Abdominoplasty ("Tummy Tuck")
Sometimes after multiple pregnancies or large weight loss, abdominal
muscles weaken, and skin in the area becomes flacid. Abdominoplasty
can tighten the abdominal muscles and, in some instances, improve
stretch marks. In both men and women, the procedure will remove excess
skin and fat. Generally, an incision is made across the pubic area
and around the umbilicus (navel). When skin laxity and muscle weakness
is confined to the lower part of the abdomen, a modified abdominoplasty
that limits tissue removal and muscle repair to the area below the
umbilicus may be performed. This usually leaves a shorter scar and
no scarring around the navel. Alpha Hydroxy Acids
Alpha hydroxy acids are derived from foods, such as fruits and milk,
and can improve the texture of skin by removing layers of dead cells
and encouraging cell regeneration.
Augmentation Mammoplasty
(see Breast Augmentation)
Blepharoplasty
(see Eyelid Surgery)
Breast Augmentation (Augmentation
Mammoplasty)
Breast augmentation is typically performed to enlarge small breasts,
underdeveloped breasts or breasts that have decreased in size after
a woman has had children. It is accomplished by surgically inserting
an implant behind each breast. An incision is made either under the
breast, around the areola (the pink skin surrounding the nipple) or
in the armpit. A pocket is created for the implant either behind the
breast tissue or behind the muscle between the breast and the chest
wall.
Breast Lift (Mastopexy)
Frequently, a woman elects this surgery after losing a considerable
amount of weight, or losing volume and tone in her breasts after having
children. The plastic surgeon relocates the nipple and areola (the
pink skin surrounding the nipple) to a higher position, repositions
the breast tissue to a higher level, removes excess skin from the
lower portion of the breast and then reshapes the remaining breast
skin. Scars are around the areola, extending vertically down the breast
and horizontally along the crease underneath the breast. Variations
on this technique, in some cases, may result in less noticeable scarring.
Breast Implants (Textured-Surface)
The shell of textured-surface breast implants are made with the same
silicone elastomer that is used for the shell of other types of breast
implants, but a special manufacturing process creates a textured surface.
Breast Reduction (Reduction Mammoplasty)
Breast reduction is normally classified as a reconstructive procedure,
since oversize breasts interfere with normal function and physical
activity. However, there is an important aesthetic component to the
operation, since the plastic surgeon can improve the shape of the
breasts and nipple areas. Breast reduction involves removing excess
breast tissue and skin, repositioning the nipple and areola (the pink
skin surrounding the nipple) and reshaping the remaining breast tissue.
Buccal Fat Pad
Buccal fat pads are located above the jawline near the corner of the
mouth. They can be removed in individuals with excessively round faces
to give a more contoured look, sometimes referred to as the "waif
look." However, plastic surgeons warn that, in some individuals,
removal of the buccal fat pads can lead to a drawn, hollow-cheeked
look as aging progresses.
Buttock Lift
Excess fat and loose skin in the buttock area can be reduced by performing
a buttock lift in combination with lipoplasty (liposuction). Incisions
required for skin removal can often be hidden in the fold beneath
the buttocks.
Calf Augmentation
Increased fullness of the calf can be achieved using implants made
of hard silicone which are inserted from behind the knee and moved
into position underneath the calf muscle.
Cannula
A hollow tube attached to a high-vacuum device used to remove fat
through liposuction. The plastic surgeon manipulates the cannula within
the fat layers under the skin, dislodging the fat and "vacuuming"
it out.
Capsular Contracture
Capsular contracture is the most common problem associated with breast
implants. It occurs when naturally forming scar tissue around the
implant shrinks and tightens, making the breast feel firmer than normal
and sometimes causing pain and an unnatural appearance of the breast.
