Pratt Plastic Surgery - www.prattplasticsurgery.com

Surgery of the Abdomen

Depending on your situation and the recommendation of David Pratt, you may be given the option of a Mini-abdominoplasty or a Full abdominoplasty. A Full abdominoplasty usually takes 2 to 3 hours, depending on the extent of work required. A partial (Mini-) abdominoplasty may take 1-2 hours. These procedures are performed in an outpatient facility under general anesthesia.

Mini- Abdominoplasty
Patients with only mild to moderate amount of abdominal skin excess, minimal or no stretch marks, and /or minimal lower abdominal protuberance, will benefit greatly from a Mini-abdominoplasty. This procedure consists of removal of 3-4 inches of skin and fat from the lower abdomen and tightening of the lower abdominal muscles, without incising around the navel. Often, liposuction of the abdomen and flanks is combined with the Mini-abdominoplasty in order to fully improve the appearance of the abdomen. The recovery time is usually significantly shorter than with the Full Abdominoplasty,

Full Abdominoplasty
The Full abdominoplasty involves a horizontal "bikini line" incision across the lower abdomen just above the pubic area. All of the stretch damaged skin and excess fatty tissue of the lower abdomen between the pubic hair and the navel is removed. The muscles are tightened in the midline with sutures, and the remaining skin is brought down and sewn to the skin at the "bikini line". Limited liposuction is often combined with the Full Abdominoplasty in order to blend in the surrounding areas and create a natural appearing result. Small drain tubes are placed under the skin in order to prevent fluid build-up during the post-operative period. The patient is placed in an abdominal binder for approximately 4 weeks. Strenuous activity is avoided for six weeks. Some people return to work after one week, while others take longer.

*As with any surgery, Abdominoplasty may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation with David Pratt.

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Breast Augmentation

At Pratt Plastic Surgery, we use only saline (salt water) filled breast implants. For the patient's maximum safety and comfort, the procedure is usually carried out under "twilight anesthesia" at an outpatient surgicenter or an area hospital. The procedure is a same-day procedure that lasts approximately 2- 2 1/2 hours. Patients typically return to work in 5-10 days. Strenuous activity is avoided for 2 weeks.

*As with any surgery, Breast Augmentation may carry some risks along with the potential of side effects. These will vary by individual and will be fully discussed during your initial consultation with David Pratt.

View David Pratt's Work --Click for the size you would like to be

• B or C cup • D cup or larger • Augmentation and Uplift

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Breast Lift

For the patient's maximum safety and comfort, the procedure is usually carried out under "twilight anesthesia" at an outpatient surgicenter or an area hospital. General anesthesia is also available upon request. The surgery is a same-day procedure that lasts approximately 2- 2 1/2 hours. Patients typically return to work in 5-7 days. Strenuous activity is avoided for 2 weeks

*As with any surgery, Breast Lift may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation David Pratt.

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What is Botox®

Botox® is the trademark for a purified medicinal form of botulinum toxin, a protein extracted from the clostridium botulinum bacteria. Injections of this medicine have been used for more than a decade in children and adults to improve the problem of muscle spasm of the facial muscles. This toxin has also been useful in correcting double vision due to ocular muscle imbalance. More recently, Botox® has been used by Plastic Surgeons for improving a patient's appearance. Injection of minute amounts of the Botox® weakens the small muscles beneath the skin, and either partially or entirely eliminates vertical mid-brow frown lines, horizontal forehead lines, "Crow's feet", other unwanted expression lines, and "turkey gobbler" neck bands.

How is Botox® administered?

Minute amounts of Botox® are injected into the offending muscle(s) with a very fine needle. The Botox® acts on the muscle, preventing the muscle from contracting, thus allowing the overlying skin to relax. Wrinkles gradually soften and may eventually disappear.

Does Botox® injection therapy work for everyone?

The majority of persons who are candidates for Botox® injection therapy, will see disappearance or at least significant improvement of the unwanted expression lines and wrinkles. Patients with mild to moderate neck muscle banding will also note significant improvement.

How many treatments will I need?

