Cosmetic surgery is a type of plastic surgery

that aims to improve a person’s appearance, but

it should be approached with caution.

Cosmetic surgery continues to grow in popularity, with 15.1

million cosmetic procedures carried out in the United States in 2013, an
increase of 3 percent on the previous year.

Procedures are available for almost any part of the body, but the choice to
undergo cosmetic surgery should not be taken lightly. The results are often
permanent, so it is important to be sure about the decision, to use an
appropriate practitioner, and to have the right motivation.

A surgeon may refer a patient for counseling before surgery if they believe
there is an underlying problem that cannot be solved by the surgery, or if
the patient shows signs of Body Dysmorphic Disorder (BDD).

BDD can cause a person to perceive that there is something seriously

wrong with their appearance, when objective evidence suggests otherwise.

Reconstructive surgery is another type of plastic surgery. It aims to improve

function and to give a normal appearance to a part of the person’s body
that has been damaged, for example, after a mastectomy. This article will
focus on cosmetic surgery only.

Types and uses

A variety of aesthetic procedures is available for different parts of the body.

Breast surgery
 Breast implants can be used to increase breast size or in reconstruction
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after surgery.

Women may seek breast surgery to improve their body shape.

Mammoplasty procedures may include:

Breast augmentation, or enlargement, traditionally performed using

saline or silicone gel prosthetics, and now occasionally with fat grafting.
It may be carried out if the woman feels her breasts are too small, if one
breast is larger than the other, or if the breasts have changed after
pregnancy or breastfeeding. Some older women opt for this treatment
when the breasts being to droop due to the skin losing elasticity.

In some women, a breast enlargement can boost self-esteem and improve

their feelings about their sexuality. In some, however, existing problems
remain. This is why women are encouraged to undergo counseling first.

Breast reduction can help provide relief from physical discomfort, while

the aim of augmentation more often relates to appearance. Breast
reduction may also reduce the risk of breast cancer in women who are at
high risk of the disease.

Mastopexy, or a breast lift, involves removing skin and glandular tissue to

make the breasts smaller and rearranging the remaining tissue to make the
breast appear lifted.

Depending on how much volume a patient has lost or desires, mastopexy

can be combined with an implant. While it is similar to a breast reduction,
which removes a much greater amount of tissue, mastopexy is not usually
covered by major insurance carriers as it is not deemed medically
necessary.

Male breast reduction treats gynecomastia, an enlargement of the

mammary tissue in men. It may be done by liposuction or with various scar
patterns, often hidden around the nipple and areola.

Liposuction

Liposuction, or suction-assisted lipectomy, uses thin cannulas, or hollow

metal tubes, to vacuum fat from various parts of the body, usually the
abdomen, thighs, buttocks, hips, backs of the arms, and neck. Liposuction
may also be used for male breast reduction.
Tools used in liposuction include standard, ultrasound, mechanical, and
laser devices. They all tend to involve suction of fat through a tube.

To prevent complications, there is a limit to the amount of fat that the

surgeon can safely remove, depending on whether the patient will be
discharged immediately after surgery or admitted to the hospital.

Liposuction should not be intended as a weight-loss procedure. When

performed in the right patient, the goal is to improve contour and decrease
limited areas of fat deposits.

Complications are rare but possible. They include the accumulation of

blood under the skin, known as hematoma, infection, changes in sensation,
allergic reactions, damage to underyling structures, and unsatisfactory
results. The doctor must discuss these with the patient beforehand.

Liposuction does not reduce the risk of developing diabetes, heart disease,

or high blood pressure.

Vulvovaginal surgery

Labiaplasty, labioplasty, labia minor reduction, or labial reduction involves

surgery of the labia majora or labia minora of the vulva, a part of the female
genitalia. It aims to reduce elongated labia, usually as part of a
vaginoplasty.

There is a lack of clinical or scientific evidence to guide gynecological

surgeons as to the safety and effectiveness of cosmetic vaginal
procedures.

Body procedures

Abdominoplasty, or “tummy tuck” reshapes and firms the abdomen.

Excess skin and fat is removed from the middle and lower abdomen, with
the aim of tightening the muscle and fascia of the abdominal wall.
This may be suitable after pregnancy or after losing a great deal of weight.

