The Woodruff Institute

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The Woodruff Institute - Overview
The Woodruff Institute, located in Napes, FL, brings together, under one roof, state of the art facial aesthetic surgery, dermatology, and reconstructive surgery. Dedicated to providing personalized, quality care in an elegant environment, The Woodruff Institute looks forward to caring for your dermatologic and aesthetic concerns.

The Woodruff Institute - Mission
The Woodruff Institute’s mission is to provide the highest quality medical care to the people of Southwest Florida. We are committed to providing our patients with the most up to date medical technology. The Woodruff Institute strives to provide our patients with first class customer service. We acknowledge that patient satisfaction determines the success of the Woodruff Institute. Patient care and service is the priority of our physicians and staff. The Woodruff Institute will maintain at all times the highest ethics and standards with our patients, staff, insurance companies and associates. Our integrity will not be compromised. We want you and your family to feel comfortable here, and we strive to provide the best experience possible.


The Woodruff Institute - Our Providers
Dr. Jonathan E. Sonne
Dr.Sonne is fellowship trained and Board Certified by the American Board of Facial Plastic and Reconstructive Surgery. He is one of a small group of surgeons that has achieved Dual Board Certification in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery.

Dr. Sonne grew up in Connecticut and attended Oberlin College. He attended medical school at New York Medical College where he was the president of the Alpha Omega Alpha National Honor Medical Society. Dr. Sonne went on to an internship in General Surgery at St. Vincents Hospital in Manhattan and continued his surgical subspecialty training at the New York Eye and Ear Infirmary.

Subsequently, Dr. Sonne completed a Fellowship in Facial Plastic and Reconstructive Surgery in Indianapolis. Dr. Sonne holds medical licenses in Florida, New York and Indiana. He is a member of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Cosmetic Surgery, the Florida Medical Society and the Collier County Medical Society.
 
Dr. Rebecca W. Lambert
Dr. Lambert is a board-certified dermatologist and fellowship-trained Mohs micrographic surgeon .She grew up in Massachusetts and attended college at Harvard University. She worked for two years at the Dana Farber Cancer Institute before attending medical school at Columbia University College of Physicians and Surgeons.

She completed an Internal Medicine Internship at St Vincents Hospital in New York’s Greenwich Village before starting her residency in dermatology at Cornell University’s New York Hospital and Memorial Sloan-Kettering Cancer Center, where she served as chief resident. During a postresidency fellowship in Mohs Micrographic Surgery at the University of Pennsylvania, she removed more than one thousand skin cancers using the Mohs surgery technique.

Before moving to Naples, Dr. Lambert was in private practice in Carmel, Indiana. Dr. Lambert holds an active medical license in the state of Florida. She is a member of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, Florida State Medical Society, and Collier County Medical Society

The Woodruff Institute - Cosmetic Services
Whether you are looking for a full face lift or a new skin care regimen, The Woodruff Institute can help you to achieve your aesthetic goals. We specialize in facial rejuvenation surgery and treatments, nasal surgery, and reconstruction following skin cancer. We are happy to arrange a consultation to determine which services best suit your needs.

Face and Neck Lift
Aging brings inevitable changes to the face. As years go by, the face and neck skin loosens, resulting in "crow's feet" at the corner of the eyes, jowls at the jawline, deep folds or "marionette lines" at the corners of the mouth, vertical folds of the neck, and a "double chin". Heredity, sun exposure, the pull of gravity, and personal habits such as smoking contribute to the aging of the face. A facelift (rhytidectomy) rejuvenates the look of the face by reducing sagging skin and wrinkles. Weakened muscles of the neck are tightened and lax mid-cheek tissues are lifted. By repositioning sagging skin and tissues, a facelift results in a natural, more youthful look.

Eyelid Surgery
With time, the delicate eyelid tissues can develop wrinkles and bags, contributing to a worn and tired look. Droopy upper eyelids are the result of excess sagging of eyelid skin. In the lower eyelids, bags develop with age due to prolapse of fat beneath the eyes. Surgery to correct saggy or baggy eyelids (blepharoplasty) removes excess skin and fat from the upper and lower eyelids. Eyelid surgery can correct both drooping upper lids as well as puffy bags that develop on or below the eyes. A refreshed, more youthful look results from this surgery.

