearing. Other times, they were simply born with small breasts that have bothered them for eons. Take Kelly Rowland, judge in X-Factor, for example. In a recent Cosmopolitan interview, Kelly talked about how happy she is with her decision to get implants. She revealed that she’d viewed her tiny breasts as little nuggets and that they’d really bothered her for years. When she finally made the decision to have an augmentation after a decade of thinking about it, she was thrilled. “The decision was 10 years in the making so I’m comfortable talking about it. It’s something I really wanted to do for myself – not for a man, not for work, for myself…and I love them!”

For patients considering breast augmentation, Maryland based Bella Cosmetic Surgery is a surgical center that is well known for great results. This enhancement consistently delivers an extremely high patient satisfaction rate. When women have lost breast volume and size due to aging or childbearing, or if, like Kelly Rowland, they just never grew to a harmonious and full size, saline or silicone implants can be placed for some “oomph.” To perform the operation, a tiny incision is made in one of three scar-hiding locations – the folded crease beneath the breast, below the areola or in the armpit. The implant is placed behind or in front of the chest muscle and there you have it, full and lovely bosoms and cleavage to boot. This operation is an outpatient procedure with minimal recovery time. Once a patient has recovered from the minimal downtime after a breast augmentation, Maryland shopping malls are open for business in order for her to shop for some new clothes.

Is Your Plastic Surgeon in Maryland Board Certified?

search influence — Tue, 10 Jan 2012 16:20:52 +0000

By finding the right plastic surgeon, Maryland residents can learn the difference in the way he or she look and feel post-op. The key, however, is to find the right one. Unfortunately, some patients are having irreversible snafus because they forgot to check some crucial details such as the doctor’s specific training and credentials. There’s a growing trend dubbed “white coat deception” that has been occurring because of some false assumptions – that just because a healthcare practitioner wears a white coat and went to medical school, he or she can perform any type of procedure. This is an incorrect assumption that both doctors and patients are making, with disastrous consequences.

One case that recently made the news illustrates this point. A healthy 40 year old woman went to a doctor to have her leaking breast implants replaced. This would have been a fairly simple procedure if it had been performed by a board certified plastic surgeon Maryland patients trust. Unfortunately, it was not. This patient chose a doctor who was not specifically trained in cosmetic surgery and when she woke up in the recovery room, she was horrified to learn that her breasts had become one large uniboob. In addition, without asking the patient’s permission, the physician also decided to surgically fix a scar near her eye. That impromptu eyelid nip-and-tuck resulted in her inability to close an eye.

The lesson of this story is to check a surgeon’s credentials. When you decide to enhance your appearance, choose a board certified plastic surgeon. Maryland cosmetic surgeon, Michael Chiaramonte, MD, FACS, for example, is board certified and highly regarded in performing breast augmentations, facial and body contouring procedures. When you want to enhance or alter any aspect of your physical appearance, choose a doctor with experience. Don’t ever let a scalpel into your life for a cosmetic enhancement unless it’s being held by a board certified plastic surgeon Maryland area residents can rely on.

Nothing but the fats, er facts, about Liposuction

Monica — Mon, 05 Dec 2011 20:16:14 +0000

A quick Internet search on weight gain after liposuction results in numerous questions revolving around what happens to the fat cells weeks to months after the procedure. Do the fat cells come back, redeposit themselves in other areas or remain gone forever after liposuction? Maryland men and women visiting our office have asked this question many times. In order to answer it properly, one must first understand how fat cells work.

Fat, or adipose tissue, is commonly found just under the surface of the skin in the subcutaneous layer. Fat tissue is also found in other parts of the body, but for purposes of explaining fat cells and liposuction, we’ll stick with the fat found in the subcutaneous layer. Fat cells are produced before birth and later during adolescence. The fat cells produced during adolescence are generally distributed according to sex, with women carrying more in the hips, waist and breast areas and men more in the abdominal area. At that point, the number of fat cells a person has is generally complete. However, fat cell turnover continues throughout a person’s lifetime. In a recent study on Fat Cell Turnover in Humans, it was established that fat cells do die and get replaced by new fat cells, but the number of cells remains constant.

