Hidden Pages

9
Mar

Cleft Lip and Palate

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A cleft lip is a separation of the upper lip that can extend into the nose.

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To repair a cleft lip, the surgeon will first make an incision on each side of the cleft from the lip to the nostril.

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The cleft lip is then drawn together and stitched to create a normal “cupid’s bow” shape to the upper lip.

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The scar left after surgery will gradually fade with time.

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When the roof of the mouth doesn’t grow together properly, the condition is called a cleft palate. To repair it, the surgeon will make an incision along both sides of the cleft.

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Tissue is drawn together from both sides of the cleft to rebuild the roof of the mouth.

If You’re Considering Surgery to Correct Cleft Lip or Palate…

In the early weeks of development, long before a child is born, the right and left sides of the lip and the roof of the mouth normally grow together. Occasionally, however, in about one of every 800 babies, those sections don’t quite meet. A child born with a separation in the upper lip is said to have a cleft lip. A similar birth defect in the roof of the mouth, or palate, is called a cleft palate. Since the lip and the palate develop separately, it is possible for a child to have a cleft lip, a cleft palate, or variations of both.

If your child was born with either or both of these conditions, your doctor will probably recommend surgery to repair it. Medical professionals have made great advances in treating children with clefts and can do a lot to help your child lead a normal, healthy, happy life.

This information will give you a basic understanding of the operation — when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on you individual circumstances. Please be sure to ask your surgeon if there is anything you don’t understand about the procedure.

The Importance of a Team Approach

Children born with a cleft lip or palate may need the skills of several medical professionals to correct the problems associated with the cleft. In addition to needing plastic surgery to repair the opening, these children may have problems with their feeding and their teeth, their hearing, their speech, and their psychological development as they grow up.

For that reason, parents should seek the help of a Cleft Lip and Palate Team as early as possible. Medical professionals with special experience in the problems of cleft lip and palate have formed such teams all over the country to help parents plan for their child’s care from birth, or even before. Typically, a Cleft Team might include a plastic surgeon, a pediatrician, a dentist, a speech and language specialist, a social worker, a hearing specialist, an ear-nose-throat specialist, a psychologist, a nurse, and a genetic counselor.

Ask your doctor for a referral to a Cleft Team in your area. Or, for more information, contact The Cleft Palate Foundation, 104 S. Estes Drive Suite 204, Chapel Hill, NC, 27514, (telephone: 800-24CLEFT).

All Surgery Carries Some Uncertainty and Risk

When surgery is done by a qualified plastic surgeon with experience in repairing cleft lip or palate, the results can be quite positive. Nevertheless, as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

In cleft lip surgery, the most common problem is asymmetry, when one side of the mouth and nose does not match the other side. The goal of cleft lip surgery is to close the separation in the first operation. Occasionally, a second operation may be needed.

In cleft palate surgery, the goal is to close the opening in the roof of the mouth so the child can eat and learn to speak properly. Occasionally, poor healing in the palate or poor speech may require a second operation.

Planning For Surgery

At your initial consultation, your doctor will discuss the details of the procedure he or she will use, including where the surgery will be performed, the type of anesthesia to be used, possible risks and complications, recovery, costs, and the results you can expect. Your surgeon will also answer any questions you may have about feeding your baby, by breast or by bottle, both before and after the surgery.

In most cases, health insurance policies will cover most or all of the cost of cleft lip or cleft palate surgery. Check your policy to make sure your child is covered and to see if there are any limitations on what types of treatment are covered.

Cleft Lip Surgery

A cleft lip can range in severity from a slight notch in the red part of the upper lip to a complete separation of the lip extending into the nose. Clefts can occur on one or both sides of the upper lip. Surgery is generally done when the child is about 10 weeks old.

To repair a cleft lip, the surgeon will make an incision on either side of the cleft from the mouth into the nostril. He or she will then turn the dark pink outer portion of the cleft down and pull the muscle and the skin of the lip together to close the separation. Muscle function and the normal “cupid’s bow” shape of the mouth are restored. The nostril deformity often associated with cleft lip may also be improved at the time of lip repair or in a later surgery.

Recovering From Cleft Lip Surgery

Your child may be restless for awhile after surgery, but your doctor can prescribe medication to relieve any discomfort. Elbow restraints may be necessary for a few weeks to prevent your baby from rubbing the stitched area.

If dressings have been used, they’ll be removed within a day or two, and the stitches will either dissolve or be removed within five days. Your doctor will advise you on how to feed your child during the first few weeks after surgery.

It’s normal for the surgical scar to appear to get bigger and redder for a few weeks after surgery. This will gradually fade, although the scar will never totally disappear. In many children, however, it’s barely noticeable because of the shadows formed by the nose and upper lip.

