As cosmetic surgery becomes increasingly popular for men and women, new options which minimize scars, discomfort
and recovery have also become available for improving the appearance of the face, breasts and body. These advances in surgical technique have made plastic
surgery increasingly predictable
and effective with the vast majority of procedures
safely performed on an outpatient basis.
Breast enhancement procedures
include breast augmentation,
breast lifts and breast reductions. While saline implants
remain the standard for increasing breast size with excellent results, new generation silicone implants may soon become available providing another option in breast augmentation. Insertion
of the implants through minimal incisions around the nipple or through well-concealed incisions in the underarm (trans-axillary) with use of the endoscope is now standard. Short scar techniques for breast lifts with or without implants and breast reductions have been developed which allow plastic surgeons to minimize the large scar previously required
under the breast.
Liposuction is a safe and effective
procedure routinely used to contour the abdomen,
hips, flanks and thighs. The tumescent technique is used which minimizes post-operative swelling and bruising
and also allows the procedure
to be performed under twilight sedation in select instances. Power-assisted liposuction
and ultrasonic liposuction
may be suggested for treating areas such as the male breast and the back where the tissues are firmer.
Facial plastic surgery has shown dramatic recent advances
in improving the appearance
of the skin, forehead,
eyelids, cheeks, neck and mouth. With non-surgical
methods of skin rejuvenation
such as chemical peels and microdermabrasion,
patients can restore a more youthful texture and
luster to the skin with minimal
recovery and virtually no discomfort. Botox used for kinetic wrinkles has allowed plastic surgeons to virtually
erase deep frown lines across the forehead, between the eyebrows and the tell-tale “crowsfeet” lines at the outer corner of the eyes. Restylane
and other new generation
soft-tissue fillers are routinely used in the office to treat deep or superficial static wrinkles in the naso-labial and peri-oral region. Lip augmentation is a very frequent technique used to enhance naturally small lips or to correct volume loss in the lips due to aging. These new FDA approved synthetic soft-tissue fillers have effectively
quadrupled the duration
of benefit over previously
used animal collagen products. Additionally, fat grafting is now a standard technique used in the operating
room to achieve similar effects potentially with permanent results.
Surgical techniques to enhance
facial appearance have focused on minimizing scars and restoring volume to the aging face through repositioning of structures beneath the skin or replacement
with fat grafting. Use of the endoscope through small scalp incisions allows improvement in brow position
and smooths transverse crease lines in the forehead. Small absorbable anchors to maintain brow position through upper eyelid incisions
alone show great promise and may completely replace scalp incisions in select
patients. The internal or transconjunctival approach to lower eyelid surgery removes
visible fat pockets and completely avoids an external
incision. Barbed sutures to lift the cheek pads and jowls may provide an interim
or “bridge” facelift without
surgery and show great promise, as do lesser facial surgery techniques such as the “S-lift” and other minimal
incision face and neck rejuvenation procedures.
A recent advance in post-operative
pain management is the “pain pump”, now routinely
used on abdominoplasty
(tummy tuck) procedures,
breast augments, lift and reductions and many
orthopedic and gynecologic operations. This device automatically
delivers an anesthetic
at a controlled rate to the operative site generally over three days and enables patients to use less narcotic pain medication. This allows better early mobility and improves
respiration and circulation,
thus reducing risk of post-operative complications.
It is important to carefully select your plastic surgeon when you are considering any cosmetic or reconstructive
plastic surgery procedures.
The American Board of Plastic Surgeons (www.plasticsurgery.org) can provide
a list of board-certified plastic surgeons in your area.