Plastic Surgery

Nose Surgery

Procedure

It is also called rhinoplasty. It reshapes the inborn or acquired deformities of the nose by reducing or increasing the size and/or removing humps, changing the shape of tip or bridge, narrowing the span of the nostrils, or changing the angle between the nose and upper lip. This procedure may also relieve some breathing difficulties when combined with surgery performed on the nasal septum /septoplasty/. The incisions are usually made on the inner surface of the nostrils, sometimes on the nasal septum skin or in the line between the nostrils and cheeks. In cases of severe deformity or when a repeat operation is required, remodeling and stabilizing of the nose elements is achieved via cartilage drafting.

Duration

Surgery takes approximately one to four hours.

Anesthesia

General or intravenous sedation and local anesthesia are used.

Inpatient / Outpatient

This can be performed as an outpatient procedure or it may be performed in a hospital, which will require a 24 hours’ admission.

Side Effects

Temporary swelling, bruising around the eyes, and/or nose and some bleeding and nasal stuffiness and numbness.

Risks

Asymmetry. Infection. Hemorrhage. Unsatisfactory nasal shape and incomplete improvement.

Recovery

The patient may go back to work after ten day to two weeks. More strenuous activities may be resumed after three to four weeks. The patient should avoid wearing glasses during that period. The skin of the face must be protected using a sunblock that provides both UVA and UVB protection for about three months after the operation has been performed. The final results may be assessed after about one year and sometimes longer, which is to the time required for reestablishment of lymphatic drainage pathways which are responsible for the resolution of swelling.

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Eyelid Surgery

Procedure

It is also called blepharoplasty and it alters drooping upper eyelid skin and the puffy bags below the eyes by removing excess fat, skin and muscle. With upper blepharoplasty the excess skin, muscle and fatty tissue are removed. The corrective surgery on the lower eyelid can be performed from the inside of the lid /no outer incision – transconjunctivial) or with an outer incision. With the first method only the lower lid fat bags may be removed. An outer incision is used in more severe cases of bags and allows for the tightening of the lower lid /eyelid lift/ and correction of the crease between the eyelid and chin. The operation may be performed with Co2 laser.

Duration

Upper eyelid blepharoplasty takes about thirty minutes to one hour. Transconjunctivial blepharoplasty of the lower lids – from thirty to forty minutes. Lower eyelid lift approximately two to three hours.

Anesthesia

General anesthesia or intravenous sedation and local anesthesia are used. It is possible to perform the operation under general anesthesia as well.

Inpatient / Outpatient

This is an outpatient procedure, or if general anesthesia is to be used, the patient is admitted in hospital.

Side Effects

Temporary discomfort, feeling of "tightness" in the eyelid area, swelling or bruising which wear off within a week after the operation. Temporary dryness, burning, or itching of eyes may also occur.

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, dryness, burning, or itching of eyes..

Recovery

Bruising and swelling fade within one to two weeks, sometimes, but rarely, it takes longer. The patient can expect to return to work at approximately five to ten days. Use of contact lens may be resumed after two weeks. The patient should not consume alcohol after the surgery. More strenuous activities and alcohol consumption may be resumed after three weeks.

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Forehead and Eyebrow Lift

Procedure

This procedure minimizes forehead creases, drooping eyebrows, hooding over the eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the forehead skin. This procedure is performed with an endoscope through small incisions across the top of the head just behind the hairline. It is best combined with upper eyelid corrections.

Duration

Two to three hours.

Anesthesia

General anesthesia or intravenous sedation and local anesthesia are options

Inpatient / Outpatient

This is most often an outpatient procedure but can be also performed in a hospital, which will require a two-days’ admission.

Side Effects

Temporary swelling, numbness, ache and bruising. The swelling and bruising often move down onto the eyelids and cheekbones. Temporary numbness of the forehead skin.

Risks

Excessive scarring or keloids. Asymmetrical look. Hemorrhage. Motor or sensory nerve trauma with temporary or persistent areas of numbness and occasionally permanent loss of their function.

Recovery

The patient usually returns to work in ten to fourteen days. The patient must limit more strenuous activities for about four weeks. The skin of the face must be protected using a sunblock that provides both UVA and UVB protection during the first 3-6 months after the procedure has been performed.

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Midface lift

Procedure

This procedure rejuvenates the central section of the face from the lower eyelid to the upper lip, by repositioning sagging tissues, which are lifted and fixed in the desired position. Incisions are small and located in the hair behind the ears. In the event that a graver facelift is required, lifting of the lower eyelid is also performed. The procedure is performed with an endoscope. This operation is best combined with laser rejuvenation of the facial skin.

