MEDICAL
Most people would agree that an individual's personality and character are more important than how that person looks on the outside. However, that well-recognized fact does not minimize the importance of outward appearance. How a person looks can have a direct impact on how they feel about themselves. People, who don't like the way they look, can feel self-conscious and lack confidence. That's the real story behind today's cosmetic surgery. In most cases, it is about ordinary people with problems. It's not necessarily a problem with the way a person looks, but how that problem makes the person feel.
Whether it's a nose that's too big, breasts that are too small, or wrinkled, sagging skin, it is a problem that can often be solved with cosmetic surgery. There are procedures available that help people not only look better but feel better as well. Improved self-esteem and increased self-confidence are normal expected results.
Cosmetic surgery (also called nip and tuck and aesthetic surgery) enhances natural beauty. Skin, fat, and muscle are surgically removed, repositioned, reshaped, and/or tightened to rejuvenate, enhance, improve appearance, and balance body proportions. People that are sensitive or concerned about some aspect of their physical appearance, turn to cosmetic surgery to give a more youthful, refreshed, and balanced look so that they will feel better about themselves. Some have noticeable changes made, others, subtle refinements.
Cosmetic surgery is a form of plastic surgery. Taken from the Greek word "plastikos", meaning to mold or give form, plastic surgery is the specialty of medicine dedicated to restoring and reshaping the human body. It includes both reconstructive and cosmetic surgery.
The best patient is in good health generally, a nonsmoker, within twenty pounds of their ideal weight, not going through major life stress (i.e. grieving a death, changing jobs, divorcing), and motivated by internal desires to look better.
This personal desire may be influenced to some degree by the individual's role in society. Because today's culture is youth-oriented, people seek ways to counter the effects of aging on their appearance. Many elect surgery to look as young as they feel, to build confidence after a lifestyle change or to retain their edge against younger competitors. Surgery should be sought because the patient desires a change for himself or herself, not just to please a spouse, child, friend or any other person.
Whether a person is a good candidate for cosmetic surgery can only be answered after a consultation with a prospective plastic surgeon. There are many things to consider including psychiatric conditions, life stress, medical illness, obesity, and motivation. Improvements in appearance can be made at any age with cosmetic surgery. However, as a person gets older, the changes do not last as long and they may not be as dramatic.
More important than where the surgeon went to school is the type of training he or she received. Has the surgeon completed an accredited residency program specifically in plastic surgery? Such a program includes two or three years of intensive training in the full spectrum of reconstructive and cosmetic procedures. While a cosmetic surgeon may choose to concentrate on a limited number of procedures, this comprehensive background gives a solid foundation to his or her skills.
Although there's no magic number (of years or procedures), that defines "experience," the patient should feel comfortable that the surgeon chosen is well versed and up-to-date in the procedure that is being considered.
The importance of the initial consultation cannot be over emphasized. The doctor's personality, recommendations regarding the surgery being sought, fees and the way they answer questions can be evaluated. More than likely there will be a charge for this consultation whether or not the surgeon is chosen.
At the initial consultation, the cosmetic surgeon should clearly answer all questions. The doctor should question the patient regarding motivation for the surgery, goals and expectations. These should be discussed and an interest shown by the doctor to the patient's reaction to recommendations. The surgeon should review a patient's medical history to evaluate any medical condition that might affect the surgical result.
The doctor, where appropriate, should recommend alternatives to surgery. There should be no pressure to consider unnecessary procedures. Recovery time and postoperative care should be reviewed. Risks of surgery and also possible variations in outcome should be explained. If pictures of other patients or computer imaging to show possible results are presented it should be obvious that there is no guarantee that the patient's results will match these. The doctor should make it clear that the final decision is the patient's. Questions regarding the surgeon's professional qualifications, experience, costs and payment policies should be welcomed. Insurance does not usually cover costs for elective cosmetic surgery so it is important to discuss payment.
Body sculpture refers to reshaping the body through cosmetic surgery. This is done in the arms, legs and trunk. It treats the results of aging, obesity, weight increase or loss and the effects of pregnancy.
When talking about reshaping or sculpting the body, people usually think of the following eight operations.