The effects of Botox® usually last three to five months, at which time another injection is required. After several treatments, the effects of Botox® may be prolonged, sometimes up to six or eight months. In certain cases, multiple treatments will lead to permanent muscle relaxation, and no further treatments will be necessary.

Is Botox® injection therapy painful?

When the Botox® is injected into the muscle with a fine needle, there is often a stinging sensation, which lasts a few seconds. Once the injection is complete, there is usually no residual discomfort.

What are the most common side effects?

The most common side effects experienced with Botox® injection therapy include the following:

Bruising
Ecchymosis (bruising) is the most common side effect to occur. Overall, bruising occurs in less than 20 percent of patients. Avoiding aspirin or aspirin-like products for 2 weeks prior to the injection can minimize the incidence of post injection bruising.

Neck Discomfort
Mild, transient neck discomfort occurs in less than 10 percent of patients following Botox® injection therapy. This discomfort usually lasts for 2 to 5 days.

Headache
A short-lived headache occasionally occurs following Botox® injection therapy. Interestingly however, many patients who have experienced frontal "tension headaches" prior to treatment with Botox® have had significant improvement of their headache symptoms following their Botox® injection.

Weakness of Adjacent Muscles
Rarely, spread of the Botox® injection to an adjacent muscle group can cause unwanted weakness of these muscles. Depending on the muscles affected, the effect could be asymmetry, droopiness of the eyebrow or eyelid, elevation of the brow, relative skin redundancy, or increased bulging of the lower eyelid fat deposits. Although extremely rare, Botox® injection can potentially cause temporary double vision. By keeping one's head up, icing the injection site, and avoiding massaging or manipulating the injected area following the injection, the incidence of these side effects can be minimized

Allergic Reactions
Very rarely a patient may have an allergic reaction to Botox®. This reaction would be treated similarly to any other allergic reaction.

Who should not be treated with Botox® injection therapy?

Patients who are taking Aminoglycoside antibiotics, are pregnant or lactating should avoid treatment with Botox®. Patients with neuromuscular disease such as multiple sclerosis should obtain a second opinion from their neurologist prior to proceeding with a Botox® injection. Finally, patients with known allergies to Botox® or any of its constituents such as albumin should avoid injections with Botox®. Patients who are unable to accept a reduction or elimination in their ability to express themselves through certain facial expressions (ie frowning) should not undergo this procedure.

Are there other types of procedures to treat unwanted expression lines, wrinkles, and neck bands?

The options available for treating wrinkles include skin resurfacing with a laser, dermabrasion, or chemical peel. Additionally, wrinkles can be "filled" with collagen or fat injections. Improvement of the frown lines and horizontal forehead lines can be obtained with a brow lift and partial removal of the frown muscles. Traditional treatment of neck muscular bands entails a neck lift operation.

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CO2 Laser Skin Resurfacing

The procedure is performed in our office surgical suite. A local anesthetic is used prior to the laser treatment, in order to prevent pain during the procedure. The laser procedure is then carried out and topical antibiotic ointment is applied. An oral pain medication will be prescribed for the postoperative discomfort you may experience.

A specific skin-care instruction sheet will be given to you before surgery, addressing all of the details of your wound care.

Healing of the skin surface usually occurs in 7 to 10 days. A certain amount of redness and swelling are normal following the laser treatment, and will decrease over several weeks time. Makeup can usually be applied within 7 to 10 days. Once the skin surface is healed, it is sensitive to the sun for another six months. Sun block and shading devices such as hats and visors should be worn during any expected exposure to the sun for 6 months following the CO2 laser treatment.

Generally, carbon dioxide laser resurfacing results in a significant improvement of skin irregularities such as wrinkles. Recent studies have reported an average of 50% clinical improvement at one year following CO2 laser skin resurfacing. Several treatment sessions may be necessary before satisfactory results are obtained.