Cellulite
Cellulite is the dimpled-looking fat that often appears on the buttocks,
thighs and hips. While there is no treatment that will eradicate this
problem, aesthetic plastic surgeons are exploring new techniques which
may improve the condition. One method is to cut the fibrous tissue
that binds the fat down in these areas and creates the lumpy appearance,
and then to inject fact withdrawn from elsewhere in the body to smooth
out the unevenness. Another technique, called the cellulite lift,
surgically removes excess skin and fat, leaving a thin scar that may
extend around the full circumference of the abdomen but is placed
discreetly within bikini lines.
Chemical Peel
Fine lines and wrinkles around the mouth and on the forehead and cheek
areas may be improved with a wide range of skin treatments. A chemical
peel solution is applied to the entire face or to specific areas to
peel away the skin's top layers. Several light to medium-depth peels
can often achieve similar results to one deeper peel treatment, with
less risk and shorter recovery time. Peel solutions may contain alpha
hydroxy acids, tricholoracetic acid (TCA) or phenol as the peeling
agent, depending on the depth of peel desired and on other patient
selection factors.
Chin Augmentation (Mentoplasty)
Chin augmentation can strengthen the appearance of a receding chin
by increasing its projection. The procedure does not affect the patient's
bite or jaw. There are two techniques: one is performed through an
incision inside the mouth and involves moving the chinbone, then wiring
it into position; the other approach requires insertion of an implant
through an incision inside the mouth, between the lower lip and the
gum, or through an external incision underneath the chin.
Collagen Injections
Collagen is an injectable protein that can be used to treat facial
wrinkles. Patients to be treated with collagen should first be tested
for any allergic reaction. The results of collagen injections are
not permanent, and treatments must be repeated periodically to maintain
results.
Dermabrasion
Dermabrasion is a procedure in which a high-speed rotary wheel, similar
to fine-grained sandpaper, is used to abrade the skin. It may be recommended
when there is extensive sun damage and heavy skin wrinkling. In addition,
dermabrasion can be used to improve the texture of pockmarked skin
resulting from severe acne or chicken pox. Following treatment, the
skin should appear firmer and smoother, but permanent pigment changes
may occur.
Earlobe Reduction
A simple, 30-minute procedure, earlobe reduction can be performed
in a plastic surgeon's office or at the same time as a facelift operation.
The earlobe should not comprise more than 25 percent of the total
length of the ear. In cases where it exceeds this dimension, an L-shaped
wedge is cut away, the earlobe edges are brought together and sutured.
Eyelid Surgery (Blepharoplasty)
Aesthetic eyelid surgery can brighten the face and restore a more
youthful appearance by reducing the fat that causes bags beneath the
eyes and removing wrinkled, drooping layers of skin on the eyelids.
Blepharoplasty is often performed along with a facelift or with other
facial rejuvenation procedures. Incisions follow the natural contour
lines in both upper and lower lids, or can be done through the lining
of the lower eyelid, providing access to skin and fatty tissue. The
thin surgical scars are usually barely visible and blend into the
eyes' natural lines and folds.
Facelift (Rhytidectomy)
A facelift can reduce sagging skin on the face and neck. Incisions
are placed in the hairline and then pass in front of and behind the
ears; the exact design of incisions may vary from patient to patient
and according to the surgeon's personal technique. For younger patients,
more limited incisions may be appropriate. When necessary, removal
of fatty deposits beneath the skin and tightening of sagging muscles
is performed. The slack in the skin itself is then taken up and the
excess removed. Scars can usually be concealed by hair and makeup.
Fat Injections
Fat withdrawn from one body site can be injected into another -- for
example, to smooth lines in the face or build up other features such
as the lips. In most cases, a percentage of injected fat is resorbed
by the body, and the procedure must be repeated. Injection of fat
to enlarge the breasts is a dangerous procedure and is not recommended
because of the possibility of dense scarring that may seriously hinder
accurate interpretation of both breast self-exams and mammograms.
Fibrel
Fibrel is a synthetic substance which is an alternative to collagen
and fat injections for the treatment of facial wrinkles. As with collagen
and fat, fibrel treatments must repeated at intervals to maintain
correction.
