Cosmetic Surgery

Cosmetic surgery, or aesthetic surgery as it is also known, is a surgery done to improve ones appearance and has come into vogue for the last couple of decades or so. The popularity of this surgery is soaring as people are becoming increasingly body aware and the desire to self improve. In today’s world unattractiveness is not taken as a curse and aged look is not necessarily associated with wisdom. Both these problems can be taken care of by cosmetic surgery, to give a pleasant and younger appearance. The concept of beauty has changed over the ages and so have the styles. The concept of beauty also differs from region to region and from race to race but there are some common factors.

Patients for cosmetic surgery can also be classified as good candidates or bad candidates, based on unrealistic expectations, technical limitations, age, mental health and physical health. If a candidate is undergoing cosmetic surgery for someone else’s wishes then the chances of disappointment are very high. Various procedures done in cosmetic surgery are described in brief below with some pre and post operative photographs.

Otoplasty

Surgeries for prominent ears, constricted ears can be performed under local anesthesia with incisions given behind the ears cartilage is exposed and missing grooves are created and incisions closed.

Split Ear Lobules

Some women who use heavy jewelry regularly have enlarged ear lobe holes or a split in their ear lobes specially when initial hole piercing is too low. Some people also have congenital clefts in their ear. These can be repaired under local anesthesia as an OPD procedure, and probably is a better option to have ear re-pierced after gap of 3 to 6 months. One can have a repair of split ear leaving a small hole for jewelry but the chances of this hole enlarging is more.

Rhinoplasty

The nose being in the center of the face any deformity in the nose is very prominent, the correction of these deformities is termed as rhinoplasty. Following things can be achieved by rhinoplasty; elevation of a depressed nose by adding cartilage, bone or implants, removal of humps reduction in the bulk of the tip of nose, reduction of the size of nostrils, narrowing of nasal bridge, nasal tip elevation, nasal base narrowing and collumelar corrections.

The incisions are usually made inside the nose or in hidden areas and nasal skin lifted to achieve augmentation or reduction as the case may be. These operations are usually done under local anaesthesia with sedation but complicated procedures which is anticipated to take a long time may be operated under general anesthesia. Some procedures are OPD procedures while others may entail a hospital stay of 3 days.

Aesthetic Surgeries of The Breast

Breast Augmentation

This operation is done to increase the size of under developed breast by placing a silicone gel implant behind the breast tissue or behind the breast muscle. The implant is introduced through a small incision either at the lower end of the breast or in the areola or in the armpit region. If done under general anesthesia it requires 1 day hospital stay.

Breast Reduction

Surgery is done where breasts are too big to cause discomfort or inconvenience. In this size of the breast is reduced by removing fat, breast tissue and skin and repositioning the nipple areola complex with recon touring of the breast. The incisions are made in such a way that most of them get hidden in the breast fold or areola complex. One scar extending vertically from areola to the infra mammary fold is prominent initially, but fades away with time.

Mastopexy

Also called the breast lift where sagging breasts are re-contoured and lifted up. In this operation the breast tissue is firmed up, excessive skin is got rid of and the nipple areola complex shifted up to give a normal appearance. The surgery is done under general anesthesia and has a hospital stay of two to three days.

Gynaecomastia Surgery

Some boys develop breasts of notable size particularly during puberty and although it settles down in most cases, some boys continue to have female like breasts which can cause a lot of psychological trauma and embarrassment. On rare occasions enlargement of breasts can occur in adult life sometimes associated with hormone therapies or treatment. Surgery for this is done under general anesthesia where incision is given in the lower half of the areola and excessive fat and glandular tissue are removed and incision closed. Sometimes when there is less of glandular tissue and more of fat then only liposuction or combined with surgery. One to two day hospital stay may be required.

Surgeries of Aging Face

Gravity as well as loss of tone and elasticity of muscles and skin result in sagging of face giving one an aged look.

Face Lift

This surgical procedure is done to tighten the face. Incisions are given above around and behind the ears, the skin of the face are lifted up the fascia is tightened and excessive skin removed. It can be done under local anesthesia and sedation and requires a hospital stay of one day. Nowadays the above results can be achieved though for a shorter duration with the help of contour threads.

Double Chin

This can be corrected by removing excess of fat by either sucking out the fat or by open method where a small cut is given below the chin in a hidden area and through the cut fat is removed and muscles are also tightened. Can be done under local anesthesia, does not require hospital stay and can be combined with facelift.

Blepharoplasty or Eyelid Surgery

Both upper and lower eyelid wrinkles and bagginess can be taken care of by this surgery. The cut is made in the lid fold of upper eyelid and lid margin of lower eyelid, skin flaps raised excessive fat removed skin is tightened and sutured back Surgery is done under local anesthesia and 1 day hospital stay is required.

Brow Lift

Both eyelid lift or a total forehead lift can be done by giving an incision in the scalp hidden in the hairline from ear to ear, lifting the whole skin and pulling it up and suturing it back after removing the excess skin. If only brow lift is required then the incisions are smaller but hidden in the hairline.

Implants

Various kinds of implants are available for highlighting ones cheek or malar region as well as for improving the appearances of a receded chin. These implants are introduced through intraoral incisions. Chin implants can be put under local anesthesia and does not require any hospital stay. Medpore implants have now replaced silicone implants.

Abdominoplasty

A bulging abdomen or a loose overhanging abdomen can be taken care of by this surgery. A loose abdomen can happen due to overstretching of skin due to recurrent pregnancy or can happen in people who loose weight drastically over a short period of time. During this surgery a fold of skin is elevated, umbilicus relocated elevated fold stretched and excessive tissue resected. A person with fat deposit can have a lipoplasty or liposuction combined with it. Along with skin and fat resection the abdominal muscles are tightened or plicated as per the requirement. General anesthesia is needed and a hospital stay of 2 to 5 days is required.

Liposuction

Also known as suction assisted lipectomy where lipo means fat and ectomy refers to removal. In this surgery long narrow tubular structures called cannula are connected to a suction machine with the help of which the surgeon loosens the fat cells and sucks them out. It is usually used to reduce fat from hips, thighs, abdomen, waistline, from under the chin and from arms. It should not be confused as a weight reducing procedure although it can help in weight reduction, but is mainly a tool for body sculpturing. Small areas can be tackled under local anesthesia but multiple areas and large areas are done under general anesthesia with a hospital stay of 1 to 2 days.

Dr. Mahesh Mangal
Consultant Plastic Surgeon