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Cosmetic Surgery - Most Popular Procedures
By Mr. Patrick Mallucci
Mr Mallucci explains: what the procedures are, what they can accomplish and the risks associated with each procedure
Breast Augmentation
Otherwise known as breast enlargement or in lay terms a 'boob job', the operation is designed to enlarge the breasts. There are generally 3 groups of women who seek breast enlargement: those whose breasts have never really developed to any significant degree and simply want 'some' breasts in order to feel more feminine. A second very common group are women who have lost breast volume after pregnancy - their greatest desire is to have back what they used to have prior to pregnancy and breast-feeding. The third group are those women who already have reasonable breasts but simply want to be bigger.
Breast enlargement remains the most popular procedure in cosmetic surgery and when carried out on the appropriate individual it can be a life changing operation restoring confidence and self-esteem.
Breast augmentation is generally very safe although, as with any surgery, complications can occur - infection is rare, as is bleeding and in the long term implants can harden and break, although this is becoming less common with modern implants. Early on after the surgery there can be sensory changes to the nipple and breast, which usually resolve over days. Silicone remains the best known and safest implant material and all doubts about it have now been resolved.
Blepharoplasty
The more common term for this is an eyelid reduction. As part of the ageing process changes occur in both the upper and the lower eyelids. In the upper eyelids excess skin - which becomes thin and less elastic over time - starts to encroach upon the eyelash margin giving the eyelids a 'hooded' appearance’ and crowding the upper lid with too much skin. The principle of an upper eyelid reduction is to reduce the excess skin by removing it and also any bulging fat that might be contributing to the bulk. The scar is very fine and lies in one of the natural creases of the lid and is hardly noticeable. Serious complications are rare, but as ever, bruising and swelling are normal - bleeding and infection are unusual, minor asymmetries are also normal.
Changes in the lower eyelid lead to the appearance of 'bags' under the eyes - these give the impression of either being tired or being sad and for these reasons people often seek to have them corrected. Once again these changes are due to the loss of elasticity in the skin and the tissues around the eyelid and the fat bulging forward to produce the 'bag' or puffiness. The operation usually involves an incision just underneath the lower lash line - removing any excess skin, and either removing a little fat or putting it back whence it originally came from within the socket of the eye to give a smoother appearance with the 'bag' removed. As with the upper eyelids complications are unusual although the balance in the lower eyelid is more delicate than in the upper because of gravity pulling down on the lower lid. Too much skin removal can result in the lower lid being pulled down and out of position, which may, in unusual circumstances, necessitate secondary correction.
The eyes are extremely important in their contribution to facial appearance and hence successful eyelid surgery can be of great benefit in improving overall facial aesthetics.
Face and Neck lift
Many changes occur as part of the ageing process in the face - the skin becomes thinner and less elastic, as well as the support tissues below it, giving rise to sagging in the jowl area in particular and under the chin or neck. There is also a loss of facial volume with the face taking on a more hollow or flat appearance around the cheekbones especially. Both fine and slightly larger wrinkles can also emerge as part of the ageing process.
Face and neck lifting seek to correct some of the changes that have occurred by removing the excess sagging skin and tightening the support structures below it in order to re-suspend the face and neck, producing a more pleasing and youthful appearance. There are many different 'types' of face-lifts and in many ways this can be confusing to those trying to understand what might suit them best. However, the principle and goal of the face lift - whichever type - remains the same as that described above. If the ageing process is more advanced, then a slightly more extensive surgery may be required to achieve the desired result. In a slightly younger patient in whom the features of ageing are only just becoming discernible, 'lesser' procedures might be appropriate using shorter scars or softer ways of re-suspending the face with sutures or threads. Each individual needs to discuss his or her individual case with his or her surgeon.
Facelift scars are generally very well concealed in the hair line above the ear, following the contour of the ear, and disappearing behind the ear into the hair line at the back. Serious complications are rare, bruising and swelling are normal and occasionally a little bleeding can occur early on. Numbness for the first few weeks and minor hairline complications are occasionally seen. Small asymmetries are normal and fortunately, damage to key nerves- such as the facial nerve- is very rare indeed.
Mr Mallucci - Member of the British Association of Aesthetic Plastic Surgeons (BAAPS) and consultant plastic surgeon at the London Plastic Surgery Associates (LPSA) for more information go to BAAPS (The British Association of Aesthetic Plastic Surgeons) - or the GMC (General Medical Council)
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