Cleft Palate Surgery

In some children, a cleft palate may involve only a tiny portion at the back of the roof of the mouth; for others, it can mean a complete separation that extends from front to back. Just as in cleft lip, cleft palate may appear on one or both sides of the upper mouth. However, repairing a cleft palate involves more extensive surgery and is usually done when the child is nine to 18 months old, so the baby is bigger and better able to tolerate surgery.

To repair a cleft palate, the surgeon will make an incision on both sides of the separation, moving tissue from each side of the cleft to the center or midline of the roof of the mouth. This rebuilds the palate, joining muscle together and providing enough length in the palate so the child can eat and learn to speak properly.

Recovering From Cleft Palate Surgery

For a day or two, your child will probably feel some soreness and pain, which is easily controlled by medication. During this period, you child will not eat or drink as much as usual — so an intravenous line will be used to maintain fluid levels. Elbow restraints may be used to prevent your baby from rubbing the repaired area. Your doctor will advise you on how to feed your child during the first few weeks after surgery. It’s crucial that you follow your doctor’s advice on feeding to allow the palate to heal properly.

The Repaired Lip or Palate

Children with a cleft palate are particularly prone to ear infections because the cleft can interfere with the function of the middle ear. To permit proper drainage and air circulation, the ear-nose-and-throat surgeon on the Cleft Palate Team may recommend that a small plastic ventilation tube be inserted in the eardrum. This relatively minor operation may be done later or at the time of the cleft repair. In addition, surgery may be recommended by your plastic surgeon when your child is older to refine the shape and function of the lip, nose, gums, and palate.

You’ll want to discuss further needs with the members of the Cleft Team seeing your child.

Perhaps most important, keep in mind that surgery to repair a cleft lip or palate is only the beginning of the process. Family support is critical for your child. Love and understanding will help him or her grow up with a sense of self-esteem that extends beyond the physical defect.

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9
Mar

Chemical Peel

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chemical_peel-1

Chemical peel is especially useful for the fine wrinkles on cheeks, forehead, and around the eyes, and the vertical wrinkles around the mouth.

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The chemical solution can be applied to the entire face, or to a specific area -for example, around the mouth – sometimes in conjunction with a facelift.

chemical_peel-3

At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area.

chemical_peel-4

A protective crust may be allowed to form over the new skin. When it’s removed, the skin underneath will be a bright pink.

chemical_peel-5

After healing, the skin is lighter in color, tighter, smoother, and younger looking.

If You’re Considering Chemical Peel…

Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient’s needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. This brochure provides basic information about certain types of chemical peel treatments and the results you might expect. It won’t answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand.

Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons — to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can’t spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin’s texture.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it’s applied to the neck or other body areas.

All chemical peels carry some uncertainty and risk Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.

With a phenol peel, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you’ll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It’s important that you make your surgeon aware of any heart problems when your medical history is taken.

It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.

Peel Formulas at a Glance

Alphahydroxy acids (AHAs)

Uses:

  • Smooths rough, dry skin
  • Improves texture of sun-damaged skin
  • Aids in control of acne
  • Can be mixed with bleaching agent to correct pigment problems
  • Can be used as TCA pre-treatment

Considerations:

  • A series of peels may be needed
  • As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA)

Uses:

  • Smooths out fine surface wrinkles
  • Removes superficial blemishes
  • Corrects pigment problems

Considerations:

  • Can be used on neck or other body areas
  • May require pre-treatment with Retin-A or AHA creams
  • Treatment takes only 10-15 minutes
  • Preferred for darker-skinned patients
  • Peel depth can be adjusted
  • Repeat treatment may be needed to maintain results
  • Sunblock must be used for several months
  • Healing is usually quick, much quicker than with a phenol peel

Phenol

Uses:

  • Corrects blotches caused by: sun exposure, birth-control pills, aging
  • Smooths out coarse wrinkles
  • Removes pre-cancerous growths

Considerations:

  • Used on the face only
  • Not recommended for dark-skinned individuals
  • Procedure may pose risk for patients with heart problems
  • Full-face treatment may take one hour or more
  • Recovery may be slow – Complete healing may take several months
  • May permanently remove facial freckles
  • Sun protection, including sunblock, must always be used
  • Results are dramatic and long-lasting
  • Permanent skin lightening and lines of demarcation may occur

Planning for a Chemical Peel

In some states, no medical degree is required to perform a chemical peel – even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming “miracletechniques” to rejuvenate the skin.

It is very important that you find a physician who has adequate training and experience in skin resurfacing. Your plastic surgeon may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.

During your initial consultation, it is important that you discuss your expectations with your plastic surgeon. Don’t hesitate to ask any questions or express any concerns that you may have. Expect your plastic surgeon to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing For Your Chemical Peel

Your plastic surgeon will instruct you on how to prepare for your peel treatment.