For any further information, questions, or to schedule a consultation, please contact us at 877-268-2639

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Collagen

The procedure is carried out in the office, and usually can be completed within 15 to 30 minutes. Prior to treatment, a minute amount of collagen material will be injected beneath the skin of the patient's arm (Test Patch), and the patient is observed for 4 weeks for signs of allergic reaction such as redness or itching. Allergic reactions are quite rare, but can occur. If no reaction occurs, the area to be treated is cleansed, then the collagen material is injected with a super-fine needle just beneath the surface of the skin. There is immediate improvement of the wrinkles noted, in-fact, there is usually a small over-correction noted, which is normal since some of the swelling noted is due to the fluid in the collagen, which is quickly absorbed by the body. Recovery time is usually minimal, with minimal bruising occurring occasionally. Over time, the effects of the treatment wear off, as your body slowly absorbs the collagen material. Re-treatment is usually required at 6 to 12 months.

For any further information, questions, or to schedule a consultation, please contact us at 877-268-2639

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Ear Reshaping

David Pratt performs Otoplasty surgery in the outpatient setting of a surgicenter or an area hospital. In children, the procedure is always carried out under general anesthesia. In adults, "twilight anesthesia" is usually used along with local anesthesia, although general anesthesia is available upon request. An incision is made on the back of the ear and the cartilage is trimmed, modified, and sutured. The skin stitches are self-dissolving, thus do not require removal. The procedure usually takes 2 hours to perform, and the patient is sent home the same day with a gauze dressing on which is left for a week, at which time most patients can return to work or school. The patient wears a sports type headband for additional 3 weeks. Contact sport activities can be resumed at 6 weeks.

*As with any surgery, Otoplasty may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your initial consultation with David Pratt.

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Endoscopic Brow Lift

For the patient's maximum safety and comfort, the Endoscopic Brow Lift procedure is usually carried out under "twilight anesthesia" at an outpatient surgicenter or an area hospital. General anesthesia is available upon request. The procedure is carried out through 4 or 5 small incisions that are hidden in the hair just behind the hairline. The incisions measure less than one inches each. The forehead skin and muscle is gently lifted and secured in an elevated position. No hair is shaved, and the incisions usually heal well. The procedure usually takes 1 to 11/2 hours. Most patients are back to work in a few days and fully resume all normal activities in a couple of weeks.

*As with any surgery, Endoscopic Brow Lift may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation with David Pratt.

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Eyelid Surgery

Blepharoplasty is usually performed in our office surgery suite or an outpatient surgical facility under local anesthesia, with or without mild sedation. General anesthesia is also available upon request. The procedure takes from 2-3 hours depending upon the extent of the condition and whether work is being done on both the upper and lower lids.

For the upper lids, an incision is made along the natural fold of the eyelid, and excess skin and fat is removed. For the lower lids, the incision may be made right below the lower lash line and excess skin, fat and muscle removed. The underlying muscles may also be tightened. The stitches used are all self-dissolving. Recovery time is usually between 1 and 3 weeks. Incisions usually heal quite inconspicuously.

*As with any surgery, Blepharoplasty may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation David Pratt.

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Facelift

The procedure is usually carried out under intravenous sedation in the outpatient surgicenter at one of the area hospitals. General anesthesia is available upon request. During the procedure, the skin and soft tissues of the face and neck are gently lifted and repositioned to a more youthful position. Because David Pratt utilizes the latest techniques in facelift surgery, the majority of the tightening of the face and neck will be in the deep tissues, and not in the skin. This technique results in a relaxed and natural appearance of the facial skin, thus avoiding an "overpulled look". Most patients will go home the day of surgery, although facilities for an overnight stay are available. Dressings and drains are removed a day or two following surgery. Bruising and swelling usually subside in 3 or 4 weeks. All sutures are self-dissolving.

*As with any surgery, Facelift surgery may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation with David Pratt.

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Laser Removal of Pigmented Spots

Most treatment sessions last from 15 to 20 minutes. If local anesthesia is used prior to the procedure, there will be no pain felt with the treatment. Without an injection, the laser feels a bit like having hot grease splattered on the skin. Most patients tolerate the treatment well without anesthesia.

