Please note that all content featuring in this section is aimed for information purposes only and is by no means exhaustive. All surgery carries some uncertainty and risk. Patients are advised to consult with the plastic surgeon before deciding to undertake any aesthetic or plastic operation.
Non invasive methods
 Botox
Botox is a simple, non-surgical, physician-administered treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age. Botox is in fact a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows to form over time. The treatment is performed at the doctor's office and only lasts for a few minutes. Within days there is a noticeable improvement in the lies between the brows, for example, which can last up to six months. Treatment is usually repeated once every six to eight months in order to maintain results. Results usually vary depending on each patient and on how often treatment is repeated. Once treatment is discontinued, frown lines are likely to reappear gradually.
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Injectable fillers
One of the earliest signs of aging is a loss of facial fullness and the development of expression lines or soft wrinkles that appear as a result of a repeated facial muscle movement. Softening of these facial lines and the restoration of volume and fullness in the face can be achieved non-surgically with injectable fillers. Injectable fillers can also plump thin lips, enhance shallow contours, soften facial wrinkles and, in some cases, improve the appearance of recessed scars.
Injection is performed in the doctor's office. Following injection, any markings will be cleansed and icing may be offered to alleviate any temporary discomfort. An improved appearance is visible almost immediately, although minor swelling or bruising may appear at the injection site. Any of these conditions will disappear within a few hours, or a few days at the most.
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Chemical resurfacing
As a result of the ageing process, skin undergoes a number of changes. With time, it thins, falls, and creases along muscular and gravitational folds. Also, scarring from trauma or acne contributes to an irregular skin surface. True skin laxity in the form of brow ptosis, eyelid bags, jowls and loss of neckline is currently treated surgically with facial rejuvenation procedures (eg, facelift, browlift, blepharoplasty). However, these procedures do not help skin textural damage. Fine lines, pigmentary irregularities over a broad area, and aging skin are treated with peeling using chemical means. The patient is normally required to go through a skin preparation period at home. The main therapeutic sessions take place at the doctor's office, where appropriate agents are applied. Each session normally lasts for about half an hour. The patient can resume social activity immediately, and the results of the session are apparent already after the first visit.
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Surgical methods
Eyelid surgery
The eyes and the area immediately around them are particularly important in establishing a first impression when meeting other people. This is often the area that betrays the first signs of ageing, which is particularly evident in the upper eyelid. Also, some people have a family history of excess swelling of the lower eyelids and thus present with lower eyelid bags in early age. This swelling which first presents only in the morning tends to last longer, making people always look tired. Correction of lower eyelid bags where there is no excess of skin can be performed through incisions on the inside of the lower eyelid. Where there is excess skin as well as fat then surgery is performed using an excision that runs just underneath the eyelashes and out into the crow's foot. Initially the scar appears as a small red mark at the side of the eye, but as time passes this fades into one of the creases in the crow's foot. This is easily concealed in the first few weeks with a little standard makeup. Excess skin in the upper eyelid can be removed through a transverse incision lying in the skin fold leaving a virtually invisible scar. Upper eyelid surgery is sometimes combined with a browlift procedure undertaken endoscopically (keyhole surgery), which allows the outer part of the eyebrow to be elevated to a more youthful position and at the same time weakens the muscles at the root of the nose which cause frowning. Surgery can either be undertaken under local anaesthetic, particularly to the upper eyelids, or under a general anesthetic. Frequently encountered complications are swelling and bruising and depending upon the extent of surgery two weeks should be allowed for complete healing and resolution of swelling.
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MACS facelift
In recent years, technology has transformed the practice of facial plastic surgery. Less aggressive procedures are gaining in popularity with patients demanding subtle but significant results with low risk and rapid return to a normal lifestyle. Minimal Access Cranial Suspension facelift (MACS facelift) is a new technique allowing for facial rejuvenation with minimal incisions. The MACS lift elevates the sagging soft tissues of the lower third of the face and the neck together with the adhering skin in a vertical direction correcting the descent seen with the ageing. As the skin is sutured without tension, scar quality is excellent and there are no troublesome post auricular scars. The indications for a MACS face lift were younger patients as well as older ones who could not undergo a longer operation, patients with secondary facelift as well as male patients. The advantages of the MACS lift are shorter operating time, quicker recovery and return to normal lifestyle with elimination of the retroauricular scar. It is well perceived by patients as a very cost effective rejuvenation treatment.
