General Practitioners

• Medical Weight Loss
  Regardless of the option employed by the patient, this can result in significant problems for patients after working hard to lose their weight.  Often patients come with cosmetic issues such as skin laxity and body contour irregularities that require correction to achieve a more satisfying outward appearance. While other massive weight loss  patients present with functional complaints such as skin rashes, breakdown in abdominal and thigh folds, difficulties maintaining hygiene, and even difficulty in ambulating due to a weighty pannus or the intense weight of loose skin in the arms and legs.  All of these problems are similar in that they are the result of skin ptosis (hanging skin).
• Pediatric Care
  Tonya then relocated to New York City where she began her clinical studies. During her surgical training, she spent time operating with Dr. Edmund Kessler at Cornell and Columbia University Hospitals. After completing medical school, Tonya began her residency training at Louisiana State University in New Orleans. After three years Dr. Boudreaux completed her Pediatrics Residency and was offered a Neonatology Intensive Care Fellowship position at Yale University.
• Primary Care
  As with any surgery, there are always risks and complications that may occur.  Surgery in the post bariatric is no different and in fact may carry more risks than surgery in the average patient.  Particularly in those that have had bariatric surgery, protein insufficiency in the diet and vitamin and mineral deficiencies may play into increased risks of complications.  For this reason, we perform comprehensive pre-operative testing and suggest that patients continue supplements as ordered by their primary treating physicians.  Some patients with multiple co-morbidities may be asked to undergo further testing or obtain a medic al clearance from a primary care physician prior to undergoing more invasive/lengthy procedures.
• Emergency Care
  Dr. Boudreaux declined the offer to be closer to her husband, Paul, and take care of their newly born son, Thomas. Tonya began her clinical practice in Stamford, Connecticut at Stamford Pediatric Associates. Still wishing to continue her care of the acutely ill, she took on a position as a pediatric neonatal hospitalist at Stamford Hospital. Next, Tonya received a position in the pediatric emergency room at Womens and Childrens Hospital in Lafayette, Louisiana. Tonya cared for thousands of acutely ill children over the course of her pediatric career, saving many from certain death.
• Constipation
• Urinary Incontinence
  A disproportionately enlarged labia minora may result for several reasons. The most common is congenital. Acquired causes are childbirth, intercourse, chronic irritation and inflammation due to urinary incontinence or dermatitis. The enlargement of the labia minora often results in discomfort in tight pants, sports activities and self consciousness and embarrassment.  For this reason, female patients seek out Dr. Chugay to help them look and feel their best.
• Diarrhea
• Pneumonia

Ophthalmologists

• Ophthalmology
  Dr. Nikolas Chugay is board certified in Facial Plastic Surgery by Osteopathic College of Ophthalmology and Otorhinolaryngology and a diplomate of the American Board of Cosmetic Surgery and American Board of Anti-Aging and Regenerative Medicine.

Gynecologists

• Pregnancy
• Labor and Delivery

Internists

• Endoscopy
  Endoscopic surgery is a minimally invasive approach to surgery and has been used for decades in a number of different procedures, including gallbladder removal, tubal ligation, and knee surgery. However, endoscopy is a very recent phenomenon in aesthetic surgery. Despite its clear effectiveness, the endoscopic technique is used by only about 10% of cosmetic and plastic surgeons.

Psychiatrists

• Depression

Endocrinologist

• Diabetes Care

Radiologist

• Ultrasound
  1 If a patient presents with signs/symptoms of capsular contracture (eg, induration of the implant site, tightness in the leg, newonset pain, new-onset swelling), ultrasound or CT evaluation of the affected extremity is warranted. If a thickened capsule is identified, typically characterized by calcifications, then a partial or complete capsulectomy is warranted. The reality is that removal of the capsule may be quite difficult in the confined space of the calf and may require larger, unsightly incisions in more severe cases.

Surgeons

• General Surgery
  Following an internship in general surgery in Virginia, Paul traveled to Stamford, Connecticut to complete his general surgical training. He then traveled to Tulsa, Oklahoma to complete his training in full body cosmetic surgery, performing over 1200 cases while in his fellowship program.  Paul is married to his lovely wife, Tonya, and has two sons, Thomas and Nikolas.
• Wound Care
  Tonya completed her undergraduate studies at Louisiana State University in Baton Rouge, Louisiana. After graduating with a Bachelor of Science in Kinesiology with concentrations in both Human Movement and Pre-Medicine she moved to New Orleans, Louisiana where she worked in the Emergency Medicine Department at Charity Hospital as a Clinical Research Associate. During her time at Charity Hospital Dr. Boudreaux conducted research studies in the area of wound care and infectious disease.
• Otolaryngology
• Reconstructive Surgery
  1972-1974 Military service – Third Brigade Surgeon for the 101st Airborne Division Medical service involved General Medicine, General Surgery and Reconstructive Surgery.