Forehead Lift
As we get older, the brow and forehead often show signs of aging. Due to the effects of sun and the pull of gravity, the skin begins to sag, resulting in lines between the eyebrows or “frown lines”, wrinkles across the forehead, and heaviness of the eyebrows and upper eyelids. These changes contribute to a tired, angry or sad expression that may not reflect the way you feel. A forehead or eyebrow lift corrects droopy eyelids and diminishes the horizontal lines and furrows that appear with aging. In this procedure, the muscles that cause forehead lines are removed and excess tissue that cause drooping of the brow are lifted. In the process, the eyebrows are raised and the forehead smoothed. The result is rejuvenation and overall brightening of the upper face. Dr. Sonne often performs the forehead lifting procedure using an endoscope through small incisions made in the hairline.

Nasal Surgery
The nose is the most defining characteristic of the face and even a slight alteration can greatly improve one's appearance. Surgery to resculpt the nose (rhinoplasty) involves rearranging or removing the underlying bone or cartilage to give the nose a more pleasing appearance. In doing so, rhinoplasty can decrease the size and change the shape of the nose. By improving its overall shape and appearance, the nose is brought into harmony with the rest of the face. In addition to improving the appearance of the nose, rhinoplasty is also performed to improve the movement of air through the breathing passages. During your consultation, Dr. Sonne will perform a thorough examination of your nose, taking into consideration all factors including skin type, age, deformity, and function of the nasal structures.

Chin Surgery
Chin augmentation (mentoplasty) uses implants to correct a receding chin or to strengthen a jawline. In general, when looking at your profile, the chin should approximate an imaginary line dropped from the edge of the lower lip. Sometimes it is necessary to augment the chin (build it up and bring it forward) in order to balance the profile. This procedure is often performed in conjunction with rhinoplasty (nose reshaping) to obtain the best possible profile. Results of these procedures are a more balanced appearance to the face.

Skin Resurfacing
With time, accumulated damage from the sun and loss of collagen fibers in the skin’s deeper layers results in a loss of skin elasticity. When this occurs, fine wrinkles form, especially around the eyes and the mouth. While this change is occurring in the deeper layers of the skin, the surface of the skin also changes, resulting in splotchy pigmentation and roughness. These changes, both at the skin’s deeper layers and at its surface, can be addressed with lasers and chemical peels. A chemical peel involves the application of a special mixture of chemicals to the skin with cotton swabs. A carbon dioxide (CO2) laser works by vaporizing the upper layer of skin. Both chemical peels and laser resurfacing can soften fine lines by tightening the deeper collagen layers of the skin, and in so doing will often result in a smoother, more youthful appearance to the skin and also help lighten areas of hyperpigmentation. These treatments can also be expected to give additional improvement and enhancement to the facelift and the eyelid surgery. Chemical peels and laser surgery are also used to treat pre-cancerous sun-damaged spots and acne scars. Laser surgery is used to treat sunspots, improve facial scars, and remove facial wrinkles.

Botox®
You laugh, you frown, and you concentrate. Over time, those expressions leave their mark upon your face. Wrinkles around the eyes ("crow's feet"), between the eyebrows ("frown lines"), and across the forehead wrinkles are caused by contractions of underlying facial muscles. Until recently, there was little that could be done to correct these wrinkles. Now, however, there is a non-surgical procedure that can dramatically reduce these wrinkles. Botox® (Botulinum Toxin A) is a purified biological protein. After treatment, the muscles relax and the overlying skin remains smooth and unwrinkled. Repetitive treatments can prevent new wrinkles from forming due to Botox’s unique protein composition. Botox can also be effective in eliminating the dynamic facial wrinkles of the upper portion of the face. An injection into the facial muscle weakens and reduces the muscular pull on the skin, eliminating the ability to form deep furrows or wrinkles. Botox injections will last approximately 3 months, and must be repeated.