Sometimes Retin A – a prescription medication derived from Vitamin A – is used to pre-treat the skin. This thins out the skin’s surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won’t tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.

You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won’t need any extra assistance if you’re having an AHA peel or superficial TCA peel.

Where Your Peel Will Be Performed

Most chemical peels may be safely performed in a plastic surgeon’s office, office-based surgical facility or outpatient surgical center. Your plastic surgeon may want you to stay overnight in a facility or hospital if other cosmetic procedures are performed simultaneously.

Types of Anesthesia

Anesthesia isn’t required for phenol or TCA peels because the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.

No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

The Peel

AHA peels/treatments: Your doctor will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No “after-peel” ointment or covering is required. Depending on the strength of the peel, periodic treatmentsmay be necessary until the desired effects are achieved.

For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Your plastic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.

Phenol and TCA peels: Typically, the skin is first thoroughly cleansed. Then, the surgeon will carefully apply the phenol or TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.

A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

If phenol solution has been used, your plastic surgeon may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering is necessary.

A full-face phenol peel generally takes one or two hours to perform, while a phenol peel to a smaller facial region (perhaps the skin above the upper lip) may take only 10 or 15 minutes. A single treatment usually suffices.

After Your Treatment

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.

After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor’s specific post-operative instructions.

A TCA peel may also cause significant swelling, depending on the strength of the peel used.

If you’ve had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.

Getting Back to Normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.

About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup. (For makeup tips, ask your plastic surgeon for the ASPS brochure on camouflage cosmetics.)

Your New Look

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.

The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.

If you’re planning a phenol peel, you can expect dramatic improvement in the surface of your skin – fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.

Research in plastic surgery assures continued advances in effective patient treatment. You may support research in plastic and reconstructive surgery with a tax-deductible contribution to the Plastic Surgery Educational Foundation Research Fund. Contributions or inquiries may be directed to the PSEF Development Officer, 444 East Algonquin Road, Arlington Heights, IL 60005-4664, 847-228-9900.

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9
Mar

Chemical or Micro Peels

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chemical_peel-1

Chemical peel is especially useful for the fine wrinkles on cheeks, forehead, and around the eyes, and the vertical wrinkles around the mouth.

chemical_peel-2

The chemical solution can be applied to the entire face, or to a specific area -for example, around the mouth – sometimes in conjunction with a facelift.

chemical_peel-3

At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area.

chemical_peel-4

A protective crust may be allowed to form over the new skin. When it’s removed, the skin underneath will be a bright pink.

chemical_peel-5

After healing, the skin is lighter in color, tighter, smoother, and younger looking.

If You’re Considering Chemical Peel…

Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient’s needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. This brochure provides basic information about certain types of chemical peel treatments and the results you might expect. It won’t answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand. Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons — to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can’t spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Your doctor will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin’s texture.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since phenol sometimes lightens the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face; scarring may result if it’s applied to the neck or other body areas.

All chemical peels carry some uncertainty and risk Chemical peel is normally a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is milder than phenol, it may also produce some unintended color changes in the skin.

With a phenol peel, the new skin frequently loses its ability to make pigment (that is, tan). This means that not only will the skin be lighter in color, but you’ll always have to protect it from the sun. Phenol may pose a special risk for patients with a history of heart disease. It’s important that you make your surgeon aware of any heart problems when your medical history is taken.

It is also possible that phenol will cause some undesired cosmetic results, such as uneven pigment changes. Certain modified phenol peels are gentler and may be preferred in some circumstances.

Peel Formulas at a Glance

Alphahydroxy acids (AHAs)

Uses:

  • Smooths rough, dry skin
  • Improves texture of sun-damaged skin
  • Aids in control of acne
  • Can be mixed with bleaching agent to correct pigment problems
  • Can be used as TCA pre-treatment

Considerations:

  • A series of peels may be needed
  • As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA)

Uses:

  • Smooths out fine surface wrinkles
  • Removes superficial blemishes
  • Corrects pigment problems

Considerations:

  • Can be used on neck or other body areas
  • May require pre-treatment with Retin-A or AHA creams
  • Treatment takes only 10-15 minutes
  • Preferred for darker-skinned patients
  • Peel depth can be adjusted
  • Repeat treatment may be needed to maintain results
  • Sunblock must be used for several months
  • Healing is usually quick, much quicker than with a phenol peel

Phenol Uses:

  • Corrects blotches caused by: sun exposure, birth-control pills, aging
  • Smooths out coarse wrinkles
  • Removes pre-cancerous growths

Considerations:

  • Used on the face only
  • Not recommended for dark-skinned individuals
  • Procedure may pose risk for patients with heart problems
  • Full-face treatment may take one hour or more
  • Recovery may be slow – Complete healing may take several months
  • May permanently remove facial freckles
  • Sun protection, including sunblock, must always be used
  • Results are dramatic and long-lasting
  • Permanent skin lightening and lines of demarcation may occur

Planning for a Chemical Peel

In some states, no medical degree is required to perform a chemical peel – even the strongest phenol peels. Many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply. You should be warned that phenol and TCA peels have been offered by inadequately trained practitioners claiming miracletechniques to rejuvenate the skin.

