Why the “Plastic” in Plastic Surgery?

The word “Plastic” comes from the Greek word plastikos, meaning “To mold or shape”. Many of the first plastic surgeries were developed to close a difficult wound or replace tissues lost due to injury or cancer. These procedures often involved the formation of a skin flap to reshape or mold the defect so as to approximate the original shape.

What is Plastic Surgery?

Plastic surgery is a surgical specialty dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease. The art and science of plastic surgery is also involved with the enhancement of the appearance of a person through such operations as facelift, rhinoplasty, breast augmentation, and liposuction.

What is the difference between cosmetic and reconstructive surgery?

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient’s appearance and self–esteem.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly.

There are a number of “Gray areas” in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or cosmetic, depending on each patient’s situation. For example, eyelid surgery (blepharoplasty) – a procedure normally performed to achieve cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient’s vision.

Will I be able to tolerate the pain post – operatively?

Each patient will tolerate pain post–operatively in a different way. While some patients may describe the pain as an ache, others experience greater discomfort. Appropriate pain medications are prescribed for the post–operative patients, and these help minimize discomfort. Most facial cosmetic operations have minimal discomfort post– operatively. Liposuction is slightly more uncomfortable, and operations that require elevation or tightening of the muscles–such as an abdominoplasty or breast augmentation have discomfort equal to that of a C–section.

How long is the recuperative period and when can I return to work?

The length of time it takes to recuperate after plastic surgery varies depending on the procedure performed and the person operated on. Most patients will require assistance for the first two days. Then most patients are able to care for themselves, but may still need assistance if they have small children to care for. The specific lengths of disability are outlined below by procedure. These are approximations, and do not include return to exercise.
Eyelid Surgery
Usually can get around independently by the second day. With the use of sunglasses,one may feel comfortable going to the store by day 3–4, and with makeup could return to work by 5–7 days.
Facelift Surgery
Usually can get around independently by the second day. Usually do not feel comfortable going out in public for 5–7 days. Requires 10–14 days before returning to work if in the public eye.
Breast Surgery
Usually can get around independently by the second day. May return to work at 5–7 days if not required to lift more than 15 pounds.
Liposuction
Usually can get around independently by the second day, earlier if smaller number of areas treated. One can return to work and normal activities in 5–7 days.
Abdominoplasty
Patients may take between 2–4 days before getting around independently. The recovery is almost identical to C–section. One can return to a desk job at 5–7 days, other jobs 10–14 days.

When can I resume regular exercise?

The time a patient resumes regular exercises varies based on the operation performed. All patients are encouraged to start a slow walking routine on the second postoperative day. Regular aerobic and more vigorous activities are not allowed during the first 2 weeks in order to decrease the risks of bleeding, swelling, and bruising. Weight lifting and contact sports are allowed after 1 month in most cases.

What is a facelift?

A facelift or "rhytidectomy" is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn’t stop the aging process but merely “Sets the clock back”.

How long does a facelift last?

No one can say for sure. The clock is turned back, but keeps ticking. Ten years later, you will look better than what you would have looked without the surgery. Many patients never need a second lift, while others may desire further surgery 7 to 15 years later.

Can surgery be done without scars?

The scars from facelift surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

How long will I be out of work?

Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.

How can I hide things during the time until I return to normal?

Your surgeon will discuss post–operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.

Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post–op patients feel its well worth the effort.

What is Liposuction?

Liposuction is the surgical vacuuming of fat from beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not an effective method of weight loss.

What is the tumescent technique?

The tumescent technique involves injection beneath the skin of large volumes of salt water containing lidocaine, a local anesthetic and small amounts of adrenaline, a naturally occurring hormone which shrinks blood vessels. By injecting this solution to the fat prior to performing liposuction the plastic surgeon numbs the tissues and shrinks the blood vessels thereby eliminating pain and reducing and minimizing bleeding, bruising, and swelling. The tumescent technique permits some patients who were previously treated under general anesthesia to be treated under local anesthesia with sedation.

Who is a candidate for liposuction?

Generally people who have localized areas of protruding fat achieve the most dramatic results. Patients who are slightly overweight can benefit from liposuction. It is best to be at or near your normal weight. Good skin elasticity permits the skin to shrink easily to the reduced contour. There are no absolute age limits for liposuction.

What areas are most frequently treated?

In women, the single most frequently treated areas are the outer thighs, followed by the stomach. In men, the flank area or “Love handles” are treated most frequently.

Can liposuction tighten up a loose neck?

If there is excess fat in the area under the chin and the skin is taut, liposuction alone can produce a more sculpted, angular, and youthful jaw line. If, however, the skin of the neck is loose, or hanging even if there is excess fat, liposuction alone will not produce the desired result. Patients with loose skin usually require a face and neck lift in addition to, or instead of liposuction. In general, most patients who benefit from liposuction of the neck are under 40. Most patients over 40 will require some surgical skin tightening.

Liposuction seems very simple and safe. Are there any dangers?

Although liposuction is very safe and effective, it is a surgical procedure and can cause complications such as infection, bleeding, and nerve damage. In addition, aesthetic complications such as skin irregularity or waviness can occur if too much fat has been removed. Fortunately, complications are uncommon and most patients are satisfied with their results.

What will my nose look like after surgery?

In general, rhinoplasty, cosmetic nose surgery, is designed to reduce excess cartilage and bone in the nose, removing irregularities and bumps to give a straightened, smooth and, usually, smaller appearance. Adding tissue to enhance certain features of the nose can also occur. The overall trend in modern rhinoplasty is away from over–reduction of tissue which can reduce the ability to breath through the nose and towards individualized treatment of each segment of the nose to give a balanced and refined look without compromising function.

How long does the surgery take and what kind of anesthesia is used?

Usually, Rhinoplasty takes from one to three hours depending on the complexity of the condition of the nose. Most patients have sedation prior to and during the procedure while some patients request a general anesthesia. Nearly all rhinoplasty operations are done as outpatient surgeries.

Is there a lot of bruising afterwards and how long will it last?

This depends again on how complex the procedure is, but in general most patients experience five to seven days of purple discoloration and swelling around the eyes and upper cheeks. The nose itself will be swollen for around ten to fourteen days or longer, but subtle resolution of the swelling at the tip of the nose can take months to disappear after surgery.

I have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for rhinoplasty?

The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Many a times this results from trauma, such as a broken nose, but often patients with this condition cannot recall an episode where this might have occurred. The condition described in this question however, could also result from allergies or both the conditions can exist simultaneously. Careful examination is needed before surgery to separate the two conditions. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a cosmetic deformity of the nose is done at the same time the cost of this part of the procedure is usually not covered by insurance.

Where are the incisions placed during nose surgery?

In general, most or all of the incisions in rhinoplasty are hidden in the insides of the nostrils. While external incisions hidden in the creases where the nose meets the cheek can be used to narrow the nose, incisions on the bridge or tip are not usually used in cosmetic surgery of the nose.

Will my nose grow after surgery?

In general, our noses tend to elongate as we enter the middle years of our life and drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is expected to last a lifetime and regrowth of bumps and deformities corrected by the operation is a rare occurrence.