Duration

The procedure takes approximately two to four hours.

Anesthesia

General anesthesia or intravenous sedation and local anesthesia are used.

Inpatient / Outpatient

May be either as an outpatient procedure, or in a hospital with a two-days’ admission.

Side Effects

Temporary discomfort, swelling, bruises. Temporary numbness and/or weakness of facial muscles.

Risks

Asymmetry. Infection. Hemorrhage. Motor and sensory nerve trauma – usually temporary and very rarely – permanent.

Recovery

The patient may resume work in ten to fourteen days. More strenuous activities have to be avoided for a month after the operation. The skin of the face must be protected using a sunblock that provides both UVA and UVB protection during the first three months after the procedure.

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Face and Neck Lift

Procedure

This procedure improves sagging facial skin, jowls and loose neck skin by removing excess fat, tightening muscles and re-draping skin. Incisions are made around the ears and as consequence are very hard to notice. The operation is best combined with laser rejuvenation of the skin.

Duration

Approximately two to four hours.

Anesthesia

Usually general anesthesia is used or the patient may elect to have sedation and local anesthesia.

Inpatient / Outpatient

Usually this is an outpatient procedure, although some patients may require a short hospital stay of two days if general anesthesia is administered.

Side Effects

Temporary bruising, swelling, numbness and tenderness of the skin, as well as a tight feeling and dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.

Risks

Asymmetry. Infection. Bleeding. Excessive scarring and keloids. Necrosis of the skin around the ears. Injury to the nerves that control facial muscles or feeling (which is usually temporary but in rare cases may be permanent).

Recovery

The patient may return to work after ten to fourteen days. More strenuous activity may be resumed after about four weeks. Bruising should begin to disappear after seven to ten days. Scars fade away within three to six months afterwards, sometimes more. Sun exposure must be limited for several months after surgery. The use of a sun block that provides both UVA and UVB protection is recommended.

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Ear Surgery

Procedure

This is a surgical procedure which corrects inborn or acquired deformities of the ear. It is usually performed to set prominent ears back closer to the head. In such case the procedure is performed without incisions. Through very small openings in the skin, the cartilage inside is treated with only some inside stitches which create the missing curves and fix them in the desired position. No outer stitches are needed. The lower age limit is seven.

Duration

Approximately one hour.

Anesthesia

Local anesthesia is used. With young children under the age of 12: usually general anesthesia is given.

Inpatient / Outpatient

Usually this is an outpatient procedure but when general anesthesia is given, it is performed in a hospital.

Side Effects

Temporary discomfort with throbbing, aching, swelling. Temporary numbness of the skin at the treated areas.

Risks

Asymmetry. Infection of the ear cartilage. Deformations. Recurrence of the protrusion, which requires repeat surgery.

Recovery

The bandage is taken down after two days. Bruising and swelling wear off after one or two weeks, rarely longer. The patient may return to school or work within three to five days.

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Breast Augmentation

Procedure

Improves the size and appearance of the breast by implanting silicone implants. These are inserted either under the pectoralis muscle or using the “dual plane” where part of the implant is behind the muscle and the other part – behind the gland. This second method is usually applied with sagging breasts after pregnancy and nursing.

Duration

This procedure takes approximately one to three hours.

Anesthesia

A general anesthesia is administrated and the patient is completely asleep, or an intravenous sedation is used, combined with local anesthesia.

Inpatient / Outpatient

Either is possible. A hospital procedure will require the patient to be admitted for two nights.

Side Effects

Temporary discomfort, mild to moderate swelling, bruising. Breasts may be sensitive to stimulation for a few weeks.

Risks

The implants may need to be removed and/or replaced to treat problems including: deflation, implant rupture /усшг saline implants/, the formation of scar tissue around the implant (capsular contracture), bleeding and/or infection.

Recovery

The patient can return to work within a few days. She should avoid any physical contact with breasts (excluding her bra) for approximately three to four weeks. Scars should fade and flatten anywhere from three months to two years after surgery, depending upon how an individual heals.

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Breast Lift

Procedure

This operation removes excess skin in and around the breast that has been stretched during pregnancy, nursing or weight fluctuations. Breast implants or breast reduction may also be used in conjunction with this procedure to achieve the desired result.

Duration

Approximately two to four hours.

Anesthesia

General anesthesia is administered. The procedure can also be performed under intravenous sedation and local anesthesia.

Inpatient / Outpatient

Either is possible. A hospital procedure will require an admission for two nights./p>

Side Effects

Temporary bruising, aching, swelling, some mild discomfort. Temporary or permanent loss of feeling in the nipples and/or the breasts.