It is very important that you find a physician who has adequate training and experience in skin resurfacing. Your plastic surgeon may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.

During your initial consultation, it is important that you discuss your expectations with your plastic surgeon. Don’t hesitate to ask any questions or express any concerns that you may have. Expect your plastic surgeon to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing For Your Chemical Peel

Your plastic surgeon will instruct you on how to prepare for your peel treatment.

Sometimes Retin A – a prescription medication derived from Vitamin A – is used to pre-treat the skin. This thins out the skin’s surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won’t tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before the doctor will schedule your actual peel.

You will need to arrange for someone to drive you home and help you out for a day or two if you are having a phenol or deeper TCA peel. You probably won’t need any extra assistance if you’re having an AHA peel or superficial TCA peel.

Where Your Peel Will Be Performed

Most chemical peels may be safely performed in a plastic surgeon’s office, office-based surgical facility or outpatient surgical center. Your plastic surgeon may want you to stay overnight in a facility or hospital if other cosmetic procedures are performed simultaneously.

Types of Anesthesia

Anesthesia isn’t required for phenol or TCA peels because the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.

No anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.

The Peel

AHA peels/treatments: Your doctor will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No after-peel ointment or covering is required. Depending on the strength of the peel, periodic treatmentsmay be necessary until the desired effects are achieved.

For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Your plastic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.

Phenol and TCA peels: Typically, the skin is first thoroughly cleansed. Then, the surgeon will carefully apply the phenol or TCA solution. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass.

A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

If phenol solution has been used, your plastic surgeon may coat the treated area with petroleum jelly or a waterproof adhesive tape. With lighter peels, no covering is necessary.

A full-face phenol peel generally takes one or two hours to perform, while a phenol peel to a smaller facial region (perhaps the skin above the upper lip) may take only 10 or 15 minutes. A single treatment usually suffices.

After Your Treatment

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.

After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor’s specific post-operative instructions.

A TCA peel may also cause significant swelling, depending on the strength of the peel used.

If you’ve had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.

Getting Back to Normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask your doctor to recommend a sunblock with adequate UVA and UVB protection and use it every day.

With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

With a phenol peel, new skin will begin to form in about seven to ten days. Your face will be very red at first, gradually fading to a pinkish color over the following weeks to months. During this time, it is especially important that you use a sunblock or blotchy, irregular skin coloring may result.

About two weeks after treatment, you may return to work and resume some of your normal activities. Your skin will be healed enough for you to wear makeup. (For makeup tips, ask your plastic surgeon for the ASPS brochure on camouflage cosmetics.)

Your New Look

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.

The results of a TCA peel are usually not as long-lasting as those of phenol peel. However, your skin will be noticeably smoother and fresher-looking.

If you’re planning a phenol peel, you can expect dramatic improvement in the surface of your skin – fewer fine wrinkles, fewer blemishes and more even-toned skin. Your results will be long-lasting, although not immune to the effects of aging and sun exposure.

Research in plastic surgery assures continued advances in effective patient treatment. You may support research in plastic and reconstructive surgery with a tax-deductible contribution to the Plastic Surgery Educational Foundation Research Fund. Contributions or inquiries may be directed to the PSEF Development Officer, 444 East Algonquin Road, Arlington Heights, IL 60005-4664, 847-228-9900.

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9
Mar

Camouflage Cosmetics

Most people are eager to return to work and social activities after plastic surgery. How quickly you do so depends on two factors: how you feel and how you look. Your surgeon will let you know when it’s physically safe to resume your normal activities. But only you can decide how comfortable you feel with the way you look.

Almost everyone has some temporary cosmetic side effects from plastic surgery, such as swelling, bruising, or visible incision marks. It may be days, weeks, or even months before these signs disappear and you can fully appreciate the results of your surgery. But there’s no need to sit at home and wait. There are a variety of makeup products and techniques that can be used by men, women, and teens to camouflage the temporary side effects of surgery and help you face the world with confidence and ease.

Here we will introduce you to the kinds of products available and show you how to use them to your best advantage. It may take some practice. But the skills you learn now will serve you well right after surgery and in the long term, helping you to enhance the permanent effects of your cosmetic surgery.