Fillers
Various injectable filler substances can be used as non-surgical procedures to reduce wrinkles and plump the lips.

Collagen:  Collagen injections attempt to replace the age-related loss of collagen in the deeper layers of skin, called the dermis. Collagen is beneficial for decreasing deep creases found between the eyes and at the outside corners of the mouth. It may also reduce the effects of acne scarring. Collagen injections will last between three and four months depending on how quickly your body metabolizes it.

Fat Injection:  Body fat is an effective soft tissue filler. Fat injection transfers fat from one body part to another using liposuction surgery (to remove the fat). This procedure is used to diminish facial wrinkles and frown lines, and to provide definition to certain areas of the face, and fill out depressed areas caused by acne scarring. Fat injection is temporary and lasts about 9 months to a year. It is often used to enhance a facelift and is a good alternative procedure to fill the cheek-lip groove. This may be a suitable alternative to patients who are allergic to collagen or other materials.

Restylane®:  Restylane is hyaluronic acid in the form of a crystal clear gel that adds contours and fills depressions to smooth facial wrinkles and folds. Restylane has just recently received FDA approval, but has been used in Canada and Europe for over 5 years. It lasts between 3 and 6 months. Dr. Sonne ensures your comfort during treatment by administering a local anesthetic. During Restylane treatment, the gel is injected into the skin in tiny amounts. The gel fills the skin’s wrinkles and depressions by plumping it with natural volume brings a rebirth of smoothness to the surface.

The Woodruff Institute - Skin Care
With the myriad of skin care products available, determining the best regimen and products can be a daunting task. At The Woodruff Institute we continually research the many different skin care lines in order to provide our patients with the best there is to offer. The Woodruff Institute philosophy towards skin care is that we must first protect our skin to prevent future damage while repairing the damage that has already occurred. The energy and resources spent on reversing the signs of age and sun damage are wasted if we do not first protect ourselves adequately from future damage.

Protect:
Sunscreen:  The most essential step regardless of age, race, or geography is sunscreen. If you plan to be outdoors, even on a cloudy day, you should not leave home without applying sunscreen. There are sunscreens available for whatever your needs may be: waterproof, child safe, sensitive skin formulas and those for oily skin.

Antioxidants:  Antioxidants, such as vitamins C and E, have been shown to prevent damage caused by the sun. Ultraviolet light produces free radicals, which damages the skin’s DNA. Antioxidants neutralize these free radicals.

Repair: 
Retinoids:  Retinoids are derivatives of vitamin A. These unique medications were originally used to treat acne. Now, retinoids are also used to enact changes at the cellular level to reduce fine lines and wrinkles.

Glycolic Acids/AHAs:  Glycolic acids or alpha hydroxyacids lift away the dead top layers of skin, resulting in a brighter, smoother complexion.

Bleaching Cream:  Bleaching creams contain the medication hydroquinone, which can help lighten sun spots, melasma, and post-inflammatory hyperpigmentation.

Sensitive Skin:  People with sensitive skin are often unable to tolerate the agents found in many of today’s skin care products. The Woodruff Institute offers skin care products for even the most sensitive skin.

Products:
The Woodruff Institute is pleased to offer products from Dematologic Cosmetic Laboratories, LaRoche-Posay, and Skinceuticals. Please visit our product center for more information about these skin care products.

The Woodruff Institute - Dermatology Services
Healthy skin is essential for maintaining a healthy appearance. Your skin is the first thing that people see. Whether you have sun damage, skin cancer, rosacea, acne, psoriasis, or eczema, it can effect how you feel about yourself and how others react to you. If you have a skin problem you may likely spend more time thinking and caring for your skin than any other organ. At The Woodruff Institute, we are sensitive to how skin disease can affect one’s quality of life and self esteem. At the Woodruff Institute we offer a full range of medical and surgical skin care services. We specialize in the prevention, detection and treatment of skin cancer. Following her dermatology training, Dr. Lambert completed a fellowship to specialize in the surgical treatment of skin cancer. She is a member of the American College of Mohs Micrographic Surgery and Cutaneous Oncoogy.

