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					By: Kim Pham & Whitney Edwards
 What is Plastic Surgery?
Plastic surgery is a general term for
operative manual and instrumental
treatment which is performed for
functional or aesthetic reasons. The word
"plastic" derives from the Greek plastikos
meaning to mold or to shape; its use here
is not connected with modern plastics.
   Two Different Types of Plastic

There are two broad fields of Plastic Surgery

              • Reconstructive
                 • Cosmetic
     Reconstructive Surgery

• Focuses on undoing or masking the
  destructive effects on trauma, surgery, or
  disease. Reconstructive surgery may
  include closing defects using sink grafts.

• It is estimated that more than 1 million procedures are
  performed by plastic surgeons every year.
    Who Has Reconstructive Surgery?

•    Two basic categories
     Congenital Deformities - known as birth defects.
     Examples: birthmarks, cleft-lip, webbed fingers.

     Those who develop deformities from accidents,
     infection, disease, or sometimes aging
     Examples: Burn wounds, lacerations, growths, and aging
     problems are considered acquired deformities
      Reconstructive Surgery
• The most common reconstructive
  surgeries would be:
               • Breast Reduction
           • Cleft lip and palate surgery
         • Contracture for burn survivors
• Closing skin after removal of tumors in head and
                      neck region
   • Sex reassignment surgery for transsexual
      Cosmetic Surgery

