Monday, April 20, 2009
cosmetic surgery at a glance
Abdominoplasty ("tummy tuck") is one of many procedures designed to assist in body sculpturing or contouring and address hanging skin folds seen with normal age or after weight loss or pregnancy...
As with many other body contouring procedures, abdominoplasty surgery is not designed to replace healthy lifestyle choices such as an appropriate diet and exercise, which have a more profound effect on weight loss and overall health. Regrettably, weight loss may accentuate the already marked skin laxity and folds.
Breast Augmentation
Breast augmentation is a very commonly performed cosmetic surgical procedure. In 1998, survey figures reveal that 34% of North American women are dissatisfied with their breasts. In 2003, breast augmentation was the third most common cosmetic surgical procedure performed by members of the American Society of Plastic Surgery (with only Botox injections and microdermabrasion being more common).
Breast Reduction (Reduction Mammoplasty) and Breast Lift (Mastopexy)
Breast reductions are very commonly requested surgical procedures. Any woman seeking this surgical care perceives herself as having large breasts. As every large breasted woman does not desire a surgical reduction, there are often other factors in play. These are very personal but often include one or more of the following factors ...
Brow Lift (Forehead Lift)
The brow lift is a rejuvenating surgical procedure aimed at restoring a more youthful appearance to the brow, forehead and indirectly the upper eyelids. Patients seeking brow lifts usually have sagging brows and forehead skin. Typically this causes the patients eyes to look tired and upper lids to look heavy. They also notice deeper horizontal wrinkles in the forehead, made worse by repeated attempts to elevate the brow and often uncorrected by Botox®...
Chemical Peels - A Re-Emerging Art
Chemical peeling - The art and science is re-emerging, once again, as one of the most effective ways to combat skin aging. Chemical peels are one of the most frequently performed aesthetic procedures in North America. Its popularity continues to grow because of the versatility of conditions where chemical peels are of significant benefit...
Dermabrasion
Dermabrasion is one of three commonly used office-based surgical skin resurfacing and rejuvenation procedures. The technique takes its origin from ancient Egypt in 1500 B.C. where healers used a form of sandpaper to even out scars. Today the technique has seen over 3500 years of evolution.
Dermabrasion mechanically removes the most superficial layers of the skin and allows your skins normal healing properties to rejuvenate the skin itself. It is designed to reduce...
Eyelid Surgery (Blepharoplasty)
Eyelid surgery or "blepharoplasty" is a method of restoring a more youthful appearance to the eyes. The eyes themselves are seen as the most expressive feature of the face and often function to transmit our inner feelings. Blepharoplasty procedures correct wrinkles, puffy bags, and heaviness of the lids leaving patients with more open eyes and a youthful, and energized look.
The process of natural aging causes changes in the eyes that can make a person look tired or worn-out. Heavily wrinkled eye skin may...
Facelift (Rhytidectomy)
The face-lift (also known as the rhytidectomy) is a surgical procedure designed to restore a more youthful appearance to both your face and neck. It is intended to set back the clock and allow you to balance your inner feelings and outward appearance...
Lip Augmentation (Cheiloplasty)
Lip augmentation or "cheiloplasty" is a commonly requested cosmetic procedure. Many women are now seeking the "Paris" or full lip look so common amongst the Hollywood elite. In all lips, there are areas of natural fullness. The attractive upper lip is centrally full with slightly less volume toward the lateral edge of the mouth. The white roll above the red lip ("vermillion") tends to also be more prominent centrally than laterally. Attention to restoration of these features provides in vogue sexy lips...
Rhinophyma
Rhinophyma is a condition of very marked overgrowth (hyperplasia) of the sebaceous glands of the nose. The condition is part of the common skin disease rosacea. Rosacea is a chronic acneform disorder of the pilosebaceous units of the skin coupled with an increase in the reactivity of the local skin capillary beds to heat. Where women commonly suffer from one of three stages of rosacea, men more typically suffer the associated nasal overgrowth (rhinophyma). The sensitivity of the capillaries in women results in flushing and finally series of dilated small red veins visible at the surface of the skin...