Risks

Unfavorable scarring with keloid formations is possible. In addition skin loss, infection, unevenly positioned nipples (asymmetry), and the possibility of permanent loss of feeling in the nipples and/or the breasts.

Recovery

The patient can return to work within one week or more and may resume strenuous activities after one month. The fading of scars may take several months to one year, sometimes more.

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Breast Reduction

Procedure

A breast reduction, also referred to as a reduction mammoplasty, is a surgical procedure to reduce the size and improve the shape of the breasts. Typically, women who are candidates for this procedure have physical symptoms related to the weight or shape of their breasts, such as back pain, neck pain mental discomfort. The incisions vary based upon the breast size before the operation and the final post operative size. An incision is made around the nipple and areola accompanied by a vertical incision below the areola with or without a horizontal incision made in the crease below the breast.

Duration

The procedure usually requires 2-4 hours of operating time.

Anesthesia

The procedure is typically performed under general anesthesia.

Inpatient / Outpatient

The operation is performed in a hospital which will require a two days’ admission.

Side Effects

Prolonged swelling, pain, bruising. Temporary or persistent numbness of the skin of the breast, the nipple and areola.

Risks

Risks associated with breast reduction include: unfavorable scarring, loss of nipple sensation, loss of nipple and breast tissue, unsatisfactory shape, and failure to achieve aesthetic goals. Infection. Persistent numbness and loss of breast sensitivity.

Recovery

Typically several days to one week is required for recovery. Strenuous physical activities are discouraged for three to six weeks after the operation. The scars, though, may take 3 months to a year to disappear, sometimes more.

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Abdominoplasty

Procedure

It is also called abdominal surgical lifting. The excess skin and fat are removed surgically from the abdominal area. Depending on the needs of the patient, the muscles of the abdominal wall are tightened. The incision is usually made in the lower abdominal area, so as it can be covered by the underwear.

Duration

Approximately two to four hours.

Anesthesia

Most commonly patients are placed under general anesthesia. This procedure can also be performed with a regional nerve block obtained with local anesthetic agents.

Inpatient / Outpatient

This procedure requires hospital admission for at least two days.

Side Effects

Temporary discomfort, post-operative swelling, soreness or tenderness in the surrounding areas, numbness of abdominal skin and bruising are possible side effects.

Risks

Infection. Bleedings. Necrosis. Keloids. Pulmonary embolism.

Recovery

The patient may return to work within two to four weeks. The patient may return to more strenuous activity after approximately four to six weeks. Scars should fade and flatten anywhere from three months to one year after surgery.

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Liposuction and Lipofilling

Procedure

Liposuction is a method for contouring the body by removing exercise-resistant fat deposits. It is also called liposculpture. This procedure is performed using a tube and a vacuum device. They break down and extract the fat from the body. The method is also used to treat subcutaneous fatty tissue tumors, called lipomas.
Lipofilling is injecting one’s own fatty tissue in order to enlarge certain outer organs’ volume, to fill out wrinkles or lower relief body areas.

Duration

Between one and three hours, depending on the number of treated zones.

Anesthesia

Usually performed under general anesthesia. Also a combination of intravenous sedation and local anesthesia can be used.

Inpatient / Outpatient

This is an outpatient procedure or it may be performed in a hospital, requiring a 24 hour admission.

Side Effects

Temporary bruising, aching, swelling, numbness and soreness of the skin. The effects wear off within five days to two weeks after the procedure, sometimes it may take a month. The skin sensitivity recovers within one to three months afterwards.

Risks

Infection, asymmetry, rippling of the skin, seroma. The procedure may upset the balance of liquids and electrolytes in the system – when larger amounts of fatty tissue have been removed.

Recovery

The patient usually returns to work after five to fourteen days. More strenuous activity may be resumed within two to four weeks. Full recovery from swelling and bruising may take one to six months depending upon the amount of fat that is removed and the areas that were treated. The skin of the treated area must be protected using a sunblock that provides both UVA and UVB protection.

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Male Breast Reduction

Procedure

Male breast reduction is applied for a condition called gynecomasty. Reduces enlarged, female-like breasts in men using liposuction and/or surgically removing excess glandular tissue. An incision is made around the nipple and areola, which makes them hard to notice later.

Duration

Approximately two to four hours.

Anesthesia

General anesthesia is used.

Inpatient / Outpatient

This procedure is performed in a hospital which will require a 24 hours’ admission.

Side Effects

Temporary discomfort, pain, bruising, swelling, soreness. Temporary or permanent numbness of the nipple skin and the nipple.

