Cosmetic Surgery
Cosmetic surgery is a type of plastic surgery that aims to improve a person’s appearance, but it should be approached with caution.
Procedures are available for almost any part of the body, but the choice to undergo cosmetic surgery should not be taken lightly. The results are often permanent, so it is important to be sure about the decision, to use an appropriate practitioner, and to have the right motivation.
A surgeon may refer a patient for counseling before surgery if they believe there is an underlying problem that cannot be solved by the surgery, or if the patient shows signs of Body Dysmorphic Disorder (BDD).
BDD can cause a person to that there is something seriously wrong with their appearance, when objective evidence suggests otherwise.
Reconstructive surgery is another type of plastic surgery. It aims to improve function and to give a normal appearance to a part of the person’s body that has been damaged, for example, after a mastectomy..
Types of cosmetic surgery
Breast surgery
Women may seek breast surgery to improve their body shape. Mammoplasty procedures may include:
Breast augmentation, or enlargement, traditionally performed using saline or silicone gel prosthetics, and now occasionally with fat grafting.
It may be carried out if the woman feels her breasts are too small, if one breast is larger than the other, or if the breasts have changed after pregnancy or breastfeeding. Some older women opt for this treatment when the breasts being to droop due to the skin losing elasticity.
In some women, a breast enlargement can boost self-esteem and improve their feelings about their sexuality. In some, however, existing problems remain. This is why women are encouraged to undergo counseling first.
Breast reduction can help provide relief from physical discomfort, while the aim of augmentation more often relates to appearance. Breast reduction may also reduce the risk of breast cancer in women who are at high risk of the disease.
Mastopexy, or a breast lift, involves removing skin and glandular tissue to make the breasts smaller and rearranging the remaining tissue to make the breast appear lifted.
Depending on how much volume a patient has lost or desires, mastopexy can be combined with an implant. While it is similar to a breast reduction, which removes a much greater amount of tissue, mastopexy is not usually covered by major insurance carriers as it is not deemed medically necessary.
Male breast reduction treats gynecomastia, an enlargement of the mammary tissue in men. It may be done by liposuction or with various scar patterns, often hidden around the nipple and areola.
Liposuction
Liposuction, or suction-assisted lipectomy, uses thin cannulas, or hollow metal tubes, to vacuum fat from various parts of the body, usually the abdomen, thighs, buttocks, hips, backs of the arms, and neck. Liposuction may also be used for male breast reduction.
Tools used in liposuction include standard, ultrasound, mechanical, and laser devices. They all tend to involve suction of fat through a tube.
To prevent complications, there is a limit to the amount of fat that the surgeon can safely remove, depending on whether the patient will be discharged immediately after surgery or admitted to the hospital.
Liposuction should not be intended as a weight-loss procedure. When performed in the right patient, the goal is to improve contour and decrease limited areas of fat deposits.
Complications are rare but possible. They include the accumulation of blood under the skin, known as hematoma, infection, changes in sensation, allergic reactions, damage to underyling structures, and unsatisfactory results. The doctor must discuss these with the patient beforehand.
Liposuction does not reduce the risk of developing diabetes, heart disease, or high blood pressure.
Vulvovaginal surgery
Cosmetic Vulvovaginal Surgery, also known as aesthetic or female genital surgery, or vaginal rejuvenation, is becoming an increasingly popular cosmetic surgery option worldwide due to its positive effects. This type of treatment can include a range of different procedures depending on each specific case and the desired outcome. Thousands of women choose cosmetic genital surgery each year to address problems of a physical nature as well as to enhance self-esteem and confidence.
In general, cosmetic genital surgery usually involves a combination of vaginoplasty: a surgical procedure to tighten the vagina, as well as labiaplasty or vulvaplasty: procedures that aim to reshape the vulva or labia (the outer and inner lips of the vagina respectively). These procedures are particularly popular among women who have experienced changes due to childbirth, significant weight loss, aging or injury.
There are many reasons to consider having cosmetic genital surgery, or why this option might be recommended by a doctor. These include:
A change in the contours of your vaginal structures (such as stretching)
Pain as a result of sexual activity, or other activities such as riding on a bicycle or on horseback
Reduced sensation during sexual intercourse, particularly as a result of multiple vaginal births
Many options are available as part of the overall cosmetic genital surgery procedure. The most commonly used one in the modern medical field involves the use of lasers to perform delicate incisions and reshaping that is as non-invasive as possible. The laser functions in a very similar way to the traditional scalpel, but allows for far greater precision, resulting in a more aesthetically pleasing result, as well as reduced bleeding. As part of the procedure, any excess tissue will be removed and all incisions will be sutured.