Cosmetic Laser Surgery
Laser resurfacing is a very controlled burning procedure during which a laser vaporizes superficial layers of facial skin, removing not only wrinkles and lines caused by sun damage and facial expressions, but also acne scars, some folds and creases around the nose and mouth, and even precancerous and benign superficial growths. In a sense, the laser procedure creates a fresh surface over which new skin can grow.
While the Food and Drug Administration does not regulate how surgeons carry out these procedures, it is responsible for clearing lasers for marketing for the uses requested by the device's manufacturer.
Lasers in Cosmetic Surgery
Since their 1958 discovery, lasers have become a powerful industrial tool, but their applications in medicine have been truly revolutionary. One reason, says Richard Felten, a senior reviewer in FDA's Center for Devices and Radiological Health, is that lasers used as surgical tools can cut through tissue without causing excessive bleeding. In fact, lasers actually can coagulate tissue to stop bleeding. "That's something a knife can't do," Felten says. Also, for many internal procedures, surgeons can get the laser's energy to reach areas within the body more easily than with a scalpel. And finally, the wavelengths of the laser light itself lets surgeons use the device selectively on very specific types of tissues, such as port wine stains or hair follicles, without affecting nearby tissue.
But using lasers for facial skin resurfacing was discovered almost by accident, Felten says. In the course of treating acne scars with a laser, surgeons noticed that after resurfacing the skin around the scar to make the scar less visible, small adjacent wrinkles were greatly diminished.
"Resurfacing is very appealing to people," says Stephen W. Perkins, M.D., president of the American Academy of Facial Plastic and Reconstructive Surgery and of the Meridian Plastic Surgery Center of Indianapolis, Ind., "because it is a way of refreshing the skin's surface and getting a new layer of non-sun damaged and more youthful skin."
Collagen is a key fibrous protein in the skin's connective tissue, and it helps give the skin its texture. Natural aging and such factors as sun damage and smoking help break down the collagen layer so that the skin's once smooth surface develops wrinkles. New, more youthful collagen actually forms after laser treatment, says A. Jay Burns, M.D., partner in the Dallas Plastic Surgery Institute and assistant professor of plastic surgery at the University of Texas Southwestern Medical School.
Laser resurfacing can often make patients look 10 to 20 years younger, and the results can last for eight to 10 years, says Tina Alster, M.D., director of the Washington Institute of Dermatologic Laser Surgery in the nation's capital. But she warns that after surgery, patients must avoid sunbathing and destroying their skin again. Patients can have a repeat treatment after one year, but usually the first procedure is so successful a follow-up is not needed.
Lasers cannot rejuvenate skin on other parts of the body nor can laser treatment lift or remove sagging jowls or smooth out "crepey" or sagging neck skin. These conditions only respond to traditional cut-and-stitch surgical methods.
Is Resurfacing for You?
Not everyone makes an ideal candidate for laser resurfacing, Perkins explains. "Certain people with very sensitive skin cannot tolerate the medications and lubricants used on the skin during healing." Perkins also feels that the darker-skinned ethnic groups are not candidates because the laser treatment alters the color of skin too dramatically and unpredictably. Alster, on the other hand, believes that in the hands of a very experienced surgeon, people with darker skin tones, although not ideal candidates, can benefit from surgery.
Alster warns that anyone not mentally prepared for resurfacing or who expects instant results is not a good candidate. "This is not easy in-easy out surgery," she says. "Potential patients have to realize that there will be bruising and swelling and they will be holed up in the house for seven to 10 days," she says. "They will have a crusty, oozy, bruised, scabbed, raw-appearing face." Further, they should not expect unflawed skin. "I can't deliver that," she says. "I am not able to give unlined, unscarred skin." Patients, however, can expect a 50 percent or greater improvement.
