COSMETIC SURGERY

JINI P ABRAHAM

Introduction• Cosmetic surgery is an optional procedure that is performed on

normal parts of the body with the purpose of improving a person’s appearance and/or removing signs of aging.

• Cosmetic surgery aims to improve the aesthetic appearance of a person.

• According to the statistics put forward by the International Society of Aesthetic Plastic Surgery (ISAPS) in 2011, the maximum number of cosmetic procedures were carried out in USA, followed by China, Japan, Brazil and Mexico.

• Out of the 15 million people worldwide who resorted to plastic surgery in 2011 to enhance their looks, there were no fewer than 466,231 Indians, placing India 8th in a league of 25 countries.

Types of Surgical procedures• Abdominoplasty (Tummy tuck)

• Blepharoplasty (Eyelid surgery)

• Phalloplasty (Penile liposuction)

• Mammoplasty – Breast augmentation (Breast implant)

Reduction mammoplasty (Breast reduction)

Mastopexy (Breast lift)

• Buttock augmentation (Butt implant) and Buttock lift

• Lip enhancement

• Rhinoplasty (Nose job)

• Otoplasty (Ear surgery/ Ear pinning)

• Rhytidectomy (Face lift)• Neck lift• Browplasty (Brow lift or Forehead lift)• Midface lift (Cheek lift)

• Genioplasty (Chin implant)

• Cheek augmentation (Cheek implant)

• Brachioplasty (Arm lift)

• Liposuction (Suction lipectomy)

• Keloid removal

• Labiaplasty

• Muscle paralysis, such as injections of botulinum toxin (Botox)

• Dermal fillers

• Chemical peels

• Microdermabrasion

• Non-surgical laser and intense light treatments

Types of Non - surgical procedures

• Abdominoplasty or tummy tuck is a type of cosmetic surgery used to make the abdomen more firm.

• The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall.

• Indications - Patients with loose or sagging tissues after pregnancy and major weight loss

Abdominoplasty

• Types – o Complete abdominoplastyo Partial abdominoplastyo Extended abdominoplastyo High lateral tension tummy tucko Floating abdominoplasty or FAB techniqueo Circumferential abdominoplasty

• Recovery depends on the problem to be treated and surgical technique. Full recovery takes 3–6 months, with further fading of scars thereafter.

Abdominoplasty

• Risks include bleeding, fluid accumulation, poor wound healing, skin loss, anesthesia complications, skin discoloration, asymmetry, recurrent looseness of skin, nerve damage, suture rupture or visible scar.

Abdominoplasty

• Blepharoplasty or eyelid surgery is the plastic surgery for correcting defects, deformities, and disfigurations of the eyelids and for modifying the eye region of the face.

• Excision and removal, or the repositioning (or both) of excess tissues, such as skin and adipocyte fat, and the reinforcement of the corresponding muscle and tendon tissues.

• Goal - Restoration of the correct functioning to the affected eyelids

Blepharoplasty

Blepharoplasty

• Breast augmentation or augmentation mammoplasty are plastic surgery approaches used to increase the size, change the shape, and alter the texture of the breasts of a woman.

• Indication – o Post - mastectomy breast reconstructiono Repair of the chest wound consequent to the removal of a cancerous

breasto Correct congenital defects of the breast

Breast augmentation

• For breast reconstruction, there are three types of breast implant devices – o Saline implants filled with sterile saline solutiono Silicone implants filled with viscous silicone gel

• Breast - implant devices presents the health risks such as adverse reaction to anesthesia, hematoma or wound infection.

• Complications specific to breast augmentation include breast pain, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue.

• The non – implant breast augmentation procedures are carried out by fat grafting techniques.

Breast augmentation

• Reduction mammoplasty is the plastic surgery for reducing the size of large breasts.

• Indications - Restoration of the bust that is proportionate to the woman's body, of the woman's self-image, and of her mental health.

