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Cosmetic Surgery: Overviews

Many of these procedures listed below may also fulfill true medical needs. You should understand that the circumstances and experience of every individual will be unique.

If you’re considering cosmetic plastic surgery, please ask Dr. Marsh for further information about the particular procedure and what you expect.

In addition, please note that all surgery carries some uncertainty and risk, including the possibility of infection, bleeding, blood clots, and adverse reactions to the anesthesia. You can reduce your risks by choosing a qualified plastic surgeon and closely following his or her advice, both before and after surgery.



Abdominoplasty

 
(Tummy Tuck)

Procedure: Flatten abdomen by removing excess fat and skin and tightening muscles of abdominal wall.
Length: 2 to 5 hours.
Anesthesia: General, or local with sedation.
In/Outpatient: Either depending on individual circumstances and extent of surgery.
Side Effects: Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months.
Risks: Blood clots. Infection. Bleeding under the skin flap. Poor healing resulting in conspicuous scarring or skin loss. Need for a second operation.
Recovery: Back to work: 2 to 4 weeks. More strenuous activity: 4 to 6 weeks or more. Fading and flattening of scars: 3 months to 2 years.


Ear Surgery

 
(Otoplasty)

Procedure: Set prominent ears back closer to the head, or reduce the size of large ears. Most often done on children between the ages of 4 and 14 years. (Occasionally covered by insurance.)
Length: 2 to 3 hours.
Anesthesia: Young children: usually general. Older children or adults: general or local, with sedation.
In/Outpatient: Usually outpatient.
Side Effects: Temporary throbbing, aching, swelling, redness, numbness.
Risks: Infection of cartilage. Excessive scarring. Blood clot that may need to be drained. Mismatched or artificial- looking ears. Recurrence of the protrusion, requiring repeat surgery.
Recovery: Back to work or school: 5 to 7 days.
Strenuous activity, contact sports: 1 to 2 months.
Duration of
Results:
Usually permanent.


Eyelid Surgery

 
(Blepharoplasty)

Procedure: Correct drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (Upper-eyelid surgery may be covered by insurance if used to correct visual field defects)
Length: 1 to 3 hours.
Anesthesia: Usually locally with sedation or general.
In/Outpatient: Usually outpatient.
Side Effects: Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
Risks: Temporary blurred or double vision. Infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare).
Recovery: Reading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol: about 3 weeks. Bruising and swelling gone: several weeks.
Duration of
Results:
Several years. Sometimes permanent.


Facelift

 
(Rhytidectomy)

Procedure: Improving sagging facial skin, jowls, and loose neck skin by removing excess fat, tightening muscles, redraping skin. Most often done on men and women over 40.
Length: Several hours.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient. Some patients may require short inpatient stay.
Side Effects: Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.
Risks: Injury to the nerves that control facial muscles or feeling (usually temporary but may be permanent). Infection, bleeding. Poor healing; excessive scarring. Asymmetry or change in hairline.
Recovery: Back to work: 10 to 14 days. More strenuous activity: 2 weeks or more. Bruising: 2 to 3 weeks. Must limit exposure to sun for several months.
Duration of
Results:
Usually 5 to 10 years.


Facial Implants

 

 

Procedure: Change the basic shape and balance of the face using carefully shaped implants to build up a receding chin, add prominence to cheekbones, or reshape the jawline.
Length: 30 minutes to 2 hours.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient. Occasionally overnight hospital stay.
Side Effects: Temporary discomfort, swelling, bruising, numbness and/or stiffness. In jaw surgery, inability to open mouth fully for several weeks.
Risks: Shifting or imprecise positioning of implant, or infection around it, requiring a second operation or removal. Excess tightening and hardening of scar tissue around an artificial implant (“capsular contracture”), causing unnatural shape.
Recovery: Back to work: about 1 week. Normal appearance: 2 to 4 weeks. Activity that could jar or bump face: 6 weeks or more.
Duration of
Results:
Permanent.