They must also plan on at least 10 days of healing before applying any makeup. For satisfactory healing, that means following rigorous after-care treatment, including proper skin cleansing, the application of a skin lubricant, and the frequent changing of dressings.
What Are the Risks?
As with any medical procedure, patients may experience certain complications--most temporary--including a prolonged redness of skin, tenderness, easy flushing, and some pigmentary changes, like hyperpigmentation, when the skin appears darker than normal, says Rox Anderson, M.D., director of the Laser Center at Massachusetts General Hospital in Boston.
Other risks are more serious, and possibly permanent, including hypopigmentation, or lightening of the skin. "Somewhere between one to two years after treatment it becomes clear that there is a permanent lightening of the skin color where the resurfacing was done," he says.
And scarring may occur in about 2 percent of the cases, he adds, from poor postoperative care, during which time an infection may develop. Or a surgeon may go too deep during the procedure, creating an injury the skin cannot repair, says Alster.
Consider the case of Anne Jones (not her real name) in semi-rural Mississippi, a stay-at-home mom and a doctor's wife. Wanting to remove some mild acne scars, she went to a well-respected local plastic surgeon, but after a five-month recovery period, Jones realized that something had gone very wrong. "He had just burned my face," she says. It was red, with scar tissue all over, she adds.
Eventually, Jones went for help to an ophthalmologist who had extensive laser knowledge--many ophthalmologists use lasers for corrective eye surgery. He took one look at her and exclaimed, "Oh, I am so sorry this has happened to you." He told her that the surgeon had been too aggressive and had not used the right settings, so that her skin had retained too much heat and had been severely burned.
Because both qualified and unqualified practitioners are flooding the cosmetic laser surgery field, consumers may face some real hazards. "All of a sudden, there's widespread use of lasers by unqualified people," says Perkins, who notes that some laser manufacturers are so eager to sell their products that they stage one- or two-day meetings, or courses, for training. That means that even dentists, obstetricians, gynecologists, and family doctors are now offering laser surgery, says Alster.
"The person planning to do laser surgery must understand the basic physics of how laser energy is absorbed by tissue and how tissue responds," warns FDA's Felten. "Then that person should go where the surgery is performed and watch a skilled surgeon use the equipment." Besides that, says Anderson, the best people to work with lasers on skin conditions are the professionals who best understand skin and surgery of the skin: dermatologists and plastic surgeons.
"Sometimes people may choose the wrong laser, or a surgeon may believe more is better, which can lead to significant burning," says Alster. And some operators don't know they must keep wiping off the partially desiccated skin or that they must keep moving the hand holding the laser instrument during the procedure.
To date, no national policy exists for credentialing those planning to practice laser surgery. Felten says FDA is responsible for granting individual manufacturers permission to market their lasers for the specific indications requested. FDA also often recommends training needed to operate the lasers.
But credentialing is a state function, since states are responsible for the licensing of doctors and nurses, and standards for laser training vary from state to state.
That's bad news for patients like Jones. Two years have passed since her procedure and she has spent nearly $70,000 for both the initial surgery and subsequent consultations and corrective surgeries to remove the scarring. She says she has partially reclaimed her life. But she bitterly regrets undergoing the initial surgery. "I will never look right," says Jones. "I would never do this again."
Finding the Best Surgeon
Selecting a laser surgeon is just like picking a qualified doctor for any medical treatment. "Consumers ask more questions of auto mechanics," says Alster. "This is surgery and with it comes inherent risks and complications. While it is perceived as easy, it is not. When you are talking about skin, it is harder to treat than eyes."
The Internet is a good place to start the search. Consumers can find thousands of Websites, including those for specialists, laser and plastic surgery societies, and information pages. But consumers should be wary of assuming the accuracy of any information taken off the Internet because the unscrupulous can put up their own Web pages just as easily as can the qualified.
