Faqs Cosmetic Surgery

Rhinoplasty is surgery to repair or reshape the nose. This may be performed for cosmetic reasons or to correct a deformity due to injury or birth defect. Almost all of these operations are performed through the nostrils,which means there are no visible cuts (or subsequent scars) to the face.

To know more, write to Dr. Manoj Khanna at drmkhanna@hotmail.com

The most common form is liposuction. Liposuction is a procedure where fat is suctioned through a hollow tube connected to a vacuum out of the body

We are all born with a set number of fat cells so when liposuction is performed, you get some of those cells out. The area that has had the fat suctioned out of it is less likely to gain weight or increase in fat because there are fewer fat cells in the area. However, if you do not gain weight, then there will be no relative increase in fat elsewhere.

I am not sure what you mean by bovine. I assume you mean bovine collagen and if that is the case, I know of no such study that indicates that breast growth increases with bovine collagen.

The ideal patient for liposuction is someone who is in good shape, but has isolated fat deposits. In those patients, there is usually no need to remove skin or tuck it. However, there are patients that have a lot of extra skin and fat that is not amenable to liposuction alone. In those patients, we usually will need to remove skin as well as fat to get the improvements in contour.

Hair loss is obviously much more common in males than in women. This is related to genetic factors and to hormonal influences. It is therefore much more common that men seek some type of treatment for their baldness.

Cellulite is a condition where there is pitting of skin and tends to be genetic in nature. It is almost exclusively present only in females. Liposuction does not improve cellulite. Some lifting procedures like a buttocks lift or a thigh lift will sometimes reduce cellulite.

The amount of discomfort that patients have with liposuction is dependent on a number of factors. If the liposuction is limited to a small area, it is less likely to cause much discomfort. Thus, the more extensive the area liposuctioned, the more discomfort you will experience. Another factor is your own tolerance to discomfort. Some people have very little discomfort after liposuction, while others require significant pain medication to alleviate their pain. On the average, you feel sore for 7 to 10 days.

There has been a change in the attitude of many surgeons when it comes to how much liposuction should be accomplished in one procedure. The recommendation by the American Society of Plastic Surgeons is to limit the maximum amount of liposuction to 5 litres. If that 5 litres limit is surpassed, it is recommended that you be admitted to a medical facility for observation and management of fluid.

The length of time the procedure takes depends on what you are trying to accomplish. For example, if you are only doing liposuction to the outer thighs, this will take 1 hour of operating, and it is an outpatient procedure. On the other hand, if you have a tummy tuck, this will require 4 hours of operating and you are usually kept in the hospital for one night. In the largest procedure done for body contouring, which is called Belt Lipectomy, tissue is removed in a circumferential fashion all the way around the belly and back. This procedure can take 6 to 8 hours to perform and may require hospitalisation for a number of days.

A tummy tuck is a procedure that is utilised to flatten out and tighten the tummy usually in women after they have had a couple of babies. These patients will usually present excess skin of the belly, as well as fat excess and a weak abdominal muscle wall. In some of these patients, if their stretch marks are all located below the belly button, then they can be removed. This is because in a traditional tummy tuck, all of the skin from the belly button to the hair bearing area is removed and the remaining skin is stretched down to the level of the hair.

For the arms, many people will present excess skin and fat from the elbow up. A procedure called brachioplasty is performed where the scar is along the length of the upper arm, but is hidden when the person has his or her arms by their side. Another area where people may benefit from body contouring surgery is excess tissue in the back or in the breast area.

The recovery period after a tummy tuck is somewhere around 7 to 14 days. Usually we ask you to take anywhere from 2-1/2 to 3 weeks off from work.

At the University of Iowa, we have one of the largest series of Belt Lipectomy in the world.
We found that there are 3 groups of patients that can be helped by this operation, which removes tissue all the way around front to back. It improves the following areas: it flattens out the tummy, lifts the outer thighs, lifts the buttocks, gives you a deeper curve in the area of the hips and reduces back rolls.

The largest group of patients that benefit from this surgery are those who have lost a significant amount of weight on the order of 100 to 200 pounds. Although these patients have either lost that weight secondary to stomach stapling surgery or an aggressive exercise and nutrition program, they still have a lot of excess skin and fat. The Belt Lipectomy procedure removes all of this excess resulting in a more normal body appearance. The second group of patients that can benefit from this surgery are those who are about 30 to 40 pounds overweight. These patients will also receive the benefits we talked about. The third group that can benefit from this surgery are people who are not overweight at all, but desire a very significant improvement in their body contour.

After tummy tuck, you should not straighten up at the waist for approximately 7 days, and avoid heavy lifting or exercise for 3 to 6 weeks.