Forehead Lift

 
(Browlift)

Procedure: Minimize forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the forehead skin. May be done using the traditional technique, with an incision across the top of the head just behind the hairline; or with the use of an endoscope, which requires 3 to 5 short incisions. Most often done on people over 40.
Length: 1 to 2 hours.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient.
Side Effects: Temporary swelling, numbness, headaches, bruising. Traditional method: Possible itching and hair loss.
Risks: Injury to facial nerve, causing loss of motion, muscle weakness, or asymmetrical look. Infection. Broad or excessive scarring.
Recovery: Back to work: 7 to 10 days, usually sooner for endoscopic forehead lift. More strenuous activity: several weeks. Full recovery from bruising: 2 to 3 weeks. Limit sun exposure for several months.
Duration of
Results:
Usually 5 to 10 years.


Laser Facial Resurfacing

 

 

Procedure: Smooth the face and smooth fine wrinkles using a carbon dioxide (CO2) laser device that treats layers of damaged skin. Softens lines around the eyes and mouth and minimizes facial scars and unevenly pigmented areas.
Length: A few minutes to 1 hour. May require more than 1 session.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient, unless combined with other surgical procedures that require hospitalization.
Side Effects: Temporary swelling, discomfort. Lightening of treated skin. Acute sun sensitivity. Increased sensitivity to makeup. Pinkness or redness in skin that may persist for up to 6 months.
Risks: Burns or injuries caused by laser heat. Scarring. Abnormal changes in skin color. Flare-up of viral infections (“cold sores”) and other infections (rare).
Recovery: Back to work: 2 weeks. More strenuous activities: 4-6 weeks. Complete fading of redness: 6 months or less. Return of pigmentation/light sun exposure: 6-12 months.
Duration of
Results:
Long-lasting, but does not stop aging. New wrinkles, expression lines may form as skin ages.


Liposuction

 
(Suction-Assisted Lipectomy)

Procedure: Improve body shape by removing exercise-resistant fat deposits with a tube and vacuum device. Can be performed using the tumescent technique, in which targeted fat cells are infused with saline containing solution with a local anesthetic before liposuction to reduce post-operative bruising and swelling. Common locations for liposuction include chin, cheeks, neck, upper arms, above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles.

For larger volumes of fat or for fibrous body areas, ultrasound-assisted lipoplasty (UAL) may be used. UAL is a new technique in which a ultrasound probe is inserted beneath the skin to “liquify” the fat before it is suctioned.

Length: 1 to 2 hours or more. UAL: 20-40 percent longer than traditional liposuction.
Anesthesia: Local, epidural, or general.
In/Outpatient: Usually outpatient. Extensive procedures may require short inpatient stay.
Side Effects: Temporary bruising, swelling, numbness, soreness, burning sensation. Tumescent: Temporary fluid drainage from incision sites. UAL: Larger incisions for cannula.
Risks: Asymmetry. Rippling or bagginess of skin. Pigmentation changes. Skin injury. Fluid retention. Excessive fluid loss leading to shock. Infection. UAL: thermal burn injury caused by the heat from the ultrasound device.
Recovery: Back to work: 1 to 2 weeks. More strenuous activity: 2 to 4 weeks. Full recovery from swelling and bruising: 1 to 6 months or more. Use of tumescent technique or UAL may decrease post-operative bruising and swelling.
Duration of
Results:
Permanent, with sensible diet and exercise.


Nose Surgery

 
(Rhinoplasty)

Procedure: Reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May also relieve some breathing problems. (May be covered by insurance.)
Length: 1 to 2 hours or more.
Anesthesia: Local with sedation, or general.
In/Outpatient: Usually outpatient.
Side Effects: Temporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness.
Risks: Infection. Small burst blood vessels resulting in tiny, permanent red spots. Incomplete improvement, requiring additional surgery.
Recovery: Back to work: 1 to 2 weeks. More strenuous activities: 2 to 3 weeks. Avoid hitting nose or sunburn: 8 weeks. Final appearance: 1 year or more.
Duration of
Results:
Permanent.