Alster suggests interviewing several doctors and evaluating their answers and their credentials. After all, she adds, it's the doctor's skill that counts--the laser is just the doctor's tool.
The next step is crucial: asking the right questions. Alster advises asking where the doctor has trained and if he or she owns or rents the equipment--those who own have likely made a commitment to training and to laser surgery. Ask to see before and after pictures of the doctor's cases, and find out how many different types of lasers the doctor owns and how often each piece of equipment is used. "There is not one laser that does everything," she says, cautioning patients to select a surgeon whose practice offers more than one laser system. "One needs to use [the right] laser for the right lesion. So the person examining you must make the correct diagnosis," she says. Alster herself has at least 10 different lasers in her office.
Of course, the final decision may be difficult, since no doctor can guarantee perfection or complete safety, but well-informed patients with reasonable expectations may be one step closer to younger, fresher-looking skin.
Who is best for a Face Lift?
| ||
| A Face Lift can make you look younger and fresher, and it may enhance appearance. If you feel young, this procedure can help make you look as good as you feel. | ||
| Anesthesia | ||
| Most Face Lifts are performed under local Anesthesia, combined with a sedative to make you drowsy. You'll be awake, but relaxed, and your face will be insensitive to pain. It may also be carried out under general Anesthesia, in which case you will sleep throughout the procedure. | ||
| Surgery | ||
| A Face Lift usually takes several hours. The exact placement of the incisions depends mainly on your facial structure and the areas to be worked on. Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin. When combined with a Brow Lift, a coronal incision will be used. This last incision follows a headphone-like pattern, starting at about the ear level and running across the top of the forehead and down the other side of the head and is usually made well behind the hairline so that the scar won't be visible. In general, the skin is separated from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The underlying muscle and membrane is then tightened and the skin is pulled back with the excess removed. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp. Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. A bandage wrap is generally used to minimize bruising and swelling. | ||
| Recovery | ||
| Back to work in 1-2 weeks. More strenuous activities 2-3 weeks. Must limit exposure to sun for several months. Duration of result is 5-6 years. |
Thinking of Cosmetic Surgery? Read this first!
Three years ago, when a 15-year-old British girl decided to get breast implants for her sixteenth birthday, the story made headlines around the world. Since then, media reports have continued to speculate that cosmetic surgery, once the exclusive domain of wealthy older women, is a trendy new option for any teenager with an adolescent hang-up.
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Dr. Darrick Antell, a top New York City plastic surgeon, says he has seen an increase in the number of teenage patients but cautions against calling it a trend. “One of the main reasons for the increase is visibility: today’s teenagers are growing up with parents who have had cosmetic surgery, so they see and hear about it more. The media has also done a good job of making people aware of the procedures available. Another reason is acceptability. In a way, plastic surgery has come out of the closet,” Dr. Antell says.
When details of cosmetic procedures are frequently discussed on talk shows and published in magazines, it’s not surprising that they filter into our consciousness. “Sometimes when I’m out to dinner with my friends, we’ll play a game called ‘What would you have done?’ where we sort of daydream and discuss what we would do if money was no object and the procedures were safe,” says 18-year-old Alison Preiss, an Ontario high school student. While Preiss doesn’t think she could actually go through with a procedure, she says it could go either way. “I could grow up to realize that there are more important things than my nose, or it could really bother me to the point where I decide to have surgery. I suppose it depends on my lifestyle and career choices,” Preiss says.
Suzanne Ma, a 19-year-old Ryerson University student, has considered a double eyelid procedure popular in Asia. “I’m Chinese, and I don’t like my eyes. I don’t have double eyelids, so I feel that my eyes look a lot smaller than they really are. My concerns are not entirely for cosmetic reasons. With my heavy eyelids, my eyelashes don’t grow out properly. Some of them get trapped under the eyelids and it’s very easy for me to get an infection,” Ma says.