Plastic Surgeons

• Botox
  She rapidly became proficient in facial injectables including Juvederm, Restylane, and Perlane. Also, she was trained in the injection of Botox for facial wrinkles. Tonya has attended many national meetings discussing advancements in facial rejuvenation and continues to increase her knowledge base to help provide her patients with the most cutting edge techniques.
• Brow Lift
  A forehead lift  or “brow lift†is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. Dr. Chugay utilizes two distinct techniques of forehead lifting: Coronal and Endoscopic.
• Eyelid Surgery
  In an eyelid surgery, an incision is usually made in the natural skin fold on the upper eyelid. The excess skin is reduced and the skin is repaired with very fine absorbing sutures. The lower eyelid incision is made directly under the eyelash line. The excess skin and some muscle are reduced from the region of the lower lids. If there is some fat in the region of the lower lids, that fat is also reduced. The skin is closed with fine dissolving sutures.
• Liposuction
  “Liposuction 360” is a term that has been increasingly used to describe liposuction that encompasses the whole body (front and back).  We typically perform liposuction on the front and back of the body to treat the body in 360 to achieve maximal effect.
• Breast Augmentation
  Dr. Chugay chooses to perform the majority of his breast augmentations, approximately 70-80% of them, with silicone implants. Silicone implants have a much more natural feel and have been demonstrated to have a very low leak rate (1% leak rate noted per year – 10% risk at 10 years). Despite previous litigation against breast implant manufacturers and concerns over an association between silicone implants and cancer, as of November 2006, the FDA has again approved silicone implants for use in breast augmentation.
• Breast Reduction
  Breast reduction surgery (Reduction Mammaplasty) is ideal for patients with excessively large breasts. The procedure allows removal of a portion of the breast gland, skin, fat and other tissues making breasts smaller, shapelier and firmer with better shaped and positioned nipples.
• Breast Lift
  Gravity, aging, and pregnancy take a toll on the female breast.  It is the cosmetic surgeon’s job to then bring a sagging and flattened breast back to a more youthful, perky, and full appearing breast.  In many instances, a simple lift will reposition a nipple and possibly reduce the size of the breast depending on the amount of tissue. However, a breast lift does not increase the fullness of the upper portion of the breast.  For this reason, the breast lift can be combined with an augmentation (breast implants) to increase the fullness and shape of the breasts.
• Rhinoplasty
  Dr. Chugay uses soft Gore-Tex nasal implants in nose sculpting surgery for certain types of secondary cosmetic and reconstructive rhinoplasty. These instances include augmentation of the nasal bridge or filling in concave deformities, often found in asymmetrical, injured or misshapen noses. These nasal implants (nose sculpting) produce a natural appearance of the nose, smooth contours, which usually cannot be achieved (regardless of the surgeon’s skill and good will) with cartilage grafts or other natural or synthetic implants or fillers.
• Breast Reconstruction
• Plastic Surgery
  Dr. Chugay has over 40 years of experience in Facial Plastic, Aesthetic, and Cosmetic Plastic Surgery. He has performed over 30,000 surgical procedures, published numerous articles in the medical press, designed many new procedures, and invented several new implants used for muscular augmentation.
• Thigh Lift
  There are two primary types of thigh lifts. A medial thigh lift is commonly used to tighten the skin and reduce excess fat from the inner thigh region. The incision is made it the inner crease of the leg and hides well.  However, the risks with this procedure are greater and can include infection, scar widening or migration, sensory alteration and possible distortion of the labia in women.  On larger legs or those with more significant skin excess, a vertical incision thigh lift, along the medial thigh, may be an option to perform the thigh lift procedure.
• Face Lift
  Dr. Chugay’s technique allows the most aggressive and natural-looking results to be accompanied by the fastest recovery possible. He has appeared in the news on multiple occasions, discussing this technique. Its various elements have been presented to other surgeons at multiple conferences around the world with the hope of teaching others how to produce a better looking face-lift.
• Neck Lift
  As effective as modern plastic surgery may seem when it comes to facial rejuvenation, our options are limited to Facelift, Neck Lift, Forehead Lift, Brow Lift, Blepharoplasty, Crow’s-Feet Reduction, Skin Resurfacing, Fillers and Facial Fat Transfer. Ultimately, we are treating symptoms, not causes of aging.
• Blepharoplasty
  The traditional blepharoplasty technique emphasizes extensive removal of fat in the lower lid in order to assure complete removal of the puffy bags. However, this overcorrection often results in hollow or even cadaverous-looking eyes. Dr. Chugay reduces fat conservatively and only from certain layers, thus producing excellent results without the hollow-eye look.
• Abdominoplasty
  Abdominoplasty or “Tummy Tuck,” is a surgical procedure carried out to reduce the excess wrinkled skin and fatty tissue from the abdomen and to tighten abdominal muscles. The overall effect is to produce a smoother, flatter tummy.
• Nose Surgery