There are areas that are less amenable to liposuction, and, as your question states, inner thighs are bad areas to liposuction aggressively. In general, the buttocks itself is not liposuctioned. We liposuction around it but very infrequently will we liposuction the buttocks itself. The upper arm from the elbow down is not liposuctioned and, in general, the face itself is not liposuctioned, although the area under the chin is a common area where liposuction is utilised.

It is always a very tough question to answer who is and who is not qualified to perform liposuction or any other cosmetic procedure. Since recent times, trained plastic surgeons learn liposuction in their training. Many of the older surgeons have learnt it later in their careers. I would suggest that a good way to address the question of qualification is to directly ask your physician if they are board certified plastic surgeons and if they perform this procedure on a regular basis. I would also ask the surgeons if they have ever had any complications. All surgeons have complications and if you are given the answer that they have never had complications, you might want to try another opinion. A very good method to check whether surgeons have proper certification to perform any surgery is to find out if they have regular hospital privileges to perform those procedures. The reason for that is that hospitals give out privileges based on the physician’s training. So the hospital has done the checking for you. It is important that the hospitals we are talking about are regular hospitals, and not surgery centres.

As with any other surgical procedure, liposuction can cause possible complications. Infection and bleeding are common complications of any surgery. Specific complications related to liposuction include seroma formations which relate to a fluid collection in the area of the liposuction, ridging which is waviness of the skin from the liposuction, unevenness, too much removal of fat, too little removal of fat, and in some very unusual situations, loss of skin. There are reported cases of even death from liposuction where very large amounts of fat were removed in one operation, and patient was not monitored. Overall, however, liposuction is a very safe procedure and is the most commonly performed cosmetic procedure. There are some other complications that are fairly unusual, and I will not include them here.

Ultrasonic liposuction fits into two categories. No. 1 is internal ultrasonic liposuction where the liposuction tube has a probe at the end of it that emits ultrasonic waves, which cause the emulsification of fat. Emulsification of fat is similar to making fat more liquid so that it can be suctioned. This is especially helpful in liposuctioning fat that is very thick or scarred. The second way that ultrasonic technology can help with liposuction is external ultrasonic liposuction. With this method, in the area to be liposuctioned, an external ultrasonic probe is applied to the skin leading to internal emulsification of the fat. The emulsified fat is then suctioned in a routine fashion. The probes used in external ultrasonic liposuction are similar to the probes used to perform ultrasound examination of a pregnant woman. In this case, however, ultrasound energy is much higher.

Implants are generally not attached to the underlying structures because they are made with depressions on the under surface to fit over the anatomic areas on which they are inserted. Implants can slip, however, in general, the pockets created are made just big enough to allow the implant to sit in the correct position. In some situations, some surgeons will use small screws to fasten the implants in place.

Yes, implants can be used in conjunction with other procedures like facelifts. The chin implants we just talked about can be placed at the same time as the facelift, or cheek implants can also be placed. Depending on your needs, certain implants can be combined with other types of face procedures.

Hard silicone is the most common kind, but there are quite a few other types.

Cheek implants will essentially pump up the area of the cheek. Depending on your needs, sometimes the plumping is needed more in the front of the cheekbone or on the side of the cheekbone.

Cellulite is a condition where there is pitting of skin and tends to be genetic in nature. It is almost exclusively present only in females. Liposuction does not improve cellulite. Some lifting procedures like a buttocks lift or a thigh lift will sometimes reduce cellulite.

Septal perforation can be covered with a silicone implant that is inserted to block the perforation.

In general, unless there is a problem with the implants there is no need for a repeat procedure.

If you are talking about cheek implants, the incision is made on the inside of the mouth generally, so you will not have an outside scar. As far as chin implants, you may have a scar underneath the chin but it is located in an imperceptible position.

Any surgery has some pain associated with it, but it is usually easily treated with ordinary pain medication.

Mentoplasty is a name given to the procedure where the chin is augmented either with an implant or having the chin bone advanced. If your husband is having a chin implant, the recovery period is rather short on theorder of a few days. If however it is an advancement of the chin bone, recovery time may be around two weeks.

Infection is one of the complications that can occur with implants. Fortunately it is fairly uncommon.

It is important to make sure your surgeon is well trained in plastic surgery. There are two main groups who perform facial implants. The largest group is board certified plastic surgeons and the second largest group is facial plastic surgeons. You should ask your surgeon about his/her training and their board certification and what specialty it is in.

Facial implants can be used in reconstructive surgery although most of the time, grafted bone from other parts of the body are used in reconstructive procedures.

People who are more ideal candidates for malar augmentation, which is the same thing as cheek augmentation, are people with a fair amount of tissue in their cheeks so they can cover the implants well. Obviously, you need to have a deficiency in this area before you can be considered a candidate.

Facial implant surgery is almost always done on an outpatient basis.

A dorsal columellar implant is used to augment the dorsum or the height of the nose as well as the tip of the nose. These implants are made of foreign material and are generally not recommended by most plastic surgeons.

