This information is intended to assist those who have general questions about plastic surgery. It includes information about how plastic surgery fits into medical care, how plastic surgeons are trained, and the types of cases that plastic surgeons commonly treat. For more detailed information about a particular surgical procedure, request one of the brochures listed on the back cover of this publication. Remember, each case is unique and a great deal depends upon the patient's individual circumstances. Specific questions about surgery can be best answered in a consultation with a board-certified plastic surgeon.
History suggests that the practice of plastic surgery has ancient roots. However, plastic surgery as a defined specialty became fully recognized during World War I. Today, scientific advances in the field allow plastic surgeons to achieve improvements in form and function thought to be impossible 10 years ago.
A board-certified plastic surgeon is a doctor trained to be a concerned care-giver, a wound-care expert, a problem-solver, an artist-designer, and a meticulous surgeon in the operating room. It's important to realize that not every doctor who has claimed the title "plastic surgeon"; has the same training. The truth is, anyone with a medical degree can call himself or herself a plastic surgeon; there are no laws that require doctors offering specialty care to meet certain qualifications. In checking a plastic surgeon's credentials, patients are advised to consider a doctor who has completed an accredited residency training program specifically in plastic surgery. Such a program includes two or three years of intensive training that covers the full spectrum of reconstructive and cosmetic procedures.
Patients are encouraged to consider a doctor certified by the American Board of Plastic Surgery (ABPS). By choosing a plastic surgeon who is certified by the ABPS, a patient can be assured that the doctor has graduated from an accredited medical school and completed at least five years of additional residency training usually three years of general surgery (or its equivalent) and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice plastic surgery for two years and pass comprehensive written and oral exams. Good credentials do not guarantee a successful outcome, but they can guide you to select a surgeon whose training and background will help you to meet your personal goals.
Although much depends upon the patient's unique circumstances, there are certain situations that almost always warrant the specialized care that a plastic surgeon can provide. Typically, a plastic surgeon is consulted when a child is born with a defect that affects function and/or normal appearance or when accident, injury, disease, or aging causes a physical abnormality. Plastic surgeons also are consulted in hand surgery, microsurgery, and craniofacial and maxillofacial surgery.
Emergency cases, such as facial lacerations, burns, trauma, and bite wounds, are also commonly treated by plastic surgeons. A patient who requests a plastic surgeon in the emergency room -- rather than allowing the "on-duty" doctor to close a significant wound -- is more likely to be satisfied with the end result. Reconstructive surgery is covered by most health insurance policies, although the specifics of coverage may vary greatly. Some carriers may fully cover reconstructive procedures, others may pay only a portion of the cost.
Cosmetic surgery, however, is usually not covered by health insurance because it is elective and not considered a medical necessity. Some plastic surgeons accept major credit cards or offer financing programs that allow patients to make manageable monthly payments for cosmetic surgery. Keep in mind that there are a number of "gray areas" in plastic surgery that sometimes require special consideration by an insurance carrier. For example, eyelid surgery -- a procedure normally performed to achieve cosmetic improvement -- may be covered if drooping eyelids obscure a patient's vision. In assessing whether the procedure will be covered, the carrier often looks at the primary reason the procedure is being performed: is it for relief of symptoms or for aesthetic improvement.
A patient's age, skin type, general health, genetic background, and the nature of his or her condition can all affect any final result. Patients who smoke may not heal as quickly as non-smoking patients. Patients with sun-damaged skin may not achieve the same degree of improvement as those without sun-damaged skin.
Though there is no way to exactly predict a surgical outcome, the surgeon will examine the known patient variables before surgery begins and can project an estimate of the surgical result. Patients can take comfort in knowing that most of the procedures performed today have been refined over several decades.
In recent years, some plastic surgeons have begun using computer-imaging machines during consultations to show patients an estimate of post-operative appearance. A photograph of the patient is transferred to a computer screen and then altered by the surgeon to approximate the post-operative result. Doctors who use imaging find that computer-generated pictures can enhance doctor-patient communication. It's important for the patient to realize that a computer image may not match reality and represents no guarantee of outcome. No computer can take into account a patient's skin elasticity, bone structure, blood supply, and healing ability.