  Nose surgery  is not without its risks. The potential risks include but are not limited to: infection, bleeding, scarring, nasal deformity, and difficulty breathing.
• Breast Surgery
  The term “mommy makeover†was coined to denote procedures that were done to correct the areas most often altered by a pregnancy and a woman’s desire to regain her pre-pregnancy appearance. A mommy makeover is typically a combination of a breast surgery and a body contouring procedure to help women regain the curvaceous and tighter look they had before having had children.
• Otoplasty
  Otoplasty is a common surgical procedure performed to “pin back†or correct protruding ears. The surgery can be performed on adults as well as on children over five years of age. It is often recommended at an early age to help alleviate teasing at school by other children. Many parents are often unaware of or underestimate the severe psychological trauma that can result from such harassment.
• Scar Revision
  Moderate and more severe scars benefit most from combining scar revision techniques with resurfacing. Similarly, very lax skin – even with the tightening achievable with resurfacing – may benefit from combining a Face Lift  with the procedure. Dr. Chugay will discuss this further if it applies to you.
• Lip Augmentation
  Collagen is primarily used for combating small lines and wrinkles. Bovine collagen is, however, not approved for injection into the deep tissues of the lip for lip augmentation or for use near the orbital rim.
• Body Contouring
  The procedure can also be utilized in females that have lost a significant amount of weight and want to bring their bodies back to the way they were before significant weight gain and weight loss. Typical breast procedures include breast augmentation, breast lift/reduction, and breast lift with implants. Typical body contouring procedures include: tummy tuck (abdominoplasty), liposuction, and occasionally fat grafting.
• Laser Resurfacing
  Laser resurfacing uses a precise beam of laser light, most frequently known as carbon dioxide (CO2) or erbium (Erbium-YAG), to vaporize away the various layers of skin.
• Cosmetic Surgery
  Born in Santa Ana California and raised in Newport Beach, Paul loves helping people and making them feel beautiful. With an artistic plastic surgeon as his father and an aspiring model as his mother; Paul’s entry into the field of cosmetic surgery seemed the natural choice.
• Dermabrasion
  For certain types of scars and pits, dermabrasion, which uses a tool to “sand†the surface of the skin, is the ideal solution. Dermabrasion uses a high speed rotating sanding wheel or brush to peel away the skin. This stimulates new, healthier appearing skin to replace and smooth sun damaged, wrinkled, discolored, or scarred areas.
• Facial Implants
  It is a fact, however, that solid silicone will not “leak out.† Furthermore, there have been absolutely no clinical findings of cancer risk from solid (or recently – even liquid silicone). Plastic surgery savvy customers know that many facial implants, including chin, cheek and jaw are usually made of soft solid silicone. The conclusion: solid silicone is just as safe as basically any other implant material. However, you should always remember that a foreign material is not a part of your body – there will always be risk for infection, implant migration, and local tissue reaction.
• Bariatric Surgery
  Suter et al reported on major complication rates during their 2-year experience with laparoscopic RYGB. In their evaluation of 107 cases, they noted a major complication rate of 12.5% in the first two¬ thirds of procedures versus 2.7 % in the last third of procedures performed. These studies show that there is a significant learning curve that must be respected, as it correlates with the complications that can occur. Patients seeking out bariatric surgery should be cognizant of the risks of having the surgery and, more importantly, should only consider having bariatric surgery in centers that specialize in that type of work to avoid higher rates of complication.
• Chin Augmentation
  Most frequently the goal is to reduce the appearance of a double or triple chin. This procedure is fairly easy to perform, and it usually yields excellent results. It is often combined with Chin Augmentation.
• Forehead Lift
  In the Coronal Forehead Lift, Dr. Chugay begins as he makes an incision starting at or near the ear and running across the top of your head slightly behind your hairline. The forehead skin is lifted up and excess skin is reduced, sometimes with part or all of the muscles that cause forehead tension and wrinkling. Dr. Chugay uses blunt dissection to free up the tissues. While using sharp cutting instruments to free up the forehead skin is faster, blunt dissection is much safer for the patient and will result in less bleeding, less risk of nerve and tissue damage, lower risk of hematoma, and faster healing and recovery.

Dermatologists

• Acne Treatment
• Chemical Peels
  There are various types of Chemical Peels. The crucial difference is the depth of peeling. Following many years of experience, Dr. Chugay has selected the following three Deep Surface Peeling techniques...
• Rashes
• Skin Care
  While undoubtedly effective in Skin Care products, lighter techniques of Peeling will not significantly reverse deep signs of aging on your face. However, as a maintenance measure, such techniques are extraordinarily effective.
• Microdermabrasion
  Fruit acids, Retin A, Microdermabrasion and other techniques will exfoliate your skin to various depths. This means that superficial dead skin layers will be forcefully reduced, and your skin would acquire a healthier glow.