In the case of a labiaplasty, the surgeon will first consult with the patient regarding the contours of the labia and vulva that are desired. Prior to the operation, these are then are outlined with a surgical marker. In most modern procedures, a laser is again used to remove tissue that falls outside the desired contour. Skin staples are then put into place to bring the edges of the labia into alignment, following which absorbable sutures are used to replace these.
While these procedure is most often conducted under general or intravenous anesthesia, due to the sensitivity of the area, some pain is to be expected following the operation. Surgeons generally prescribe a powerful painkiller (often a pudendal block), which provides up to twenty-four hours of pain relief, to address this issue.
Lip Augmentation cosmetic surgery
The lips are some of the most attractive features on the face, and as a result are often the focus of cosmetic surgery procedures. Lips that are full and plump are often considered signs of health, beauty and youthfulness, and are aesthetically attractive to all. A deficit of these characteristics in your lips can lead to a lack of self-confidence and a desire to alter this aspect of your appearance. Fortunately, regardless of whether you have thinner lips due to genetic factors, the natural aging process or some kind of defect or injury, cosmetic medicine offers many different ways to enhance them.
One common form of lip augmentation comes in the form of lip injections, which use natural or synthetic filling material to plump up your lips, keeping them looking full for months at a time. More permanent solutions include lip implants and other surgical procedures that last for longer periods of time (if not indefinitely). Lip lifts, vermillion advancement, and permanent makeup are other options that are used by thousands of people each year to achieve their desired goal of healthy, attractive-looking lips, with the added benefit if increased self-confidence that goes along with it.
There are many reasons to consider lip augmentation as part of your cosmetic surgery package. These may include the following:
- Your lips have always a thin appearance, and all but disappear when smiling
- Your lips were once fuller, but have thinned with age
- The appearance of your lips makes you feel self-conscious or lacking in self-confidence
- Your lips appear out of proportion with the rest of your face, and need filling out to compensate for this
- Your lips are uneven (for example, one lip is larger than the other, or is larger on one side than the other)
- You are unsatisfied with the shape of your mouth in general
Alternatively, your lips are too large or full, and require reductive surgery to correct this issue.
Many methods for lip augmentation exist, and a combination of these are often required depending on the desired results and recovery time.
In fat transfer procedures, autologous fat (fat from your own body) can be taken by means of liposuction and injected into your lips to fill them out. Repeated injections are often necessary until the correct level of fullness is achieved. Fillers made from natural or synthetic material can also be used as a fat substitute to fill out the lips in a similar manner to the above. Surgical procedures, such as the use of a skin graft to add area and fullness, implants to permanently alter the size or shape of the lips, or a lip lift, in which loose skin on or around the lips is lifted and tightened to achieve a more aesthetically pleasing appearance, are also commonly used depending on the individual in question.
EAR CORRECTION SURGERY
A wide variety of cosmetic surgery procedures exist to target various parts of the body. Ear correction surgery, also known as otoplasty or ear reshaping, is a common procedure that aims to change the size, position, proportion, or other aesthetic properties of the ears. As everyone’s ears are different, the outcome of ear reshaping surgery can vary considerably depending on the desired changes and the specific ears themselves, but the procedures involved are generally considered to have a high success rate. These procedures can improve self-confidence in those who have problems with the way their ears currently look, and can be especially beneficial for children and teenagers.
There are a number of different approaches that are taken with regard to ear correction surgery depending on the characteristics of the ears themselves. In the case of ears that stick out too far, ear pinning procedures can help to flatten the ears against the head, resulting in a more aesthetically pleasing appearance. If one ear is positioned higher than the other, one or both of the ears can be repositioned in order to promote symmetry. Ears that are too large can be treated alone, or may need to be treated in conjunction with other ear-related issues.
There are many reasons for a potential recipient of cosmetic surgery to consider ear correction surgery. These might include some of the following:
- Ears that are either overly large or too small
- Ears that are out of proportion with the head, or are oddly placed in relation to other facial features or the shape of the head in general
- Ears that stick out too prominently or are overly noticeable
- Having received an injury that has altered the appearance of your ears in a way that is undesirable
Most cosmetic surgeons generally prefer to perform ear correction surgeries during childhood (assuming an aesthetic issue is noticeable), usually from the age of six. In children, the ear cartilage is softer than in adults, allowing for the shape of the ears to be moulded during surgery using splints, and with a minimum of damage to surrounding tissue. In adults, more cutting and repositioning of the harder cartilage is necessary in order to reshape the ear effectively. Depending on the changes that are necessary, cartilage may need to be removed, reshaped recontoured, or permanently sutured in order to achieve the desired result. A combination of these techniques is most often used.
Ear correction surgery procedures are mostly performed under general anaesthetic, with very little needed in the way of postoperative care or recovery time. Although the location of incisions (and subsequent scarring) is dependent on the specficial changes that need to be made, most surgeons make an effort to hide these in inconspicuous locations, such as behind the ear where it attaches to the head, or in the inner folds of the ear.