The materials that the implant is made out of are generally inert enough to not elicit an immune response. However, it is possible to have sensitivity or to develop an infection around the implant, and this in essence will force the implant to be removed.

If your question were in general about cosmetic procedures, it would be difficult to answer because it depends on the particular procedure. If however you are talking about implants, it is possible to exchange the implant for a larger one, reposition the implant, or simply remove it.

In general, cosmetic surgery is performed on people who can withstand the surgery. This means that you should not have any medical problems that would prevent them from withstanding the surgical procedure or the anesthesia associated with it. Since many of these implants are performed under local anesthetic, most people would be able to tolerate the procedure. General categories of people who are not good candidates for surgery are people with significant heart problems, bleeding disorders, immune deficiencies and a variety of other problems that are too many to mention here.

In general it is better to quit smoking overall, but if you do smoke, it is a good idea stop for a period of time before and after surgery.Are there any cases why an external approach to cheek implants would be used over an internal approach ?

In general it is better to quit smoking overall, but if you do smoke, it is a good idea stop for a period of time before and after surgery.Are there any cases why an external approach to cheek implants would be used over an internal approach ?

The external approach to cheek implants is performed through a lower eyelid incision. If you were going to have a lower eyelid incision as part of another procedure along with the cheek implants, then it would make sense to insert them in that fashion. However, there are surgeons who prefer the external approach exclusively for the insertion of cheek implants.

In general, the limitation to whether a facial implant is utilized is related to their anatomy and not their age. However, it would be unusual to find people over the mid 60s who would desire facial implants. We prefer to perform implants in people who have reached their adult size so that we are augmenting on a stable base.

I believe what you are referring to is a capsule that forms around an implant. Any foreign material that is placed in the body will form a capsule around it. Breast implants, because they are free floating, have a capsule that can be more palpable than the capsules that would form around facial implants.

Nerve damage in facial surgery is a fairly general question. Certain procedures have more nerve damage than others. If we limit our discussion to facial implants then we can talk about damage to the nerve that supplies sensation to the middle of the face, which is associated with cheek implants, and the nerve that supplies sensation to the lower lip, which is associated with chin implants. Fortunately this is fairly unusual.

To know more, write to Dr. Manoj Khanna at drmkhanna@hotmail.com

Facial plastic surgery is a field of medicine devoted exclusively to cosmetic and reconstructive surgery of the face, neck and head. Facial plastic surgeons are specifically trained to treat conditions such as aging, sagging skin, skin wrinkles and blemishes, acne or facial scars, precancerous and cancerous skin lesions and hair loss, in addition to the more commonly- thought of facial plastic procedures like facelift, rhinoplasty (nose job), blepharoplasty (eyelid tuck), dermabrasion (skin sanding), chin augmentation and facial laser and chemical peeling. Make sure your facial plastic surgeon is a member of the American Academy of Facial Plastic and Reconstructive Surgery; while some plastic surgeons operate on all parts of the body, the American Academy of Facial Plastic and Reconstructive Surgery is the largest organization of surgeons devoted to the practice of facial plastic surgery.

Minimally invasive cosmetic facial surgery describes an approach to enhancing facial appearance while minimizing extensive surgery and recovery time. Endoscopic brow, face and neck lifts utilize small telescopes and specially designed instruments, avoiding long incisions and extensive surgery to rejuvenate the face. New lasers, such as the Erbium-YAG laser, allow for faster recovery than earlier skin resurfacing lasers. Biologic materials, such as collagen and other skin proteins, are now available in forms that can be easily injected or implanted in an office procedure to fill in wrinkles and folds or augment thin lips. Minimally invasive surgery is a concept based on tailoring treatment with advanced techniques and equipment for each patient in order to provide consistently excellent results and an early return to everyday life.

It is important to distinguish facial wrinkles from skin folds. Skin folds are formed by the action of facial muscles on the skin. Facial wrinkles are textural changes of the skin that persist without active facial movement. A number of procedures are available for facial wrinkles; these include laser or chemical peeling, dermabrasion and collagen injections. A facelift generally does not treat wrinkles. Skin folds generally are more difficult to treat. Your facial plastic surgeon can help you determine the best procedure for you.

A facelift is designed to reposition loose and sagging skin. It can be combined with facial liposuction to remove fat from the area under the chin and from jowls. It is not the best treatment for facial wrinkling, but can restore a refreshed and youthful appearance to a face with sagging and lax skin.

Face lifts are designed to reduce the slackness in the tissues of the face; a face lift tightens or excises muscle, fat and skin, producing a more youthful, rested appearance. Generally speaking, face lift procedures only address the two-thirds of the face, although a surgery can combine both face lift and eyelid surgery or browlift.