Liposuction and ultrasonic liposuction is used for spot fat reduction in contouring the body. This is not used for weight loss although ultrasonic liposuction in stages can reduce large amounts of fat. Liposuction is done to remove localized areas of fat from many areas of the body. It is often hard for the patient to decide between an abdominoplasty and liposuction. Liposuction does not tighten skin although sometimes the underlying tissue seems pulled tighter by a thin layer of scar tissue (adhesions). Cellulite is not usually improved by traditional liposuction and in some cases may be made worse. Ultrasonic liposuction is just one of the various liposuction techniques used for effective fat removal. How ultrasonic liposuction differs from other methods is that ultrasound high frequency waves are used to break up the fat before it is removed.
Breast Augmentation enhances or enlarges the size of the breasts using implants. Since the advent of breast augmentation surgery in the 1960s, millions of women have enhanced their bodies with silicone and saline implants. Breast augmentation has become one of the most commonly performed cosmetic plastic surgical procedures.
Women who choose to have breast augmentation surgery do so to improve their self-image. Some feel dissatisfied because their breasts never developed to a size to meet their expectations. Others wish to bring balance to a breast that is somewhat smaller than the other. Often, women want this procedure to restore their natural breast volume that may have decreased as a result of pregnancy, weight loss or aging.
The most common placement for implants is submuscular or subpectoral, under the pectoralis muscle. This placement does not affect the ability to produce milk and to breast feed a baby. Implants can also be placed above the pectoralis muscle and below the breast tissue or gland. This is called subglandular. Submuscular augmentation usually requires a general anesthetic, whereas, the subglandular approach can often be performed with some intravenous sedation and local anesthetic.
The saline implants that are currently in use have a shell or envelope made of silicone plastic. Silicone "gel" implants that were used from the 1960's until 1992 have been the subject of much controversy and even resulted in the short term ban of silicone gel implants in 1992. After much investigation, the FDA declared in 2001 that silicone implants do not place women at increased risk of disease.
Breast tightening (mastopexy) sometimes called a breast-lift, firms and tightens the breast. It raises the nipple on the profile of the breast.
Over the years, factors such as pregnancy, breast-feeding a baby, and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast-lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts--at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. An implant may also be inserted along with the breast-lift.
Breast reduction (reduction mammoplasty) makes the breast smaller. It can sometimes be done with liposuction. Excessive breast enlargement (mammary hypertrophy) causes a number of medical and social problems including back and neck pain, poor posture, difficulty participating in recreational activities, finding clothes that fit well, social embarrassment and even harassment.
Breast reduction surgery is designed to make large breasts smaller, lighter, symmetrical and more proportionate to the rest of the woman's body. In most cases the areola is reduced in size and the nipples elevated to a more normal position. The scars on the breasts are carefully placed so they are relatively inconspicuous once faded and are hidden by a bra or swimwear (poor healing and wider scars are more common in smokers).
Abdominoplasty is sometimes called a “tummy tuck.” Abdominoplasty is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. It does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.
The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.
Brachioplasty (arm lift) is cosmetic surgery that tightens the upper arm skin when liposuction alone is not enough. Arm tissue relaxes and descends with aging, gravity, and weight loss. The drooping of skin is from stretching and loss of supporting fat. The extra sagging can result in significant "loose hammock" like deformity from the axilla (armpit) to the elbow. Some call this a "bat wing" deformity.
There are different degrees of ptosis (drooping) deformity. Brachioplasty arm reduction surgery can remove the excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and how loose the supporting tissues have become.
Thigh and Buttock Lift (body lifting) surgery is performed when a patient has excess skin rather than excess fat in the thighs, hips and buttocks. Patients who have lost 50 pounds or more often benefit from one or both of these procedures. Older patients, with pronounced wrinkling of the skin, can also benefit from a thigh and buttock lift.
This body lifting surgery is designed to improve skin texture and underlying tissue that has become loose and flabby due to weight loss or aging. If the skin has poor elasticity and will not contract with conventional liposuction, then body lifting procedures may be indicated. Body lifting changes the texture of the skin by stretching it, thereby making the crepiness and wrinkling less apparent. It may take six to twelve months to see the final result of body lifting surgery.
Gynecomastia (breast reduction in men) is a medical term that comes from the Greek words for "woman—like breasts." Though this oddly named condition is rarely talked about, it is actually quite common. Gynecomastia affects an estimated 40% to 60% of men.
It may affect only one breast or both. Though certain drugs and medical problems have been linked with male breast over development, there is no known cause in the vast majority of cases. The enlargement can be from excess glandular tissue or fat or both. For men who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured. Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body's new contours.