Forehead Lift (Brow Lift)
The forehead lift is designed to correct or improve skin wrinkling,
as well as loss of tone and sagging of the eyebrows that often occurs
as part of the aging process. The procedure may also help to smooth
horizontal expression lines in the forehead and vertical frown lines
between the eyebrows. Incisions are placed behind the hairline above
the ear and pass over the top of the head. In some cases, incisions
may be placed in front of the hairline. Some patients may have the
procedure performed with the use of an endoscope, requiring much shorter
incisions. Improvements are made beneath the skin and on the deep
muscles; skin and muscle are then tightened to give a fresher, more
youthful appearance.
Hydroxyapatite Granules
Hydroxyapatite granules are a bone substitute made from coral that
can be used to enhance facial contours, such as forming more prominent
cheekbones. The substance also has reconstructive uses in craniofacial
surgery.
Lasers
Lasers can be effectively used to eliminate surface blood vessels
on the face that become reddened and enlarged due to sun exposure.
The problem is most often seen in fair-skinned individuals who cannot
tan or have difficulty tanning. The use of lasers for skin resurfacing
is effective in reducing the effects of sun damage. Laser resurfacing
is an alternative to chemical peel for some patients.
Lip Augmentation
A permanent method of augmenting the lips is accomplished by surgically
advancing the lip forward, with incisions placed inside the mouth.
A dermal-fat graft, taken from the deeper layers of the skin, may
then be positioned under the mucosa (the lining of the lip) to add
additional "plumpness." Injecting fat collagen or other
substances for lip augmentation is another alternative. The correction
is not permanent, and injections must be repeated periodically to
maintain results.
Lip Lift
A technique that surgically lifts the corners of the aging mouth can
eliminate the pronounced droop and unhappy facial expression that
often develops with advanced age. By cutting away small diamonds of
skin just above the corners of the mouth, the vermilion (border of
the lips) is raised into a slight smile.
Lip Reduction
To reduce the lips, a small strip of the mucosa (the lining of the
lip) is surgically removed to narrow the lips to the desired proportion.
The small scars on the outside of the lips are barely noticeable.
Lipoplasty (Liposuction)
Lipoplasty allows the plastic surgeon to remove localized collections
of fatty tissue from the legs, buttocks, abdomen, back, arms, face
and neck using a high vacuum device. The procedure leaves only minute
scars, often as short as one-half inch in length or less. The use
of refined equipment allows removal from delicate areas such as calves
and ankles. Lipoplasty removes fat, but it cannot eliminate dimpling
or correct skin laxity. If a patient's skin has lost much of its elasticity,
the plastic surgeon may recommend a skin tightening procedure such
as a thigh lift, buttock lift or arm lift, all of which leave more
extensive scars.
Malar (Cheekbone) Augmentation
The cheekbones may be built up by placing an implant over them. This
is usually performed through an incision within the mouth, but it
may be done through a lower eyelid or brow lift incision.
Mastopexy (see Breast Lift)
Otoplasty
(Ear Surgery)
The ears are positioned closer to the head by reshaping the cartilage
(supporting tissue). This is usually accomplished through incisions
placed behind the ears so that subsequent scars will be concealed
in a natural skin crease. Otoplasty can be performed on children as
early as age five or six.
Peel: Buffered Phenol
Buffered phenol offers yet another option for severely sun-damaged
skin. One such formula uses olive oil, among other ingredients, to
diminish the strength of the phenol solution. Another slightly milder
formula uses glycerin. Buffered phenol peels may be more comfortable
for patients, and the skin heals faster than with a standard phenol
peel.
Phenol
The chemical phenol is sometimes used for full-face peeling when sun
damage or wrinkling is severe. It can also be used to treat limited
areas of the face, such as deep wrinkles around the mouth, but it
may permanently bleach the skin, leaving a line of demarcation between
the treated and untreated areas that must be covered with makeup.