When to Start

It’s best to ask you surgeon’s advice before you start using camouflage cosmetics. Most people can begin applying makeup to cover bruising or disguise swelling as early as a day or two after surgery. If you want to hide incision lines, you’ll need to wait until the stitches have been removed and the incision is completely closed.

After nose surgery, you can normally use makeup as soon as the cast is removed. With a chemical peel or dermabrasion, if a crust has formed you’ll need to wait until it’s completely gone.

What to Look For

You may use special camouflage products recommended by your plastic surgeon, commercial camouflage products available in many large department stores, or even a standard makeup that you already use.

The important thing is to look for products that are hypoallergenic and fragrance free. If you’re happy with the products you currently use, you can continue using them after surgery–but buy fresh ones with new applicators so they’ll be as clean as possible.

There are three basic approaches to camouflage cosmetics: concealing–hiding incision lines and bruises; color correcting–neutralizing color in reddened or yellowish skin; and contouring–disguising swelling and creating the illusion of highlights and shadows.

Concealing

Concealers are thicker and more opaque than regular foundation makeup. They can cover healed incision lines as well as scars or bruises on your face or body.

Choose a concealer that’s opaque and waterproof, but creamy enough that it doesn’t pull on your skin when you apply it. If you can find a concealer that closely matches your skin tone, you may not have to use a foundation on top of it.

It’s not a good idea to use concealer on the thin, delicate skin around your eyes, since concealer is thick and will collect in the creases. Instead, try using a normal fluid foundation, color corrector, or eye makeup alone.

Color Correcting

Color correctors are used to disguise the yellowish shade of a bruise or the overall redness that follows chemical peel and dermabrasion. They come in tints: lavender corrector neutralizes yellow tones, while green corrector removes red.

Less opaque than concealers, color correctors have the same consistency and sheerness as foundation. They’re generally used under your foundation.

Contouring

Contouring can be applied anywhere on the face, but it’s most often used to disguise the swelling that accompanies nose surgery and facial implants. Contouring creates dimension using light and shadow: lighter areas appear to come forward, while darker areas recede.

You’ll need two separate products for contouring: a highlighter, which is about two shades lighter than your normal foundation; and a contour shadow, about two shades darker than your foundation. (You probably won’t find products labeled highlighter and contour shadow. Just look for the appropriate shades of foundation makeup or pressed power.)

Blending is the key to successful contouring: you want to create the illusion of angles without seeing stripes of makeup. The techniques of contouring are subtle and take some practice. Once you’re adept, however, you can use contouring to create “higher” cheekbones, narrow your nose, or minimize a swollen chin.

Removing Camouflage Cosmetics

Camouflage cosmetics tend to be thicker and more adherent than everyday makeup, so it’s important to remove them every night. First, use a cleansing cream that removes all of your makeup. Then use a gentle, alcohol-free toner applied with a cotton ball to remove any cleanser residue. Follow this with a moisturizer formulated for your skin type: oily, dry, or combination.

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9
Mar

Breast Reduction Surgery

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Heavy breasts can lead to physical discomfort, a variety of medical problems, shoulder indentations due to tight bra straps, and extreme self-consciousness.

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Incisions outline the area of skin, breast tissue, and fat to be removed and the new position for the nipple.

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Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast it’s new contour.

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Scars around the areola, below it, and in the crease under the breast are permanent, but can be easily concealed by clothing.

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With smaller, better proportioned breasts, you’ll feel more comfortable and your clothes will fit better.

If You’re Considering Breast Reduction…

Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight-from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations in their shoulders. And unusually large breasts can make a woman-or a teenage girl-feel extremely self-conscious.

Breast reduction, technically known as reduction mammaplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.

If you’re considering breast reduction, this will give you a basic understanding of the procedure- when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.

The Best Candidates for Breast Reduction

Breast reduction is usually performed for physical relief rather than simply cosmetic improvement. Most women who have the surgery are troubled by very large, sagging breasts that restrict their activities and cause them physical discomfort.

In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. Breast reduction is not recommended for women who intend to breast-feed.

All Surgery Carries Some Uncertainty and Risk

Breast reduction is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams. You can reduce your risks by closely following your physician’s advice both before and after surgery.

The procedure does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples. Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples.

Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)

Planning Your Surgery

In your initial consultation, it’s important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient-and every physician, as well-has a different view of what is a desirable size and shape for breasts.

The surgeon will examine and measure your breasts, and will probably photograph them for reference during surgery and afterwards. (The photographs may also be used in the processing of your insurance coverage.) He or she will discuss the variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breasts.

Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. The surgeon should also explain the anesthesia he or she will use, the facility where the surgery will be performed, and the costs. (Some insurance companies will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed. Check your policy, and have your surgeon write a predetermination letter if required.)