-Full Body Skin Exams 
-Mohs Surgery 
-Basal Cell Carcinoma
-Squamous Cell Carcinoma 
-Melanoma 
-Actinic Keratoses
-Rosacea 
-Acne 
-Acne Scarring
-Psoriasis 
-Eczema 
-Warts
-Laser 
-Botox 
-Fillers
-Chemical Peels 
-Skin Care

The Woodruff Institute - Mohs Surgery
If you have had skin cancer and are not familiar with the Mohs surgery technique, please take a moment to read this page. Mohs micrographic surgery, an advanced treatment for skin cancer, offers the highest potential for complete eradication or cure – even if the skin cancer has been previously treated. Mohs surgery is used to treat two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma. Often skin tumors have a subtle appearance, with the visible portion representing only a small part of a larger, deeper tumor. Using a microscope, Dr. Lambert is able to trace out and remove the skin cancer. Doing so, Dr. Lambert is able to see beyond the visible disease, and to precisely indentify and remove the entire tumor, leaving healthy tissue intact and unharmed.

History:
Developed by Frederic E. Mohs, M.D., in the 1930s, the Mohs micrographic surgical procedure has been refined and perfected for more than a half a century. A procedure that once took several days to complete is now performed in a few hours.

Common Skin Cancer Treatments:
Skin cancers that are detected early can often be treated by curettage and electrodesiccation, cryotherapy, surgical excision, or radiation. However, if the tumor is in a cosmetically sensitive area, has been previously treated, is large, is not clearly defined, or arises in a scar, Mohs surgery offers the highest potential for complete removal of the cancer, while sparing the surrounding healthy tissue. Mohs surgery has superior cure rates to surgical excision with frozen sections. In Mohs surgery, the tissue is processed so that every cell along the margins is examined. With traditional frozen sections only a few samples of the whole specimen are examined, with the hope that the samples represent the entire tumor.

Procedure:
Mohs surgery is performed in the office under local anesthesia. As the procedure will take several hours to complete, we recommend that you eat before your procedure, bring a snack, bring reading material, and bring a friend or family member. Although you will be physically able to drive yourself home, you may be tired and have some swelling.

After a local anesthetic is injected into the area, the visible tumor is removed with a scalpel. A dressing is applied to the wound and the patient returns to the waiting room. Meanwhile, the first stage of tissue is taken to the laboratory (located in the office), where the tissue is processed and microscopic slides are prepared. Dr. Lambert reads the slides with the aid of a microscope and prepares a map of any remaining tumor.


If there is tumor present, the patient returns to the room, additional local anesthesia is administered, and another layer of tissue is removed (only in the areas where tumor remains). This second stage of tissue is brought to the laboratory where the process is repeated until the cancer has been completely removed.

Reconstruction:
The best method of managing the wound resulting from surgery is determined after the cancer is completely removed. Management of the surgical site is individualized to achieve the best results, preserving functional capabilities and maximizing aesthetics. A small wound may be allowed to heal on its own. Alternatively, the wound may be closed with stitches, a skin graft or flap. Dr. Sonne, the Woodruff Institute’s Facial Plastic Surgeon, is available on site to perform your reconstruction, if you desire.

The Mohs Surgeon:
A Mohs surgeon is a specially trained dermatologist who removes skin cancers and is also speically trained as a pathologist and reconstructive surgeon. The American College of Mohs Micrographic Surgery and Cutaneous Oncology (Mohs College) (www.mohscollege.org) is the oldest professional organization of physicians trained in Mohs micrographic surgery. To be accepted as a member of the Mohs College, a physician must complete a three-year residency in dermatology or a related field, plus a one- or two-year fellowship approved by the Mohs College that includes extensive training in pathology and reconstructive surgery. Physicians who have completed a Mohs College approved fellowship will, by virtue of their rigorous training, possess the skills and expertise necessary to perform Mohs microgaphic surgery at all levels of complexity.