Following the procedure, the treated area will heal over with a crust, which usually resolves in 5 to 7 days. There is also a possibility of blisters or a burning sensation. Local care consists of applying antibiotic ointment to the treated areas 2 to 3 times per day until fully healed. The treated area should be protected from the sun for 6 months with sunscreen.

The initial consultation fee is $50. The cost of each treatment varies according to the size of the tattoo. The fee is based on the number pulses used (number of times the laser hits the skin).
The exact number of treatments varies from one person to another, and is related to several factors such as the depth of the pigment in the skin and the size and number of the spots to be treated. Most dark spots that respond favorably to the first treatment will fade significantly with 2 to 3 treatments.

For any further information questions, or to schedule a consultation, please contact us at: 877-268-2639

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Liposuction

Liposuction is an outpatient procedure that usually lasts from one to three hours, depending upon the amount of fat to be removed. If only a small amount of fat and a limited number of body sites are involved, Liposuction can often be performed under local anesthesia, which numbs only the affected areas. A general anesthesia will be used for more extensive procedures or when it is performed in conjunction with other cosmetic surgery. The area to be treated is marked by David Pratt prior to surgery. A small incision is made to allow the insertion of a hollow tube (cannula). The other end is connected to a device that suctions out the fat. There are several Liposuction techniques that are used by David Pratt. These newer procedures may offer the benefit of better results, fewer side effects, and faster recovery.

David Pratt most commonly uses Tumescent Liposuction, a technique in which a medicated solution is injected into fatty areas before the fat is removed. The fluids, a mixture of intravenous (saline) salt solution and epinephrine (a drug that contracts blood vessels) facilitates fat removal and reduces bleeding during the procedure, and bruising following surgery.

Ultrasound-Assisted Lipoplasty (UAL). This technique utilizes sound waves to break up fat deposits. A special cannula is used which is connected to an ultrasonic generator. As the cannula (tube) is passed through the tissues, fat cells are ruptured, releasing their contents. The liquefied fatty material is then removed. UAL improves the ease and effectiveness of Liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when scar tissue is present and when enhanced precision is needed. In general, UAL requires slightly larger incisions than the plain tumescent technique, and takes a while longer to perform than traditional liposuction

Power-Assisted Liposuction (PAL). With this latest form of Liposuction technology, the traditional Liposuction cannula is combined with an integrated power source that automatically moves the Liposuction cannula in and out in an oscillating-type motion. Similar to an electric toothbrush, the PAL reduces the amount of movement the surgeon's hand, wrist, and arm must make during the procedure. With PAL, it is thought that lessened surgeon fatigue during long procedures may lead to improved liposculpture results. David Pratt reserves this technique for extensive Liposuction procedures involving the treatment of several large areas

Following Liposuction surgery, regardless of which technique is being used, you will wear a custom-fitted elastic garment for approximately 4 weeks in order to control swelling and to help your skin better fit its new contours.

*As with any surgery, Liposuction may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation David Pratt.

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Male Breast Reduction

The treatment of Gynecomastia depends on the underlying cause. It is very important to review your complete medical history with your David Pratt during your initial consultation in order to rule out any specific medical problems. Although certain drugs (e.g. estrogen-containing medications, anabolic steroids, etc.) or specific medical conditions (e.g. impaired liver function, cancer, etc.) can cause male breast enlargement, in most cases, the exact cause is unknown. Longstanding Gynecomastia in a patient that has no obvious cause or association may be a candidate for surgical treatment. The surgical options include:

Liposuction
The term "Liposculpture" is actually more descriptive, since the surgeon permanently changes the contour of the chest with the procedure. Liposuction is performed at an outpatient surgicenter or area hospital, and usually lasts 1 hour. If only a small amount of breast tissue requires removal, Liposuction can often be performed under local anesthesia, which numbs only the breast area. A general anesthesia will be used for more extensive procedures or when it is performed in conjunction with other cosmetic procedures.

The area to be treated is marked by David Pratt prior to surgery. An incision is made in an inconspicuous area (e.g. around the areola or in the underarm area) and tissue is then removed around the breast following the insertion of a hollow tube (cannula). The other end is connected to a device that suctions out the fatty breast tissue.