Preparing For Your Surgery

Your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Some surgeons suggest that their patients diet before the operation.

Breast reduction doesn’t usually require a blood transfusion. However, if a large amount of breast tissue will be removed, your physician may advise you to have a unit of blood drawn ahead of time. That way, if a transfusion should be needed, your own blood can be used.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where Your Surgery Will Be Performed

Breast reduction surgery may be performed in a hospital, an outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one. The surgery itself usually takes two to four hours, but may take longer in some cases.

Type of Anesthesia

Breast reduction is nearly always performed under general anesthesia. You’ll be asleep through the entire operation.

The Surgery

Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. He or she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.)

Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.

After Your Surgery

After surgery, you’ll be wrapped in an elastic bandage or a surgical bra over gauze dressings. A small tube may be placed in each breast to drain off blood and fluids for the first day or two.

You may feel some pain for the first couple of days-especially when you move around or cough-and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.

The bandages will be removed a day or two after surgery, though you’ll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your stitches will be removed in one to three weeks.

If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.

Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting Back to Normal

Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks.

Your surgeon will give you detailed instructions for resuming your normal activities. Most women can return to work (if it’s not too strenuous) and social activities in about two weeks. But you’ll have much less stamina for several weeks, and should limit your exercises to stretching, bending, and swimming until your energy level returns. You’ll also need a good athletic bra for support.

You may be instructed to avoid sex for a week or more, since sexual arousal can cause your incisions to swell, and to avoid anything but gentle contact with your breasts for about six weeks.

A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don’t hesitate to call your doctor.

Your New Look

Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy.

Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You’ll be rid of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better.

However, as much as you may have desired these changes, you’ll need time to adjust to your new image-as will your family and friends. Be patient with yourself, and with them. Keep in mind why you had this surgery, and chances are that, like most women, you’ll be pleased with the results.

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9
Mar

Breast Lift

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Over time, a woman’s breasts begin to sag and the areolas become larger. All surgery carries some uncertainty and risk

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Incisions outline the area of skin to be removed and the new position for the nipple.

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Skin formerly located above the nipple is brought down and together to reshape the breast. Sutures close the incisions, giving the breast its new contour.

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After surgery, the breasts are higher and firmer, with sutures usually located around the areola, below it, and in the crease under the breast.

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If your expectations are realistic, chances are you’ll be satisfied with your breast lift.

If You’re Considering a Breast Lift…

Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breastlift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts–at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume–for example, after pregnancy–breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you’re considering a breast lift, this brochure will give you a basic understanding of the procedure–when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.

The Best Candidates for Breast Lift

A breast lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn’t interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

All Surgery Carries Some Uncertainty and Risk

A breast lift is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following your physician’s advice both before and after surgery.

Mastopexy does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.

Planning Your Surgery

In your initial consultation, it’s important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient–and every physician, as well–has a different view of what is a desirable size and shape for breasts.

The surgeon will examine your breasts and measure them while you’re sitting or standing. He or she will discuss the variables that may affect the procedure–such as your age, the size and shape of your breasts, and the condition of your skin–and whether an implant is advisable. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.

Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He or she should also explain the anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved.

Don’t hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing For Your Surgery

Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where Your Surgery Will Be Performed

Your breast lift may be performed in a hospital, an outpatient surgery center, or a surgeon’s office-based facility. It’s usually done on an outpatient basis, for cost containment and convenience. If you’re admitted to the hospital as an inpatient, you can expect to stay one or two days.

Types of Anesthesia

Breast lifts are usually performed under general anesthesia, which means you’ll sleep through the operation. In selected patients–particularly when a smaller incision is being made–the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and will feel minimal discomfort.

The Surgery

Mastopexy usually takes one and a half to three and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the doughnut (or concentric) mastopexy, in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.

If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.

After Your Surgery

After surgery, you’ll wear an elastic bandage or a surgical bra over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn’t be severe. Any discomfort you do feel can be relieved with medications prescribed by your surgeon.

Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You’ll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.

You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting Back to Normal

Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel. And avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don’t hesitate to call your surgeon.

Your surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.

Your New Look

Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

You should also keep in mind that a breast lift won’t keep you firm forever–the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer.

Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.

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9
Mar

Breast Augmentation

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Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery.

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Incisions are made to keep scars as inconspicuous as possible, in the breast crease, around the nipple, or in the armpit. Breast tissue and skin is lifted to create a pocket for each implant.

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The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.

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After surgery, breasts appear fuller and more natural in tone and contour. Scars will fade with time.