Is most often performed in order to
change features the patient finds
unflattering. In many cases, however,
there are medical reasons. Ex: breast
reduction when orthopedic problems are
Cosmetic Surgery Statistics
• In the U.S. Alone in 2004 11.9 million
  cosmetic procedures were performed.
• More than 10 million cosmetic procedures
  were performed in 2005, a 38% increase
  since 2000.
• There are 5000 members on the board-
  certified plastic surgeons in the world,
  94% is found in the U.S.
        Cosmetic Surgery
Critics of plastic surgery note that it is legal for any
doctor, regardless of specialty, to perform "cosmetic
surgery", but not "plastic surgery". It is thus
important to distinguish the terms "plastic surgery"
and "cosmetic surgery“ Plastic Surgery is recognized
by the American Board of Medical Specialties as the
subspecialty dedicated to the surgical repair of
defects of form or function. The term "cosmetic
surgery" however, simply refers to surgery that is
designed to improve cosmetics, or appearance. Thus
there is no real art of "cosmetic surgery“. Doctors
are not allowed to use the term "plastic surgery".
        Most Common Cosmetic
           Females                   Males
•   Breast Augmentation   •   Breast Reduction
•   Breast implant        •   Chin Augmentation
    removal               •   Hair Transplant
•   Breast Lift           •   Otoplasty (Ear)
•   Butt lift             •   Laser Hair removal
•   Botox                 •   Microdermabrasion
•   Cellulite Treatment
  (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
    (Augmentation Mammaplasty)
•   Procedure:Enhance the size of breasts using inflatable implants filled with
•   Length:1 to 2 hours.
•   Anesthesia:Local with sedation, or general.
•   In/Outpatient:Usually outpatient.
•   Side Effects:Temporary soreness, swelling, change in nipple sensation,
    bruising. Breast sensitive to stimulation for a few weeks.
•   Risks:Lack of implant permanence -- surgical removal or replacement of
    the implants may be required to treat problems, including: deflation; the
    formation of scar tissue around the implant (capsular contracture), which
    may cause the breast to feel tight or hard; bleeding or infection. Increase or
    decrease in sensitivity of nipples or breast skin, occasionally permanent.
    Mammography requires a special technique. (Note: Some women have
    reported symptoms similar to those of immune disorders. Ask your doctor
    about these and other FDA concerns.)
•   Recovery:Back to work: a few days. Physical contact with breasts: 3 to 4
    weeks. Fading of scars: several months to a year or more.
•   Duration of Results:Variable. Implants may require removal or
• Procedure:Raise and reshape sagging breasts by removing excess
  skin and repositioning remaining tissue and nipples.
• Length:1 to 3 hours.
• Anesthesia:Local with sedation, or general.
• In/Outpatient:Usually outpatient. Sometimes inpatient.
• Side Effects:Temporary bruising, swelling, discomfort, numbness, dry
  breast skin. Permanent scars.
• Risks:Thick, wide scars; skin loss; infection. Unevenly positioned
  nipples. Permanent loss of feeling in nipples or breast.
• Recovery: Back to work: 1 week or more. Strenuous activities: 1
  month. Fading of scars: several months to a year.
• Duration of Results:Variable; gravity, pregnancy, aging, and weight
  changes may cause new sagging. Results may last longer or be
  enhanced when breast implants are inserted as part of the procedure.
• Procedure:Plump up creased, furrowed, or sunken facial skin; add
  fullness to lips and backs of hands. Works best on thin, dry, light-
  colored skin.
• Length:15 minutes to 1 hour per session.
• Anesthesia:Collagen: usually none; local may be included with the
  injection. Fat: local.
• In/Outpatient:Outpatient.
• Side Effects:Temporary stinging, throbbing, or burning sensation.
  Faint redness, swelling, excess fullness.
• Risks:Collagen: allergic reaction including rash, hives, swelling, or
  flu-like symptoms; possible triggering of connective-tissue or
  autoimmune diseases. (A skin test is required before collagen
  treatment to determine whether an allergy exists.) Both: Contour
  irregularities, infection.
• Duration of Results:Variable; a few months to 1 year.
•   Procedure:Mechanical scraping of the top layers of skin using a high-speed
    rotary wheel. Softens sharp edges of surface irregularities, including acne
    and other scars and fine wrinkles, especially around the mouth.
•   Length:A few minutes to 1 hour. May require more than 1 session.
•   Anesthesia:Local, numbing spray, or general.
•   In/Outpatient:Usually outpatient.
•   Side Effects:Temporary tingling, burning, itching, swelling, redness.
    Lightening of treated skin. Acute sensitivity to sun; loss of ability to make
    pigment (tan).
•   Risks:Abnormal color changes (permanent). Tiny whiteheads (temporary);
    infection; scarring; flare-up of skin allergies, fever blisters, cold sores.
•   Recovery:Back to work: 2 weeks. More strenuous activities: 4 to 6 weeks.
    Fading of redness: about 3 months. Return of pigmentation/sun exposure: 6
    to 12 months.
•   Duration of Results:Permanent, although new wrinkles may form as skin
•   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.
•   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.
•   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
•   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.
•   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.
•   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.
•   Procedure:Fill in balding areas with a patient's own hair using a variety of
    techniques including scalp reduction, tissue expansion, strip grafts, scalp
    flaps, or clusters of punch grafts (plugs, miniplugs and microplugs). Works
    best on men with male pattern baldness after hair loss has stopped.
•   Length:1 to 3 hours. Some techniques may require multiple procedures
    over 18 months or more.
•   Anesthesia:Usually local with sedation. Flaps and tissue expansion may be
    done with general anesthesia.
•   In/Outpatient:Usually outpatient.
•   Side Effects:Temporary achy, tight scalp. Unnatural look in early stages.
•   Risks:Unnatural look. Infection. Excessive scarring. Failure to "take." Loss
    of scalp tissue and/or transplanted hair.
•   Recovery:Back to work: usually 2 to 5 days. More strenuous activities: 10
    days to 3 weeks. Final look: may be 18 months or more, depending on
•   Duration of Results:Permanent.
•   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
•   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
•   Duration of Results:Long-lasting, but does not stop aging. New wrinkles,
    expression lines may form as skin ages.
    (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.
    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
•   Side Effects:Temporary bruising, swelling, numbness, soreness, burning sensation.
    Tumescent: Temporary fluid drainage from incision sites. UAL: Larger incisions for
•   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.
•   Procedure:Reduce enlarged, female-like breast in men using liposuction
    and/or cutting out excess glandular tissue. (Sometimes covered by medical
•   Length:1 hour or more.
•   Anesthesia:General or local.
•   In/Outpatient:Usually outpatient.
•   Side Effects:Temporary bruising, swelling, numbness, soreness, burning
•   Risks:Infection. Fluid accumulation. Injury to the skin. Rippling or bagginess
    of skin. Asymmetry. Pigmentation changes (may become permanent if
    exposed to sun). Excessive scarring if tissue was cut away. Need for
    second procedure to remove additional tissue.
•   Recovery:Back to work: 3 to 7 days. More strenuous activity: 2 to 3 weeks.
    Swelling and bruising: 3 to 6 months.
•   Duration of Results:permanent
•   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
•   Duration of Results:Permanent.
                   Average Pricing
•   Arm Lift (Brachioplasty)$5000-6500      •   Laser (Erbium)$2500-4000
•   Blue Peel$500-700                       •   Laser (CO2)$4000-5000
•   Botox$200-400 per area                  •   Lip Augmentation$600-2000
•   Breast Augmentation (saline) $5000-     •   Liposuction (1 area)$2500-4500
    6500                                    •   Liposuction (3 areas)$5500-7000
•   Breast Augmentation (silicone) $6000-   •   Liposuction (5 areas)$8000-10,000
    8000                                    •   Medium Peel$1500-2500
•   Breast Lift$5000-6000                   •   Micro Peel$60-100
•   Chin or Cheek Implants$3000-4500        •   Nose Surgery$5000-6000
•   Collagen Injection$500-1500             •   Pectoral Implants$6000-7000
•   Deep Chemical Peel$3500-5000            •   Permanent Eyeliner$300-1000
•   Dermabrasion$2000-4000                  •   Permanent Lip Liner$300-1000
•   Eyelid Tuck (upper & lower)$4000-5500   •   Spider Vein Rx (Laser)$400-1000
•   Face Lift$7000-9000                     •   Spider Vein Rx (Sclero)$200-500
•   Forehead Lift (Brow Lift)$3500-5000     •   Tattoo Removal (Laser)$300-800
•   Hair Removal (Laser)$300-800            •   Tummy Tuck$6000-8000
      Appropriate Candidates
                       Two Categories

