Introduction to Plastic and Cosmetic Surgery

What is Plastic Sugery?

The Changing Attitude

Who and When

Things to Consider

The Goal

Initial Consultation

Preoperative Visit

Risks of Surgery

Where the Surgery is Performed

Anesthesia and Blood Transfusions

Healing

Revisions

WHAT IS PLASTIC SURGERY?

The word "plastic" is derived from the Greek word "plastikos" which means to mold or give form. The term "plastic surgery" then refers to the surgeon's work to mold or reposition tissue. The aim of this specialized field of medicine is to improve appearance as well as physical function, either by the patient's choice, or as an effort to minimize deformities resulting from accidents, disease, or birth defects.

The field of plastic surgery includes both aesthetic and reconstructive surgical procedures. Aesthetic procedures are primarily intended to improve facial and bodily features. Reconstructive surgery is generally involved with the correction of birth defects or other deformities that may result from illness, trauma, or cancer surgery.

It is important to understand that plastic surgeons are trained in both aesthetic and reconstructive surgery and that the knowledge of both is important to overall excellence in surgical results.

Some of the more frequently performed procedures in plastic surgery are:

Aesthetic procedures of the face, breast, and torso.

Correction of congenital deformities, such as cleft lip and palate.

Breast reconstruction following mastectomy.

The treatment and reconstruction of defects related to skin cancer.

Rhinoplasty.
Rhinoplasty is commonly performed to reduce or change the size and shape of the nose. It may also be performed to improve breathing or correct deformities resulting from injury or cancer.

Rhytidectomy or "face lift."
A face lift is an aesthetic procedure for the face, intended to improve or eliminate evidence of aging or sun-damaged skin. The procedure dramatically improves the wrinkled and sagging skin of the face, jowl area, and neck. With new, improved techniques for correcting deformities under the facial skin, the face lift results are now better and longer lasting.

Liposuction.
Suction-assisted lipectomy is a relatively new technique that removes localized collections of excess fatty tissue. Typical areas for suction-assisted lipectomy include the hips, thighs, buttocks, abdomen, as well as the facial and neck areas. Suction-assisted lipectomy has increased rapidly in popularity, largely because of minimal scarring and overall excellent results with a high degree of safety. Since being introduced in the United States in the early 1980's, it has become the most common single procedure done in plastic surgery.

Breast Augmentation/Breast Reduction.
Breast augmentation is the surgical enlargement of the breasts to correct either congenitally small breasts or breasts that have lost volume, typically after pregnancy. Breast reduction is a surgical procedure with a high degree of patient satisfaction that can reduce disproportionately large breasts and their associated symptoms of shoulder, back, and neck discomfort.

Blepharoplasty.
Blepharoplasty is a surgical procedure of the eyelids, intended primarily to eliminate wrinkled and redundant folds of the skin and prominent puffiness, which give the eyes an unwarranted tired or aged appearance. The surgery involves well-hidden incisions and primarily removes excess skin and fat from the upper and lower eyelids. In addition, there are reconstructive blepharoplasties intended to correct missing eyelids or eyelids whose function has been lost. We also offer laser blepharoplasty.

THE CHANGING ATTITUDE

Others see you as you see yourself. Our society demands that we be concerned about how we appear to others, but we, as individuals, are becoming increasingly concerned about how we feel about ourselves. Many people have found that when they take care of themselves, they feel better, and that others notice and respond positively to this increase in self-esteem.

An estimated 400,000 Americans will decide to have aesthetic surgery this year. This figure reflects not only an enormous growth in demand for plastic surgery in both women and men, but also a greater awareness of its availability. In today's mobile society, in which more and more people are finding their lives in a state of flux due to career transitions and changing relationships, plastic surgery is increasingly becoming a way to boost self-confidence and create that important first impression.

Aesthetic surgery has now become an affordable and common form of elective surgery for mainstream America. Aesthetic surgery is more widely accessible today due to advances in the field of plastic surgery which enable many patients to avoid costly hospital stays. In fact, most aesthetic procedures can now be completed on an outpatient basis.

Plastic surgery is no longer limited to women: an increasing number of men are realizing it is acceptable to be concerned about their appearance and have elected aesthetic surgery to advance their careers or to improve their image in the workplace.

WHO AND WHEN

People frequently ask who is a candidate for cosmetic surgery and at what age should a person consider such surgery. There is no one answer. Cosmetic procedures may be performed on young patients and may include surgery for problems such as protruding ears or nasal deformities. In adults, surgery for facial aging can be performed to correcvfects of gravity on facial features. There is no set age for this procedure. When the changes that accompany aging become bothersome, the time may be appropriate to consider surgery to correct these changes.

THINGS TO CONSIDER

Patients who may be considering aesthetic surgery should examine their expectations and motivations for undergoing any procedure. It is unrealistic to expect aesthetic surgery to solve life's problems. However, aesthetic surgery can improve the way you feel about yourself and, consequently, help you tackle these challenges with an improved outlook and perspective.

Following is a list of questions which you might want to ask yourself to determine whether you are a good candidate for aesthetic surgery.