EYELID SURGERY
As most people know, your eyes are some of the most prominent features of the face, and ones towards which people are instinctively attracted. Eyes are also used in communication, and can say a lot about the personality and attitude of their owners. If the appearance of a person’s eyes is aesthetically unpleasant, then this can negatively affect people’s attitudes towards that person, while also decreasing self-confidence.
Fortunately, many cosmetic surgery procedures exist that can address issues relating to the eyes in different ways. Eyelid surgery, also known as an eye lift or blepharoplasty, is a popular procedure that is used by thousands of people around the world each year, with a high success rate that results in increased self-confidence and satisfaction with one’s appearance.
There are many good reasons to consider eyelid surgery as part of a cosmetic surgery procedure. These might include the following:
- Having excess skin that hangs down from above the eye socket, covering the natural folds of the upper eyelids in a way that is undesirable
- Having loose skin that hangs down from the upper eyelids, and especially that which covers the eyelashes
- Having upper or lower eyelids that appear puffy or sagging, resulting in eyes that look more tired or older than they really are
- Having grooves beneath your eyes that are noticeable deep in an aesthetically unpleasant way
- Having upper eyelid skin that impairs your vision in some way
- Having bags or dark circles under the eyes, resulting in a tired or sad appearance
- Having an upper eye surface that (possibly as a result of one or more of the above issues) is too small or too wrinkled to apply makeup properly
Eyelid surgery procedures can be performed on the upper or lower eyelids, or a combination of both. Following an evaluation of factors such as the muscle and bone structure underlying your face, and the symmetry of your eyebrows, the surgeon will decide how much material (such as skin, muscle, or fat) needs to be removed in order to achieve the desired results.
Eyelid surgery procedures generally target either the upper or lower eyelid (or sometimes both). In the case of the upper eyelid, the main incision line will usually be located at the natural eyelid crease. Lasers, rather than scalpels or similar cutting tools, are often used to remove excess tissue in an effort to reduce swelling and bruising. In the case of the lower eyelid, the traditional approach is to locate the main incision just below the eyelashes, or inside the lower eyelid itself (this approach is known as transconjunctival insicion). Most procedures are done under general anaesthetic and require around two weeks of recovery time.
Body procedures
Abdominoplasty, or “tummy tuck” reshapes and firms the abdomen. Excess skin and fat is removed from the middle and lower abdomen, with the aim of tightening the muscle and fascia of the abdominal wall.
This may be suitable after pregnancy or after losing a great deal of weight.
Other body contouring procedures
Buttock augmentation enhances the appearance of the buttocks by making them larger. The surgeon will either graft fat from another part of the patient’s body using liposuction. This is known as the “Brazilian Butt lift.” Silicone implants may also occasionally be used in the buttocks.
A buttock lift, or lower body lift involves removing excess skin from the hips, buttocks, and thighs in order to tighten and lift them. These procedures are often combined with abdominoplasty in patients who have lost a considerable amount of weight after bariatric, or weight loss, surgery, for example.
Facial cosmetic surgery
Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age, the skin becomes lax, and there may be drooping or hooding of the upper lids, and bags on the lower lids. Eyelid surgery may be functional, cosmetic, or both. It usually involves removing or repositioning excess skin and fat, and the procedure may reinforce surrounding muscles and tendons.
Surgery can change the shape of the face or tighten the skin.
In rhinoplasty, also known as a “nose job,” the surgeon reshapes the patient’s nose to improve the appearance and often breathing, too. It may involve reshaping the tip and reducing the bony hump at the upper aspect of the nose.
It can be performed with small incisions that are well hidden, often inside the nostrils. Surgeons do not recommend rhinoplasty until the patient is at least 15 years old, to allow for full growth of the cartilage and bone of the nose.
Otoplasty, or ear surgery, treats prominent or misshapen ears by surgically “pinning” the ear closer to the head with sutures, reshaping the cartilage, or both.
One or both ears may be treated. It is most commonly performed in children after of 5 or 6 years as the ears have essentially reached adult size by that age.
Rhytidectomy, also known as a facelift, aims to surgically remove wrinkles and tighten facial skin in order to achieve a more youthful appearance.
Typically, the incision is placed in front of and behind the ears, extending into the hairline in the temple area. The skin is lifted off the deeper facial tissue, redraped more tightly, and the excess skin is removed. The incisions are then closed with sutures.
The deeper tissues of the face and neck may also be tightened. Blepharoplasty, or eyelid surgery may be done at the same time.
A brow lift, browplasty, or forehead lift aims to remove signs of aging by raising drooping eyebrows and removing forehead wrinkles, or worry lines. It is often done alongside other cosmetic procedures to achieve a more harmonious facial appearance.