There are several Liposuction techniques that are used by David Pratt. These newer procedures may offer the benefit of better results, fewer side effects, and faster recovery

David Pratt will often combine both the Tumescent and Ultrasonic-Assisted techniques in the removal of breast tissue.

Tumescent Liposuction, a technique in which a medicated solution is injected into breast before the tissue is removed, is the technique most commonly used by David Pratt. The fluids, a mixture of intravenous (saline) salt solution and epinephrine (a drug that contracts blood vessels) facilitates breast tissue removal and reduces bleeding during the procedure, and bruising following surgery.

Ultrasound-Assisted Lipoplasty (UAL). This technique utilizes sound waves to break up fat and breast tissue deposits. A special cannula is used which is connected to an ultrasonic generator. As the cannula (tube) is passed through the tissues, fat cells in the breast tissue are ruptured, releasing their contents. The liquefied fatty material is then removed. UAL improves the ease and effectiveness of Liposuction in fibrous areas of the body, such as the enlarged male breast. It is also commonly used in secondary procedures, when scar tissue is present and when enhanced precision is needed. In general, UAL requires slightly larger incisions than the plain tumescent technique, and takes a while longer to perform than traditional Liposuction. To control swelling and to help your skin better fit its new contours, you will wear a snug elastic garment for approximately 4 weeks following surgery.

Direct Excision
In patients with severe Gynecomastia and significant skin excess, surgical removal of both skin and breast tissue is sometimes required to obtain a satisfactory result. This procedure closely resembles a breast reduction in the female breast, with similar scars resulting.

Following surgery, the patient is placed in a compression garment for 4 weeks and should avoid strenuous activity for 2 weeks.

*As with any surgery, treatment of Gynecomastia may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your initial consultation with David Pratt.

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Nose Reshaping

Pratt, performs rhinoplasty surgery in the outpatient surgicenter of an area hospital. Although generally carried out under general anesthesia, minor procedures such as refinement of the nasal tip can be performed under local anesthesia and light sedation. Incisions are generally internal and not visible, however in some cases an external incision may be required. When surgery is complete, a splint is applied to help your nose maintain it's new shape. Recovery time usually varies from 1 to 2 weeks, with strenuous activity allowed at 2 weeks. Contact sports should be avoided for a minimum of 8 weeks.

*As with any surgery, Rhinoplasty may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your consultation David Pratt.

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Scar Revision

The particular procedure chosen will vary with each patient's individual problem. The possible options for treatment include:

Surgical Excision of the scar, and sewing the defect closed using a delicate Plastic surgical technique. This option is most commonly chosen by David Pratt when the scar is not amenable to other more conservative techniques, such as with severely raised, depressed, widened, or pigmented scars. Corticosteroid Injection of the scar is usually employed with either Hypertrophic or Keloid scars, which represent an abnormal overgrowth of scar tissue. These scars are usually severely elevated and are often itchy or sometimes even painful. The injected medicine tends to dissolve some of the scar tissue away and often will relieve the symptoms and improve the appearance of the scar. Dermabrasion of the scar is an excellent technique to treat raised scars, as well as small shallow depressed acne scars. A small sterilize sanding wheel spinning at a high rate of speed is used to take the scar tissue down to the level of the normal surrounding skin. In the case of acne scars, the raised skin around the shallow depression is taken down in order to smooth the area. Laser Resurfacing of the scar is similar in effect to dermabrasion, however instead of sanding the raised surface, the laser energy vaporizes the raised scar tissue or the raised skin around the shallow depression in the case of acne scars. In general, the goal of scar revision is to improve the appearance or a scar, and to help the scar tissue blend in with the surrounding normal skin, thus making it less noticeable. (Home) (Breast & Body) (Head & Neck) (Laser/Lunchtime) (Testimonials) (Contact Dr David Pratt) The procedures are usually carried out under local anesthesia in adults, although general anesthesia sometimes is required in children. Time of recovery varies with the technique, although most scars will continue to improve beyond a year following surgery. All wounds following scar revision should be covered with antibiotic ointment until the outer layer of skin has healed over, and sunblock should be used for up to 6 months following the procedure. Following scar revision, David Pratt may prescribe additional treatment, such as silicone sheeting, a pressure earring for earlobe scars, or a lightening cream to prevent subsequent darkening of the scar. David Pratt has extensive experience in the revision of scars and will offer you his expert opinion during your consultation.