Platysma
The muscle which, when tight and firm, gives the neck underneath the
chin and jawline its youthful contour. The platysma muscle can be
tightened during a facelift or as a separate procedure.
Reduction
Mammoplasty (see Breast Reduction)
Retin-A
Retin-A cream may be applied to enhance the overall texture of the
skin and is often prescribed as a pre-treatment prior to a facelift
or chemical peel.
Rhinoplasty: Open
The open rhinoplasty technique can sometimes benefit patients who
need more complex correction or are undergoing a secondary rhinoplasty
procedure. A small incision is made outside the nose across the columella
(the tissue that divides the two nostrils). This enables the plastic
surgeon to turn the outer tissue of the nose back, providing visualization
of the structures inside. Additional incisions, like those used in
the traditional closed approach, are made inside the nose as well.
The scar resulting from the incision on the outside of the nose eventually
becomes barely visible.
Rhinoplasty (Nose Reshaping)
Rhinoplasty is usually performed to alter the size and shape of the
bridge and tip of the nose. Reshaping is generally done through incisions
inside the nose, but there may also be an incision passing across
the central portion of the nose between the nostrils. It is sometimes
necessary to narrow the base of the nose or reduce the size of the
nostrils, which involves removing small wedges of skin at the base
of the nostrils. The nose is reduced, or sometimes built up, by adjusting
its supporting structures, which is done either by removing or adding
bone and cartilage. The skin and soft tissues then redrape themselves
over this new "scaffolding."
Rhytidectomy
(see Facelift)
SMAS
The superficial musculoaponeurotic system (SMAS) is a layer of tissue
that covers the deeper structures in the cheek area and is in continuity
with the superficial muscle covering the lower face and neck, called
the platysma. Some facelift techniques lift and reposition the SMAS
as well as the skin.
Superficial Syringe Liposculpture
Use of a syringe to withdraw fat, instead of vacuum suctioning pumps,
allows for less blood loss and speedier postoperative recovery. Superficial
syringe liposculpture is performed on the layer of fat just beneath
the skin.
Tattooing (Cosmetic)
Cosmetic tattooing, or micropigmentation, can be used for permanent
eyeliner, eyebrows or lip color. It can also be used for permanent
blush and eyeshadow, though this is infrequent. Other uses by plastic
surgeons include recreating the coloration of the areola around the
nipple following breast reconstruction; restoring the color of dark
or light skin where natural pigmentation has been lost through such
factors as vitiligo, cancer, burns or other scarring; and eliminating
some types of birthmarks or previous tattoos. Micropigmentation should
be performed only under medical supervision by appropriately trained
personnel.
TCA
Trichloroacetic acid is used for peeling of the face, neck, hands
and other exposed areas of the body. It has less bleaching effect
than phenol, and is excellent for "spot" peeling of specific
areas. It can be used for deep, medium or light peeling, depending
on the concentration and method of application.
Thigh
Lift
A thigh lift can be performed to tighten sagging muscles and remove
excess skin in the thigh area. Because a thigh lift leaves noticeable
scars in the inner or outer thigh area that some patients find undesirable,
it is not a frequently performed procedure.
Tissue
Expansion
Tissue expansion is a technique in which skin or other tissue is stretched
using inflatable balloons. It can be of particular value in performing
breast reconstruction, breast enlargement or treatment of male pattern
baldness.
Transconjunctival Blepharoplasty
Transconjunctival blepharoplasty (eyelid surgery) is performed by
making an incision from inside the lower eyelid. It avoids any scarring
on the lower lid. It is a useful technique when only fat, and not
skin or muscle, needs to be removed from the eyelid area.
Source: The American Society for Aesthetic Plastic Surgery (ASAPS)
is the leading organization of plastic surgeons certified by the American
Board of Plastic Surgery (ABPS) who specialize in cosmetic surgery
of the face and the entire body.