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If You’re Considering Breast Augmentation…

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast for a number of reasons:

  • To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
  • To restore breast volume lost due to weight loss or following pregnancy
  • To achieve better symmetry when breasts are moderately disproportionate in size and shape
  • To improve the shape of breasts that are sagging or have lost firmness, often used with a breast lift procedure
  • To provide the foundation of a breast contour when a breast has been removed or disfigured by surgery to treat breast cancer
  • To improve breast appearance or create the appearance of a breast that is missing or disfigured due to trauma, heredity, or congenital abnormalities

By inserting an implant behind each breast, surgeons are able to increase a woman’s bust line by one or more bra cup sizes. If you’re considering breast augmentation, this will give you a basic understanding of the procedure–when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please ask your surgeon if there is anything you don’t understand about the procedure.

The Best Candidates for Breast Augmentation

Breast augmentation can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.

Types of Implants

The choice of implant filler, implant size, shape and other features will be determined based on your breast anatomy, body type and your desired increase in size. Your lifestyle, goals and personal preferences, as well your plastic surgeon’s recommendations and sound surgical judgment are also determining factors. Implant manufacturers occasionally introduce new styles and types of implants, and therefore there may be additional options available to you.

Breast implants are medical devices with a solid silicone, rubber shell. The implant shell may be filled with either saline solution (sterile salt water) or elastic silicone gel. Both saline and silicone gel breast implants are approved by the U.S. Food and Drug Administration (FDA). Approval means that an implant has been rigorously researched and tested, and reviewed by an independent panel of physicians for safety.

The size of a breast implant is measured in cubic centimeters (ccs) based on the volume of the saline or silicone filler. Breast implants vary both by filler and in size, but there are additional features to consider:

  • Texture: the implant shell may be smooth or textured
  • Shape: the implant may have a round profile or one that is anatomic (teardrop or tapered shape)
  • Profile: the implant may have a low, medium or high projection (the depth of the implant from the base to the highest point of the implant curve)
  • Diameter: the width of the implant measured across it’s base (the side of the implant that will be positioned over the chest wall)

Adult women of any age can benefit greatly from the enhancement breast implants provide. It is usually recommended, however, that a woman’s breasts are fully developed prior to placement of breast implants. Saline implants are FDA approved for augmentation in women 18 years of age and older. Silicone implants are FDA approved for augmentation in women age 22 and older. Saline or silicone implants may be recommended at a younger age if used for reconstruction purposes.

You should be aware that breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants. Regular examinations for breast health and to evaluate the condition of your implants are important whether you have chosen saline or silicone breast implants.

All Surgery Carries Some Uncertainty and Risk

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

Breast implants do not generally interfere with a woman’s ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman’s body may alter the results of any breast surgery, including surgery to place breast implants. Therefore, it is important to discuss the options of breast implant surgery with your plastic surgeon if you are interested in becoming pregnant and breast feeding in the future.

Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak.

  • If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be absorbed and naturally expelled by the body.
  • If a silicone-gel filled implant leak or break, the elastic silicone gel may remain within the implant shell, or may escape into the breast implant pocket (a capsule of tissue that surrounds the implant). A leaking implant filled with silicone gel may not deflate and may not be noticeable except through imaging techniques such as an MRI. For this reason, a woman with silicone breast implants is advised to visit her plastic surgeon annually to assess that her implants are functioning well. An ultrasound exam or MRI screening can assess the condition of breast implants; after 3 years it is recommended that all silicone implants be properly screened.

Following the placement of breast implants mammography is technically more difficult. Obtaining the best possible results requires specialized techniques and additional views. You must be candid about your implants when undergoing any diagnostic breast exam. In many cases, an ultrasound exam or MRI may be recommended in addition to mammography.

While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.

Planning Your Surgery

In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift.

Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each. You may want to ask your surgeon for a copy of the manufacturer’s insert that comes with the implant he or she will use — just so you are fully informed about it. And, be sure to tell your surgeon if you smoke, and if you’re taking any medications, vitamins, or other drugs.

Your surgeon should also explain the type of anesthesia to be used, the type of facility where the surgery will be performed, and the costs involved. Because most insurance companies do not consider breast augmentation to be medically necessary, carriers generally do not cover the cost of this procedure.

Preparing For Your Surgery

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. A mammogram may be recommended prior to your procedure to ensure breast health and serve as a baseline for future comparison.

In addition to explaining your surgical procedure, you plastic surgeon will discuss anesthesia, the recovery process and your obligations as a patient. You will also discuss where your procedure will be performed. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications of your surgery. There may be a waiting period of several days to weeks from the time of your consent to the day of surgery.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

Where Your Surgery Will Be Performed

Your surgeon may prefer to perform the operation in an office facility, a freestanding surgery center, or a hospital outpatient facility. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

Types of Anesthesia

Breast augmentation can be performed with a general anesthesia, so you’ll sleep through the entire operation. Some surgeons may use a local anesthesia, combined with a sedative to make you drowsy, so you’ll be relaxed but awake, and may feel some discomfort.