Chin augmentation aims to make the chin more prominent and provide a better balance of facial features. It may be done at the same time as rhinoplasty, depending on the measurements taken before surgery. It can be performed with either a prosthetic implant or through manipulation of the chin bone.
Malar, or cheek, augmentation can make the cheekbones more prominent. The surgeon may place an implant at the top of the cheekbones.
Peels, fillers, grafts, and laser treatment
Less invasive treatments may include peels, fillers, injections, grafting, and laser treatment.
Fillers can be used to iron out wrinkles and to make the lips look plumper.
Chemical peels may help treat acne, pock marks, scars, or wrinkles. A number of active agents may be used.
A light or superficial peel uses Alpha Hydroxy Acids (AHAs) such as glycolic, lactic, or fruit acids to treat the outermost layers of the skin. The treatment is not as deep as with some peels, so the recovery time is minimal.
A medium peel usually involves TCA (tri-chloroacetic acid) of various concentrations. It penetrates the dermis, or deep layer of the skin, to a greater depth than the light peels. The recovery and pain are more significant than the lighter peels. Redness and flaking may persist for several days or weeks.
A deep peel, or phenol peel, penetrates the skin to the deepest extent. As a result, it has the greatest impact on resurfacing the skin, but it also has the longest recovery time, and it can causing scarring and skin lightening.
Chemical peels have been shown to be safe and effective for both light and darker skin types.
Botulinum toxin, or botox, is the brand name of a toxin produced by the bacterium Clostridium botulinum (C. botulinum), first approved by the FDA in the 1980s for muscle spasm.
A range of cosmetic surgery procedures aim to improve appearance.
It is used to treat wrinkles and facial creases.
It acts by blocking the signal from nerves to the muscles that are injected. The injected muscle can no longer contract, or tighten, as forcefully as before, and this leads to a controlled relaxation of the muscles.
It is approved for treatment of frown lines on the forehead, crow’s feet, or lines around the eye, and axillary hyperhidrosis, or increased sweating of the armpits.
Apart from “botox,” several other brand names of botulinum toxin are now commercially available.
Soft tissue fillers, or dermal fillers, are medical device implants approved by the FDA for use in helping to create a smoother, fuller appearance in the face.
They can be used to treat nasolabial folds, cheeks, and lips, and to increase the volume of the back of the hand.
They can also reduce wrinkles, lines and scars, and augment soft tissue contours. They are not permanent, but they are degraded by the body, so repeat treatments may be necessary to maintain the effect.
Commercially available products include hyaluronic acid, poly-L-lactic acid (PLLA), calcium hydroxyapetite, and polymethylmethacrylate beads (PMMA).
These products normally come in a gel formulation that fine needles can inject into the deeper layers of the skin and underlying soft tissue of the face. Collagen injections are no longer performed because some patients experienced allergic reactions, some of them serious.
Complications can occur with facial fillers, and especially permanent fillers. Clinicians and patients are urged to check the contents of a filler and discuss all the implications of surgery before going ahead with a procedure.
Fat injections and fat grafting have broad applications in cosmetic surgery.
The patient’s own fat is collected from one part of the body using liposuction, and it is injected into areas requiring volume enhancement. It is usually applied to the face, including the lips, the hands, and depressions in skin contour.
The results are generally safe and long lasting, and it can have the additional benefit of removing fat from a place where it is not wanted. The fat is removed, washed, and purified and then carefully re-injected with specially designed needles. Sometimes the procedure needs to be repeated several times for best results.
Stem-cell enriched fat grafts have been trialed for reconstructive surgery, with promising results, suggesting that the procedure is reliable, safe, and effective. However, tumor growth may be an adverse effect, so further research is needed before stem cells can become central to plastic and reconstructive surgery.
Lasers and light-based facial treatment, also known as facial laser resurfacing or laser skin treatment, can help reduce fine lines, wrinkles, and abnormal pigmentation, such as sunspots. Treatment utilizes concentrated, pulsating beams of light.
A variety of laser types are used and these vary in aggressiveness and downtime. It may take several sessions to see results.
Hair transplantation
Surgery can return hair growth to those with hair loss.
Hair transplantation is a kind of cosmetic surgery. can help renew hair growth.
Tiny hair follicle grafts are obtained from the back of the scalp, where hair tends to be denser. It is then transplanted with minute incisions to the areas of the scalp that are affected by hair loss.
Patients may need several sessions to achieve the desired results. After 6 weeks, the transplanted hair will fall out, but about 3 months later, new hair will appear.
Anyone who is considering cosmetic surgery should stop smoking or using any tobacco products several months prior to any procedures, as they can interfere with wound healing.