• Those who have a strong self-image, who are bothered by a
  physical characteristic that they’d like to improve or change. After
  surgery, these patients feel good about the results and maintain a
  positive image about themselves.

• Those who have a physical defect or cosmetic flaw that has
  diminished their self-esteem over time. These patients may adjust
  rather slowly to the results of their surgery.
  Inappropriate Candidates
• Patients in crisis, such as those who are
  going through divorce, death of a spouse,
  or loss of a job. These patients may be
  seeking to achieve goals that cannot be
  obtained through an appearance change-
  goals that relate to overcoming crisis.
 Post-operative Depression
• After surgery, most patients experience mild
  feelings of unhappiness, some cases might be
  more severe. After about three days prior to
  surgery when you may be regaining some of
  your physical stamina, your results have not
  begun to improve. Surgeons would call this “the
  Third-Day Blues”, this may last for a few days to
  several weeks. This emotional let down may be
  caused by stress, exhaustion, metabolic
  changes, or frustration.
Effects of Plastic Surgery

         Your wallet
                 Main Risk
The main risks of plastic surgery operation are rejection
of implants, sensory change in or around the operation
site, decolourisation of the skin, tissue necrosis,
asymmetry, infection, formation of bad scar tissue, and
allergic reaction on the sedation.

These complications can be corrected by one or more
additional operations. It is very important to be well
informed before under going an operation.
• They found that 87% of patients reported being satisfied
  with their cosmetic surgery outcomes. A year after
  surgery, 97% reported that they would recommend
  surgery to others and 93% say they would have the
  surgery again.