For individuals interested in reducing sagging in the facial area, face lifts may be the best way to address the problem. For many patients, the key issues corrected by face lift surgery include sagging jowls, loose neck skin, and fat accumulation under the chin (double chin). Face lifts work in essentially the same manner, although there are some variations in face lift techniques, depending upon the specific individual facial constructions, and the intended outcome of the face lift surgery.

Individuals investigating the ways in which a face lift could help them should meet with a plastic surgeon who specializes in face lifts. During the consultation, the surgeon and patient will determine reasonable expectations for face lift results, depending upon the facial bone structure, and specific problems to be addressed by the face lift procedure. Many surgeons will use photographs of the individual from an earlier period to guide face lift surgery and create a more youthful-looking face. A good plastic surgeon can help decide if face lift surgery is a good choice for the prospective patient, and will explain all of the face lift benefits and risks.

Although the traditional facelift is usually the best choice for most patients, an endoscopic facelift can be beneficial for certain select individuals who do not have a significant amount of excess skin. An endoscopic facelift can focus on problems in a specific area of the face, making smaller, more concentrated adjustments. Patients who undergo endoscopic facelifts typically require less recovery time, experience fewer side effects and have lower risk of complications.Endoscopic facelifts make use of the latest technology, using small incisions (often less than one inch in length) that are easily hidden. The surgeon performing the endoscopic facelift inserts the endoscope probe-a small camera-and tiny instruments through these incisions. While performing the endoscopic facelift, the surgeon and others in the operating room are able to monitor the progress of the procedure using the internally placed camera.
The typical endoscopic facelift will require three or more short incisions which are concealed in the hairline and/or behind the ears. Because the incisions used in an endoscopic facelift are significantly smaller than those used in a traditional facelift, the risk of sensory loss from nerve damage is decreased. Endoscopic facelift patients also have significantly reduced bleeding, bruising and swelling; tend to recover more quickly and are often able to return to work and other activities within a week of the procedure.

Endoscopic facelifts have an additional benefit: they can generally be performed on an outpatient basis, under local anesthesia. Patients who choose endoscopic facelifts often save a great deal of money compared to the cost of a traditional facelift, since an endoscopic facelift does not require an overnight stay in a hospital or the use of general anesthesia.

Almost any problem that can be treated with a traditional facelift can also be addressed through endoscopic facelifts. A surgeon can tighten loose muscles of the neck, smooth and tighten the tissues of the mid-face, repositions the cheeks, etc.

To discuss the endoscopic facelift and determine if you would be a suitable candidate for this procedure, contact Dr.Manoj Khanna.

A non-surgical face lift can be a viable and cost-efficient means to enhance the physical appearance of the facial area. A non-surgical face lift can reduce the appearance of fine lines and wrinkles and boost the overall appearance of the face. Non-surgical face lift procedures are often less expensive and require a shorter recovery time than the surgical alternative.
This surgical procedure also requires a relatively long recovery period and a greater risk of complications from the procedure.

Non-surgical face lift procedures are generally less-invasive, do not require an extended recovery period, and generally have a lower risk of complication as compared to a surgical face lift. Non-surgical face lift results, as a general rule, tend to last for a shorter period of time than surgical results. Non-surgical face lift methods may be better suited for men and women who have minor skin imperfections that they wish to cosmetically correct.

There are a multitude of non-surgical face lift procedures that are available to patients who wish to improve the appearance of their facial features. Some of these are more invasive than others, each have their own risks and benefits, and all require different fees. The most popular non-surgical face lift procedure is Anti-aging. More than two million people underwent a Anti-aging non-surgical face lift procedure in 2003 alone. Anti-aging involves a series of injections in the facial area that work to relax the muscles in the area to smooth the skin and reduce the appearance of wrinkles. Anti-aging costs average four hundred dollars a session and the results last three to six months.

Collagen injections are another type of non-surgical face lift procedure. This technique involves injecting collagen (a protein naturally found in the skin) into the skin to raise the tissues and decrease the visibility of wrinkles and fine lines. An alternative to collagen has also been developed and is touted as a safer method than collagen. This non-surgical face lift procedure injects a hyaluronic acid compound (a sugar naturally found in the body) into the skin layers to achieve the same results as collagen and other dermal fillers.

Skin resurfacing techniques such as the chemical peel, dermabrasion, microdermabrasion, and laser skin resurfacing are also common types of non-surgical face lift procedures Skin resurfacing techniques such as the chemical peel, dermabrasion, microdermabrasion, and laser skin resurfacing are also common types of non-surgical face lift procedures If you are interested in learning more about non-surgical face lift options, you may wish to speak with Dr.Manoj Khanna who is an experienced and knowledgeable cosmetic surgeon in your area. This expert can determine what procedure may be best for you and discuss the risks and benefits associated with prospective non-surgical face lift procedures.e.