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Breast reduction
Women with very large, pendulous breasts may experience a variety of medical problems caused by the excessive weight - from back and neck pain and skin irritation to skeletal deformities and breathing problems. And unusually large breasts may make a woman or young girl feel extremely self-conscious. This operation removes fat, glandular tissue and skin from the breasts, thus making them smaller, lighter and firmer. It can also reduce the size of the areola, the darker skin around the nipple. The operation is done in hospital. The surgery is performed under general anesthesia. The patient should expect to stay in hospital for two to three days. Breast will ache occasionally for a couple of weeks but most patients can return to work and social activities after this period. It is important to know that the procedure does leave noticeable, permanent scars. Future breast feeding may not be possible.
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Breast augmentation
Breast augmentation allows for the size and shape of breasts to be enhanced, thus giving the woman a more proportionate figure. Breast implants are either silicone gel-filled implants or saline-filled implants, which consist of a silicone shell filled with sterile saltwater. The implant is placed in a pocket located either directly behind the breast tissue or underneath the pectoral muscle. Incisions are made either underneath the breast, just above the crease, around the lower edge of the areola or within the armpit.
When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast's appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.
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Breast lift
Over the years, factors such as pregnancy, breast feeding and the force of gravity will impact a woman's breasts. The skin loses its elasticity and the breasts often lose their shape and firmness. Breast lift raises and reshapes sagging breasts, at least for a period of time as no surgery can permanently delay the effects of gravity. Often breast implants are inserted in conjunction with breast lift, thus leaving breasts increased both in firmness and volume. The operation is performed under general anesthesia. The surgeon removes excessive skin and moves the nipple and areola to a higher position. The skin around the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area and along the lower crease of the breast. After surgery, the patient is required to wear an elastic bandage or surgical bra over gauze dressings. Breasts might be uncomfortable for a day or two but the pain shouldn't be severe and can be relieved with medications. Healing is a gradual process and patients should allow for a week or two before they return to their normal social activities.
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Abdominoplasty
The skin and muscles of the anterior abdominal wall are stretched during pregnancy and whilst in some people this returns to normal, in the majority of cases some loose skin and some abdominal wall muscle weakness will remain. Also, as part of the normal ageing process there is a redistribution of fat which often results in fat deposits around the umbilicus and hips. In some cases this can be removed by fat suction alone, or in combination with an abdominoplasty.
The classic operation of abdominal reduction involves removing skin and fat from the lower abdomen between the pubic area and the umbilicus. Muscles are pulled closer together and tightened into their new positions. This provides a firmer abdominal wall and narrows the waistline. In some patients what is called mini abdominal reduction may be undertaken. The midline rectus abdominus muscles are repaired and a small excess of lower abdominal skin is excised leaving a limited lower transverse abdominal incision.
Of all the cosmetic operations abdominoplasty has the most prolonged recovery time. Very few mini abdominal reductions can be done as a day case but if the rectii muscles are repaired then frequently the patient needs to stay one or two nights in hospital. It takes at least two weeks for the patients to fully mobilise and heal and at least six weeks before they are back doing strenuous exercise. It is important to realise that abdominoplasty is not an operation to cure obesity. It requires a fit well-motivated patient and the operation itself is individualised depending upon what the problem is.
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Liposuction
Liposuction is a technique to remove unwanted fat deposits from specific areas of the body, including the chin and neck; the upper arms, the abdomen, buttocks, hips and thighs. It should be emphasised that liposuction is not a method for weight reduction, but a technique or removing localised fat that does not respond to diet and exercise. Liposuction can be performed under local or general anaesthesia, depending on how extensive it is. During the procedure, the surgeon makes a small incision, just large enough to allow the insertion of a hollow tube called a cannula. The opposite end the cannula is attached to a machine that creates a strong vacuum. The surgeon manipulates the cannula deep within the fat layers under the skin, breaking up the fat and suctioning it out. As the patient loses fluid along with fat during liposuction, additional fluids with be given intravenously. Healing is a gradual process that usually requires avoiding strenuous activities for at least two weeks.
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