Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand surgery, microsurgery, and the treatment of burns.
Aesthetic surgery is an essential component of plastic surgery. Plastic surgeons use cosmetic surgical principles in all reconstructive surgical procedures as well as isolated operations to improve overall appearance.
The most prevalent aesthetic/cosmetic procedures include:
• Abdominoplasty (“tummy tuck”): reshaping and firming of the abdomen. Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (mini-tuck abdominoplasty) can be completed between 1 to 2 hours.
• Complete abdominoplasty
In general, a complete (or full) abdominoplasty follows these steps:
1. An incision is made from hip to hip just above the pubic area.
2. Another incision is made to free the navel from the surrounding skin.
3. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
4. Liposuction is often used to refine the transition zones of the abdominal sculpture.
5. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.
• Partial abdominoplasty
A partial (or mini) abdominoplasty proceeds as follows:
1. A smaller incision is made.
2. The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
3. Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
4. Sometimes a portion of the abdominal muscle fascia wall is tightened.
5. Liposuction is often used to contour the transition zone.
6. The flap is stitched back into place.
• Extended abdominoplasty
An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing your open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty and allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.
• High lateral tension tummy tuck
This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.
• Floating Abdominoplasty or FAB Technique
This new technique, also known as an extended mini abdominoplasty, allows for tightening and shaping through a smaller incision that isn’t placed around the belly button. Though this smaller incision, excess skin is removed and the belly button is temporarily detached, floating above the muscles during this process. The muscles are tightened and reshaped from sternum to pubic area. The skin is then tightened and the belly button is reattached, or moved down one or two cm if desired. Liposuction may also be performed to achieve desirable results.
• Circumferential abdominoplasty
A circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.
• Combination procedures
An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a “mommy makeover”.
• Blepharoplasty (“eyelid surgery”): reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty.
Blepharoplasty is usually performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids. Incisions may be made from the inside surface of the lower eyelid (transconjunctival blepharoplasty); this allows removal of lower eyelid fat without an externally-visible scar, but does not allow excess skin to be removed. External skin resurfacing with a chemical peel or carbon dioxide laser may be performed simultaneously. This allows for a faster recovery process.
The operation typically takes one to three hours to complete. Initial swelling and bruising resolve in one to two weeks but at least several months are needed until the final result becomes stable. Blepharoplasty’s effects are best appreciated by comparing before and after photos of surgical patients.
Breast augmentations (“breast implant” or “boob job”): augmentation of the breasts by means of fat grafting, saline, or silicone gel prosthetics, which was initially performed to women with micromastia.
Reduction mammoplasty (“breast reduction”): removal of skin and glandular tissue, which is done to reduce back and shoulder pain in women with gigantomastia and/or for psychological benefit men with gynecomastia.
Mastopexy (“breast lift”): Lifting or reshaping of breasts to make them less saggy, often after weight loss (after a pregnancy, for example). It involves removal of breast skin as opposed to glandular tissue.
Buttock augmentation (“butt implant”): enhancement of the buttocks using silicone implants or fat grafting (“Brazilian butt lift”) and transfer from other areas of the body
Buttock lift: lifting, and tightening of the buttocks by excision of redundant skin
Chemical peel: minimizing the appearance of acne, chicken pox, and other scars as well as wrinkles (depending on concentration and type of agent used, except for deep furrows), solar lentigines (age spots, freckles), and photodamage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid(AHA), or salicylic acid (BHA) as the active agent.
Labiaplasty: surgical reduction and reshaping of the labia
Lip enhancement: surgical improvement of lips’ fullness through enlargement
Rhinoplasty (“nose job”): reshaping of the nose
Otoplasty (“ear surgery”/”ear pinning”): reshaping of the ear, most often done by pinning the protruding ear closer to the head.
Rhytidectomy (“face lift”): removal of wrinkles and signs of aging from the face
Browplasty (“brow lift” or “forehead lift”): elevates eyebrows, smooths forehead skin
Midface lift (“cheek lift”): tightening of the cheeks
Chin augmentation (“chin implant”): augmentation of the chin with an implant, usually silicone, by sliding genioplasty of the jawbone or by suture of the soft tissue
Cheek augmentation (“cheek implant”): implants to the cheek
Orthognathic Surgery: manipulation of the facial bones through controlled fracturing
Fillers injections: collagen, fat, and other tissue filler injections, such as hyaluronic acid
Laser Skin Rejuvenation or Resurfacing:The lessening of depth in pores of the face
Liposuction (“suction lipectomy”): removal of fat deposits by traditional suction technique or ultrasonic energy to aid fat removal
Brachioplasty (“Arm lift”): reducing excess skin and fat between the underarm and the elbow.
Phalloplasty (“penile liposuction”) : construction (or reconstruction) of a penis or, sometimes, artificial modification of the penis by surgery, often for cosmetic purposes.