Other body contouring procedures

Buttock augmentation enhances the appearance of the buttocks by

making them larger. The surgeon will either graft fat from another part of
the patient’s body using liposuction. This is known as the “Brazilian Butt
lift.” Silicone implants may also occasionally be used in the buttocks.

A buttock lift, or lower body lift involves removing excess skin from the
hips, buttocks, and thighs in order to tighten and lift them. These
procedures are often combined with abdominoplasty in patients who have
lost a considerable amount of weight after bariatric, or weight loss, surgery,
for example.

Facial cosmetic surgery

Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age,

the skin becomes lax, and there may be drooping or hooding of the upper
lids, and bags on the lower lids. Eyelid surgery may be functional,
cosmetic, or both. It usually involves removing or repositioning excess skin
and fat, and the procedure may reinforce surrounding muscles and
tendons.

Surgery can change the shape of the face or tighten the skin.

In rhinoplasty, also known as a “nose job,” the surgeon reshapes the

patient’s nose to improve the appearance and often breathing, too. It may
involve reshaping the tip and reducing the bony hump at the upper aspect
of the nose.

It can be performed with small incisions that are well hidden, often inside
the nostrils. Surgeons do not recommend rhinoplasty until the patient is at
least 15 years old, to allow for full growth of the cartilage and bone of the
nose.
Otoplasty, or ear surgery, treats prominent or misshapen ears by
surgically “pinning” the ear closer to the head with sutures, reshaping the
cartilage, or both.

One or both ears may be treated. It is most commonly performed in

children after of 5 or 6 years as the ears have essentially reached adult
size by that age.

Rhytidectomy, also known as a facelift, aims to surgically remove wrinkles

and tighten facial skin in order to achieve a more youthful appearance.

Typically, the incision is placed in front of and behind the ears, extending
into the hairline in the temple area. The skin is lifted off the deeper facial
tissue, redraped more tightly, and the excess skin is removed. The
incisions are then closed with sutures.

The deeper tissues of the face and neck may also be tightened.
Blepharoplasty, or eyelid surgery may be done at the same time.

A brow lift, browplasty, or forehead lift aims to remove signs of aging by

raising drooping eyebrows and removing forehead wrinkles, or worry lines.
It is often done alongside other cosmetic procedures to achieve a more
harmonious facial appearance.

Chin augmentation aims to make the chin more prominent and provide a

better balance of facial features. It may be done at the same time as
rhinoplasty, depending on the measurements taken before surgery. It can
be performed with either a prosthetic implant or through manipulation of the
chin bone.

Malar, or cheek, augmentation can make the cheekbones more

prominent. The surgeon may place an implant at the top of the
cheekbones.

Peels, fillers, grafts, and laser treatment

Less invasive treatments may include peels, fillers, injections, grafting, and
laser treatment.

Share on Pin terest Fillers can be used to iron out wrinkles and to make the lips look plumper.

Chemical peels may help treat acne, pock marks, scars, or wrinkles. A

number of active agents may be used.
A light or superficial peel uses Alpha Hydroxy Acids (AHAs) such as
glycolic, lactic, or fruit acids to treat the outermost layers of the skin. The
treatment is not as deep as with some peels, so the recovery time is
minimal.

A medium peel usually involves TCA (tri-chloroacetic acid) of various

concentrations. It penetrates the dermis, or deep layer of the skin, to a
greater depth than the light peels. The recovery and pain are more
significant than the lighter peels. Redness and flaking may persist for
several days or weeks.

A deep peel, or phenol peel, penetrates the skin to the deepest extent. As a
result, it has the greatest impact on resurfacing the skin, but it also has the
longest recovery time, and it can causing scarring and skin lightening.

Chemical peels have been shown to be safe and effective for both light and
darker skin types.

Botulinum toxin, or botox, is the brand name of a toxin produced by the

bacterium Clostridium botulinum (C. botulinum), first approved by the FDA
in the 1980s for muscle spasm.

A range of cosmetic surgery procedures aim to improve appearance.

It is used to treat wrinkles and facial creases.

It acts by blocking the signal from nerves to the muscles that are injected.
The injected muscle can no longer contract, or tighten, as forcefully as
before, and this leads to a controlled relaxation of the muscles.

It is approved for treatment of frown lines on the forehead, crow’s feet, or

lines around the eye, and axillary hyperhidrosis, or increased sweating of
the armpits.