• Contraindications – o Lactating women or has recently ceased lactating o If breasts contain unevaluated tissue masseso If she is suffering a systemic illness

Reduction mammoplasty

Breast augmentation

Reduction Mammoplasty

• Mastopexy or breast lift is the procedure for raising sagging breasts upon the chest of the woman by correcting and modifying the size, contour, and elevation of the breasts.

• In surgical practice, mastopexy can be performed as a discrete breast-lift procedure, and as a subordinate surgery within a combined mastopexy - breast augmentation procedure.

Mastopexy

• Buttock augmentation or gluteoplasty denotes the plastic surgery for the correction of the congenital, traumatic, and acquired defects and deformities of the buttocks and the anatomy of the gluteal region.

• The corrective procedures for buttock augmentation and buttock repair include the surgical emplacement of a gluteal implant, fat transfer and liposuction.

Buttock augmentation

• Rhinoplasty or a nose job is a type of plastic surgery for correcting and reconstructing the form, restoring the functions of the nose.

• Indications – o To resolve nasal traumao Congenital defect o Failed primary rhinoplasty

• The procedure is done by separating the nasal skin and the soft tissues from the osseo-cartilaginous nasal framework, suturing the incisions, and applying a pack to immobilize the corrected nose to ensure the proper healing of the surgical incision.

Rhinoplasty

• The non-surgical rhinoplasty procedure modifies slight defects of the nose by means of subcutaneous injections of biologically inert fillers.

Rhinoplasty

• Otoplasty denotes the surgical procedure for correcting the deformities and defects of the pinna.

• Indications - Reconstructing a defective, deformed, or absent external ear, consequent to congenital conditions and trauma.

Lip augmentation• Lip augmentation is a type of cosmetic surgery that aims to improve the

appearance of the lips by increasing their fullness through enlargement.

Otoplasty

• Liposuction or lipoplasty is a cosmetic surgery that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere.

• Removal of very large volumes of fat is a complex and potentially life-threatening procedure. The more fat removed, the higher the surgical risk.

• The procedure may be performed under general, regional, or local anesthesia. The safety of the technique relates not only to the amount of tissue removed, but to the choice of anesthetic and the patient's overall health.

• It is ideal for the patient to be as fit as possible before the procedure and not to have smoked for several months.

Liposuction

• Side effects – bruising, swelling, varying sized scars, pain and numbness

• Complications –o Allergic reaction to medicationso Infectiono Damage to the skino Skin necrosis (rare complication)o Puncture of an internal organo Contour irregularitieso Thromboembolism

Liposuction

• Botox is a purified form of botulinum toxin A. They work by blocking the nerves that contract muscles, softening the appearance of wrinkles.

• Botulinum toxin injections block certain chemical signals from nerves, mostly signals that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that underlie and cause wrinkles, such as frown lines and forehead furrows.

• Other conditions are lazy eye, cervical dystonia, muscle contractures or chronic migraine.

Botox

• Botulinum toxin injections usually begin working a few days after treatment. Depending on the problem being treated, the effect may last for three to 12 months. To maintain the effect, regular follow-up injections should be done.

• Side effects includes headaches, bruising, pain at the site of injection, and, in fewer than 1% of cases, drooping eyelids or eyebrows that return to their natural position within a few months.

Botox

• A chemical peel is a technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the dead skin to slough off and eventually peel off.

• The regenerated skin is usually smoother and less wrinkled than the old skin.

• Possible complications include photosensitivity, prolonged erythema, pigmentary changes, skin atrophy, and textural changes.

• Types - o Alpha hydroxy acid peelso Beta hydroxy acid peelso Jessner's peelo Retinoic acid peel

Chemical peel

• Laser in cosmetic surgery can reduce facial wrinkles, scars and blemishes.

• Laser treatment can improve minor facial flaws, such as:o Fine lines or wrinkles around or under your eyes, forehead or moutho Scars from acne or chickenpoxo Aged or sun-damaged skino Wartso Birthmarks such as linear epidermal nevio Enlarged oil glands on the nose

Laser Treatment

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