Spider and varicose veins can develop after childbirth or after taking certain medications, because of hormone changes, weight gain, or prolonged sitting or standing, or they may be an inherited family trait. Spider and varicose veins can be embarrassing—they make many people self-conscious about wearing sports clothes, shorts, or summer tops. And if you have spider veins on your face, even a good makeup concealer won’t always cover the veins completely.
Spider veins are cherry red in color and usually appear on the legs, sometimes on the arms, and occasionally on the face. They are thin and thread-like, usually 1-2 mm in diameter, and generally appear in a linear pattern, a branch-like pattern, or a spider pattern. Spider veins on the face, legs, arms, or body can usually be treated with lasers.
Spider veins can be treated with lasers, especially on the face, where the veins are too small and too close to the skin’s surface to be effectively collapsed with sclerotherapy. Lasers destroy the targeted veins without damaging surrounding tissues. Laser treatments are performed on an outpatient basis and usually take from 15 minutes to an hour. You may require more than one treatment. Cold compresses are recommended to reduce swelling, the treated area may bruise for approximately a week, and discoloration may last for a few weeks. In darker skin types, there is the risk of permanent discoloration of the skin, so you should discuss this issue with your nurse or physician during your consultation. Although laser treatment does not prevent new veins from forming, it is a very effective treatment that usually produces few, if any, side effects.
This noninvasive laser treatment uses gentle beams of light to get rid of hair. The hair's melanin (the part that gives hair its color) absorbs the light, which turns into heat. The heat damages the follicle (but not the surrounding skin or tissue) and prevents it from producing more hair. Treatments typically last about 30 minutes and you don't have to take time off to recover-so you can get back to your normal activities immediately. Laser hair removal usually requires three to seven treatments and works best for people with light skin and dark hair. Laser hair removal can treat hair anywhere on the face or body. Women often treat the bikini area, chin, upper lip, and legs. Men can safely eliminate unwanted hair from places such as their backs.
Administered by a licensed nurse or physician, a small hand-held laser device used to deliver the light beams is placed on the treatment area. You might experience some mild discomfort during the session-like the feeling of a rubber band snapping against your skin. A topical anesthetic can be applied 60 minutes before your session, if needed, and some people like to briefly apply an ice pack afterwards. During the procedure you'll wear tinted goggles to protect your eyes from the laser light. For each treatment, we typically schedule three to seven sessions about four to five weeks apart.
Laser hair removal works when the light beams are absorbed by the melanin in the hair shaft and follicle. People with dark hair are considered the best candidates. Blonde, gray, and strawberry-blonde hair may not absorb the laser light. And contrast between the hair and your skin is also important, so people with dark or olive-colored skin may not have enough contrast for the beams to be absorbed by the hair follicle.
Each person responds differently to laser hair removal. Some may require more treatments than others. And sometimes laser hair removal can't eliminate hair completely. If some hair does grow back, it's usually thinner and finer than before the treatment.
Acne Vulgaris is a skin disease which is caused by the changes in the top most layer of the skin. It appears in the forms of pimples or other blisters. Acne Scar removal procedure acquires importance as the disease infects almost 90 percent of the entire global populace.The scar removal procedures are actually surgical procedures which help to fade, improve or completely remove the various degrees of acne scarring. It is, however, extremely important to not get fooled by the numerous non-invasive methods or fake over-the-counter products that are also available in the market.
The scar removal procedures use laser lights, topical medications, chemicals, manual abrasion or surgical removal for smoothening out the skin. Fillers and filling products are also used where the procedure calls for filling up the depressions on the skin. The different types of fillers used are your own fat, pig collagen, cow collagen, cultured human collagen, synthetic fillers like polymethylmethacrylate (PMMA), Artefill and Sculptra and so on. In some cases, only topical medications applied over the skin are enough to heal and fill up the scars on its own.
But before opting out for scar removal treatments you must be in good health. Since these procedures are surgical procedures, needles will be injected in your skin and certain things might be added to your body, or removed from it. You must also not be suffering from any major or minor disease in addition to your acne.