Apart from “botox,” several other brand names of botulinum toxin are now
commercially available.
Soft tissue fillers, or dermal fillers, are medical device implants approved
by the FDA for use in helping to create a smoother, fuller appearance in the
face.

They can be used to treat nasolabial folds, cheeks, and lips, and to
increase the volume of the back of the hand.

They can also reduce wrinkles, lines and scars, and augment soft tissue
contours. They are not permanent, but they are degraded by the body, so
repeat treatments may be necessary to maintain the effect.

Commercially available products include hyaluronic acid, poly-L-lactic acid

(PLLA), calcium hydroxyapetite, and polymethylmethacrylate beads
(PMMA).

These products normally come in a gel formulation that fine needles can
inject into the deeper layers of the skin and underlying soft tissue of the
face. Collagen injections are no longer performed because some patients
experienced allergic reactions, some of them serious.

Complications can occur with facial fillers, and especially permanent

fillers. Clinicians and patients are urged to check the contents of a
filler and discuss all the implications of surgery before going ahead
with a procedure.

In 2015, the U.S. Food and Drug Administration (FDA) warned that rare but
serious problems may arise if soft tissue fillers are accidentally injected into
blood vessels in the face.

Fat injections and fat grafting have broad applications in cosmetic

surgery.

The patient’s own fat is collected from one part of the body using
liposuction, and it is injected into areas requiring volume enhancement. It is
usually applied to the face, including the lips, the hands, and depressions in
skin contour.
The results are generally safe and long lasting, and it can have the
additional benefit of removing fat from a place where it is not wanted. The
fat is removed, washed, and purified and then carefully re-injected with
specially designed needles. Sometimes the procedure needs to be
repeated several times for best results.

Stem-cell enriched fat grafts have been trialed for reconstructive surgery,

with promising results, suggesting that the procedure is reliable, safe, and
effective. However, tumor growth may be an adverse effect, so further
research is needed before stem cells can become central to plastic and
reconstructive surgery.

Lasers and light-based facial treatment, also known as facial laser

resurfacing or laser skin treatment, can help reduce fine lines, wrinkles, and
abnormal pigmentation, such as sunspots. Treatment utilizes concentrated,
pulsating beams of light.

A variety of laser types are used, and these vary in aggressiveness and
downtime. It may take several sessions to see results.

Hair transplantation

Surgery can return hair growth to those with hair loss.

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Hair transplantation is a kind of cosmetic surgery. can help renew hair

growth.
Tiny hair follicle grafts are obtained from the back of the scalp, where hair
tends to be denser. It is then transplanted with minute incisions to the areas
of the scalp that are affected by hair loss.

Patients may need several sessions to achieve the desired results. After 6
weeks, the transplanted hair will fall out, but about 3 months later, new hair
will appear.

Anyone who is considering cosmetic surgery should stop smoking or using

any tobacco products several months prior to any procedures, as they can
interfere with wound healing.

Choosing a surgeon
It is important to choose a surgeon who is qualified and accredited by a
professional board, such as the American Board of Plastic Surgery.

Medical spas offer various services, but there is a lack of regulation

regarding their practice. No organization sets standards for medical spas,
and there is no recognized definition of what constitutes a medical spa.

Cosmetic surgery and mental health issues

Research suggests that people who undergo cosmetic surgery are also
more likely to experience psychological issues, such
as depression and body dysmorphic disorder (BDD).

One study found that women who had breast augmentation also had a

higher risk of suicide. Doctors are asked to be aware of this possibility
when assessing patients for surgery.

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Tips
People who are considering cosmetic surgery need to weigh up the options
carefully before going ahead.

Here are some tips:

 Choose a reputable surgeon and checking their credentials.

 After obtaining the surgeon’s opinion, make your own decisions, and
resist being persuaded to opt for something you did not previously
want.
 Get full information about the procedure and weigh up all the pros
and cons beforehand.
 Be aware of any risks and limitations, for example, will this need
redoing in 6 months?
 Choose the right moment, avoiding, for example, the time around a
stressful event, such as changing jobs, bereavement, having a baby,
or moving house.
 Never seek cosmetic surgery to please or impress anyone else.
 Do not travel too far for treatment, or if travel is necessary, ensure
the arrangements are reliable, especially if opting for surgery abroad.
 Beware of non-refundable deposits, and be prepared to change your
mind.