Best Way to Understand Cosmetic Surgery

Once upon a time there was an ordinary girl from Ohio who was not only without a date for the high-school prom, but had also been rejected as a cheerleader for simply not being pretty enough. Then she visited the plastic surgeon, not once, but twenty or so times, for a nip here and a tuck there, as well as two face-lifts, three eye operations, lip enlargement, two breast operations, four liposuction treatments, three chemical peels, dermabrasion and a few other procedures. Several years later she was, undeniably, a beautiful woman, but her face and body was no longer her own.

Cindy Jackson – who is said to have modelled herself on the Sindy doll – was lucky: fall into the hands of a charlatan and you could be scarred for life. You can indeed get fantastic results with cosmetic surgery, but because of the risks involved, all surgical procedures should be considered carefully.

And don’t think that cosmetic surgery will magically solve all your problems and make you a happy person, or resurrect your marriage: it is by no means a cure-all. You may recall the true-life story of a woman called The Bride of Wildenstein – no amount of surgery would keep her husband.

Before you embark on any surgical procedure, make sure that you find a reputable and highly qualified cosmetic surgeon: ask your doctor and contact any related professional associations for advice until you find a surgeon with whom you feel happy about leaving your appearance in his or her hands.

Cosmetic procedures

These are the latest methods used for the most popular cosmetic procedures, compiled with the help of one of the world’s leading plastic surgeons, Mr Brian Coghlan.

Face-lifts

The latest endoscopic face- and brow-lift has done away with the taut, giveaway sign of a face­lift and, according to Mr Coghlan, this method also reduces scarring. ‘Using keyhole surgery, we reposition muscle and facial tissue in the face and brow area with a telescope,’ he explains. ‘This works well on women in their late thirties and forties who have facial sagging. But for more mature women, and those with excess, loose skin, a “skin-lift” is more effective!

There are also several other face-lifting procedures. One of the most popular is the SMAS (subcutaneous muscles aponeurotic system) lift: ‘The SMAS layer and the platsyma muscle in the neck are corrected,’ explains Mr Coghlan. ‘This takes the tension off the skin layer allowing excess skin to be removed, before lifting, stretching and stitching it to the ear area and along the hairline.’ Performed under general anaesthetic, the recovery time after a face-lift is approximately two weeks. Depending on the scale of the face-lift and the area of the face lifted, swelling can last for several weeks.

Nose reshaping

It’s not only Michael Jackson who has bought the nose of his choice: rhinoplasty is one of the most popular cosmetic procedures. The nose can be shortened, lengthened, built up or made smaller but, according to Mr Coghlan, nowadays the trend is towards adjusting the shape of the nose as opposed to making it smaller. Changes on the surgical front to what is termed ‘open surgery’, in which the skin is lifted up, have resulted in easier access for surgeons. Although the patient is left with a tiny, barely noticeable scar on the central strut, open surgery makes remoulding easier,’ says Mr Coghlan. After undergoing a general anaesthetic, the patient must wear a plaster for seven to ten days. Any bruising and swelling should subside after a couple of weeks.

Ear pinning

Those who hate their sticking-out ears can have them pinned back by means of this fairly simple operation (otoplasty). This procedure involves stitching the ears back onto the head leaving no visible scarring. ‘In most cases we reshape the cartilage framework of the ear, which involves having to make incisions behind the ears’, says Mr Coghlan. Ear pinning can be carried out under local anaesthetic, after which the patient must wear bandages for one week.

Cheek and chin augmentations

Using preshaped implants made from collagen, bodily fat or synthetic, bone-like substances, surgeons can build up cheekbones. Chin augmentation (mentoplasty) involves implants being inserted under the chin or through the mouth to reshape a receding chin. ‘One of the current implants being used is coral, as it is-e natural fibre that closely matches bone,’ says Mr Coghlan, who goes on to explain that as the implants are inserted through the mouth there is no visible scarring. This operation requires a general anaesthetic and patients must expect some swelling. If the implant has been inserted via the mouth, aftercare involves meticulous oral hygiene in order to prevent infection.

Breast enlargements and reductions

Breasts can be enlarged, as well as reduced or uplifted. With both of these procedures, surgical advancements have resulted in a reduction in the amount of visible scarring: ‘Surgeons are making smaller and neater incisions. For example, on a minor breast reduction there would only be scarring around the nipple,’ says Mr Coghlan. Despite the silicone scare, breast augmentation remains in demand. For the past eighteen months Mr Coghlan, along with many other surgeons, has been using Hydrogel: ‘The shell, as with all breast implants, is silicone, but inside is a salty, sugary, water-like substance that will not cause problems if any leakage occurs.’ After all types of breast surgery, which require a general anaesthetic, patients must wear a support bra for several weeks to help mould their breasts into shape.

Eye surgery

Droopy eyelids can benefit from upper-eyelid surgery (blepharoplasty). ‘For this operation we need to make an incision which leaves a small, single scar line in the crease; this is not visible when the eyes are open’, says Mr Coghlan. Lower-eye surgery removes or redeposits fat, but as it cannot eliminate crow’s-feet, it is often combined with laser resurfacing. ‘The incision is made inside the eye area so there is no visible scarring’, emphasises Mr Coghlan. He prefers to carry out lower-eye surgery when his patients are under a general anaesthetic, although he uses a local for those patients who are undergoing upper-eye surgery. Both procedures leave bruising and some swelling for approximately a week.

Liposuction and liposculpture

Liposuction – in which fat is sucked out of the patient’s body – can be carried out on various parts of the body, although the thigh area is the most popular. ‘The latest technique, called “ultrasonic-assisted liposuction”, uses an ultrasound frequency to break down the fatty emulsion before sucking it out,’ Mr Coghlan explains. As usually occurs after any loss of weight, the skin has to shrink back, which is why reputable surgeons will only carry out liposuction on patients who have good skin elasticity.

The type of anaesthetic used depends on the size of the area to be treated. Patients need to wear a support garment for four weeks afterwards, followed by regular massage to soften the skin which, incidentally, can take from six weeks to three months. Liposculpture is a less drastic procedure than liposuction: ‘We use a fine canulas syringe to remove superficial body fat or inject autologous [the patient's own] fat into hollow areas,’ says Mr Coghlan.

Stomach tucks

A flabby tummy can be firmed up with a tummy tuck (abdominoplasty): ‘We remove fat and tighten up the skin,’ says Mr Coghlan. ‘The scar is disguised by the pubic-hair line.’ A tummy tuck requires a general anaesthetic and recovery can take several weeks.