Risks

Excessive scarring and keloids. Wrinkles or rough skin on the breasts. Zonal skin necrosis. Asymmetry of the nipples. Infection. Seroma.

Recovery

The patient may go back to work after about seven days. More strenuous activity may be resumed after four weeks. Most of the swelling and scarring will disappear after three to twelve months, sometimes more.

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Breast Reconstruction After Amputation

Procedure

This is a two stage operation for recreation of a woman’s breast after amputation. It can be performed 1 year at the earliest after the complex treatment of the cancer. The purpose of the first stage is to transport tissue from the abdominal wall or the back into the breast area. The second stage or operation is made to recreate the areola and the nipple and to make the two breasts symmetrical.

Duration

This procedure takes approximately from for to six hours for the first operation. The length of the second varies between one and four hours, depending on the symmetrification.

Anesthesia

A general anesthesia is administrated for the first stage. The second operation is possible under intravenous sedation, combined with local anesthesia, but more often than not, general anesthesia is used.

Inpatient / Outpatient

The first operation usually requires hospital admission for two to five days. Follow-up operation and procedures may be done at an outpatient facility or in a hospital, depending on the amount of the reconstruction needed.

Side Effects

Temporary discomfort, pain, swellings, bruising. Permanent numbness of the skin of the reconstructed breast and the donor area. Asymmetry.

Risks

Partial or overall necrosis of drafted tissue. Necrosis of skin areas. Bleedings. Seroma. Infection. Abdominal wall hernia.

Recovery

The patient can return to work within one to two weeks. All strenuous activity should be avoided for about one month after reconstruction.

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Reconstructive Surgery

Procedure

These are surgical methods for grafting of tissues with retained blood vessels and supply in areas with tissue deficit. They are performed when there are inborn or acquired defects and deformities of the human body. The grafted tissue may come from neighbouring or more distant parts of the body. The purpose of this operation is to reestablish the wholeness of the body covering tissues, the body contours and relief and in some cases to reestablish damaged motor activity.

Duration

From two to four hours, rarely up to six hours.

Anesthesia

General anesthesia is administered. The procedure can also be performed under intravenous sedation and local anesthesia.

Inpatient / Outpatient

Either is possible. A hospital procedure will require the patient to be admitted for two nights.

Side Effects

Temporary discomfort with throbbing, aching, swelling and bruising. Temporary or permanent numbness of the skin at the treated areas.

Risks

Partial or full necrosis of the grafted tissue. Hemorrhage. Infection.

Recovery

The patient may return to work after several days to one week. Strenuous activities must be avoided for one month after the procedure has been performed.

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Surgical Removing of Skin Formations and Tumors

Procedure

Various skin formations need to be removed surgically. Usually, those are pigmented nevi – moles, located on different places on the face and body, which bear a high risk of transformation into malignant skin tumors. When small formations are removed, the incision is stitched from within, and the resulting scar is only a small line. With larger size formations, it is often necessary to apply more complex surgical methods, which are described in the “reconstructive operations” feature.

Duration

Varies from twenty to thirty minutes for small size formations, and from one to two hours for larger size formations.

Anesthesia

Local anesthesia is used. It is also possible to use general anesthesia for specific locations.

Inpatient / Outpatient

The procedure can be performed in an outpatient facility, or in a hospital if general anesthesia is to be used.

Side Effects

Mild discomfort, aching, swelling, bruising, which fade usually within one week after the operation. Temporary numbness of the skin surrounding the operative wound.

Risks

Infection. Haematomas.

Recovery

Usually some time off work will be required.

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Surgical Correction of scars

Procedure

In case of any impairment of skin integrity, by a surgical procedure or an injury, a scar develops, which is a result of healing processes restoring skin integrity. The removal of small size scars is done by stitching the incision from within and the resulting scar is only a line. With larger size scars, it is often necessary to apply more complex surgical methods to reestablish damaged motor functions or achieve a better cosmetic result.

Duration

The length varies from twenty to thirty minutes for small size scars and between one and three hours for large size scars.

Anesthesia

Local anesthesia. It is possible to perform the operation under general anesthesia for multiple or large size scars.

Inpatient / Outpatient

The operation can be performed in an outpatient facility or when general anesthesia is given – the patient is admitted to s hospital.

Side Effects

Discomfort, aching, swelling, bruising, which wear off within a week afterwards. Temporary numbness of the skin around the incision.

Risks

Infection. Hematomas. Necrosis.

Recovery

Depending of the seriousness of the surgical procedure.

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Medical Procedures