So, your next question might be, if the number of fat cells remains constant after adolescence, why did I gain weight later in life? Weight gain has nothing to do with the number of fat cells, but everything to do with the volume of the fat cells (though this can get tricky with obesity and severe obesity). Fat cells store triglycerides and when more calories are consumed than used in a day, over time, excess triglycerides will increase the diameter of the cell, or cause the fat cells to appear puffy.

Now that you have a good understanding of how fat cells work, let’s talk liposuction. Maryland residents may already know that it’s a surgical procedure that removes subcutaneous fat cells using a suction method. It’s the most common cosmetic surgery procedure done in the United States. It essentially reduces the number of fat cells in a person’s body. However, because the body has a set number of fat cells, once the surgery is complete, the body will work on fat cell homeostasis. In other words, the body will regain its balance by generating the number of fat cells lost during the procedure. After surgery, the treated area usually doesn’t acquire the new fat cells because the procedure destroys the matrix in which the cells live. Therefore, the fat cells tend to be distributed throughout other parts of the body in order to maintain its set level.

Remember that quick Internet search on weight gain after liposuction? Here’s how it all makes sense. Some people have complained that they’ve gained weight after having fat suctioned out. Could this be true? Indeed, it can be. However, it’s not from surgery, fat cell redistribution or anything similar. What causes the weight gain, you might ask? It’s from an increase in fat cell volume. When too many calories are consumed, the fat cells become puffy. The treated area doesn’t tend to look puffy because of the diminished number of fat cells in the area.

What can you do to avoid gaining weight after liposuction? Remember, the fullness of a fat cell is directly related to the amount of calories consumed. If too many calories are consumed, fat storage takes place and the cells become puffy. To avoid excess fat storage, be sure to incorporate a healthy diet and exercise into your daily routine.

This procedure is a great way to boost self-confidence, reduce areas of cellulite and eliminate areas of unwanted fat. As long as you maintain your post-operative weight, your new, slimmer contour will be permanent. If they are considering liposuction, Maryland residents shouldn’t let concerns of weight gain stop them.

Face Winter with Maryland Skin Care Treatments

caketeam — Tue, 08 Nov 2011 16:13:15 +0000

During the winter months in Maryland, skin care routines are often neglected, which cause your skin to feel dry, flaky and irritated. Now is the time to take charge of your winter skin care regimen. Here are some tips to keeping your skin looking radiant and healthy all winter long.

Choose a cleanser specific to your skin type. Everyone’s skin is unique and will benefit from a cleanser targeting your skin’s needs.

MYTH: The stronger the cleanser, the better.

FACT: Stick with a gentle, fragrance-free cleanser. Soaps and stronger cleansers can strip your skin of natural oils.

Apply sunscreen daily. The American Cancer Society reports more than 2 million skin cancers each year in the US.¹ Therefore, year-round sunscreen protection is a must. You’ll want to use a broad-spectrum sunscreen, providing UVA and UVB protection. A thin layer over your face, neck and hands can help protect against damage that could cause precancerous and cancerous lesions, discoloration of the skin, including freckles and pigmentation problems, and wrinkles. Add in a UVA/UVB lip balm and you’ll be better off during the long winter months ahead with a Maryland skin care plan.

MYTH: Sunscreen isn’t necessary during cold or cloudy days.

FACT: According to the American Academy of Dermatology, a broad spectrum, water resistant sunscreen with an SPF of 30 should be used year-round.² Damaging ultraviolet rays can penetrate the cloud layer as well as reflect off snow, causing significant skin damage.

Moisturize, moisturize, moisturize. It’s essential to keeping to your skin soft and healthy in Maryland. Skin care is important when your skin is exposed to the sun daily. However, not all moisturizers are alike. Choosing the right moisturizer for your skin is a key step.

MYTH: Oily skin doesn’t need a moisturizer.

FACT: Skipping a moisturizer might actually make oily skin more oily. A lightweight moisturizer, used once a day, will help keep skin balanced and keep oil production down.

If the weather has your skin looking dull and uneven, you might want to consider microdermabrasion and/or chemical peels.