The Surgery

The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. In addition, a saline implant may be placed through an incision at the navel. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue (submammary or subglandular placement) or may be placed beneath the pectoral muscle and on top of the chest wall (submuscular placement). Once the implant is positioned within this pocket, the incisions are closed with sutures, skin adhesive and/or surgical tape. A gauze bandage may be applied over your breasts to help with healing. The surgery usually takes one to two hours to complete. You’ll want to discuss the pros and cons of these alternatives with your doctor before surgery to make sure you fully understand the implications of the procedure he or she recommends for you.

After Your Surgery

You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.

Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear.

Getting Back to Normal

You should be able to return to work within a few days, depending on the level of activity required for your job.

Follow your surgeon’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery.

Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

Routine mammograms should be continued after breast augmentation for women who are in the appropriate age group, although the mammography technician should use a special technique to assure that you get a reliable reading, as discussed earlier.

Your New Look

For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance.

Even if you believe your implants are functioning well, it is important that you follow-up as directed with your plastic surgeon to assess the condition of your breast implants. In addition, whether you choose to have breast implants or not, it is essential to your health that you practice a monthly breast self-exam and schedule regular diagnostic breast screenings.

Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.

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9
Mar

Botox Injections

Botox® Injections

The cosmetic form of botulinum toxin, often referred to by its product name Botox®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.

 

Who should consider Botox?

Botox Cosmetic is indicated for the temporary correction of moderate to severe glabellar lines (frown lines) associated with corrugator and/or procerus muscle activity in patients 18 to 65 years of age.  If you exhibit lines on the smooth part of your forehead above and between the brows (the glabella), you should consider treatment with Botox Cosmetic.

Botox Cosmetic is contraindicated if the patient exhibits an infection at the proposed injection site(s) and or has a known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.  Do not undergo Botox treatment if you are allergic to any of the ingredients or if you have experienced an allergic reaction to another product containing botulinum toxin.  Ask your plastic surgeon about the possible side effects of Botox.

 

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9
Mar

Non-Surgical

Botox

Botox Cosmetic is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance.

 

Chemical Peel

Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation.

 

Injectable Fillers

Soft-tissue fillers, typically made of collagen, hyaluronic acid, or fat, can help fill in lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face.

 

Microdermabrasion

Microdermabrasion is a skin-freshening technique that helps repair facial skin that takes a beating from the sun and the effects of aging. The plastic surgeon uses a device like a fine sandblaster to spray tiny crystals across the face, mixing gentle abrasion with suction to remove the dead, outer layer of skin.

 

Permanent Makeup

Permanent makeup is possible through a procedure called micropigmentation in which an organic pigment is embedded beneath the skin to add permanent color.

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Laser Skin Resurfacing

In laser skin resurfacing a laser is used to remove areas of damaged or wrinkled skin, layer by layer. The procedure is most commonly used to minimize the appearance of fine lines, especially around the mouth and the eyes.

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Camouflage Cosmetics

There are three basic approaches to camouflage cosmetics: concealing–hiding incision lines and bruises; color correcting–neutralizing color in reddened or yellowish skin; and contouring–disguising swelling and creating the illusion of highlights and shadows.

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Port Wine Stain

Dark red port-wine birthmarks are typically treated with a series of laser treatments. Other birthmarks such as brown patches or red spots, also referred to as hemangiomas, may also be treated with a laser or surgically.

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Skin Management

Whether you’re planning a surgical or nonsurgical skin treatment, it’s important that you find a doctor who has training and experience with a variety of skin-management techniques. You’ll want a doctor who can give you the best possible single treatment or treatment combination.

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9
Mar

Face

Brow Lift

A forehead lift or browlift is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired.

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Chin Surgery

Chin surgery, also known as mentoplasty, is a surgical procedure to reshape the chin either by enhancement with an implant or reduction surgery on the bone.

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Dermabrasion

Dermabrasion and dermaplaning help to refinish the skin’s top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance.

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Ear Surgery

Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. The operation is usually done on children between the ages of four and 14.

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Eyelid Surgery

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat–usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision.

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Nose Surgery

Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip.

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Facelift

A facelift (technically known as rhytidectomy) can’t stop this aging process. What it can do is set back the clock, improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck.

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Facial Implants

Facial implants are used to improve and enhance facial contours. Frequently, these implants will help provide a more harmonious balance to your face and features so that you feel better about the way you look.

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Hair Replacement

Hair transplantation involves removing small pieces of hair-bearing scalp grafts from a donor site and relocating them to a bald or thinning area.

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