All About Plastic Surgery

Plastic surgery is the restructuring of any body part by the manipulation of tissue, and it is done to change the appearance of that particular body part. It involves a number of different techniques that move or manipulate body tissue.

A study by the American Society of Plastic Surgeons (ASPS) revealed that there were over 17.5 million surgical and minimally-invasive cosmetic procedures performed in 2017 in the United States, with men making up about eight percent of this number.

There are a variety of reasons why people decide to undergo plastic surgery. Some people get it to fix a physical disfigurement caused by illness, an accident or a congenital defect. Others get it to boost their self-esteem and improve the way they feel about themselves, and some have it to ease the discomfort of an ongoing issue.

Since it involves the permanent change of appearance, having plastic surgery is a big decision that requires a lot of thought and research. Finding the right plastic surgeon and learning all you can about the procedure will help you to make an informed decision about whether or not plastic surgery is the right choice for you.

Plastic Surgery Overview

The term “plastic surgery” comes from the Greek word “plastikos,” meaning “to give form” or “to mold.” This surgical specialty involves both improving the physical appearance and reconstructing the facial and body tissue due to illness, trauma or birth defect. Plastic surgery is meant to restore and improve tissue function as well as physical appearance.

While plastic surgery can be done on almost every area of the anatomy, it is most commonly done on the:

• Face
• Nose
• Breasts
• Abdomen

Plastic surgery includes the areas of:

1. Reconstructive Surgery

This type of surgery is done to change abnormal structures on the body that are the result of:

• Disease
• Tumors
• Congenital anomalies
• Infection
• Trauma
• Developmental abnormalities

2. Cosmetic Surgery

Cosmetic surgery is usually done to change the appearance of a particular part of the body. It involves repairing and reshaping otherwise normal structures of the body.

Common cosmetic surgery procedures include:

• Breast augmentation or enlargement
• Breast lift (with or without implants)
• Buttock lift
• Eyelid lift (blepharoplasty)
• Facelift (rhytidectomy)
• Liposuction (lipoplasty)
• Thigh lift
• Tummy tuck (abdominoplasty)
• Upper arm lift (brachioplasty)
• Vaginal rejuvenation

What Happens During Plastic Surgery?

Many different surgical techniques are used to perform both reconstructive and cosmetic plastic surgery. They include:

1. Skin Grafts

Skin grafts involve removing healthy skin from another area of the body to cover areas where there is lost or damaged skin. Skin grafts are commonly used to cover areas where skin has been removed due to trauma, cancer, or burns.

Depending on the size of the site, general or local anesthesia will be given. The graft is held in place with glue, clips, staples or stitches, and it’s covered with a sterile dressing for about five to seven days — or until it has connected with the recipient’s blood supply. A sterile dressing will also be placed on the donor site, which usually heals within several days to weeks, depending on the type of skin graft used.

There are two different skin graft types:

• Split-thickness skin graft: Uses a thin layer of skin shaved from an area such as the thigh, buttocks or calf.
• Full-thickness skin graft: Uses all of the layers of the skin including the blood vessels, and it’s commonly taken from the neck, upper arm, groin or behind the ear.

2. Tissue ExpansionIn this type of plastic surgery, an expander — which is a balloon-like device — is inserted under the skin. General anesthesia is typically necessary for this procedure. The expander is gradually inflated over the course of several weeks to months, stretching the skin so it can be used to reconstruct a nearby area.This option is commonly used for breast reconstruction and for patients with large wounds. With tissue expansion, a second surgery is needed to remove the expander, reposition the new tissue, and possibly place a permanent implant.3. Flap SurgeryIn this surgical technique, blood vessels are kept intact, and the skin usually remains partially attached to the body to form a flap. It is commonly used for breast reconstruction, large wounds, open fractures, and other areas that have lost fat, skin skeletal support, or muscle movement.Depending on the size and location of the flap, the procedure may take place under local or general anesthesia. There are several different types of flap procedures that deal with bones, tissues, and specific blood vessels. For large areas where specific tissue is needed, for example, a free flap procedure works well. This requires the flap to be fully removed and placed in a new location. Blood vessels are then reattached through microsurgery.
   
   4. Endoscopic Surgery
   
   This type of plastic surgery uses an endoscope, which is a tube with a tiny camera and bright light, inserted into an incision in the skin. The images are transmitted to a screen that the surgeon watches to help guide the endoscope. Additional incisions are used to insert the instruments needed to perform the surgery. Endoscopic surgery allows for major procedures to be done with minimal scars.
   
   5. Laser Technology
   
   Lasers may be used to perform certain types of plastic surgery, according to the surgery type and location. The use of lasers provides minimal scarring, bleeding, and bruising. Your plastic surgeon will be able to tell you the types of laser procedures available and if they are right for you.

Factors to Consider and Things to Know Before Getting Plastic Surgery

When making the decision to undergo plastic surgery, there are some very important factors to consider. These topics will be covered during the consultation with your plastic surgeon who will fully explain what to expect before, during and after your surgery:

