PLASTIC SURGERY (HEAD TO TOE)

Saturday, April 4, 2009



INTRODUCTION

Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes a variety of fields such as craniofacial surgery, hand surgery, burn surgery, microsurgery, and reconstructive surgery. The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic. In plastic surgery the transfer of skin tissue (skin grafting) is one of the most common procedures. (In traditional surgery a "graft" is a piece of living tissue, organ, etc., that is transplanted.

  • Autografts: Skin grafts taken from the recipient. If absent or deficient of natural tissue, alternatives can be:
    • Cultured Sheets of epithelial cells in vitro.
    • Synthetic compounds (e.g., Integra—a 2 layered dermal substitute consisting superficially of silicone and deeply of bovine tendon collagen with glycosaminoglycans).
  • Allografts: Skin grafts taken from a donor of the same species.
  • Xenografts: Skin grafts taken from a donor of a different species.

Usually, good results are expected from plastic surgery that emphasizes:

  • Careful planning of incisions so that they fall in the line of natural skin folds or lines.
  • Appropriate choice of wound closure.
  • Use of best available suture materials.
  • Early removal of exposed sutures so that the wound is held closed by buried sutures.

1. Breast Augmentation

Breasts are enlarged by placing an implant behind each breast.

Risks:

  • implants can rupture, leak, and deflate
  • infection
  • hardening of scar tissue around implant, causing breast firmness, pain, distorted shape, or implant movement
  • bleeding
  • pain
  • nipples may get more or less sensitive
  • numbness near incision blood collection around implant/incision
  • calcium deposits around implant
  • harder to find breast lumps

2. Breast Lift

Extra skin is removed from the breast to raise and reshape breast.

Risks:

  • scarring
  • skin loss
  • infection loss of feeling in nipples or breast
  • nipples put in the wrong place
  • breasts not symmetrical

3. Breast Reduction

Fat, tissue, and skin is removed from breast.

Risks:

  • if nipples and areola are detached, may lose sensation and decreased ability to breastfeed
  • bleeding
  • infection
  • scarring
  • harder to find breast lumps
  • poor shape, size, or position of nipples or breasts

4. Eyelid Surgery

Extra fat, skin, and muscle in the upper and/or lower eyelid is removed to correct "droopy" eyelids.

Risks:

  • blurred or double vision
  • infection
  • bleeding under the skin
  • swelling
  • dry eyes
  • whiteheads
  • can't close eye completely
  • pulling of lower lids
  • blindness

5. Facelift

A facelift, technically known as a rhytidectomy (literally, surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful appearance. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. The first facelift was performed in Berlin in 1901 by Eugen Holländer.

In the traditional facelift, an incision is made in front of the ear extending up into the hairline. The incision curves around the bottom of the ear and then behind it, usually ending near the hairline on the back of the neck. After the skin incision is made, the skin is separated from the deeper tissues with a scalpel or scissors (also called undermining) over the cheeks and neck. At this point, the deeper tissues (SMAS, the fascial suspension system of the face) can be tightened with sutures, with or without removing some of the excess deeper tissues. The skin is then redraped, and the amount of excess skin to be removed is determined by the surgeon's judgement and experience. The excess skin is then removed, and the skin incisions are closed with sutures and staples.

Facelifts are helpful for eliminating loose skin folds in the neck and laxity of tissues in the cheeks. The areas not well corrected by a facelift include the nasolabial folds and perioral mounds marionette lines which are more suitably treated with Botox or liposculpture, respectively. A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous. Hair loss in the portions of the incision within the hair-bearing scalp can rarely occur. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue. Achieving a natural appearance following surgery in men can be more challenging due to their hair-bearing preauricular skin. In both men and women, one of the signs of having had a facelift can be an earlobe which is pulled forwards and/or distorted. If too much skin is removed, or a more vertical vector not employed, the face can assume a pulled-back, "windswept" appearance.

Facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.

The most common complication can be bleeding which usually requires a return to the operating room. Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps, or infection.

Contraindications to facelift surgery include severe concomitant medical problems. While not absolute contraindications, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes. Patients should abstain from taking aspirin or other blood thinners for at least one week prior to surgery.

Risks:

  • infection
  • bleeding under skin
  • scarring
  • irregular earlobes
  • nerve damage causing numbness or inability to move your face
  • hair loss
  • skin damage

6. Facial Implant

Infection feeling of tightness or scarring around implant shifting of implant

Risks:

  • infection
  • feeling of tightness or scarring around implant
  • shifting of implant

7. Forehead Lift

Extra skin and muscles that cause wrinkles are removed, eyebrows are lifted, and forehead skin is tightened.

Risks:

  • infection
  • scarring
  • bleeding under skin
  • eye dryness or irritation
  • impaired eyelid function
  • loss of feeling in eyelid skin
  • injury to facial nerve causing loss of motion or muscle weakness

7. Lip Augmentation

Material is injected or implanted into the lips to create fuller lips and reduce wrinkles around the mouth.

Risks:

  • infection
  • bleeding
  • lip asymmetry
  • lumping
  • scarring

8. Liposuction


Excess fat from a targeted area is removed with a vacuum to shape the body.

Risks:

  • baggy skin
  • skin may change color and fall off
  • fluid retention
  • shock
  • infection
  • burning
  • fat clots in the lungs
  • pain
  • damage to organs if punctured
  • numbness at the surgery site
  • heart problems
  • kidney problems
  • disability
  • death

9. Nose Surgery

Rhinoplasty (Greek: Rhinos, "Nose" + Plassein, "to shape") is a surgical procedure which is usually performed by either an otolaryngologist-head and neck surgeon, maxillofacial surgeon, or plastic surgeon in order to improve the function (reconstructive surgery) and/or the appearance (cosmetic surgery) of a human nose. Rhinoplasty is also commonly called a "nose reshaping" or "nose job". Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct trauma, birth defects or breathing problems. It can be combined with other surgical procedures such as chin augmentation to enhance the aesthetic results.Nose is reshaped by resculpting the bone and cartilage in the nose.

Rhinoplasty can be performed under a general anesthetic, sedation, or with local anesthetic. Initially, local anesthesia which is a mixture of lidocaine and epinephrine is injected to numb the area, and temporarily reduce vascularity. There are two possible approaches to the nose: closed approach and open approach. In closed rhinoplasty, incisions are made inside the nostrils. In open rhynoplasty, an additional inconspicuous incision is made across the columella, the bit of skin that separates the nostrils. The surgeon first separates the skin and soft tissues of the nose from the underlying structures. Reshapes the cartilage and bone, and then sutures the incisions closed. Some surgeons use a stent or packin inside the nose, followed by tape or stent on the outside.

The patient returns home after the surgery. Most surgeons recommend antibiotics, pain medications, and steroid medication after surgery. Most people choose to remain home for a week, although it is safe to be outdoors. If there are external sutures, they are usually removed 4 to 5 days after surgery. The external cast is removed at one week. If there are internal stents, they are usually removed at four days to two weeks. The periorbital bruising usually lasts two weeks. Due to wound healing, there is moderate shifting and settling of the nose over the first year.

Risks:

  • infection
  • bursting blood vessels
  • red spots
  • bleeding under the skin
  • scarring

10. Tummy Tuck


Tightening of the rectus muscles of the abdomen from the chest to the pubic region, Abdominoplasty - high lateral tension technique, Removal of large section of loose skin and scar from transverse cesarean section, Recreation of belly button through transposed skin. Extra fat and skin in the abdomen is removed, and muscles are tightened to flatten tummy.

Risks:

  • blood clots
  • infection
  • bleeding
  • scarring
  • fluid accumulation under the skin

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