Microdermabrasionis a non-invasive procedure that stimulates collagen production through the removal of dead skin cells. This procedure will leave your skin feeling smoother and looking healthier in hours.³

Chemical peel is another non-invasive procedure that rejuvenates the skin’s surface by chemically smoothing the texture of your skin. Chemical peels reduce the signs of aging, sun damage, acne and more. This procedure will leave your skin feeling and looking rejuvenated.⁴

To learn more about winter skin protection and your personal Maryland skin care treatment, call for a complimentary personal consultation at 866-245-1880. We’ll help you choose the products and determine the procedures that are right for your Maryland skin care needs.

CALL OUR NATIONAL HARBOR OFFICE AT 301.825.5793

American Cancer Society. Skin Cancer Prevention and Early Detection. http://www.cancer.org/Cancer/SkinCancer-Melanoma/MoreInformation/SkinCancerPreventionandEarlyDetection/skin-cancer-prevention-and-early-detection-intro. Accessed October 21, 2011.
American Academy of Dermatology. Sunscreen. www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreens. Accessed October 21, 2011.
American Academy of Cosmetic Surgery. Patient Information. http://www.cosmeticsurgery.org/patients/dermabrasion.cfm. Accessed on October 21, 2011.
American Academy of Cosmetic Surgery. Patient Information. http://www.cosmeticsurgery.org/patients/peels.cfm. Accessed October 21, 2011.

Breast Enhancement Patients Get Better Results with Body Procedures

caketeam — Fri, 03 Jun 2011 15:42:16 +0000

Advanced options in body contouring are helping women improve the results of their breast enhancement surgery. One plastic surgeon explains how.

National Harbor, Maryland (October 2009)—Many women who want fuller breasts are turning to procedures beyond just breast augmentation in Maryland to help them achieve the look they want. Board certified plastic surgeon Dr. Michael Chiaramonte, founder of Bella Cosmetic Surgery, says that body contouring surgery is growing in demand with women who want to emphasize their breasts by reducing excess fat in typically “overlooked” areas.

“Cosmetic surgery is all about creating balance, and combining body contouring procedures with your breast augmentation can have an immense impact on how balanced your body appears,” notes Dr. Chiaramonte. “Many women are adding these procedures to their Alexandria area breast enlargement surgery for exactly that reason.”

Typical Northern Virginia and Maryland breast enhancement procedures focus on the breasts alone, but Dr. Chiaramonte says that in recent years, many surgeons have been offering paired procedures designed specifically to create more “complete” results. Most women will add just liposuction or a tummy tuck, but Dr. Chiaramonte says that, at his practice, many women have decided to include additional procedures such as arm lift and an advanced abdominoplasty procedure he calls the Bella Body Lift.

“Standard tummy tuck and liposuction procedures have plenty to offer patients because they can help slim areas that can make the body look bottom-heavy,” Dr. Chiaramonte explains. “However, many patients also have concerns about fat or muscle laxity in areas like the upper arms, the buttocks, and the flanks, and that’s where these other procedures can make a big difference.”

At the practice of Maryland plastic surgeon Dr. Chiaramonte, the top alternative to the standard body contouring options is the Bella Body Lift, a liposuction-abdominoplasty variation that he designed specifically to address the upper abdominal area. Typically, he will perform this type of combined breast and body enhancement in one procedure, but Dr. Chiaramonte says he is also seeing more women who have already had breast surgery choose body contouring as a follow-up procedure.

“More patients understand that these procedures can complement each other,” he explains. “Every woman wants a youthful, sexy appearance, and in many cases, that means taking steps to enhance the breasts while making the body look slimmer, smoother, and more balanced.”

Learn more about your many options for breast enhancement when you request a free consultation or call 866-BELLA-06 today.

By Michael F. Chiaramonte, MD, FACS, Bella Cosmetic Surgery

Maryland Plastic Surgeon Now Offers Sciton Laser Treatments

caketeam — Fri, 03 Jun 2011 15:32:50 +0000

Dr. Michael Chiramonte—a Maryland plastic surgeon serving the greater Washington, DC, area—offers a new skin care option in the Sciton laser, which can be used for skin resurfacing, ProFractional treatments, and skin tightening.

National Harbor, MD (June 2009)—Residents of Maryland and Washington, DC, looking for advanced skin care have a new treatment choice with the Sciton laser, now available from Dr. Michael Chiaramonte, a board certified Maryland plastic surgeon who was recently voted President of the National Capital Area Plastic Surgery Society. Through the use of the Sciton laser, Dr. Chiramonte is able to offer a full range of skin enhancement treatments, including ProFractional rejuvenation and SkinTyte skin tightening.