As in North America, plastic surgery is booming overseas, especially in wealthier Asian countries like Taiwan and Korea, where it is seen as a way to improve career prospects and self-confidence. In China, women and some men are paying thousands of dollars to have a brutal surgical procedure performed that lengthens their legs so they can fulfill height requirements often used to narrow down the number of job applicants.
Although reasons for cosmetic surgery range from getting a better look to improving job prospects, often the common factor among patients is more than skin deep. “Teenagers who are thinking about having plastic surgery to change the way they look are often addressing issues of self-esteem,” says psychotherapist Dorothy Ratusny.
“Between the ages of 13 and 19, there’s a lot of emphasis on peers and what others think of you. It’s also a time when things such as not being part of the popular crowd, changes in financial situation and divorce can negatively affect a teenager’s self esteem.”
Cosmetic surgery may have a positive impact if your body image is consistently tied to a negative focus on a particular facial feature or body part. Dr. Antell says, “The classic case is a teenage patient of mine who had reconstructive surgery to correct a significant discrepancy between her upper and lower jaws. When she came into my office for the initial consultation she was constantly looking at the floor. After the surgery, she was looking up and smiling. Now she’s singing in her local school group.” Dr. Antell is careful to point out that there are murky areas. “Liposuction is one of those areas. So is breast augmentation because you’re not really sure that the teenager has stopped growing yet. But there are exceptions, for example, if a patient has breast asymmetry.” Dr. Mitchell Brown, a plastic surgeon at Sunnybrook and Women’s College Health Sciences Centre in Toronto says, “Correcting breast asymmetry, when women develop breasts that are different in terms of shape and size, can be appropriate for teenage girls because it causes a very significant psychological impact on them during their developmental years.
Doctors are very aware of the psychological drama affecting our lives and it has become a very important factor when evaluating a patient. Dr. Brown says, “The key thing from my perspective is to assess physical, emotional and psychological maturity before treating a patient. I spend a great deal of time with my patients, regardless of their age, to determine that they have thought out their concern carefully and have reasonable goals and expectations.” In other words, cosmetic surgery can improve a patient’s body but it won’t necessarily improve their self-image or guarantee happiness. Dr. Antell says, “I’ve done liposuction on a Sports Illustrated swimsuit model. This is somebody most people would think looked perfect. But she was very insecure. She didn’t see herself the way others did. I can’t give people confidence.”
So, if you’re considering cosmetic surgery you need to ask yourself what you hope to achieve because it’s not going to be the one magic solution that makes everything better. In fact, it may even change you for the worse—just surf the Web and read the thousands of horror stories from people hoping to find peace of mind or happiness by going under the knife.
Dr. Ratusny says, “[Teens] need to be really realistic with the fact that cosmetic surgery may be only one piece of many things that serve to improve aspects of themselves. There may be physical changes but the real change begins with who they are inside.”
Friday, April 17, 2009
plastic surgery encyclopedia
A cosmetic surgery is not always a perfect or better solution and it can go wrong due to a number of reasons. There are a number of risks involved in the cosmetic surgery. Aspiration can cause you mild discomfort, and it can also lead you towards a number of infections. Cosmetic surgery may also cause you chronic cough and obstruction in your lungs and pneumonia. If you are going to have an eyelid or eye surgery, then it may cause you infections, like dry eye problems and bleeding. It may also cause you blindness and can also damage your nerves. If you are going to have a chin surgery, then it may cause you one big problem, and that is skin infection or allergy. Another big problem that can be caused is the skin cancer. 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Information for Cosmetic Surgery
the all surgeries in america are done with the help of The American Board of Plastic Surgery. A lot of Hollywood stars resort to plastic surgery to sustain their youthful appearance so they can keep working and to some degree look good.such as
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The one thing that is often overlooked by many people is that, no matter if you are getting a facelift or tummy tuck, plastic surgery is a medical procedure and there are risks involved that should be greatly considered before going under the knife.