• Your overall health: Ideal candidates for plastic surgery are generally in good health, non-smokers and free from serious medical conditions. Your surgeon will go over your entire health history, including health habits and medications you are taking. They may even give you a psychological assessment, to determine if you are a good candidate for the procedure. You may be asked to stop taking certain medications and supplements for several weeks before and after your surgery.
• Your goals: Be honest with yourself and your plastic surgeon about what you wish to achieve by having plastic surgery. It’s important to realize that while plastic surgery may change your outward appearance, it may not change your internal feelings. If you’re looking to alter your appearance to address emotional issues, consider consulting with a therapist first. They can help you work through those feelings and decide if something as permanent as plastic surgery is right for you.
• Have realistic expectations: It’s important to have realistic expectations about the outcome of your surgery. Be aware that results are usually not immediate and that it takes time for any bruising or swelling to subside. It’s not uncommon for full results to take several weeks, or even months, to be seen. Discuss the intended results with your surgeon to be sure the procedure will help you to achieve them. You must also be willing to follow post-surgery instructions to increase the chance of successful results.
• Associated risks: As with any surgery, plastic surgery procedures all carry a certain degree of risks. It’s important to discuss these with your plastic surgeon before deciding to undergo any procedures. Be sure to educate yourself about the procedure you are considering along with the associated risks and complications. Don’t feel intimidated to ask a lot of questions, either. Consider that you may need more than one surgery to achieve the desired results.
• Recovery time: With most plastic surgery procedures, there is associated recovery time. You may need someone to assist you with everyday tasks in the days immediately following your procedure. Additionally, it may take several weeks before you are physically able or comfortable enough with your appearance to return to work.
• Associated costs: The cost of plastic surgery varies according to the procedure and region. Insurance also may not cover it if the procedure is done for cosmetic reasons. However, there are many ways to finance it. Do not let cost be the sole factor when choosing a plastic surgeon, though — selecting a surgeon based on the lowest price can lead to a poor surgical outcome and other complications. Associated surgery costs include:
  • Hospital or surgical center fees
  • Surgeon’s fees
  • Anesthesia fees
  • Medication fees
• Choosing the right plastic surgeon: Choosing a plastic surgeon for your procedure is just as important as deciding to have it done. It’s imperative that you find a plastic surgeon with whom you feel comfortable. The right plastic surgeon will answer all of your questions and fully educate you about the procedure you are considering, including when and where everything will take place. Your surgeon should also have a portfolio of their work, and they should be easy to reach for any questions you may have after surgery.

Risks of Plastic Surgery

As with any surgery, plastic surgery carries with it some associated risks. Be sure to discuss the possible risks and complications with your plastic surgeon prior to your procedure:

• Infection: Though many steps are taken to reduce the risk of infection after surgery, they still may occur and require antibiotic treatment. Proper wound care and hand washing can minimize the chance of infection.
• Scarring: You will usually have some degree of scarring after your procedure. It’s important to discuss with your surgeon the location of where your incisions will be, along with any history of hypertrophic scarring, where scars heal thick and raised.
• Seroma: A seroma is a collection of lymphatic fluid around the surgical site. Seromas may look like large blisters and cause swelling and pain. They are most common after more invasive surgeries such as tummy tucks and often need to be drained with a syringe.
• Dissatisfaction with the final result: Although uncommon, there is a possibility of being unhappy with your postoperative results. Revision surgery to correct this may be needed.
• Anesthesia complications: General anesthesia, commonly used in plastic surgery, is usually well-tolerated. Complications may occur, however, that include shivering, lung infections, stroke, heart attacks, and even death.
• Blood loss: Although some bleeding is common with most surgical procedures, excessive bleeding can be a sign of too much postoperative activity or that the wound is not healing properly. Excessive blood loss can result in an unsafe drop in blood pressure that can be life-threatening.
• Blood clots: Blood clots are a common risk in most surgical procedures. Deep vein thrombosis (DVT) happens when a clot develops somewhere in your body’s deep veins — usually the leg. Blood clots can be life-threatening if they begin to move toward the lungs and heart.
• Nerve damage: Although uncommon, nerves can be damaged or cut during plastic surgery procedures. Numbness and tingling after plastic surgery can be a sign of nerve damage.
• Hematoma: These are pockets of blood that resemble a large bruise and are a risk in nearly all surgeries. In more serious cases, they may need to be drained.

To minimize these post-surgical risks, it’s essential to follow all post-surgical care instructions exactly. Making certain lifestyle changes, such as quitting smoking and eating a healthy diet both before and after surgery, can help to speed up your healing, reduce scarring and minimize the risk of developing other complications.

Tips for Choosing a Cosmetic Surgeon

Choosing a plastic surgeon takes careful consideration and is a decision that is just as important as deciding to undergo the procedure itself. Be sure to ask a lot of questions and consider bringing a friend or family member with you to your consultation — as well as a notepad and paper to take notes. An expert plastic surgeon will discuss your goals with you and help you to decide if the procedure you’re considering is right for you.

Your plastic surgeon should be:

• Board certified: Be sure to ask your prospective surgeon if they are board certified by an organization that oversees the education, training and certification of surgeons.
• Experienced in your desired procedure: It’s important that your surgeon has had substantial experience doing the procedure you are considering. During your consultation, you’ll want to ask about their training in the procedure, their years of experience doing it and how many times they have performed it. Most plastic surgeons also have a portfolio of before and after photos for you to review.
• Approachable and compassionate: When consulting with a plastic surgeon, ask yourself if you feel comfortable discussing your procedure and medical history with them. You should feel a sense of trust in their recommendations and that they are concerned about your feelings. Ask lots of questions and be sure you understand the procedure entirely before deciding to have it done.
• Easy to reach: Your plastic surgeon and their staff should be friendly, helpful and give you a prompt reply when you contact them. They should also provide you with all of the information and materials needed for both surgery and recovery, including fees and surgical center or hospital information.

Dr. Nathan Brought is board-certified in plastic surgery and is proud to provide quality plastic and reconstructive surgical care to the Nashville, TN community. Dr. Brought and his staff provide outstanding patient care with a holistic approach that uses both surgical and nonsurgical therapies to achieve results.

To arrange a consultation, you can call our office at (615) 791-9090, or contact us online.