*As with any surgery, Scar Revision may carry some risks along with the potential of side effects. These may vary by individual and will be fully discussed during your initial consultation with David Pratt.

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More Information on David Pratt

Originally from Connecticut, David Pratt began his academic career in the New England town of Chestnut Hill just outside of Boston where from 1976 to 1980 he attended Boston College. He graduated with honors and went on to medical school at The George Washington University School of Medicine, in Washington D.C.

Following his graduation from medical school, David Pratt spent 6 years training in General Surgery at the University of Nevada and the University of Kansas Medical Center in Kansas City, Kansas. During his General Surgery training, David Pratt performed over 2000 major general surgical procedures such as breast cancer surgery including mastectomy and lumpectomy, surgery of the thyroid, parathyroid, and pancreas, stomach and bowel surgery, as well as major vascular, lung and esophageal procedures. David Pratt served as Chief Resident in General Surgery at the University of Kansas from 1992-93, and was in charge of teaching medical students and residents. After passing both written and oral examinations, David Pratt was granted certification in General Surgery by the American Board of Surgery. Subsequently, David Pratt completed 2 years of additional fellowship training, specializing in the field of Plastic, Reconstructive, and Cosmetic Surgery at the Oregon Health Sciences University. During his training, David Pratt perfected his microsurgical technique and performed intricate procedures such as reattachment of finger and hands. David Pratt was even able to successfully reattach the finger of a one-year-old boy, a rare surgery indeed.

David Pratt received his cosmetic plastic surgery training under the direction of 18 prominent plastic surgeons, including those from hospitals at Harvard University, Massachusetts General Hospital, Johns Hopkins University, UCLA, University of California San Francisco, Walter Reed and Madigan Army Hospitals. After passing rigorous written and oral examinations, David Pratt was granted the right of passage to become certified by the American Board of Plastic Surgery, and has subsequently been accepted as a member of the American Society of Plastic Surgery. Following his residency in Plastic Surgery, David Pratt went on to receive special training in the use of the CO2 laser at the Harvard Medical School. Since that time David Pratt has obtained extensive experience in skin resurfacing with the CO2 and Erbium lasers, as well as use of the Q-switched Ruby laser used for treatment of tattoos and pigmented skin spots.

Following completion of his training, David Pratt built a thriving practice in Chicago, eventually rising to the level of the Chief of Plastic Surgery Division at the Watertower Surgicenter in Chicago's "Gold Coast" region. During his time in Chicago, David Pratt performed a variety of cosmetic surgical procedures of the face, such as facelifts, rhinoplasty (nasal surgery), blepharoplasty (eyelid surgery), as well as lip augmentation, chin and cheek implants. Additionally, he perfected the body contouring techniques such as the tumescent and ultrasonic liposuction procedures, as well as the major abdominoplasty procedure.

David Pratt has over 10 years of experience in breast surgery, having performed more than 400 major breast surgical procedures. As a General Surgeon, he performed cancer treatment procedures such as mastectomy and lumpectomy, and also assisted in some of the early trials of regional radiation treatment of breast cancer following partial breast removal. David Pratt currently concentrates on cosmetic and reconstructive surgery of the breast, including breast lift and augmentation.

While in Chicago, David Pratt's practice included a large number of men who benefited significantly from both facial and body plastic surgical procedures.

With his wife Dr. Sana Isa-Pratt, David Pratt recently returned to the Pacific Northwest following completion of her residency in Internal Medicine at Northwestern University Medical Center in Chicago. Dr. Isa-Pratt, M.D. is currently an attending physician practicing Internal Medicine at Overlake Internal Medicine Associates in the Bellevue area.

The Pratt family enjoys snow skiing, in-line skating, bicycling, and hiking.

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