“I spent a great deal of time evaluating the laser technologies on the market today,” says Dr. Chiaramonte. “The bottom line is that Sciton is able to offer my patients the widest variety of safe and effective laser skin therapies, in many cases greatly improving their appearance in ways that are simply not possible through traditional spa facials or over-the-counter, at-home treatments.”

The expanded menu of services made possible through the addition of the Sciton laser at Spa Bella Skin Care and Laser Center includes:

Erbium laser resurfacing: This treatment removes surface layers of aged or sun-damaged skin. As a result, younger and healthier-looking skin can grow in its place. This helps Dr. Chiaramonte’s patients gain a smoother complexion.
ProFractional™ skin rejuvenation: By removing “micro-columns” of damaged tissue, this treatment encourages new skin production and collagen rebuilding in the deeper tissue layers. Dr. Chiaramonte’s patients are seeing remarkably younger-looking skin with ProFractional.
MicroLaserPeel: Treating skin conditions associated with aging and active lifestyles, MicroLaserPeel is ideal for patients who want improved skin with immediate results that last for a significant amount of time. Treatments are comfortable and downtime is minimal.
BBL: Broadband light (BBL) treatments gently heat the top layers of skin and are an effective treatment for age spots, small facial veins (telangiectasias), rosacea, freckles, and brown spots.
SkinTyte: This treatment heats underlying collagen in the skin, causing it to contract and thus tighten the appearance of surface skin. Spa Bella professionals use SkinTyte for a wide variety of areas, including the face, neck, abdomen, and arms.

“I’m excited to offer such a full range of laser treatment options for my Maryland and Washington, DC, skin care patients,” adds Dr. Chiaramonte. “Sciton treatments are easily combined with the other medical spa procedures available at Spa Bella, including BOTOX® Cosmetic, wrinkle fillers like Restylane®, and laser hair removal.”

In addition to a complete line of medical spa services, Dr. Chiaramonte is known for his skill and extensive experience performing plastic surgery in Maryland, including body contouring and facial sculpting procedures. In many cases, Sciton laser treatments will help put the finishing touches on the results of a plastic surgery procedure such as a facelift or eyelid surgery.

Dr. Chiaramonte offers a full menu of cosmetic surgery procedures and medical spa services at Bella Cosmetic Surgery. He specializes in performing body contouring procedures, including the Bella Body Lift, as well as facial enhancements. Request a free consultation to learn more about the practice and how you can achieve advanced facial rejuvenation results.

By Michael F. Chiaramonte, MD, FACS, Bella Cosmetic Surgery

Maryland Plastic Surgery Practice Opens New Location

caketeam — Fri, 03 Jun 2011 15:23:51 +0000

Bella Cosmetic Surgery recently relocated to a new facility in National Harbor, Maryland, to serve cosmetic surgery patients in Washington, DC, and neighboring communities with a full menu of procedures for the breasts, body, and face.

National Harbor, Maryland (November 2008)—Michael F. Chiaramonte, M.D., a board certified plastic surgeon and founder of Bella Cosmetic Surgery, announces the opening of his new office location in National Harbor, Maryland, only a 15-minute drive from the heart of the nation’s capital. At the new office, Dr. Chiaramonte and his staff will continue to offer the latest plastic surgery options for Maryland and Washington, DC, residents.

“We are very excited to relocate in one of the region’s up-and-coming destination locations,” says Dr. Chiaramonte. “I have a lifelong passion for cosmetic surgery—Washington, DC, and Maryland men and women who are already my patients know that they can expect high-quality outcomes through the procedures I offer. By moving to a more convenient and vibrant area, I look forward to serving a larger patient base while continuing to provide a high level of personal service for each and every patient I serve.”

National Harbor is a mixed-use entertainment, business, and residential destination located less than 15 miles south of Washington, DC. This growing community offers shopping, dining, and entertainment along with a first-class marina on the Potomac. Dr. Chiaramonte decided that this up-and-coming area would be an perfect location for his expanded, patient-centered cosmetic surgery location.

