Cosmetic surgery is a type of plastic surgery that aims to improve a person’s appearance, but it should be approached with caution.
Cosmetic surgery continues to grow in popularity, with 15.1 million cosmetic procedures carried out in the United States in 2013, an increase of 3 percent on the previous year.
Procedures are available for almost any part of the body, but the choice to undergo cosmetic surgery should not be taken lightly. The results are often permanent, so it is important to be sure about the decision, to use an appropriate practitioner, and to have the right motivation.
A surgeon may refer a patient for counseling before surgery if they believe there is an underlying problem that cannot be solved by the surgery, or if the patient shows signs of Body Dysmorphic Disorder (BDD).
BDD can cause a person to perceive that there is something seriously wrong with their appearance, when objective evidence suggests otherwise.
Reconstructive surgery is another type of plastic surgery. It aims to improve function and to give a normal appearance to a part of the person’s body that has been damaged, for example, after a mastectomy. This article will focus on cosmetic surgery only.
Types and uses
A variety of aesthetic procedures is available for different parts of the body.
Women may seek breast surgery to improve their body shape. Mammoplasty procedures may include:
Breast augmentation, or enlargement, traditionally performed using saline or silicone gel prosthetics, and now occasionally with fat grafting.
It may be carried out if the woman feels her breasts are too small, if one breast is larger than the other, or if the breasts have changed after pregnancy or breastfeeding. Some older women opt for this treatment when the breasts being to droop due to the skin losing elasticity.
In some women, a breast enlargement can boost self-esteem and improve their feelings about their sexuality. In some, however, existing problems remain. This is why women are encouraged to undergo counseling first.
Breast reduction can help provide relief from physical discomfort, while the aim of augmentation more often relates to appearance. Breast reduction may also reduce the risk of breast cancer in women who are at high risk of the disease.
Mastopexy, or a breast lift, involves removing skin and glandular tissue to make the breasts smaller and rearranging the remaining tissue to make the breast appear lifted.
Depending on how much volume a patient has lost or desires, mastopexy can be combined with an implant. While it is similar to a breast reduction, which removes a much greater amount of tissue, mastopexy is not usually covered by major insurance carriers as it is not deemed medically necessary.
Male breast reduction treats gynecomastia, an enlargement of the mammary tissue in men. It may be done by liposuction or with various scar patterns, often hidden around the nipple and areola.
Liposuction
Liposuction, or suction-assisted lipectomy, uses thin cannulas, or hollow metal tubes, to vacuum fat from various parts of the body, usually the abdomen, thighs, buttocks, hips, backs of the arms, and neck. Liposuction may also be used for male breast reduction.
Tools used in liposuction include standard, ultrasound, mechanical, and laser devices. They all tend to involve suction of fat through a tube.
To prevent complications, there is a limit to the amount of fat that the surgeon can safely remove, depending on whether the patient will be discharged immediately after surgery or admitted to the hospital.
Liposuction should not be intended as a weight-loss procedure. When performed in the right patient, the goal is to improve contour and decrease limited areas of fat deposits.
Complications are rare but possible. They include the accumulation of blood under the skin, known as hematoma, infection, changes in sensation, allergic reactions, damage to underyling structures, and unsatisfactory results. The doctor must discuss these with the patient beforehand.
Vulvovaginal surgery
Labiaplasty, labioplasty, labia minor reduction, or labial reduction involves surgery of the labia majora or labia minora of the vulva, a part of the female genitalia. It aims to reduce elongated labia, usually as part of a vaginoplasty.
There is a lack of clinical or scientific evidence to guide gynecological surgeons as to the safety and effectiveness of cosmetic vaginal procedures.
Body procedures
Abdominoplasty, or “tummy tuck” reshapes and firms the abdomen. Excess skin and fat is removed from the middle and lower abdomen, with the aim of tightening the muscle and fascia of the abdominal wall.
This may be suitable after pregnancy or after losing a great deal of weight.
Other body contouring procedures
Buttock augmentation enhances the appearance of the buttocks by making them larger. The surgeon will either graft fat from another part of the patient’s body using liposuction. This is known as the “Brazilian Butt lift.” Silicone implants may also occasionally be used in the buttocks.
A buttock lift, or lower body lift involves removing excess skin from the hips, buttocks, and thighs in order to tighten and lift them. These procedures are often combined with abdominoplasty in patients who have lost a considerable amount of weight after bariatric, or weight loss, surgery, for example.
Blepharoplasty, or eyelid surgery, aims to reshape the eyelids. With age, the skin becomes lax, and there may be drooping or hooding of the upper lids, and bags on the lower lids. Eyelid surgery may be functional, cosmetic, or both. It usually involves removing or repositioning excess skin and fat, and the procedure may reinforce surrounding muscles and tendons.
Surgery can change the shape of the face or tighten the skin.
In rhinoplasty, also known as a “nose job,” the surgeon reshapes the patient’s nose to improve the appearance and often breathing, too. It may involve reshaping the tip and reducing the bony hump at the upper aspect of the nose.
It can be performed with small incisions that are well hidden, often inside the nostrils. Surgeons do not recommend rhinoplasty until the patient is at least 15 years old, to allow for full growth of the cartilage and bone of the nose.
Otoplasty, or ear surgery, treats prominent or misshapen ears by surgically “pinning” the ear closer to the head with sutures, reshaping the cartilage, or both.
One or both ears may be treated. It is most commonly performed in children after of 5 or 6 years as the ears have essentially reached adult size by that age.
Rhytidectomy, also known as a facelift, aims to surgically remove wrinkles and tighten facial skin in order to achieve a more youthful appearance.
Typically, the incision is placed in front of and behind the ears, extending into the hairline in the temple area. The skin is lifted off the deeper facial tissue, redraped more tightly, and the excess skin is removed. The incisions are then closed with sutures.
The deeper tissues of the face and neck may also be tightened. Blepharoplasty, or eyelid surgery may be done at the same time.
A brow lift, browplasty, or forehead lift aims to remove signs of aging by raising drooping eyebrows and removing forehead wrinkles, or worry lines. It is often done alongside other cosmetic procedures to achieve a more harmonious facial appearance.
Chin augmentation aims to make the chin more prominent and provide a better balance of facial features. It may be done at the same time as rhinoplasty, depending on the measurements taken before surgery. It can be performed with either a prosthetic implant or through manipulation of the chin bone.
Malar, or cheek, augmentation can make the cheekbones more prominent. The surgeon may place an implant at the top of the cheekbones.
Peels, fillers, grafts, and laser treatment
Less invasive treatments may include peels, fillers, injections, grafting, and laser treatment.
