DrNovoa.com

Dr. Novoa is a pioneer in the surgical technique known as fully conscious tumescent lidocaine breast augmentation or AWAKE breast augmentation.

Beginning in 2008, Dr. Novoa trained with Dr. Anil Gandhi the creator of AWAKE Breast Augmentation.

The technique allows for the placement of saline or silicone breast implants up to 800cc size in a submuscular plane (below the muscle).

Using only tumescent lidocaine without the use of narcotics or anxiolytics, IV sedation or General Anesthesia, AWAKE breast augmentation takes less than one hour.

The significant benefits of this technique are its safety and the fact that it allows the patient to see the range of implant sizes and allows the patient to make the final decision on implant size before closing.

There are no surprises or guess work since the patient makes the final decision on size, not the surgeon.

Dr. Novoa has performed over 4000 fully conscious tumescent lidocaine breast augmentation since 2008. He lectures on this procedure at international conferences. He is published and peer reviewed and he has written Chapters on tumescent anesthesia in the Springer Medical Series.

AWAKE MINI-TUMMY

Smaller Procedure. Faster Recovery. Natural Results.

The AWAKE MINI-TUMMY is designed for women and men with loose skin, a Cesarean section apron, lower abdominal fullness, or a mild "mommy pouch" located primarily below the belly button.

Performed under local tumescent lidocaine, the procedure avoids IV and general anesthesia in appropriately selected patients and focuses on improving the contour of the lower abdomen.

Ideal For

• Cesarean section apron deformity
• Cesarean scar tethering or indentation
• Mild to moderate lower abdominal skin laxity
• Lower abdominal "mommy pouch"
• Persistent lower abdominal fullness despite diet and exercise
• Patients seeking a smaller alternative to a full abdominoplasty

AWAKE MINI-TUMMY May Include

• Cesarean scar revision
• Release of scar adhesions
• Removal of excess lower abdominal skin
• Limited lower abdominal fat reduction
• Repair of mild lower abdominal laxity
• Cosmetic multilayer closure
• Subcuticular absorbable sutures
• Abdominal binder support

Benefits

• Performed awake with local anesthesia and sedation
• Smaller incision hidden within the bikini line
• Faster recovery than a traditional full abdominoplasty in selected patients
• Improved lower abdominal contour
• Reduced appearance of the Cesarean apron
• Thin, low, and inconspicuous scar placement

Not a Full Tummy Tuck

The AWAKE MINI-TUMMY focuses primarily on the area below the belly button. Patients with significant abdominal skin laxity, severe diastasis recti, or excess upper abdominal tissue may benefit from a more extensive procedure.

AWAKE MINI-TUMMY
Small Scar. Big Difference.
Novoa MedSpa / Novoa Medical Services
915-595-9944

TOLAC / VBAC / VBA2C / VBA3C Philosophy and Safety Protocols

When criteria are appropriately met, Trial of Labor After Cesarean Section (TOLAC) and Vaginal Birth After Cesarean (VBAC) are encouraged.

For women with two previous Cesarean sections (TOLA2C/VBA2C), vaginal delivery is offered under strict protocols and individualized risk assessment.

For women with three previous Cesarean sections (TOLA3C/VBA3C), management is conservative and physiologic. No elective labor augmentation with Pitocin is performed, and patients are not pressured or coerced into repeat Cesarean section.

Following established protocols, we have maintained a documented vaginal delivery success rate of approximately 90%, available online for all deliveries from 2012 to the present.

To help patients understand candidacy for TOLAC and the potential risk of uterine rupture, I recommend the acronym PLANE:

- P – Fetal Position
Proper fetal positioning is important for successful vaginal delivery.

- L – LUST (Lower Uterine Segment Thickness)
A lower uterine segment thickness of 3 mm or greater is an important consideration, especially when evaluating induction or augmentation.

- A – Augmentation, Induction, or Natural Labor
Spontaneous labor generally carries lower risk than induction or augmentation.

- N – Number of Fetuses or Neonatal Weight
Multiple gestation and larger neonatal size may increase complexity and risk.

- E – Experience of the Provider
Provider judgment, training, and experience are among the most important factors in safe TOLAC management.

Based on my clinical experience, Lower Uterine Segment Thickness (LUST) is a particularly important consideration, especially in patients undergoing induction of labor.

Using our established protocols and the PLANE approach, we have not observed a uterine rupture in patients undergoing TOLAC after one, two, or three previous Cesarean sections.