“I chose to open my new location for plastic surgery in Maryland because National Harbor is an ideal location in many respects,” says Dr. Chiaramonte. “For starters, the actual office space is state-of-the-art, with the latest medical technology, beautiful furnishings, and a welcoming atmosphere. In addition, National Harbor is convenient to many nearby cities and towns including DC, Alexandria, Virginia, and even Baltimore. I expect many patients will stay in the National Harbor area before and after their procedures to take advantage of the entertainment, shopping, and dining.”

Dr. Chiaramonte performs a full range of surgical and nonsurgical procedures for residents of Maryland and Washington, DC, including breast enhancement, body contouring, and facial sculpting. Breast augmentation and breast lifts are popular procedures for women who want a more flattering breast size and shape. Dr. Chiaramonte also offers the Bella Body Lift, a plastic surgery technique that combines abdominoplasty (tummy tuck) with liposuction of the upper abdomen to achieve a full midsection makeover. Facial cosmetic surgery options at the practice include facelift, eyelid surgery, and rhinoplasty (nose surgery).

“I think my existing patients, when they come in for their next appointment, will be very happy to take a look around the new location and see the sites in the nearby area,” adds Dr. Chiaramonte. “While Bella Cosmetic Surgery has moved only about 10 miles from its prior location in Clinton, Maryland, our new office is a step above in terms of furnishings and features. But of course, our commitment to achieving unmatched levels of high quality care continues unchanged.”

Dr. Michael Chiaramonte looks forward to meeting you in his new Maryland plastic surgery location, convenient to Washington, DC, and many Maryland and Virginia communities. Request a free consultation online or call Bella Cosmetic Surgery at (866-BELLA-06).

By Michael F. Chiaramonte, MD, FACS, Bella Cosmetic Surgery

Maryland Plastic Surgeon Develops the Bella Body Lift

caketeam — Fri, 03 Jun 2011 15:05:46 +0000

Dr. Michael Chiaramonte is a board certified plastic surgeon whose latest body contouring technique—the Bella Body Lift—combines tummy tuck and liposuction, allowing Maryland patients to sculpt and contour their entire mid-sections with a single lipoabdominoplasty procedure.

National Harbor, Maryland (July 2008)—The Bella Body Lift has been designed and implemented by Dr. Chiaramonte, a board certified plastic surgeon serving Maryland and Northern Virginia, to contour and shape the upper torso of patients with unsightly and disproportionate fat deposits. This surgery eliminates surplus skin and fat from underneath the bust area through the middle and lower abdomen to the lower buttocks.

Dissimilar to a tummy tuck or lower body lift, both of which concentrate only on the stomach or hips and thighs respectively, the Bella Body Lift shrinks and shapes that section between the breasts and upper stomach, which is often ignored. “The procedure at its heart is a complex combination of liposuction and abdominoplasty,” says Dr. Chiaramonte. “Therefore, it can also be called an ‘lipoabdominoplasty.’”

As with the tummy tuck, women and men who are in relatively good shape, but are bothered by large fat deposits that exercise just does not seem to address are the best candidates. “If you are plagued with bulges that show through your sweaters and form-fitting clothes,” adds Dr. Chiaramonte, “the Bella Body Lift could be the answer for you.”

Tummy tucks are a very effective procedure when the end goal is removal of surplus skin from the front of the body. However, the tummy tuck can leave many patients with unwanted deposits in the upper abdomen, love handles, and back. In most cases, an additional liposuction procedure will have to be performed a few months later to reshape the middle of the body. The “lipoabdominoplasty” procedure designed by Dr. Chiaramonte for his Maryland plastic surgery patients is a unique operation that combines liposuction of the entire midsection with a tummy tuck, resulting in a remarkable effect with a sole operation and conserving both time and funds for his patients.

“The operation is ideal for individuals who are at a secure and healthy weight who want to get rid of disproportionate bulges and deposits of fat,” says Dr. Chiaramonte. “For people on the lookout for the maximum effect of a body lift in Maryland, the Bella lipoabdominoplasty is an option worth considering.”

To learn more about the Bella Body Lift, Maryland and North Virginia residents can visit Dr. Chiaramonte’s office in National Harbor, Maryland, request a free consultation online or call the office at 866-BELLA-06.

By Michael F. Chiaramonte, MD, FACS, Bella Cosmetic Surgery