What specific problems do I want treated?
You may want to change more than one aspect of your appearance. List these in order of priority.

Why do I want to do this?
Aesthetic surgery should be your decision (for example, not your mother's or your spouse's).

Can I afford aesthetic surgery?
Since the surgery is usually elective, you should plan and budget for it well in advance. Expenses for reconstructive surgery may be fully or partially covered by insurance. Insurance will generally not cover aesthetic surgery costs.

The ideal candidate for aesthetic surgery will be a psychologically stable and medically sound patient. Aesthetic surgery is an operation, and does carry some risks. However, when performed by a qualified surgeon who carefully screens his patients, these risks are minimal.

Having considered the above questions and your overall physical and mental health, your next step should be finding a qualified surgeon. Although many physicians now claim to "do plastic surgery," it is important that patients select the best qualified surgeon they can find: one who is board certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons. The American Board of Plastic Surgery is the only board that is recognized by the American Board of Medical Specialties in the field of plastic surgery.

THE GOAL

Cosmetic surgery uses the subtle reshaping of normal structures of the body to improve appearance in a natural way and to enhance self-esteem, not to change a person's overall appearance. Each patient also has individual anatomic limits to the changes that can be accomplished. The goal is to achieve a natural appearance without any hints of surgery having been performed.

THE INITIAL CONSULTATION

If you are considering cosmetic surgery, the initial consultation will be an important part of learning about the procedure you are considering and in selecting a surgeon. At The Center for Plastic Surgery, we require a consultation to identify your goals and expectations regarding the outcome of cosmetic plastic surgery, answer your questions, discuss your fears and concerns, and make recommendations about the appropriate procedure for you. At this time, we will take photographs to use in planning your procedure and for comparison afterwards. A member of our staff will discuss fees with you, including fees for your particular procedure and cost estimates for the surgical facility and anesthesia services. The staff also will give you copies of the surgical consent forms, and explain preoperative and postoperative care instructions.

PREOPERATIVE VISIT

When you decide to go ahead with the cosmetic surgery, we will request a deposit and will schedule the required preoperative visit and the date of your surgery. At the preoperative visit, we will review the photographs taken previously and again discuss the operative plan so that you clearly understand the procedure to be done and the goals of the surgery. Prior to this visit, you should review the preoperative and postoperative instructions you received at the initial consultation so we can answer any questions you may have about your care and recovery. We will give you prescriptions for any postoperative pain medication, antibiotics, etc. We also will ask you to sign the surgical consent forms. The remainder of your surgical fees should be paid two weeks in advance of your procedure, since these procedures usually are not covered by health care insurance.

RISKS OF SURGERY

There are risks in any surgical procedure, including cosmetic surgery . These risks include the possibility of bleeding, infection, poor healing and problems with the anesthetic. Although serious reactions to medication or surgery are possible, they are extremely rare. You can help reduce the risk of complications by following your presurgical instructions exactly. It is especially important that you avoid any aspirin or other anti-inflammatory medications to reduce the chance of bleeding. Smoking is a known cause of poor healing and should be avoided for two weeks prior to surgery. You also should avoid taking any over-the-counter or prescription medication without first checking with your surgeon and anesthesiologist.

WHERE SURGERY IS PERFORMED

Most cosmetic surgery is performed on an outpatient basis in the surgical facilities in our offices. These facilities are fully accredited by the American Association for the Accreditation of Ambulatory Surgical Facilities. This assures that our facilities are as safe and as modern as any hospital operating room while offering the convenience, comfort and privacy of an office setting. Some types of cosmetic surgery can also be performed on an outpatient basis at a local hospital.

ANESTHESIA AND BLOOD TRANSFUSIONS

Almost all cosmetic procedures require the assistance of an anesthesiologist to ensure your safety and health. Appropriate sedation or a full general anesthetic is essential to ensure your comfort, to reduce the difficulty of the surgery and to reduce the risk of complications. By having a qualified anesthesiologist to administer and monitor sedation, your surgeon and other staff can devote their attention to your procedure and your comfort.

Blood transfusions rarely are required for cosmetic surgery. If a transfusion may be necessary, we will help you make arrangements to donate your own blood before surgery. This is called an autologous blood donation. By receiving your own blood, there is little, if any, risk of a transfusion reaction or disease transmission.

HEALING

All surgical scars go through a period of healing for up to a year. For most patients, facial scars from cosmetic surgery will be inconspicuous. You should be aware that surgical scars of any type become increasingly noticeable for about three months after surgery. During this time, the scars become somewhat red and may be raised. Over about the next nine months, they begin to flatten, soften and fade. In rare cases, scars may remain more red or raised than normal. This is called a hypertrophic or overactive scar. Most overactive scars respond to mild topical steroid creams. In rare cases, injections of steroids into the scar are necessary.

REVISIONS

Occasionally, even after a year has passed, there may be a problem with the result. Usually these are small problems that can be remedied under local anesthesia in our office's minor procedure room. There is no charge for these revisions. In the rare case where a major revision is required in the first year after surgery, we do not charge a surgical fee. There may, however, be a small facility fee, and there will be a fee for any required anesthesia services.