• A new study indicates that patients experience improved
  body image after undergoing common cosmetic surgery
  procedures, but the research did not suggest that
  participants experience decreased depressive symptoms
  or improvements in their body image-related quality of
Some people appear to become addicted to
cosmetic surgery, possibly because of Body
Dysmorphic Disorder. Sufficient amounts of
repeated cosmetic surgery can lead to
irreversible damage to the normal body
structure. However, due to the high cost of
repeated cosmetic surgery, this disorder is
generally one limited to the wealthy. However,
others have been known to take out loans for
repeat procedures.
  Body Dysmorphic Disorder
• BDD is a mental disorder, which involves a disturbed
  body image. BDD is generally diagnosed of those who
  are extremely critical of their physique or self image,
  despite the fact there may be no noticeable
  disfigurement or defect.

• BDD combines obsessive and compulsive aspects which
  has linked it to the OCD spectrum disorders among
  psychologists. People with BDD may engage in
  compulsive mirror checking behaviors or mirror
  avoidance, typically think about their appearance for
  more than one hour a day and in a severe cases may
  drop all social contact. This disorder is linked to an
  unusually high suicide rate among all mental disorders.
         Diagnoses of BDD
• The patient is preoccupied with an imagined
  defect of appearance or is excessively concerned
  about a slight physical anomaly.
• This preoccupation causes clinically important
  distress or impairs work, social or personal
• Another mental disorder (such as Anorexia
  Nervosa) does not better explain the
             Symptoms of BDD
• Compulsive mirror checking, glancing in reflective doors, windows
  and other reflective surfaces.
• Inability to look at ones own reflection.
• Compulsive skin-touching, especially to measure or feel the
  perceived defect
• Reassurance seeking from loved ones.
• Social withdrawal and co-existent depression.
• Obsessive viewing of favorite celebrities or models the person
  suffering from BDD may wish to resemble.
• Excessive grooming behaviors: combing hair, plucking eyebrows,
  shaving, etc.
• Obsession with plastic surgery or multiple plastic surgery with little
  satisfactory results for the patient.
• In obscure cases patients have performed plastic surgery on selves,
  including liposuction and various implants with disastrous results.
           Common Locations
•   hair                 •   arms/wrists
•   nose                 •   lips
•   skin                 •   chin
•   teeth                •   stomach/waist
•   genitalia            •   breasts/pectoral
•   eyes                 •   buttocks
•   Facial structure     •   eyebrows
•   overall body build   •   People with BDD often
•   legs                     have more than one area
•   cheeks                   of concern.
• CBT (Cognitive Behavioral Therapy) coupled with
  exposure therapy has been shown to be effective in the
  treatment. Low levels or insufficient use of serotonin in
  the brain has been implicated with the disorder and so
  SSRI drugs are commonly and with some success used
  in the treatment of Body Dysmorphic Disorder. Drug
  treatment will sometimes also include the use of an

• BDD Tends to be chronic.

• Treatment should be initiated as early as possible
  following the diagnoses
What effect does plastic surgery
have on children and teenagers?

• In 2004, about 240,682 cosmetic
  procedures were performed on patients 18
  years old or younger, and the top surgical
  procedures were nose reshaping, breast
  lifts, breast augmentation, liposuction, and
  tummy tucks.
 When does changing your
appearance qualify as BDD?
People with BDD repeatedly change or examine
the offending body part to the point that the
obsession interferes with other aspects of their
life. Several studies show that 7 to 12 percent
of plastic surgery patients have some form of
BDD. Plus, the majority of BDD patients who
have cosmetic surgery do not experience
improvement in their BDD symptoms, often
asking for multiple procedures on the same or
other body features.
 Does plastic surgery make
   patients feel better?

Studies have show that people report
increased satisfaction with the body part
that had surgery on, but results are mixed
on whether plastic surgery boosts their
self-esteem, quality of life, self-confidence
and interpersonal relationships in the long
Some studies have even gone as far as
linking dissatisfaction with cosmetic
surgery procedures to suicide. For
example, in one study, the National
Cancer Institute found in 2001 that women
with breast implants were four times more
likely to commit suicide than other plastic
surgery patients of the same age as the
women who underwent breast implants.

    Too many surgery
procedures….led to this…
Micaela Romanini
Joceyln Wildenstein
 The Ultimate…