Your communication with your doctor must be complete and sincere. And, you must not have any unrealistic expectations out of your surgery. The surgical options are mainly suitable for cystic acne scar removals. You can go for microdermabrasion or macrodermabrasion. In microdermabrasion aluminum oxide or magnesium oxide crystals are used to blast away the upper most layer of the skin which holds the scar. Both positive pressure, i.e. blower, as well as negative pressure, i.e. suction is applied at the same time to clear away the mess. This also increases the blood flow in the affected area allowing it to heal on its own.
Macrodermabrasion uses salts or ultrasonic energy to remove the top layer of the affected area.
Chemical peels include salicylic acids, lactic acids, trichloroacetic acid, and so on, to peel off the scar from the skin. Intense Pulsed Light (IPL) removes hyper-pigmentation by exposing the affected part of the skin to a very bright light. Laser resurfacing uses lasers such as Carbon Dioxide, CoolTouch and Smoothbeam to remove the affected portions of the skin. Punch Graft is used for the more severe, ice-pick scars. The entire skin portion is punched out and then the wound is stitched closed. Skin Lifting is another procedure which is suitable for those with multiple but shallow scars. It stretches out the skin, thereby, lessening the visibility of the scars. Therefore, we see that acne scar removal procedure has come of age and newer and safer techniques have been evolved to assist you now.
What happens during a scar revision surgery?
Anesthesia. The medicine given to your comfort during the surgical procedure. Including the option of local anesthesia, intravenous sedation and general anesthesia. Your doctor will recommend the best option for you. Maintenance. The level of improvement that can be achieved with a scar revision will depend on the severity of your scars, and the type, size and location of the scar. In some cases, a technique that can provide a significant improvement. However, your plastic surgeon may recommend a combination of scar revision techniques to achieve the best results.
Topical treatment, such as gel, tape or external compression, may assist in wound closure and healing, or to reduce the ability to produce skin pigment irregularities. This product can be used to treat existing wounds and surface color changes, and to help the healing wound revision procedure. Maintenance injections are often used to fill depressions or sunken scars. Depending on the injection of substances used and the condition of your particular scar, the results may last from three months to several years. Therapy should be repeated to maintain results. One form of injection therapy using steroid-based compound to reduce the formation of collagen and can change the appearance, size and texture of raised scar tissue.
Surface treatment is most often used for cosmetic improvement of scars. These methods can soften uneven surfaces and reduce pigmentation irregularities. Surface treatment is controlled by means of either mechanically remove the top layer of skin or change the nature of the network. These treatment options include Mechanical dermabrasion is a skin polishing. Laser or light therapy causes changes in the skin surface allowing new, healthy skin to form scars on the site. Chemical peel solution to penetrate the skin's surface to soften the irregularities in the texture and color. Skin bleaching agent applied topical medication to relieve the skin.
Sometimes for more in-depth surgical incision scar is required to remove the old scar. Some scars require layered closure. Layered closure is often used in which the excision extended to the network under the skin or in areas with high levels of movement. The first step, or sub-dermal layers require closure (under the skin) to be absorbed or non-removable stitches. Layer closure continues to build, concluded with the closure of the remaining surface of the wound. Sophisticated techniques in scar revision including the closure of the complex to cover the scar positioned so that the less conspicuous, or increase the flexibility in which contracture have limited mobility.
Pharmacy network replacement can be used if a lot of healthy tissue is not present for the closing of scar excision. This is more likely with scar revision severe burns. Network expansion can be a substitute for skin grafts. In this procedure, an inflatable balloon, called a tissue expander is placed under the skin near the scar site. Over time, the balloon slowly filled with sterile solution to expand the area of healthy skin. After the skin has been stretched enough, the developers and the scar is removed and the stretched skin is moved to replace the scar tissue. This process may involve several stages or surgical procedures to achieve the final result.
Important facts about the safety and the risk of scar revision surgery
The decision to have scar revision surgery is very personal and you must decide whether the benefits will achieve your goals and if the potential risks and complications are acceptable. Your plastic surgeon and / or staff will explain in detail the risks associated with surgery. You will be asked to sign a consent form to ensure that you fully understand the procedure you will experience, one alternative and the most likely and the potential risk of complications.
